An update on me...

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djeaton3162's avatar
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I know this is self-serving, but it is my journal so I thought I'd give folks an update on my insurance nightmare.

I am still physically wiped out from 3-hours of phone calls yesterday.  I had been promised on 4/30 that a decision would be made on reinstating my benefits on 5/1 and that if I had not heard anything in 24 hours to call them back.  I did so.  This time I actually spoke to my case worker who denied that she had any messages to call me and that she still had a couple of days to make a decision.  She had a real attitude about me "bugging" her.  It came across like I was interrupting her and she could work on my case for dealing with the interruptions and the expectation of calls that she never promised to make.   I told her that I needed to know that decision as soon as it was made and asked her to call me with it.  She promised she would.  I told her that since she was promising to call me in a couple days time, I would not bother her again and wait for her call.  I let a whole additional week pass by before I called her boss.

Yesterday, I spent 3-hours on the phone.  My first call was to the boss.  I told him in a voice mail that it had been 17-days since I had faxed in the info that they had requested, that I had requested a call verifying that they received the fax - which I never received, and that I was still waiting on a promised call with an update when I was told that a decision would be made on the 1st or 2nd.  I asked him to assign me a new case worker that could/would communicate with me and to call me back with a status.

From there, I moved to the office of the GA Insurance Commissioner.  After getting through to someone in the right department (a nightmare in itself), I found that since ATT's plan was self-administered that I needed to go to the Feds.  A couple of calls later and I was on the phone with someone with the Federal Employee Benefits and Securities Administration.  I didn't even know there was such an thing.  They oversee self-administered insurance plans for employees.  They told me that I needed to get in touch with ATT and get the plan summary from them defining the rules.  A company can set up any rules they wish on plans that they administer themselves.  The problem is that I can't find them.  The online link on the ATT employee benefits web site is broken.  And the first several attempts to get through to ATT had my called routed to this same thrid-party administrator company that I was having issues with as soon as I mentioned "disability".  It took a while, but I finally got through to someone in HR that took down my information and concerns and has promised me a call from a HR manager in the next 24 hours.  My goal with them is two-fold.  First, I need the rules.  Second, I need them to know that this third-party company is a problem, not part of any solution.  They represent ATT and ATT needs to know how they are treating ATT (or former-ATT) people that they deal with.

Anyway, after all that, I was wiped out.  I curled up in a fetal position in bed for hours.  Other than making myself some dinner and a couple of bathroom breaks, I stayed in bed for 20 hours.  I only slept for about 3-4 of that though.  And, for most of it, I was too mentally drained to even watch TV or listen to an audio book.  I basically stayed there and tried to get some physical and mental rest until the phone rang a couple of hours ago.

I just spoke to the supervisor at the LTD administrator place.  He told me that my case/claim was now marked "open" and "approved".  It is still going to be going under some kind of medical review though.  If anything changes, he told me I would be notified.  I've heard that before though.  It may turn out that I don't hear back from them until they do a regular review of my case which is at least twice a year.  I asked him if a letter in my medical record every six months stating that I still had this would be sufficient, and he didn't know and couldn't say.  That didn't help.  I explained to him that I am more than willing to jump through any necessary hoops, but I need to know what they are.  Right now, I don't know and he doesn't seem to know how many visits to doctors that don't treat this for a condition that can't be treated is enough to satisfy their requirements.  I told him that I'm happy to meet the requirements, but need to know what they are because I can't afford to exceed them.  Every doctor visit that I make comes right out of my grocery money.  The money I've spent on doctor visits this month means that I've had to borrow money for groceries for the next two weeks.  I also told him that I needed someone there that would actually communicate with me and that the last time I spoke to my case worker all I got was attitude.  She acted like I was bothering here to call her and promised to call me in a couple of days and weeks went by.  

I also told him that the lack of communication wasn't just a financial impact, but a health impact as well.  My heart rate was 192 beats per minute the other night and all I did was take a 6-8 minute shower.  He seemed to understand my confusion and frustration over this and told me that I could call him at any time and he would return my call within 24 hours.  In the meanwhile, I told him that I also had a call in to ATT to find out the rules.  I told him that I should not be penalized for not following them when he himself could not tell me what they were.  Someone has to know what they are and I have to find them.

Anyway, enough about me.  I promise to make my next journal post of interest.  I'm actually working on a companion piece to my Giving Away The Store (djeaton3162.deviantart.com/jou…) post about free stuff.  I'm working on a list of all the free programs and utilities that I use on a regular basis.  Some are pretty well known, but some are a bit obscure and very beneficial.  I hope to post it as soon as I get all the links located so that people can download them and check them out for themselves.
D.
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scootnoodles's avatar
I feel for you fractal brother. As a telecommunictions worker with some titanium parts inside me, I feel (albeit to a tiny extent) what you are going through.

Was yours an AT&T Union Job?

Can the Local be of any assitance if it was?

Just a thought. CWA for 17 years here.