Long term disability insurance: Navigating a system that is designed to screw us

June 15, 2012

I’ve written about the roller coaster effect before, and it’s happening again now.  This time it’s both physical and emotional, not to mention financial.

In addition to all of the irritating, difficult, painful physical problems, I’m also dealing with bureaucratic crap.  I wrote last week that the long term disability insurance company is denying my claim for benefits, but it turns out that it’s worse than I’d thought.  As it turns out, they aren’t suggesting that I’m not ill.  Instead, they are saying that I’ve been sick for a long time and they see no evidence that it’s gotten any worse.  Basically, if I was well enough to work a year ago, I should be able to work now, too.  But how do you prove worsening fatigue?  I don’t have a blood test or MRI for that.

Then it gets worse.  According to the lawyer I spoke to (who came highly recommended by friends who used her for their own SSDI claim) I will have an extra problem because I did not see a doctor in the few weeks leading up to my leave from work.  In fact, my last appointment before leaving my job was 2 months earlier.  At that appointment my doctor and I discussed the possibility that I might have to stop working, but I don’t know if that was recorded in my medical records.  I think it’s time to cough up the money and get a copy of my own records.  I wish someone would have told me that life would be easier if I saw my doctor in person before leaving my job, instead of just speaking with her on the phone 4 separate times.  I’d have gladly done it, if I’d only known.

The lawyer talked about the many steps we would take to appeal the LTD denial, including getting letters from my doctors and from friends and family, as well as hiring a vocational expert to study my case and write a report explaining why I can’t work.  This all sounds wonderfully proactive, but there’s one part that makes me very nervous: the lawyer isn’t confident enough in my case to take it on a contingency basis.  Damn!

So basically the system is designed to screw us.  I got insurance and paid my premiums, and the company denied my claim to save themselves money.  In order to get them to pay what they rightfully owe me, I have to spend a lot of time and energy and effort and money (none of which I have any extra of) to hire a lawyer.  If I ever get well (or well enough, at least) I am going to fight this system.  I don’t know how I’ll do it, but I will get it publicized, I’ll get my legislators involved, I’ll do whatever it takes, but this simply can not be allowed to continue!  But first I need to get my own claim approved and focus on my health.

And in case you’re wondering, the appeal will take approximately 6 months and cost me $7000-$10,000, plus expenses.  Expenses are for things like paying for copies of medical records, paying for the vocational expert, etc.  If we lose, I’m out that money.  If we win, the insurance company owes me $30,000 per year and they will pay me what they owe me from the date I became eligible a few months ago.  They will not pay the legal expenses I incur.

Yep, the system sucks.

Oh, and of course this is also at the same time that I am looking into practitioners, tests, and treatments that will not be covered by my health insurance, I feel like crap daily, I am enduring the most stress of my entire life, and my scant energy should be used to research my treatment options and to recover.  Like I said, this system is designed to screw us.

3 Comments | Educating, Expectations, Frustration, Healthcare, Rants, Symptoms, Unpredictable | Permalink
Posted by chronicrants

And the verdict is in: they’re calling me a liar

June 6, 2012

You’d think by now I’d be used to having people call me a liar, but somehow it’s still upsetting me.  Of course, they don’t actually use that word, but it’s the same message anyway.

Yesterday I got the official word that my claim for long term disability insurance was denied.  According to them, there’s nothing in my record to suggest that I can’t work at my old job.  Maybe they want a blood test to prove fatigue?  Great, invent one and I’ll happily take it!  Otherwise, fuck off.

When the symptoms first began I was a kid, and some people suggested that I was making it up to get attention.  Then there were others who believed that I really thought I was in pain, but that the pain wasn’t real, so they suggested I see a psychologist.  That was only barely an improvement, but at least they believed that I meant it.

Over the years I have had to plead my case to many people.  If I had something easily recognizable and definitely diagnosable, like cancer, there wouldn’t be an issue.  People would offer sympathy and would try to help.  If I’d been in a car crash, with the accompanying photos and x-rays and whatnot, they wouldn’t question it.  But I have invisible illnesses, hard to define, hard to diagnose, with symptoms that vary from person to person, and that vary for a given person from day to day.  So the easiest thing?  Say it’s not real and enjoy living in denial.  That’s great for them, but it doesn’t do me a damn bit of good.

To add insult to injury, every time I have to plead my case, I have to focus even more on the most negative thing in my life.  It isn’t enough that I have to live with this shit, think about it constantly, rearrange my life for it repeatedly, and give up my dreams for it, apparently it’s also necessary that I relive the worst of it just to convince some asshole that they really must pay me the money that they owe me.  Signing up for the insurance policy and paying the premiums guarantees a right to file a claim; it doesn’t for a second mean that the claim will be approved.  So how do I prove that I was so exhausted when I stopped working, I had to take a break and lie down to rest in the middle of getting dressed each morning?

I realized a few weeks ago that the claim would probably be denied, and mentally I was ready for it, but I guess that emotionally I hadn’t prepared.  Mentally I figured out what I would need to do to appeal the decision.  Emotionally, I didn’t realize how strongly I would react to being called a liar again.  Again.  Always, over and over, year after year, decade after decade, people would rather believe that I’m lying or confused than believe the truth: that this could just as easily happen to them, too.

Of course in this case, it’s probably just as much about the money.

4 Comments | Educating, Expectations, Frustration, Insensitive, Isolation, Rants, Symptoms | Permalink
Posted by chronicrants

Stairway success

June 4, 2012

As I carefully avoid gluten and dutifully do my physical therapy exercises, not to mention generally taking care of my body, I’m trying to be aware of the small improvements.  I’d love to wake up tomorrow and feel fantastic, but I know that won’t happen, so I want to be realistic about small wins.

Today’s small win is against my staircase.  I live on the third floor of my apartment building.  I only considered a third floor apartment because there was an elevator in the building.  Of course, when the elevator breaks down (which happens more than you’d think) then I have to take the stairs.

My knees started to bother me on stairs and hills many years ago, probably around 1999.  Earlier that year I’d climbed the stairs up La Sagrada Familia in Barcelona – I later discovered it was about 450 stairs.  By the next year, a single flight was incredibly painful.  As I’ve been strengthening my muscles, I’ve hoped to be able to climb more stairs without feeling like my knees are filled with jelly.

The goal was never to climb 450 stairs again.  I mean, I wouldn’t complain if I had that option, but again, I’m trying to be realistic.  I figured that if I could climb the stairs to my third floor without any pain, that would be amazing.  I have been working on this for a while now.  I won’t say that it’s completely painless, and I don’t even try it when I’m carrying anything heavy, but when I reach my floor, I can actually walk down the hall without limping, and within a few minutes the aches are gone!  Even better, I can get to the third floor without that jelly feeling!  And for the first time in the 6 years that I’ve lived here, I can now climb all the way from the 1st floor to the 3rd without having to stop and rest on the way up!!

I’m not running up 5 flights of stairs, I’m not looking for stairs instead of elevators everyplace I go, and I’m not choosing the stairs when I’m carrying extra weight, but for me, this is a WIN!

Leave a Comment » | Expectations, Limitations, Milestones, Raves, Symptoms | Permalink
Posted by chronicrants

Bring on the LTD fight

May 30, 2012

I don’t get truly angry very often, but today was one of those days.  I’m not talking about getting a bit mad.  This isn’t about being pissed off or annoyed.  I’m talking about blood boiling, can’t stop shouting, punching things kind of angry.  But without the punching, since my joints can’t take it.  But if I could, I’d have punched some pillows, or maybe worse.

To be honest, I never expected it to be easy to get my long term disability (LTD) claim approved.  I assumed they would make it difficult.  I didn’t expect to encounter pure ineptitude, though.  It is infuriating!

I won’t go into the details.  They aren’t that interesting to an outsider and I’d just get mad if I typed them all out again.  Basically, the LTD insurance company uses a separate company to get my medical records.  I was told they use this company because they can follow up with the doctors’ offices more frequently than the LTD insurance agency can.  Too bad this isn’t true.  As it turns out, this company hasn’t been following up.  I spoke today to a doctor’s office who contacted this company on APRIL 30!, then was never called back.  When the company did receive records from another doctor, they misplaced them and only realized it when they turned up 3 weeks later!  Until the records appeared, these people were saying that they hadn’t received the records at all.  Like I said: inept.

In all, this company’s ineptitude has set my claim back at least 5 weeks.  That’s based on the setbacks that I know of.  My guess is that there are others that I haven’t discovered yet.  But I will.

I don’t plan on taking this lying down.  First, I contacted the LTD insurance company and made it clear that from now on, I will handle anything that horrible company would have done.  They are to have nothing at all to do with my claim from now on.

Second, as soon as my claim is approved (no point in ruffling feathers before that) I am going to call the CEO of that inept company, I am going to file complaints with the LTD insurance company, and I am going to report that company to every regulatory agency that I can think of.  How dare they make worse a time that is already so difficult for people?  And don’t get me started on the idea of such inept people handling so much confidential information!

It took a lot of heavy pacing, a lot of nasty words, a lot of venting to a friend, and a lot of effort, but I have finally managed to reduce my anger to mere… well, at least to a lower level of anger.  I am certainly not doing this for those idiots, though; I’m doing it for me.  I need to relax and take care of my body.  And then when the time comes, I will definitely hold them accountable.

2 Comments | Decisions, Expectations, Frustration, Healthcare, Rants | Permalink
Posted by chronicrants

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