Insurance Forum

[mmglobal]

Thank you to Dr. J (Justin) for recommending an insurance forum. I was denied by BCBS in 2002 for my surgery and that was expected. However, ADR was first FDA approved in October 2004 and here it is more than 4 years later and they are still largely denying ADR surgeries.

I hope this forum helps. For the first post here... I'll recommend a book about fighting your insurance company.... THE INSURANCE WARRIOR, by Laurie Todd.

All the best,

Mark

[jane1111]

What do you do if you were on workman's comp and when the Dr. says surgery they pay a Dr. to say that I was not injured at work and returns you to work with no restrictions? My Dr. released me for sit down work only and they fired me because of my restrictions. So now I have no insurance and no job. I have a herniated disk in my neck and 2 herniated torn disk @ L4-L5 & L5- S1. I have the shots, and PT both only made it worse. I am in constant pain and am unable to sleep more than a couple hours at a time. I have applied for unemployment but the company is fighting it. My pain medication is running out and I don't have money to go to the Dr. or pay for my meds. Am waiting for my landlord to kick me out, so I have that to worry about also. This has thrown me into a depression so deep that I can hardly do anything at all. No job, no insurance, fighting for unemployment, looking for a job I can do with my restrictions, who is going to hire a new employee with restrictions? no money to see the Dr., no money for the pain meds, and facing the possibility of being homeless. How can this happen to workers who go to work everyday and do their job?? Only to get used up, broken and thrown away.

[dshobbies]

Hi Jane,

Welcome to the forum. Your circumstances sound horrific. Not only are you dealing with the pain of a spinal injury but the bureaucracy then kicked you in the ass until you see no way out. You're depressed on top of your depression.

OK, first things first. Though cliche, you need to get yourself a lawyer and quickly. Obviously, your employer and their ins co has no intention of allowing this claim or your benefits and your only recourse is a lawsuit. Since you think you're about to become homeless, I'd say that time is short. Do it now! If a lawyer thinks you have a case, and from what you've written I'd say you do, then (s)he should take it on contingency and no upfront fee will be charged. Look until you find this arrangement.

I'd also complain to your state's fair labor practices board. Where do you live? Unfotunately, with today's economy, all states are cutting back and they might not see the same urgency in your case that you do and this route may take longer.

Then, you also have to address your health concerns, which right now, seems to come in second. This is such a travesty of a system that should support people. But that's another post

Jane, I'm so sorry you have to go through everything else on top of your pain, which by itself is enough to throw you in the deep end. This post belongs in it's own thread.

Let me assure you that you have our support which will get you nowhere in your legal troubles. Right now my blood is boiling. How dare they but I suppose this happens far more than we'd like to think.

We're with you Jane, one step at a time. BTW, where do you live? Perhaps someone knows of a good lawyer that will take your case.

Dale

[jane1111]

Thank you Dale for your response. I am living in Byron, Illinois a very small community in the northern part of the state. I do have a lawyer, but he just keeps telling me to hang in there and not give up. I haven't given up, but it's hard to keep positive when everything seems to be falling down around me. I haven't been to my Dr. since they took my Workman's Comp and insurance away, but I have an appointment on the 1st of June and then another on the 2nd with a third Dr. who I have never been to before. The lawyer's are fronting the money for the 3rd Dr. but have not offered any for my meds and my daily living expense. Both of the Dr.'s I have been to that I and my lawyer picked out have agreed with us that I am injured and need surgery, the second Dr., Dr. Sweeney informed me that I am worse off than was origianlly diagnosed. The lawyer said that it will take time to prepare my case. Time that I am afraid will take to long. I thought that by now I would have had my surgery and be on the mend, but after reading some post on this site, I now know that all of us do not have an easy road to follow. I am so outraged that I want to find a way of exposing these Dr.'s that sell themselves to the highest bidder, to warn others to refuse to even set foot in their office. If that is at all possible. But I am an uneducated middle age lady and I don't know where to start and where to find the research material I would need.
And this is America, how can this happen? We pay for insurance to protect us when we need it, and all they do is refuse, and get richer. And the companies that don't even pay a livable wage, who work us like dogs, then spit us out after we are broken. This should also be against the law. Who is out there protecting the crumbling lower middle class, what is left of us?? Our nation runs off of our hard work and labor, but when we are in need, we are thrown away like garbage.
Does anyone have any suggestions on where to start looking for these answers??
Thank you for taking the time to read my post.

[dshobbies]

Jane,

You will ultimately be paying for your lawyer's services and you have every right to demand service. Call him and let him know that if you must wait for surgical intervention, then medications are a necessity. Tell him your housing situation is urgent, as is your entire financial situation and you cannot afford to wait, period. If you don't like his answers, the 'there, there, now' blanket assurances, tell him you will start looking for another attorney. If he has agreed to take your case on contingency, he still must wait for payment, prorated to the work he has already done. Should this become the case, be sure to inform your new lawyer so he can obtain the necessary records.

Yes, the wheels of justice turn slowly but there are ways to speed things up. You have every right to demand the service you're paying for.

You are your own best advocate. Remember that, always! If you don't have a backbone, let your pain remind you it's there. Let your anger and frustrations speak loudly. When dealing with injustice, you have little time for feeling sorry for yourself. If you find you wimp out when confronted, write it down and present whomever with this letter and demand they read it in your presence. Dont' ask, demand, demand, demand!!!!!!!!

My best, Dale