Whenever the rainbow appears in the clouds, I will see it and remember the everlasting covenant between God and all living creatures of every kind on the earth." Genesis 9:13

Wednesday, August 31, 2011

Disability insurance-it's not for wimps. Or sick people.

This sounds awful but this is the 4th time I've been on disability.  The other 3 times were related to bipolar and 2 of them were triggered by stress.  One of the earlier times was short, 4 or 6 weeks.  The other two were long, 4 months apiece.

Every time pretty much has been a fight.  The first time I was turned down for a reason that I couldn't appeal because it was valid (I was about 3 weeks from eligibility) and my company overturned it and I got a surprise check. The 2nd time whoever my coverage was through tried to make life a living hell.  They kept trying to play Dr. Brain and I against one another, telling her that I knew to put my case number on all paperwork including hers when I didn't eve have a case number assigned per my case manager.  Once they denied the whole thing say she didn't include some information in box 15.c.123.3f or something.  It was there, clearly marked with an arrow, written beside the box because of lack of space.  I finally got approved for that one after I had been off for 2 months when I was getting so scarily sick that Dr. Brain had me come to her "real" office (back then I saw her where I see Dr. Mind; she was there 3 days/month) for an extra visit that wound up being 3  hours long because after I cried out my frustration with disability and she realized what they were doing and then found ways to adjust my meds to help me to try to sleep after not sleeping for so long I felt like I might die she called them and pretty much completely told them off, including that since my claim was clearly valid if they did not approve it and reduce the stress on me that she would simply keep me off work longer to cope with the stress.  She was livid; she also called HR at my company to tell them this was the single worst disability claim she'd ever had to work on.  Soon after I was approved.  The 3rd time was a mess because they demanded every note from every provider including psychotherapy notes.  Psych notes are generally considered off limits to everyone.  Dr. Mind was very upset about this, saying he had never realized psych notes to anyone ever in his many years in practice.  But he did then because they wouldn't pay otherwise.  If I went near a doctor, even just seeing Dr. Body for bloodwork, then those notes had to be sent in.  To make it worse they insisted on having updates every few weeks from both Dr. Body and Mind and so I was constantly on a paper chase.

This time the insurance has been much more helpful and kind.  However, my claim is still not processed despite today having been the planned day for review, because Dr. Body's practice sent a bunch of stuff not needed but not the sole note that was needed from him, the note for the day he took me off work.  I called and was told the person who could send that was off today.  After a great deal of begging I convinced them that since this paper was keeping me from getting paid and I have not been paid in weeks and that the paper was requested and they are having copier issues that just maybe it was possible to take 12 seconds to fax that in.  The reviewer had told me that if she had that today she could do the review; the review remains pending so I'm not sure what that means.  Then there is the nightmare of trying to get stuff from Cleveland Clinic.  Two requests were sent there, one from the insurance that "didn't specifically say Cleveland clinic--did too as well as giving the specific names of doctors", and then other submitted by me which they decided not to honor because they only release up to the date the thing is faxed and ignored my "ongoing"  statement.  Yet they did not call me to tell me this; they claim they notified my case manager but since she hadn't heard anything I doubt that.  The woman I talked to there was SO rude and condescending.  She was clearly not going to help me not matter what and was enjoying telling me everything I did wrong, repeating things like she thought I wasn't too bright despite the fact that her answers didn't have anything to do with my questions.  So I pretty much hung up on her so that I could rush around and get the whole thing faxed again, and then I'll have to request more records after appointments next week and on and on.  I'm hoping to go back in a couple weeks but that's dependent on various things and these requests may get old.  Oh well, whatever makes them happy.  So that was how I spent a big part of the afternoon, freaking out.  I was last paid for my remaining vacation time which ran out 8/12.  I had some money saved for this but not as much as hoped for since I was planning/hoping to work for another 6 days before going on leave.  And my case manager has been willing to go for weeks.  Its just been incredibly hard; many things didn't want to fax, including everything that needed to go to Dr. Body's office and the main office for his clinic.   Cleveland Clinic has no real desire to make this easier despite having a whole department that is supposed to be there fore these situations.  Hopefully we'll get this done this week, but I'm not sure because Cleveland Clinic says that they may take 3 weeks.  So I suspect I may get a determination for the days up to surgery, then have to wait for the days after.  In reality that's ok, I guess; It means I'll be paid for a week or week and a half, then once Cleveland Clinic steps up hopefully I'll get paid for whatever portion of last week, along this week and next and from then hopefully I'll be back to work depending on my psychiatric condition. It's hard because when I go back I  won't be paid for 2 weeks because I go back (if that's what happens) at the beginning of the pay cycle.  I also have at least 2 days I have to take off soon after going back that will probably be unpaid because I have followup.

So this is all stressing me out immensely.  This makes sense given that I'm due a pretty big amount of money at this point and I would like to pay bills, buy food, and still have enough to not be constantly worrying.

I can't believe the insurance is being fabulous and the hang up is basically secretarial........Maybe I'll get Dr. Brain on it.:)

1 comment:

Anonymous said...

I will be out of the country for a few days but my prayers will continue. I'll catch up soon. Keep healing!