MESSAGE TO EmpowHER:
I am writing this to whoever is reading information sent asking for help in dealing with an illness that has gone on for a decade. I am new to EmpowHer and was told about it by my sister in attempt to help me find a source for an advocate.
My current providers are not helping me yet. I lost my last Doctor of 9 years since he moved to an Urgent Care facility and I can’t see him now. My company has different insurance also and I have been out of work for the last 3 consecutive months without pay. I worked for them 10 years full time with all this pain. I was on FMLA for about 9 years and they say I'm not allowed any renewal and have to return. This FMLA coverage gave me job protection and was re-approved each 6 or 12 months. In October of 2011 I just could not take the pain and the stress of my job and was receiving no help from my new physicians by a pain specialist and a PCP. (Preferred Contracted Provider)
I have been using the Fentanyl Duragesic or Transdermal system pain patch for 9 years and also morphine for breakthrough pain. I told my employer Oct 10th 2011 that I had to lay down before something awful happened and they allowed that. I am an adjustor for provider adjustment/appeal requests. I explained that I doubted I’d be well enough to work the next day. I progressively got worse and applied for STD (short term disability) a benefit afforded to all employees. I had also been paying extra premiums for 10 years just in case something like this happened and it would allow me 80% of my pay instead of 60% for 3 months and after that if unable to work, would be eligible to apply for LTD, (Long term disability). I am 62 years of age.
My employer, a very large well known Health Care company knew quite a bit about my condition over the years. I was denied STD and all income stopped except for small unpaid PTO (sick and vacation pay accrued). When denied by the firm that oversees these Leaves I was of course shocked. I spoke to them and my doctors about this several times. I tried to talk to my supervisor by phone and email and she was terminated from the company shortly after I got too sick and weak to work and even think clearly. I tried to talk to her manager now my present supervisor and she did not give me any phone number that worked on an 800 call number since I could not afford long distance and she did not respond to many emails that I sent to her and then I started sending them to her and several layers of management above her. We have reorganized recently before this took place and this new chain of command was not very familiar with the long standing high quality of my work. I continued to try to reach out to other members of management in my old chain of command at the same time as my current one. I did all I could do to get the providers to continue to resubmit more information to the group known as Sedgwick to review my appeal for STD and no one spoke to me for weeks on end except the external group reviewing the information called Sedgwick. Finally the pain specialist doctor admitted to me that the information was not true I had been given. The Pain Doctor said that he had resubmitted supporting documents for my appeal. My PCP was not well versed in pain management but she did write a letter to excuse me from Jury duty that basically said improvement was not expected and that I could not serve on jury duty due to sitting so long at one time and might not ever improve in addition to responding to requests by Sedgwick for detailed information.
My employer has still not given me any answer to all of my questions and to my appeal. Today is January 8th 2012. They have not terminated me yet, so I still have insurance coverage but that’s about it. I did finally speak to my current temporary supervisor and she said several conflicting things but after calling me back she stated she was trying to help me by saying I needed to apply for LTD immediately and be approved in a few days which was absolutely an impossible feat. No doctors would do what is needed in that amount of time, and I had also been told by Sedgwick that I was not allowed to return to work until the appeal was final which is expected no later than January 13, 2012. They informed that manager of their thinking about not returning to work till after appeal is final and that they refused me receiving the paperwork I requested to apply for LTD, due to the instruction from my new boss. The communications have been at best confusing and very limited.
There are so many issues I have to face and have already faced during a time of illness that they are too numerous to convey now. But there are a few major points I would think need someone to help me as an advocate.
1. Allowing me the benefits due all employees, STD and LTD coverage with the back pay to October that is due under our employee benefit plans and rules governed by ERISA.
2. Assistance in finding providers that can actually address this chronic pain in my UPPER MIDDLE BACK. Not lower back; that is ongoing and is completely different than the deterioration of disks AND focused arthritis in that exact same area of my upper middle back. (2 orthopedic surgeons that saw me in the beginning both indicated that surgery was not an option due to the dangerous location so close to my heart.) Physical therapy during that time essentially was not providing improvement and they told me not to waste my time or money continuing to visit their lab. Many other attempts to address the pain proved to be a failure until my previous doctor put me on the Fentanyl Patch much more potent than the morphine I take and are in the protected class of drugs that is extremely expensive and without insurance will cost a few hundred dollars per month. Totally unaffordable on the forced early retirement income that they have ultimately made me have to face. I am currently applying for Social Security Disability payments which take several months for approval and is said to be denied frequently on first application. So far the social security department has been a thousand times more gracious and helpful than my own employer and their firm Sedgwick.
3. I need help from someone somewhere. Are you able to assist me? By January 13th 2012 I may be denied again and I just don’t know what I should do or say at that point in time.
THANK YOU for any assistance or advice. I am so humiliated and saddened by my employer it has of course increased the pain and depression that I was dealing with for all these years and still keeping a quality rating of 100% non-financial errors that would have been 3 years in a row if I had been able to work till December 2011. I have Certificates all over my walls and last year an award with special recognition for 2 years. I was so looking forward to whatever happened this December.
In what seems to be a previous life now I was a V.P. of H.R. in a semiconductor subsidiary of the largest computer manufacturer in Japan. I know my company is not doing what is right. I wanted this all to end on a high note and amicable. Any more stress is the last thing I need. Coping has become almost impossible. I used to think and make decisions clearly. Now I'm lucky if I can get out of bed. Please let me know if this is the correct forum for obtaining good advise quickly. THANK-YOU. Marcia.
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