KADY & anyone else having hard time w/disability

Kady - I'm reposting here what I'd posted to you under racwhites post about her problems with her disability ins. etc., hoping this might be of some help to you:

I saw a lot of my husband's worker's comp patients going thru the same things. (He was a psychologist.) Here is what we helped them with:

1) Find out if there's lawyers available anywhere near you willing to do work on sliding fee scale, etc. Make phone calls to lawyers' offices individually if you have to - they'll often have a name to refer you to. Interview a couple before you sign anything, however. And READ the fine print - even take it home to look over if you feel the need to.

2) Call and write your State's Ins. Commissioner. Call him/her if you can get thru, and definitely write regardless of whether you actually get to talk to someone initially. Document everything.

3) Write to your state and federal representatives. (Even tho the fed reps don't deal with these cases specifically, they will often/usually refer your letters to appropriate people, and they need to know what's going on with disabled people on the local level in case of federal bills, etc.) In my experience, the state reps will try to give assistance (especially with SSD). That's what they're there for - you are paying their salary.

4) Get not only documentation (records) from your doctor(s), but if your doctors will also write letters attesting to how they evaluate you, this always seems to add weight.

5) Lastly, and also just as important, send a copy of all your letters and documentation that you send to all the above people to your insurance company also. The LAST thing any insurance co. wants is the state hearing complaints about them!

I used to actually write these letters for his clients since most didn't have access to any office equipment, had a hard time hand writing it, etc. There was ALWAYS forward movement in the cases when the above approach was taken, even when #1 wasn't possible.

soft Hugs,
Victoria

Isn't this all a moot point now that I have had to resume working? No one would pay any attention now, would they? I believe I'd have to start EVERYTHING ALL OVER now because I've been back to work over a week now. I was well-read on all that you've mentioned and I think I did everything correctly the first time....it's just that I declined to have the epidurals due to lack of funds and that looked bad PLUS I drove myself to the psych eval, cause I had no other means of transportation and that looked bad. I'd LOVE to appeal, but I can't BECAUSE I'M WORKING, so I'm no longer eligible.
PLUS, The thought of being investigated, maybe even video-taped and watched is VERY difficult for me. I never lied a time about my condition; I didn't have to. My doctor took me out of work for my spinal stenosis, a condition that was diagnosed per MRI. I had the MRI done because of disabling pain which made my job unbearable. I didn't exaggerate a thing and I hated feeling like I had to "act" as a "cripple" even on my "better" days. The guilt is horrible when I drive to the store and put my groceries in the trunk of the car; I keep wondering if I'm being watched. Yes, that activity causes pain, as does driving, as does walking, as does sitting, as does standing in line, as does lying flat, as does when bending slightly......BUT, I HAVE to do these things. I take much medication just to maintain some degree of comfort, but NOTHING takes all this sacral pain away...NOTHING at all does.
I don't think I can stand to work, but I MUST have an income, so I'll try again; at least until my husband is well enough to make a good income and I can try again, BUT:
now that I'm just working PRN, not full or part-time (on paper), I am entitled to NO benefits anymore, so that means if I do get hurt or sick or can't do my job anymore, I won't be eligible for short-term or long-term disability!!!!!!!!! See, when I went on LOA in November, I was full-time and I had paid premiums for short and long-term disability and I had accrued Paid Time Off hours......not any longer, because my position was filled when I was out of work over six months. Now, I'm not able to get these benefits, so if I have to be out, I'll not get any type of disability $$$. I'm screwed. And I'm not eligible to appeal the SSD cause I'm working! See? I'm screwed. The best thing I can do is get hurt on the job now and file Workmen's Comp., which I have never used in the thirty+ years I've been on the job. Even then, they'd say my back pain was a pre-existing condition and I'd be denied. So, I have to suck it up and work on the days they have call-ins and no-shows and do no more than I absolutely HAVE to, (like a lot of other nurses) and accept the pay for a half-a$$ed job done! This is hard for me because I'm quite the perfectionist, but I have to learn how.
Thanks for the suggestions, but I'm afraid it's too late for me to use them.
Love,
kady

[This Message was Edited on 07/03/2003]

and then unable to keep up with it and have to stop, then it would be what SSD considers a failed work attempt. Which, according to my attorney actually would be in your favor. It shows that you have really tried but just couldn't do it. As far as being videotaped, even if they saw you doing something, isn't everyone allowed to have a good day once in a while?

Before I had to quit working I had days where I just felt like I couldn't keep going, but I did keep going. I missed a lot of work, and then the day came when no matter the consequences, I could not make it to work. So, if you get to that point then how could there be any other decision, than to quit?

Dara

While I'm not a lawyer and I'm not quite sure I followed your response, I think they still put you off in some way illegally. Not having $$ for a med does not equate non-compliance in most people's eyes other than an insurance co.'s. And if you went back to work and couldn't do it, it just further proves your case.

I would still look for a good lawyer who's handled such cases asap.... if you let it go too long, it gets more difficult, like the ins. co. might look like it was correct in its assumptions. I would also still contact your local state reps and the state insurance comm. They don't like constituents getting scr**ed!

And don't worry about people following you... most likely they're not, but even so, everyone has good and bad days. .. Unless you're claiming to be paralyzed and are seen running in the 4th of July marathon.... :-/ and I know you're not.

Please persist, my gut reaction is there's still something here that can be changed in your favor.
Love, Victoria
[This Message was Edited on 07/03/2003]

Honey I don't get it. I thought your doctors had all the documentation down and one of them said definately you are disabled? And not even cuz of the fibro but because of your back disintegrating.
You did have a lawyer didn't you? For the SSD? What does the fact that you could drive have to do with being able to perform the rigorous duties of a nurse?! Driving is sitting down and steering.
I'm not trying to get on your case really. Why did you go back to work? Money? You know you are'nt going to be able to do it for long.
Spend your free time getting a lawyer and appealing. Man I hate this. You were so happy when you were first off. I'm sorry kiddo. N

P.S. Didn't know the hubby wasn't working, I understnd.[This Message was Edited on 07/04/2003]

Kady, I don't know that you're totally screwed. You have to appeal your claim in some way. I know you have to work in the meantime, but you have to appeal, too. (I don't remember where you were at in the process, whether it was your "final" appeal or not.)

I know that if I go into remission, and then have a relapse, my original claim still holds. (Of course, they're going to deny again, etc.) I don't remember if this is a lifetime thing, or not.

And calling your State Insurance Commissioner (and whatever else Victoria suggested) is a good idea. My LTD was *only* approved (after several denials) because they were being investigated by the federal Bureau of Labor.

I'm guessing that psychiatrist who diagnosed "conversion syndrome" was hired by your insurance company???

Gee how did I guess....Since when is he a specialist anyway in all those areas in which you have symptoms? Not that it can't happen, but it's usually a way of blaming the patient when the doctors can't figure it out.

Anyway, regardless of who hired him, his opinion is not worth more than all your doctors' opinions, regardless of what the insurance co. might claim.

All of you keep at it...
one of my hubby's patients was diagnosed the same, sent to my husband for psych. treatment, who said no way were her symptoms psychosomatic. Guess what, no one had done an x-ray -- she had a broken ankle! (No, I'm not kidding) Another patient sent to him for same reasons ultimately was found to have had brucellosis for 15 yrs.

Victoria

IM NEW TO ALL OF THIS COMPUTER STUFF BUT I HAVE BEEN LIVING WITH MY HUSBAND WHO HAS FIBRO. i HAVE BEEN A STAY AT HOME MOM FOR YEARS BUT IT LOOKS LIKE I HAVE TO GO BACK TO WORK. WE ARE JUST GETTING READY TO FILE FOR DISABILITY,SO THANKS FOR THE HELPFUL INFO. I HAVE ALL KINDS OF DOCUMENTS. I'M GLAD MY DAUGHTER CAME OVER TODAY AND HELPED ME FIND THIS SITE. THANKS,ECHOSTORM2003

IM NEW TO ALL OF THIS COMPUTER STUFF BUT I HAVE BEEN LIVING WITH MY HUSBAND WHO HAS FIBRO. i HAVE BEEN A STAY AT HOME MOM FOR YEARS BUT IT LOOKS LIKE I HAVE TO GO BACK TO WORK. WE ARE JUST GETTING READY TO FILE FOR DISABILITY,SO THANKS FOR THE HELPFUL INFO. I HAVE ALL KINDS OF DOCUMENTS. I'M GLAD MY DAUGHTER CAME OVER TODAY AND HELPED ME FIND THIS SITE. THANKS,ECHOSTORM2003

Yes, My doctors did say I am disabled. I had my PCP who first ordered the MRI for my back pain, my Rheumatologist I saw for the FMS and chronic pain, who I continued to see for my back, as well, and the Neurologist who saw me for the back problems. The Neurologist COULD have been part of the problem for me. He told the Rheumatologist that I COULD have been born with the spinal stenosis and he tended to focus on my piriformis syndrome and sciatica as my ACUTE problem and ordered PT and epidurals. I had to stop the PT because my chronic angioedema and hives flared up and I couldn't tolerate any type of physical therapy while hiving so terribly, PLUS I was ordered water therapy and the clorine was making the hives and respiratory distress worse. It all just had terrible timing, as usual! So, it MAY have looked like I wasn't co-operating, but I was. Then, the Neurologist suggested the epidural injections, which are very expensive and, with my husband ALSO being out of work due to severe depression/thyroiditis, I KNEW we couldn't bear to have MORE hospital bills coming in with threats for being unable to pay them, so I said the epidural injections would have to wait until we could better afford them.
And, NO, the lawyer I called when I first applied for SSD back in December said to call him when I received my first denial. I just received the first denial a few weeks ago and this coincided with the LTD denial AND my husband's being out of work, so I haven't called him, KNOWING that I HAD to start working NO MATTER WHAT. So, I think I'll make an appointment to see the lawyer next week, for a consultation to ask the following questions:

***can I appeal the LTD while back to work?

***can I appeal the LTD, even though I am not eligible for ANY ST or LTD at work now? (I'm working on an "as needed" basis only now~~I lost my full-time position during my LOA and an employee is not eligible for ANY benefits if they aren't full-time. (I only got a phone call saying I was denied and they said I'd be getting a letter of denial, which I haven't. The appeal process only can be started once you've received your letter of denial!)

***can I appeal the SSD while working?

***do I HAVE to submit to the epidural injections, even though they are very expensive, invasive and their effect may be negative instead of positive?

***since I'm working now, would I have to start ALL over with my SSD application or can I use the appeal process, since it has been less than 60 days since I got my letter of denial?

See, I just started the SSD application in December of 02. This is my first denial, so I haven't been to a judge or anything.

Thanks for all the advice, so far.
Love,
kady

God, you're just in the first stages! Some of the most painful, in my book. First, your body says you can't work, then the d#@* disability people tell you you CAN. Yeah, right, tell that to my body! And what's disability *for* if not this!?! It must be especially disheartening when you had your STD claim approved.

For LTD, I was denied initially. I appealed and that was denied (the day AFTER I finally got my diagnosis of CFS; a couple months after I'd seen their independent psychologist--who actually said my problems weren't due to depression!). Then they did the QA review process which, silly me, I thought would be imPARtial. Denied.

One thing I did find, though, when I was so profoundly depressed/angry every time I was denied, I didn't feel sick! (I was, just didn't feel it.)

Maybe I shouldn't be posting this, but I am. You are still in my prayers, and will be 'til this is resolved (hopefully God's and my opinions on that are the same!).

kadywill
I have Fibro and spinal stenosis I had one of those epiduerals I was suppose to have three of them.I had one and I was flat of my back for two weeks.The DR. said there was not any use in having another one it has made me alot worse I would not worry myself about not taking it. I no some people they may help but others they may not. I have been trying to get my SSI for over one year now I have been turned down twice but I have got me a lawyer I am to go before the judge for my hearing soon. If they refuse me I will try again. Good luck and may God Bless