posted
i feel like a big "pain" in everyone's neck by having to ask to revisit this but i am so scared and have no one else to turn to so please bear with me.
please see my earlier post titled mental health clause for the basis of my problem. i want to add some more to it and my post gets pushed down so low on the list that i am worried no one will notice it.
i see a pain specialtist who also addressed a flare up in depression symptoms a few months ago by changing my antidepressant and it worked. my depression sx have mostly been stable for the 2 years cigna has paid me. But honestly, what holds me back functionally from a pain specialty standpoint is pain and fatigue that does not respond to narcotics and fatigue that could be related to taking narcotics.
cant my pain doc make a case for disability, focusing on residual functional capacity as minimal, due to pain that doesnt respond to narcotcs? perhaps the focus should be on pain and function rather than on Lyme sx (neurocognitive)
my letter of denial from cigna quotes my medical record from my pcp as my depression being stable and "in remission" and my lyme symptoms as deteriorated due to memory loss and other encephalopathy related symptoms.
the letter also said they did not get any requested records from my pain doc and needed those before they would reverse any ruling. my pain doc swears the records were sent but i dont know what to think. it doesnt matter. i think that the fact that my neuro lyme sx documented as deteriorated along with stable depression (no depressive sx) would have been enough to continue benefits.
I dont get it??!! are they just mad that the records didnt come?
have any of you successfully received private long term disability because of pain related to lyme disease?
thanks so very much for all your precious time and energy. Posts: 68 | From washington/oregon | Registered: Apr 2001
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cantgiveupyet
Frequent Contributor (1K+ posts)
Member # 8165
posted
in my opinion, they got the records.
Try to remember one thing, they are always out to cut you off, that is their job. LTD is just plain evil and that company is one of the worst.
They told a baseball player he could still work, even though he injured his shoulder, they said he could still throw with the other hand. Do some google searches, you can find some stories on them.
hmmmm, not sure about the depression being in remission. You really need to consult with a ERISA laywer to do your appeal. They are really the only ones that can tell you based on the experiences they have had.
There are a few sites that I could recomend where some attorneys post. Send me a PM.
One is the yahoo group, disinssues.
-------------------- "Say it straight simple and with a smile."
"Thus the task is, not so much to see what no one has seen yet, But to think what nobody has thought yet, About what everybody sees."
-Schopenhauer
pos babs, bart, igenex WB igm/igg Posts: 3156 | From Lyme limbo | Registered: Oct 2005
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posted
If records are resent, they need to be sent certified mail with a return signature card.
Any thing sent to an insurance company needs to be sent certified.
Posts: 177 | From God's Grace | Registered: Apr 2007
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Bugg
Frequent Contributor (1K+ posts)
Member # 8095
posted
NP-
It's hard to tell from your e-mail all of the facts of your case. For example, we don't have the content (the entire paragraphs) of the letter from Cigna stating the reason/reasons for your denial. Additionally, we don't know what medical records you've given them or what you completed on your application.
As such, I strongly urge you to contact an attorney (I'm guessing your policy is governed by ERISA so you will need an ERISA attorney)...PM me if you want to just talk with an ERISA attorney to see if he could help you with your appeal (no monetary commitment)...
If your case falls under the ERISA laws, you want an ERISA attorney and not one who just deals with Social Security Disability issues (very different thing)....
Posts: 1155 | From Southeast | Registered: Oct 2005
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