2014-01-23

A couple weeks ago I mentioned my problems with an insurance company.  This is the latest on the story.

I previously posted twice about the matter.  Here is the first.  And the second.

I rely on my disability policy from my last place of work.  I won’t name the insurance company, yet.  But, I will if it gets ugly.

They sent me a letter, two days before Christmas, telling me to go back to work.

You lazy bum!  I kept thinking the letter contained those exact words, as I read it again and again.

Yes.  I took it personal.  At first.  But, then, as I researched, I began to see.

Disability fraud is rampant.

For example.  In a couple counties bordering Kentucky and West Virginia, as much as 15% of the population receives some form of disability.  One lawyer handles most of the cases.  At 25%, this guy must be very rich, even after paying off a judge and some doctors.

My insurance company needed to know that I am not one of ‘them’.  So, as they paid my short-term disability claim, they also demanded a physical evaluation by my doctor.

But, my neurologist wouldn’t help me.  As a policy, he doesn’t provide help with disability claims.  His secretary was adamant.

I have heard hospitals and clinics commonly refuse to help with claims.  They must think it is outside the realm of medicine.  So I had to take my records back to my primary-care physician.

She had not seen me in almost two years.  I remember her smile as she asked, “What’s new?”

“Well, I have muscular dystrophy.  Here are my records from Mayo Clinic.  Will you help me?”

I saw her at least three times over the summer, as my insurance company kept hounding us.  They wanted more evidence.  Phone calls and letters.  Follow-up exams and forms.  I can see why some medical institutions won’t waste their time.

Evidently, they were never satisfied.  They were just biding their time until they could drop me.

We don’t believe you.  Go back to work.

I consulted with an attorney.  He was friendly and sympathetic.  Then we discussed fees.  He wanted 25% of the lifetime settlement!

I kept thinking, This is all I have left to survive on.  Why do you get 25%?  It’s a straightforward case.

I asked him how he thought his fee was moral.  He never answered directly.  Instead, he told me what other lawyers charge.

But, after some conversations with the insurance company, I learned what they wanted.

So, this past Monday I paid to have a functional capacity evaluation.

A functional capacity evaluation is typically performed by a physical trainer with special certifications.  A subject is put through a battery of physical examinations, as well as tests designed to simulate the type of work performed.  The evaluator summarizes his findings in an objective, legal-medical dialect of English.

In my case, there was an interview, and a review of medical records.  Followed by strength and agility exercises.  He pushed me to the point of failure, so he could to accurately describe what he was seeing.  He also took lots of photos.  As he escorted me out, afterwards, he told me what he saw, in the dialect spoken by insurance bureaucrats.

I try to see insurance professionals as people.  But, I had no sympathy for them on Monday.  By the end of the exam, I was weak and shaking.

About six hours after it began, I left for home.  Muscle spasms left me too tired to do anything.  I just tried to keep myself awake until bedtime.

Tuesday, I was still in too much pain.  But, yesterday, I started writing.  Today, I have enough energy for editing, but not much else.

I don’t, yet, know the final cost.  I will get the bill before I receive the report.  It will be somewhere between $1200 and $1600 for everything.

And, when I heard that, I thought, sure.  If that’s the cost for a report that will hold up in a court of law,  I will pay.

It’s also more palatable than what a lawyer would leave me to let me live on, in exchange for his services.

So I gladly antied-up for Monday’s torture.  I can afford the cost, both financial and physical.  And, after a week I can forget about it.

I made the decision a couple days after my second post on this matter.  And I spent the remaining time, until Monday, blissfully writing.  It was definitely worth it.

I enjoyed each productive day.  Essentially, I feel like I bought myself a two-week writing vacation.

A worry-free mind is priceless.  Especially when it is affordable.

I’m hoping this will be enough.  Common sense tells me it will be.

2014-01-05

Last night I went to dinner three friends.  They were arguing that my belief, insurance companies are populated with human beings, is wrong.  And, I failed to ask them.  But I should.

Have they enjoyed their segment of conspiratorial thought?

How else could I justify my opinion?  I haven’t had any actual experiences to back up my belief.

Their voices swirled in my head as I lay myself to sleep.  I had become fearful.

Probably wasn’t thinking as much as feeling.   Subterranean embers still glowed deep beneath the cool of the evening crust.

Bad experiences remembered.  Insurance stories related.  Wrapped in a pleasant visit.

So, who’s crazy?  Me?  Or the three of them?  I guess we will see which of these two notions crystalizes in the coming weeks.

This is my first fearful experience with an insurance company.  Fearful, because my survival depends on it.  Or, at least, the quality it all.

And yet.  People do survive for a time in the gutter.  Who says I couldn’t?

Besides my common sense?

And which opinion is true?  The one based in fear?  Or the one built firmly on the calmness of knowing?

I am right.  This is an epistemology course for disabled people fighting insurance industry brutality.

Brutality? First person?

Present!  Because fighting this burns.  My daily allotment of fuel for focused mental energy has shrunk quite small.

Don’t know if my tiny budget for laser thinking is a brake on my mind, or my body, or both.  It could be any combination of the three.

Keep positive.  Gonna need it.

If my friends are right.  And because life is more enjoyable not dragging baggage everywhere.

Four and-a-half years ago I pulled a trailer of cargo on my bike to a writing retreat.

In Tucson.  End of May, the temps hover somewhere above that third digit.

One hundred miles.  One day.  That was easier then.

Because.  Retaining bad emotions exhaust me now.  Is this physical?  Or an enlightened state just before sleep?

Last night before sleep I was one.  Against three.  Both times in our thoughts.

The insurance industry and God.  Three believers and one form of dissent.  A good conversation.  And, an effective segue for next time.

God.

Well.  That’s it.  My budget spent.  I won’t work on my letter to the un-named insurance company.   Appealing their decision to stop paying my disability allowance.  Instead, I need.

Rest.