@grass16
Don’t necessarily assume that though. I think they know a certain number of patients will NOT appeal. I had to appeal lots of stuff.
One way to approach these rejections is -IMO - not by computer communication. A well typed letter (that you keep copy of) can impress and catch the eye. The other thing is sit down with someone who writes well (if you don’t feel up to it, it does get exhausting). What I think you may want to strongly point outspush buttons on is you know you have this malformation, that you were told it shouldn’t cause an issue (if I have it correctly?) but you just KNOW it isn’t normal to have salty fluid draining etc which could certainly ??
be cerebral spinal fluid (CSF) and what happens if no one deals with it and you get an infection with all the subsequent problems and complications 😳😬
Do you see where I’m suggesting you can use that for pressuring them to action?
Also, if I didn’t say this before document everything! What date/time you discussed ABC with Dr X etc. Then you include that in your nice but concerned firm answer and send it by certified mail, return receipt required - that way someone acknowledges they received the information, they signed for it - you’ll have a paper trail so someone can’t say they never saw/read/got this.

Hoping this makes sense. I still have my file on all this to see if it helps anyone else.
If I think of more I will touch base with! - Ginni