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EL CAJON, Calif. (KGTV) - An El Cajon man says a new spinal procedure changed his life, but the Army veteran is now locked in a battle with his military health insurance plan which refuses to cover it.Ronald Maddern says he can't understand why TRICARE, his secondary insurance, would deny coverage of the procedure after his primary insurance, Medicare, agreed to cover 80 percent of the cost. Both insurance plans are run by the federal government."Makes me feel like a second-rate citizen after I served in the military for so many years," he said.The denial by TRICARE left him with a bill of ,756.Maddern had the Vertiflex procedure in 2017 to treat spinal stenosis, which had largely confined him to a wheelchair for 17 years. Maddern is now able to walk with help from a cane for balance."It was a drastic success," said the 71-year-old. "My quality of life now is very, very good."The procedure, developed by a Carlsbad company, was approved by the FDA in 2015. It has been performed thousands of times across the country, said Maddern's surgeon Dr. Michael Verdolin."It is extremely frustrating that one arm of the government says yes and the other portion, really the pinky, says no," he said.In a letter of denial, TRICARE argued Vertiflex is an "unproven procedure," despite its FDA approval."There have been 15,000 cases across the US. It's been cleared for use," Verdolin said. "There is no question to be asked about its efficacy."TRICARE did not immediately respond to requests for comment by 10News.Ronald Maddern's insurance case is now before an administrative law judge. He's hoping the judge's ruling will convince TRICARE to conform its benefits with other federal agencies, so more veterans can get the procedure. 1746

Dr. Anthony Fauci said the country is at a critical place during the pandemic, and that the worst is probably still ahead. Despite warnings about traveling and getting together with people outside a household, Fauci feared another surge on top of the current surge following the Christmas holiday.“We very well might see a post-seasonal — in the sense of Christmas, New Year’s — surge, and as I’ve described it, as a surge upon a surge,” Fauci said on CNN’s “State of the Union.”“I share the concern of President-elect Biden that as we get into the next few weeks it might actually get worse,” Fauci continued.During the interview, he also expressed optimism about the speed of vaccinations happening across the country.As of Monday morning, almost 2 million Amerians have received the first dose of either Pfizer or Moderna’s two-dose COVID-19 vaccine. Nearly 10 million doses have been distributed to states, the CDC reports.Over the weekend, Fauci said he now believes the country will need to reach a 80-85% rate immunity to reach so-called herd immunity. This is an increase over earlier estimates, which were closer to 70%.On Sunday, Senator Marco Rubio called out Fauci in a tweet questioning the change.“Dr. Fauci lied about masks in March. Dr. Fauci has been distorting the level of vaccination needed for herd immunity. It isn’t just him. Many in elite bubbles believe the American public doesn’t know ‘what’s good for them’ so they need to be tricked into ‘doing the right thing,’” Rubio’s tweet says. 1520

Educators in Arizona and Colorado on Thursday are taking to the streets, calling out lawmakers for what they say is too little investment for far too long in their paychecks and their classrooms.Spurred by the recent efforts of teachers in West Virginia, Oklahoma and Kentucky, teachers in Arizona are walking out of their classrooms, while Colorado's teachers are rallying at their state Capitol.Dozens of school districts across both states were expected to be closed Thursday. 487

Doctors are concerned seasonal affective disorder, also referred to as SAD or "the winter blues," could be a lot more prominent this year due to the coronavirus pandemic.“It is going to be more challenging this year than others, certainly going through all the stress we’ve been dealing with during this global pandemic,” said Dr. Eric French, a psychiatrist with the HealthONE Behavioral Health and Wellness Center.SAD is a form of depression brought on by multiple factors, including less daylight and more time indoors.It can be treated with a number of therapies and medications, but even that looks different because of the pandemic.“But certainly, Zoom calls might not feel as personal as a visit, but quite frankly, it works and it’s certainly a lot better than isolating,” said French.French says telehealth works, as does group therapy, light therapy and sticking to a strict schedule.“We want people planning their day instead of just kind of hibernating and ending up in their pajamas on their couch and not taking care of themselves,” said French.He says that historically, October is one of the busier months for adult behavioral health.They are experiencing a surge in hospitalized patients due to the pandemic, in part because substance abuse and suicide attempts are up.French also says avoid marijuana and alcohol to deal with anxiety or depression. Instead, focus on getting outside, eating right, sleeping well and staying socially connected. 1469

EL CAJON (CNS) - A 49-year-old man was arrested Saturday on suspicion of fatally shooting a 31-year-old man in an unincorporated area near El Cajon.Daniel Christopher Allen, a resident of that unincorporated area, was booked into the San Diego Central Jail on suspicion of murdering James Owen who also lived in unincorporated El Cajon, according to the San Diego County Sheriff's Department.The shooting was reported in the 6000 block of Stallion Oaks Road, southeast of Dehesa Road and northeast of the Sycuan Resort, around 10:30 p.m. Thursday, sheriff's Lt. Thomas Seiver said.Before deputies arrived, an acquaintance of Owen drove him about a mile and a half from the shooting scene, Seiver said.Deputies stopped the vehicle on Stallion Oaks near Dehesa and found Owen inside suffering from a gunshot wound. It was not immediately clear if Allen was the driver.Owen was pronounced dead at the scene, he said. 921