posted
my disability company had a Dr. William J. Hall review my chart and make a determination which was not in my favor unfortunately, when i appeal i am asking for a board certified lyme literate dr to review my chart cause if they say i don't have lyme i sure would like to know what i have.he is from maine says he is internal medicine
karen
------------------ waiting and praying for a miracle
Posts: 106 | From south western new york | Registered: May 2004
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posted
Hi, I cannot answer your question, but can co-miserate. Just got my final denial from Unum today. Basically it says I'm a nut and my doctor is a quack, in four pages.
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
Posts: 71 | From Warren, Mi, USA | Registered: May 2003
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Rita
Unregistered
posted
Have you asked your LLMD for a referral for a consult? She'd/He'd probably know of the best LLMD available.
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posted
SC Didn't know that, thanks. My attorneys told me no one sues Unum, everyone settles. Will look up the case you are referring to. Cathy
Posts: 71 | From Warren, Mi, USA | Registered: May 2003
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posted
The lawyers that SC was referring to are Ray Bourhis & Alice Wolfson. They practice in California. They won a big lawsuit against Unum.
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.
Posts: 111 | From Tick Country | Registered: Jun 2004
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posted
i find thids very interesting my company is unum also from Chatanooga Tn?
------------------ waiting and praying for a miracle
Posts: 106 | From south western new york | Registered: May 2004
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Lishs mom
Frequent Contributor (1K+ posts)
Member # 2344
posted
DO NOT APPEAL WITHOUT A LAWYER! Period
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.
minoucat
Frequent Contributor (1K+ posts)
Member # 5175
posted
Amen to Lish's mom.
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.
posted
Hi Annettsky, sounds like you need a good lawyer now, I got Binder and Binder and they were excellent. I truly helps to have the lawyer do the work for you, and well worth it? Where in south east wny are you? I think that is where I contracted lyme some 30 yrs ago. Mary
Posts: 44 | From PA | Registered: Jul 2004
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Lishs mom
Frequent Contributor (1K+ posts)
Member # 2344
posted
I doubt he really reviewed the chart. Here is his information. He is supplying a testimonial for a huge Federal Hearing. I suspect that is a "stamp", rather than the true evaluation.
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).]
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