karen
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waiting and praying for a miracle
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waiting and praying for a miracle
I had been prepared for this, evidently it is how the game is played. I'm told they don't approve anyone's claim. They like the lawyers to hammer out a settlement. At least that is what I am told about my company. Would recommend an attorney if you don't already have one.
Good Luck, and you are not alone!
Cathy
I hear that your insurance company is having some legal issues over their denials.
If I got it straight a couple of lawyers in California just won a big case against them.
You may want to do a search on the issue to see what info you can find to help your case.
sc
Unum has been sued several times. They are known for their practice of denying benefits to people. I can't find the web site where I found this info, but you might do some research and find it.
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waiting and praying for a miracle
The appeal process under new rulings of the past four years, is a way to "subdue" to think you are getting a full and fair.
YOU WONT, plus, when they make a ruling, you just sealed your fate.
A lawyer knows what must be presented prior to the ruling being administered. If you get into the denial process the likelyhood of winning is VERY VERY POOR.
I told this to a woman in Arizona...(lisa in arizona here on lymenet) and she said, no...they are working well with me and things are going smoothly.
They blindsided her with a big fat denial.
We are in the middle of a lawsuit, we have a very very very strong case...the only hitch???
We didnt have a lawyer so there is some evidence which may be "closed" from the case...in otherwords the judge may not be able to use that evidence.
So, please...take it from a lyme expert...get an attorney.
We didn't get a lawyer until late in the process, unfortunately.
BUT -- we did get one, finally. He consulted with us free for over an hour (more like 3 hours, adding in the phone calls), told us what to submit with our appeal, to get it into the record that the judge reviews, and what to expect. He also told us to expect a final denial, but said that if we get everything into the record as he requested, we have a strong case. So we did. We're expecting to have to go to court.
DONT rely on your doctor making good medical notes. My previous doctor's records were pathetic -- I'd have denied me based on what he said!
Fortunately, my husband's medical records are much better. Just be warned -- look over your own records, make sure that there are strong statements in there about bloodwork, sx, etc. Write up your own stuff to be put into the notes, if necessary. Ask to see what the doc submitted to the insurance company.
Good luck.
Dr. William J. Hall
President
American College of Physicians - American Society of Internal Medicine
2011 Pennsylvania Avenue, N.W.
Suite 800
Washington, DC, 20006
What do you do now? In writing request a FULL CLAIM FILE.
CC US Dept of Labor
Find a lawyer. If they "close the case" you will be unable to add additional information.
When you write them, stuff the file with supportive evidence of your situation, and why it is "disability" including peer reviewed articles. So, cognitive, you cant do your job, you cant drive anymore or whatever. Physical, you can not lift over 20 lbs, you can not do repeated motions.
Focus on the disabilities you have...not the lyme. Yes lyme caused it, disability is the symptom. Disability comes from not able to do a function. Not from a bacteria.
You need to make sure they yget the information before CLOSING the file, because if it goes to court, they "didnt know". This way you know they know!
PS: Send everything registered and require a signature.
PPS: hey TREE, you found the same website I did.
[This message has been edited by Lishs mom (edited 18 August 2004).]