Late September 2006: digestive issue leads to an anal fissure. Put on medication and surgery scheduled for November.
Early November 2006: colorectal surgeon cannot find a fissure on the day of surgery. Pain still persists. Surgeon advises that the pain would disappear after some time because it may be due to the nerves and muscles that have affected due to the fissure.
late November 2006: pain disappears. A variety of tests are done to figure out the cause of the digestive issue. Put on a medication called zelnorm. Life slowly starts getting back on track.
March 2007: US FDA discontinues zelnorm. The substitute drug amitiza does not help at all.
April 2007: another anal fissure happens. Put on medications again.fissure seems to have healed within a week.
May 2007: while cleaning the apartment, I accidentally lift a 4 lb dumbbell.There is a tearing sensation in the abdomen and pelvic region. Intense pain follows this episode. The trip to the doctor reveals no pathology.
Pain continues. It is difficult to sit or stand. Walking is painful though much lesser than sitting or standing. The only relief is while lying down. Colorectal surgeon suspects levator ani syndrome. The medications fail to make a dent in the pain.
June 2007: after a frantic search on google for some form of pain relief, I come across the Stanford protocol a list of specially trained pelvic physical therapists. Despite the steep cost of the Stanford protocol, I enroll myself for the July 2007 session. Meanwhile, I also start physical therapy with a specially trained pelvic physical therapist.
July 2007: it is increasingly clear that despite my best efforts, I am not being productive at work at all. I request for short-term disability for the next two months. Five days at Stanford protocol clinic failed to reduce the pain. By now I've lost 20 pounds. The only relief comes by taking 7.5 mg Valium which puts me out for most of the part of the day.
August 2007 to December 2007: I tried a variety of therapies including lyrica, amitryptiline, multiple NSAID, homeopathy, PEMF, ayurvedic etc. desperate for any form of relief, I also tried energy healing, hypnotherapy and psychotherapy. MRI and other diagnostic tests revealed nothing. Ultimately, I am forced to work lying in bed.
December 2007 to April 2008: I am able to work from bed with frequent rests in between. By March 2008, I start developing shoulder and cervical pain. After a particularly intense chiropractic session in May 2008, I wake up with the intense pain on the right shoulder and neck. I'm forced to file for permanent short-term disability again.
May 2008 to December 2008: I continue to experiment with various treatments without success. Hartford advises to file for long-term disability claim. Long-term disability claim finally approved in January 2009.
January 2009 to May 2009: immediately on approval of the long-term disability claim, Hartford sends detectives to my apartment to put me under video surveillance. They fail to find me venturing outside the apartment for two days. Meanwhile, I continue with various unconventional treatment considered experimental by the health insurance. My life is now a daily struggle with pain, doctors and arguing on medical bills with the health insurance company.
May 2009: Hartford asks me about my schedule with the pain management doctor. As I learned later, the real intention was to follow me to the doctor and put me under video surveillance once again.
August 2009: Hartford advises that an investigator will come and visit me for an interview. Unaware of the tactics used by Hartford to deny claims, I readily agree. The investigator talks to me for about two hours. I try to answer honest questions truthfully and to the best of my knowledge. At the end of the interview, he shows me a video of my trip to the doctor. I explained to him that there is nothing wrong about it since I have to visit the doctor to try out some sort of treatment. He says that Hartford thinks that the doctor was 80 miles away. I explained that he is 40 miles away and even if he was further down, I had no choice but to pop in the painkillers, sit on a heating pad and drive with the one good leg.
I realized later that Hartford took pains to send me a letter about the interview but failed to mention that they would be showing the CD with the video surveillance to me.
October 2009: Hartford sends a letter to the treating doctor. The letter is full of misstatements and a spin on the facts so as to peesuade the treating doctor that I was capable of 40 hours of work.for example,Hartford claims that "Mr. Verma demonstrated functional capabilities during the Activity Check that was performed on May13the and 14th.".The letter conveniently ignores the fact that the activity check was done when I was going to visit a doctor.On my way back, a family member accompanying me picked up groceries from the store.Apparently, Harford does not went patients to visit doctors,yet it expects that the patient should beunder the continued an of a doctor as stated in its policy booklet.The treating doctor disagrees and continues to support my claim for disability. I send a letter to Hartford pointing out the numerous mistakes in the letter.
January 2010: Hartford informs me that based on a paper review of my medical records by Hartford appointed physician, my disability claim has been denied. As the letter says, the physician agrees that I have pain but claims that I should be able to work 40 hours a week. This is despite the fact that my treating doctors spoke to him and disagreed with his conclusion. Also, the physician is a pain management doctor but has no credentials in the field of pelvic pain. As it turns out, pelvic pain is quite different from the spinal pain that pain management doctors usually treat
February 2010 to August 2010: I hire a disability claims attorney to file an appeal with Hartford. We produce records of two independent pelvic pain physical therapists and a vocational analyst to support the disability claim. Further, we point out that there was no change in condition on paper from January 2009 when Hartford first approved the claim to January 2010 when Hartford denied the claim. Hartford denies the appeal. In its letter, it clearly states that it did not take into account the records that were forwarded as a part of the appeal."Although information submitted with your appeal included medical literature regarding cognitive impairment and pain, our appeal review focused on Mr Verma 's functional capacity. Therefore a review of the literature submitted did not take place."
At this stage, thus,Harford has deliberately chosen some portion of the medical records that help it to show capable of working 40 hours a week.It completely disregarded the opinion of 5 treating physicians and instead relied on findings made by physicians appointed by itself.
Early November 2006: colorectal surgeon cannot find a fissure on the day of surgery. Pain still persists. Surgeon advises that the pain would disappear after some time because it may be due to the nerves and muscles that have affected due to the fissure.
late November 2006: pain disappears. A variety of tests are done to figure out the cause of the digestive issue. Put on a medication called zelnorm. Life slowly starts getting back on track.
March 2007: US FDA discontinues zelnorm. The substitute drug amitiza does not help at all.
April 2007: another anal fissure happens. Put on medications again.fissure seems to have healed within a week.
May 2007: while cleaning the apartment, I accidentally lift a 4 lb dumbbell.There is a tearing sensation in the abdomen and pelvic region. Intense pain follows this episode. The trip to the doctor reveals no pathology.
Pain continues. It is difficult to sit or stand. Walking is painful though much lesser than sitting or standing. The only relief is while lying down. Colorectal surgeon suspects levator ani syndrome. The medications fail to make a dent in the pain.
June 2007: after a frantic search on google for some form of pain relief, I come across the Stanford protocol a list of specially trained pelvic physical therapists. Despite the steep cost of the Stanford protocol, I enroll myself for the July 2007 session. Meanwhile, I also start physical therapy with a specially trained pelvic physical therapist.
July 2007: it is increasingly clear that despite my best efforts, I am not being productive at work at all. I request for short-term disability for the next two months. Five days at Stanford protocol clinic failed to reduce the pain. By now I've lost 20 pounds. The only relief comes by taking 7.5 mg Valium which puts me out for most of the part of the day.
August 2007 to December 2007: I tried a variety of therapies including lyrica, amitryptiline, multiple NSAID, homeopathy, PEMF, ayurvedic etc. desperate for any form of relief, I also tried energy healing, hypnotherapy and psychotherapy. MRI and other diagnostic tests revealed nothing. Ultimately, I am forced to work lying in bed.
December 2007 to April 2008: I am able to work from bed with frequent rests in between. By March 2008, I start developing shoulder and cervical pain. After a particularly intense chiropractic session in May 2008, I wake up with the intense pain on the right shoulder and neck. I'm forced to file for permanent short-term disability again.
May 2008 to December 2008: I continue to experiment with various treatments without success. Hartford advises to file for long-term disability claim. Long-term disability claim finally approved in January 2009.
January 2009 to May 2009: immediately on approval of the long-term disability claim, Hartford sends detectives to my apartment to put me under video surveillance. They fail to find me venturing outside the apartment for two days. Meanwhile, I continue with various unconventional treatment considered experimental by the health insurance. My life is now a daily struggle with pain, doctors and arguing on medical bills with the health insurance company.
May 2009: Hartford asks me about my schedule with the pain management doctor. As I learned later, the real intention was to follow me to the doctor and put me under video surveillance once again.
August 2009: Hartford advises that an investigator will come and visit me for an interview. Unaware of the tactics used by Hartford to deny claims, I readily agree. The investigator talks to me for about two hours. I try to answer honest questions truthfully and to the best of my knowledge. At the end of the interview, he shows me a video of my trip to the doctor. I explained to him that there is nothing wrong about it since I have to visit the doctor to try out some sort of treatment. He says that Hartford thinks that the doctor was 80 miles away. I explained that he is 40 miles away and even if he was further down, I had no choice but to pop in the painkillers, sit on a heating pad and drive with the one good leg.
I realized later that Hartford took pains to send me a letter about the interview but failed to mention that they would be showing the CD with the video surveillance to me.
October 2009: Hartford sends a letter to the treating doctor. The letter is full of misstatements and a spin on the facts so as to peesuade the treating doctor that I was capable of 40 hours of work.for example,Hartford claims that "Mr. Verma demonstrated functional capabilities during the Activity Check that was performed on May13the and 14th.".The letter conveniently ignores the fact that the activity check was done when I was going to visit a doctor.On my way back, a family member accompanying me picked up groceries from the store.Apparently, Harford does not went patients to visit doctors,yet it expects that the patient should beunder the continued an of a doctor as stated in its policy booklet.The treating doctor disagrees and continues to support my claim for disability. I send a letter to Hartford pointing out the numerous mistakes in the letter.
January 2010: Hartford informs me that based on a paper review of my medical records by Hartford appointed physician, my disability claim has been denied. As the letter says, the physician agrees that I have pain but claims that I should be able to work 40 hours a week. This is despite the fact that my treating doctors spoke to him and disagreed with his conclusion. Also, the physician is a pain management doctor but has no credentials in the field of pelvic pain. As it turns out, pelvic pain is quite different from the spinal pain that pain management doctors usually treat
February 2010 to August 2010: I hire a disability claims attorney to file an appeal with Hartford. We produce records of two independent pelvic pain physical therapists and a vocational analyst to support the disability claim. Further, we point out that there was no change in condition on paper from January 2009 when Hartford first approved the claim to January 2010 when Hartford denied the claim. Hartford denies the appeal. In its letter, it clearly states that it did not take into account the records that were forwarded as a part of the appeal."Although information submitted with your appeal included medical literature regarding cognitive impairment and pain, our appeal review focused on Mr Verma 's functional capacity. Therefore a review of the literature submitted did not take place."
At this stage, thus,Harford has deliberately chosen some portion of the medical records that help it to show capable of working 40 hours a week.It completely disregarded the opinion of 5 treating physicians and instead relied on findings made by physicians appointed by itself.
Your right, finding a reputable insurance agency can be a hard thing. People should always do there research and even try to compare different quotes and benefits if possible. Also choosing the right type of insurance whether it is Life Insurance or Long Term Disability.
ReplyDelete