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December 5, 2008
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  • Mood: Christmas Spirited
I was reminded that I haven't updated my friends here on my situation in a while.  The good news is that I was finally approved for Social Security Disability.  That is good news, but I have run out of savings and had to borrow money to pay the bills for this month.  I'm pinching pennies until they scream! LOL  I'm supposed to get my first Social Security Disability check later in the month, and it will cover January expenses, but they are withholding the 40 months of back payment pending a review to see if there is any supplemental benefits or anything that they can deduct from it.  There isn't any, but I've been told that it may be 60-90 days before they actually process the check.  I'll be lucky if I get to keep 1-2 months worth of it though.  Most of it goes to pay back the long term disability that I received for 29 months and to the IRS.

My biggest problem right now is in trying to get my Long Term Disability reinstated.  It has been canceled for four months now.  Without it, my family (including my daughter with spina bifida) has no health insurance.  AT&T was going to look into the situation.  It took four months to get a response from them that my only recourse was to appeal to the same folks that denied it to begin with...and BTW you've used up four of your six months in order to do that.  Some day, either here or in eternity, people are going to pay for that.

The claims administrator flagrantly violated the rules of the disability plan in canceling my coverage.  In determining if I could work, the plan states that my "functional capacities" have to be taken into account.  She ignored statements from multiple doctors that say that I can't sit, stand, walk, climb, lift, drive, concentrate, and so forth (some not at all, some for only an hour or two at the most) and got a job survey done for office clerk jobs that are a three-hour round trip drive from my home by only listing three or four of my documented physical limitations and none of my mental ones.  Totally bogus.  

To top it off, the denial of my claim was based on an anonymous fax that was allegedly received from "my doctor" even though the claims administrator and her supervisor were told that my doctor never got a request for information from them and never responded to it.  From everything I can tell, the insurance claims manager made it up....and this would not be the first time they have been documented fabricating things.  And even after being told that I had a doctor's appointment in a week to document my limitations with a cardiologist (see this journal for the details), they would not wait a week for the report and canceled my benefits because of this "new information" that they got in the fax.  Even if the fax were ligit though and identified the person that sent it, the fax says two words..."no revision".  That's it.  No signature.  No date.  No ID as to who sent it.  Nothing.  And it wasn't "new".  It was an alleged followup on a medical report from 2005.  An alleged faxed request to my Kaiser doctor that sees me for everything BUT my disability asking if there was any update on a list of three or four listed limitations was allegedly faxed back to them with "no revisions" written across it.  Yet they used an alleged "update" that says "no revision" *AS* a revision of my medical records and took it to mean that the *only* limitations that I had were the couple that they allegedly specifically asked about in their request for an update.  

It is all bogus and a flagrant violation of the LTD plan, but my only recourse is to appeal the decision to the very group that denied it to begin with and hope that they start playing by the rules that they've shown no hesitation to ignore before.  I am unable to get AT&T to even look into the fact that the people that are supposed to be administering the plan are themselves not following the plan.  I can't seek any kind of legal recourse until after an appeal is written up and denied (80% of appeals are denied).  I do need to get some legal help with this though.  I have no money to hire an attorney, but this is likely to go to court eventually (possibly even as a class action suit) and I'm sure some attorneys somewhere are going to make some serious $ off it.

But enough of that.  I'm trying to NOT think about the crooks in the world and concentrate on Christmas and the reason for the season.  Maybe for Christmas I'll get an attorney that will help with this appeal and likely subsequent law suit against some rather deep pockets.  Justice for Christmas.  Has a nice ring to it.
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:iconwolfepaw:
wolfepaw Dec 18, 2008  Hobbyist Digital Artist
Oh, Daniel. I'm so sorry to hear of your troubles. God knows the insurance companies need to be reined in for f--king with people's lives while they sit behind a desk counting beans! I wish you all the best and hope this can be resolved well for you. I know this must be very stressful to you and your family, particularly at this holiday season. I hope your Christmas is a happy one and that someone gets their head out of their a-- and helps you get this cleared up. And you're right, to paraphrase what you said, what goes around, comes around, and I hope the people who have been messing with your life get theirs in CAPITAL LETTERS. My thoughts and prayers are with you. Godspeed and all the best.
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:icondjeaton3162:
djeaton3162 Dec 18, 2008  Hobbyist Digital Artist
Thanks.
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:iconshroompills:
ShroomPills Dec 7, 2008   Digital Artist
It might take some time, but it sounds nice that you actually got this to 'work'. I wish the best to you.
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:iconphoenix75:
phoenix75 Dec 5, 2008
Good luck, Daniel! I hope things work out the way they finally should. Be sure to take care of yourself in the meantime. I know all of this is very stressful for you. I hope you and your family do have a beautiful Christmas. Good thoughts coming your way from here. :hug: :heart:
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:iconevilpj:
all my positive energy is with you :hug:
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:icon1arcticfox:
Daniel....I've been through much of what you have. People have no idea what it's like to go through that and how much emotional toll it takes on one.......that creates it's own physical toll.....unless they've been through that. It's a nightmare of paperwork to document everything, but it's time to contact your Senator/s and/or Representatives in your state and let them know about this - and your state's oversight division of the Insurance companies that provide insurance coverage in your state. (don't know what they call that dept. in your state) I had to contact my Senator's office when my Federal SS Disability check didn't come one month and they told me I'd just have to "wait and see' if it came, and after 30 days file a claim, and then wait for that to be processed. I told them I had NO money for food and that was NOT possible! I then came home and picked up the phone and called my Senator's office. I had a check replacement, within a week! I can't guarentee you this will happen with you, but I have learned from all the advocacy I have done in this state for OTHER people over the years..........that there are times you have to go "right to the top" Good luck Daniel and many prayers speed your way. :hug: :-) :pray:
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:icondjeaton3162:
djeaton3162 Dec 5, 2008  Hobbyist Digital Artist
I've been in touch with the senators. I believe their involvement had a lot to do with the SSDI getting approved. They have the Employee Benefits and Securities Administration, part of the Department of Labor, looking into my case. It was these people that were finally able to get AT&T to look into my issue. I've sent AT&T an email after my last communication with them, but the "lady" in charge of HR was out for the holidays. If I don't hear anything back by Monday, I am going back to the Department of Labor.
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:iconlive2b:
My prayers are with you and your family!!
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:iconlillyanna:
Sorry to hear of your mostly bad news :(

This wording YOU used said it all.

Some day, either here or in eternity, people are going to pay for that.

Try to keep a smile on :)

Lillyanna
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