Monday, March 10, 2008

U.S. INSURANCE COMPANIES SHOULD BE ASHAMED

I feel a need to talk about private (or company-sponsored) disability insurance. Disability insurance is something an individual signs up and pays for, with the understanding that if they become disabled, i.e., unable to work, then their insurance provider will pay a percentage of their salary at disability until they are able to work again. Most people depend upon this income, and the income they receive from SSDI (social security) to live.

I went on disability in the summer of 1998. Not working was incredibly difficult for me, because I enjoyed work and I derived self-esteem and a sense of identity from my job. It is obvious to Tim and I that I cannot work - my mental health won't allow for it. In past posts, I have discussed my MPD/DID and some of the symptoms I get. Some of my symptoms I prefer not to talk about here because they are of a more private and sensitive nature. However, some of my symptoms are consistent with most “mentally ill” people, e.g., difficulty concentrating, problems with interpersonal relationships, the inability to deal with various environmental stimulants (noise, talking, music, heat, crowds, etc.). With trauma survivors, there is also the chance of becoming triggered by an event or a person. When triggered, a person could have any type of originally adaptive, but possibly, negative response (e.g., crying, hiding, dissociating (spacing out), anger, hostility, etc.).

Since I was diagnosed in 1997, my life has changed. I had already suffered from depression, so I was used to the excessive sleeping and isolation. At one point, I tried to do too much and ended up in the hospital from a “breakdown” of sorts. What occurred is that one of my child alters attempted suicide by overdosing on prescription medicine (with a wine chaser). This might seem unbelievable to most readers of this blog, but I still have the note written in a child's hand saying “Judi go bye bye”. Even more strangely, I watched this event from somewhere up by my dining room's ceiling. Fortunately, I had helper parts of me who thought to call my psychiatrist, and an ambulance arrived at my door. I hardly remember the stomach pumping at the hospital, but I recall enough to know that I don't want to ever experience it again. As I write this, my mind darts to all the things that need more explanation, but I am not inclined to get into that much detail here.

Returning to the purpose of this entry, disability insurance in the United States is a huge and corrupt scam. I read an excellent article recently:

“Practices in Health care and Disability Insurance: Delay, Diminish, Deny, Blame”
by Peter Phillips and Bridget Thornton
(I can send you a pdf copy by email if you'd like to read this article.)

This article explains how the insurance industry has become so corrupt and why the disabled population - people who have the least energy or ability, but often the greatest need - are put through hell in attempts to get what is rightfully owed to them. Cigna Healthcare terminated my disability insurance benefits effective last summer. Since that time, Tim and I have been appealing their decision, currently working on a new appeal since the last appeal was denied. My doctor has stated that I am unable to work and why. Cigna, however, has chosen to follow the assessment of two doctors who do not know me, and are obviously quite ignorant about DID. Cigna is also basing most of its decision to terminate my insurance on this blog! For example, because they read that I was able to attend and enjoy an opera with Zoe and Tim, that I must be able to have sustained concentration over a period of time. An opera? I'd bet that any number of mental hospitals would love to have opera available to their patients to enjoy and relax with. So a three hour light opera proves that I am able to work - what are they thinking? This is just one small and silly example of their reasoning.... it goes on and on.

I heard that Cigna, among other insurance companies, was mentioned in Michael Moore's film, Sicko. Apparently, the staff who pay claims are awarded for how many claims they deny. The more claims denied, the better the advancement and compensation. I know this has to be true, because as a former HR professional and on behalf of employees, I had to fight Cigna on several occasions to get claims paid that should never have been denied in the first place. Now, since I have been sick, I have had to do the same for my own claims. I still haven't been paid for my last claim submissions, and it has been months. The last Explanation of Benefits I received was ridiculous. They denied most of my doctor visits because my provider's number was not listed (or something like that). Well, duhhhhhhhhhhhhhhhhh, she's here in Australia! Wouldn't you expect the international claims people to figure out that the provider numbers might be different in a country other than the US? I am certain that they just made up ridiculous reasons to deny my claims, hoping that I would get tired of fighting them. Unfortunately, that's what many people do. They give up and give in to the insurance companies - mostly because they are intimidated by insurance or rude and abusive claims people, or they are too sick or tired (or tired of caring for a sick loved one), to keep fighting.

Something has to change. I am tired of fighting, but I also can't give in because I really can't work now and I am entitled to the insurance payments.

I want to work. I like work. I would like the better income that work provides me.

Since Cigna has been monitoring this blog, they will probably say that what I have just written indicates my ability for sustained and coherent thought thereby proving that I am capable of maintaining employment. I never said I was stupid, I just told them that some days I can't go outside, talk to other people, or answer the telephone. Hmmmmm, why would that interfere with a job do you think?

Hopefully more ranting and raving to come....
Judi

2 comments:

Anonymous said...

Wow Judi... that is crazy! I'm so sorry you've gone through so much stress and worry over something that you should NOT have to fight for!

Just curious, would you be able to find any similar coverage in Australia from an Australian provider?

Anonymous said...

Hi Judi, I'm sorry that you are having to fight Cigna, especially when you are so unwell.

But, I am inspired by your spirit and your tenacity.

I am currently going through something similar here in Australia. I've been waiting for more than 18 months for a disability payout but the insurance company is stalling and using delay tactics. I know there is a lot of deception around their actions (or lack of them) but I am determined not to give up, no matter what.

However, it is difficult, particularly when I feel so depressed and tired, to find the energy. Today is the first time I have started to research what's really going on with people like you and me and large insurance companies that delay, deny and defend their denial.

I would like to receive the article. Thanks again for your blog.

odysseyx