This is topic Denied short term disability claim-need help. in forum General Support at LymeNet Flash.


To visit this topic, use this URL:
https://flash.lymenet.org/ubb/ultimatebb.php/topic/3/15188

Posted by Lola (Member # 9129) on :
 
I need some help on info to send insurance company for info and lyme and treatment because obvioulsy they don't know anything about it!!

They said you don't have symptoms that coincide with lyme. (numbness/tingling, major brain fog, weakness, fatigue, forgetfullness, slurred speech, palpitations, left side numbness, joint pain, cold hands/feet) which most have gotten better with treatment.

Also said all my tests have been negative so I don't have lyme. ELISA negative of course and Ignenex WB neg, but had some positive bands. Am going to go off antibiotics and retest so I can get a positive result.

This just makes me sick. I just knew there was going to be a problem. Do they think I would fake an illness so I could stay at home and be socially isolated? Do they think I had a spinal tap for fun? I have never been sick in my life and used to run 20miles a week and was very healthy.

LLMD already wrote them a letter which I guess didn't help. My short term will probably have to go into long term dis. so this is going to be a big problem financially.

I read treeparols links on disability, but if anyone has any advice PLEASE let me know. Hopefully I am not the first person who has to deal with this.

This is all I need write now is extra stress.
 
Posted by cantgiveupyet (Member # 8165) on :
 
Hi lola,

i sent you a PM....here is a link to one of my posts....in it you will see a site for the consultant who can offer you some advice.

I sent her a few emails when i was being denied and forced back to work.

Also might want to check out the link of ERISA lawyers also on the same post.

http://flash.lymenet.org/ubb/ultimatebb.php?ubb=get_topic;f=3;t=014116#000005


dont give up whatever you do that is what they count on. You have the right to appeal their denial, so work on collecting all information.
 
Posted by bettyg (Member # 6147) on :
 
did you read MINOUCAT'S disability links; I added a lot to hers involving DISINISSUES web site and my personal experiences.. gotta get off for night/morning!

Bettyg
 
Posted by tabbytamer (Member # 3159) on :
 
Have any of your doctors diagnosed you with Chronic Fatigue Syndrome/Fibromyalgia?

What about headaches? Do you get repeated migraines often?

Sometimes those diagnoses are more readily recognized for disability. That's evidence they can "see" in your medical history.
 
Posted by snowflake (Member # 8950) on :
 
Oh man, this stinks. Sorry you have to go through this.

Did you have positive bands on IGM or IGG? What numbers?

Request that they send you a copy of the denial information and on what they are basing their decision. It is always good to have everything in writing. Find out about steps necessary to appeal the decision.

Send me a PM if you want me to help you gather published scientific literature that could help to persuade the people making the decision. I could provide articles from the CDC or other sources discussing clinical diagnosis, problems with testing, etc.

If you have a good LLMD they surely have been through this many times before and will have several tricks in their hats to help you through this.

Hang tough,
[kiss]
 
Posted by Lola (Member # 9129) on :
 
Tabby- none of the doctors I saw diagnosed me with anything. They had no clue what was going on with me.
Snowflake - PM sent
here is my WB results:
IGM
23-25 IND
31 IND
39 IND
41 +
66 +
IGG
39 IND
41 ++
 
Posted by cantgiveupyet (Member # 8165) on :
 
this happend to me too. I was diagnosed with migraines...and they gave me a real tough time about it last december. I was forced back to work and i got very very sick.

Do you have a lyme disease diagnosis now? How long have you been seeing your llmd? Please request that the company send you everything they used for this denial.

I found out that they did not include my llmd's note at all in there decision making. Once I appealed my LLMD faxed his notes and I was approved based on the notes. I was just approved for long term disability too.


Your WB is very similar to mine.
 
Posted by Bruceallan (Member # 9317) on :
 
Lola its going to be a battle no getting around that.

if you havent allready get a copy of your WB, if you allready have it look on the bottom of each page, it says

"Diagnosis should not be based on labratory tests alone. Results should be interpited in conjunction with clinical symptoms and patient history"

My WB and coinfections from Igenex was 8 pages long and this was at the bottom of every page.

You may need to write a letter and draw attention to this and say this is Igenexs way of acknowledging that a person can have a

negitive test result and still have lyme, quote LLMDs who say that may with neg tests still have lyme because of there Clinical Diagnoses.

And do get another WB as a positive result will get you some more treatment

Hang On and keep fighting. Later Bruce
 
Posted by Elizabeth in MN (Member # 8466) on :
 
Lola - so sorry to hear this. Same thing happened to me when I was diagnosed with Fibromyalgia.

I know it might sound expensive, but the very best thing I ever did for myself was to get a good lawyer with expertise in disability law. She had many options for payment to make it easy for us. My husband and I chose to pay her for a few hours of consultation. She was worth every penny.

I won on the first appeal, and was then able to reuse my appeal documentation when I applied for SSDI, which went through on the first application. This was the best few hundred bucks I've ever spent (next to the $$ for my wonderful LLMD!).

Good luck!

Warmly,
Elizabeth
 
Posted by bettyg (Member # 6147) on :
 
Elizabeth, wonderful story! Glad you got his expertise for a couple humdred $$ vs. the $5300 of 25% of your annual income.

My former lawyer would have gotten $7000 at the time of my 2nd hearing had he NOT QUIT me.

Good suggestion for her.
 


Powered by UBB.classic™ 6.7.3