Next Steps: Appealing Lincoln Financial Group

Next Steps: Appealing Lincoln Financial Group

It’s been a while since I’ve updated you guys on appealing Lincoln Financial Group. There are a couple of reasons for that:

  1. Constantly worrying about money and maybe losing your house is kind of stressful.
  2. It turns out that being depressed about brain tumor stuff, being unable to work, and having no money is EXCEEDINGLY. FUCKING. DEBILITATING.
  3. These things move painfully slowly by design,
    because the longer Lincoln Financial Group gets away with not paying a claim, the more money the company and its CEO can hoard.

As things stand currently, I have submitted my appeal to them and it’s queued up for their review. If they don’t make things right, and decide to deny me again, then we move on to the Second Appeal. If (or should I say when?) they deny the second appeal, then–and only then–can I sue them.

Honestly, I’m surprised they don’t have a clause that forces policyholders to complete Appeal Elevensies before they can be taken to court. I should shut up, in case they’re looking for ways they can be even worse to their policyholders.

Anyway, I was going to post an entertaining version of my appeal letter here on the blog, but I can’t right now. Sadly this bullshit with Lincoln Financial Group is only one of several fires we’re dealing with at the moment, thanks to my homeowner’s insurance premiums unexpectedly rising 20% from last year, and some confusion with the IRS.

But back to the long-term disability stuff. I do have the official appeal letter that I could share, but I don’t want to just put that up on the blog for all to see. I’ve considered making it a Patreon post, so it’s only available to patrons. But I’m not sure if that really serves any meaningful purpose. I don’t know, I’ll wait and see what people think. I could see how someone in a similar situation would benefit from seeing how another person handled their appeal. Eh. I don’t know yet, OK? Stop pressuring me.

(Also, about Patreon: the new chapter of Who You Gonna Believe will be available to all subscription tiers starting tomorrow at 10:00 AM CT. So keep your eyes peeled for that. If you’re not already one of my patrons, you can get access for a $1 pledge.)

I’m going to drop a couple of other links if you’d like to help support our cause this month, because, like I mentioned at the top of this post, we’re kind of low on income for the foreseeable future.

Give a few dollars via Paypal.

Or give a few dollars via Ko-fi.

Lincoln Financial Group Insurance Policies Are Shit

Lincoln Financial Group Insurance Policies Are Shit

If you’ve got a second, I’d like to tell you about my experience with Lincoln Financial Group Insurance Policies. I’m guessing you know this isn’t going to be a glowing review, just based on the title.

On Friday, I took my husband Dan, four pages of notes, and a copy of LFG’s policy cancellation letter to my primary doctor. I highlighted the most absurd parts, and when Dr. S. got to them, she laughed.

“Do they know about your SSDI determination?”

“Yes,” I said.

In fact, Lincoln Financial Group forced me to apply for Social Security Disability Insurance (SSDI) when I first submitted the claim. Then, when SSDI was awarded to me, they reduced their benefit from about 60% of my prior income to about 30%.

That’s probably standard procedure for any long-term disability policy—reducing benefits if SSDI is awarded—but it highlights a significant point: Lincoln Financial Group acknowledged Social Security’s determination in order to reduce my benefit and save money while I underwent treatment. But now they’re ignoring it and paying Dr. Brian Samuels to say I should no longer receive any benefit at all.

And I’m like, look, assholes, either my SSDI is relevant, or it isn’t. That they can discard this kind of information when it helps their bottom line is fucking disgusting.

Speaking of bottom lines. According to Forbes, Lincoln Financial Group’s CEO, Dennis R. Glass, has made an estimated $28 million in the last four years and Google search estimates his net worth at between $88.4 million and $90.4 million, depending on the source. In a February press release, Lincoln Financial Group (NYSE: LNC) reported net earnings of $399 million for the fourth quarter of 2018. QUARTER. They made $399 million dollars in just three months. For all of 2018? $1.6 billion.

Partly by paying doctors to say in writing that brain cancer patients like me are able to work. Yes, we all know it’s cheaper to pay an old, tired doctor to lie than it is to pay out the benefit they promised a couple dozen long-term disability claimants.

I wonder, do lowly LFG employees like the ones I always interact with buy these policies for themselves? Do they think they’ll be covered if the worst happens? Or are they all job hunting on the company dime when business is slow? Biding their time until they can finally stop helping a billion-dollar industry take advantage of the sick and disabled?

But back to my appointment on Friday. “This says you can occasionally squat and climb but never bend over? You can work 40 hours a week? You can stand and walk for up to 30 minutes?” My doctor read more from the policy cancellation letter. Even a toddler would question their logic. It was devastating to read it the first time. And outright insulting to hear it read aloud by my doctor.

“I know! It’s ridiculous!” I forced a laugh, because I knew if I started crying I wouldn’t be able to talk.

She asked if she was remembering correctly that the brain tumor was stable but still in there and that it was inoperable. I confirmed for her that yes, the doctors at Wash U had stopped or slowed the tumor’s growth for the time being and that I was not currently undergoing treatment. Then she assured me that she would contact my oncologist and do some investigating. She did not agree with Lincoln Financial’s determination, and she was going to support my appeal.

I admit, I was really nervous going into that appointment Friday. Although Dr S has never done me wrong, many other doctors and medical personnel have, and I’m always wondering when the next one is going to call me a liar or choose their personal bias over my lived reality.

I say this a lot, but my anxiety in medical situations is a result of things that have actually happened to me, and not just wild imaginings concocted by an overactive imagination. I earned the right to doubt first and withhold trust for as long as I want to.

Anyway, Lincoln Financial group still hasn’t mailed me the forms they’re required to send. I emailed the claims examiner on 4/11/19 about it and got this response:

Ms. Suess,
Your file copy was mailed to you on 4/4/19, with additional information mailed on 4/8/19. Your file copy includes a copy of your long-term disability policy. Please let me know if you have any additional questions.

I requested the report I’m legally entitled to on April 1, 2019. LFG claims to have mailed a copy three days later. It’s been two weeks now, and my mailbox still sits empty. Meanwhile, Lincoln Financial Group continues to not pay me. And the 30-day deadline they’ve imposed on me to submit supporting documents continues to tick away, even though it’s still unclear what specific lies and misinformation I’m supposed to be appealing.

Don’t buy insurance policies from these people. They are shady AF.

If after today’s mail arrives I still haven’t received the promised documents, I’m going to email them again. Give me a fucking tracking number or some kind of receipt, because I don’t believe anyone who works for Lincoln Financial Group. No. One.

When Checking the Mailbox is Terrifying

When Checking the Mailbox is Terrifying

I have a love-hate relationship with my mailbox. Sometimes, it’s filled with gifts and notes and well wishes from family and friends. But more often it’s filled with medical bills, collection letters, and insurance policy cancellation notices that say I’m capable of working an 8-hour day. That’s why checking the mailbox is terrifying.

Currently, I’m waiting for Lincoln Financial Group’s complete report to arrive in the mail. It’s supposed to contain the documents they received from my primary doctor’s office as well as my oncologist’s, plus some kind of official report on how they arrived at their determination. I also requested credential information for Dr. Brian Samuels when I wrote my appeal. (I’m 99% sure it’s this guy.) They didn’t specifically say they’d provide that information, so we’ll see if I get it. I want a license number for that assshole to make sure I’ve got the right one when I start reviewing him on Healthgrades.com and stuff.

Every piece of mail I’ve ever received from Lincoln Financial Group comes a minimum of 10 days AFTER the letter is dated. I know they do this on purpose.

While I require that information to continue with their appeals process, I also dread checking the mailbox every day, because I’m worked up over what could be in it. Here’s why:

  • It contains information from my doctors that I have not seen. I am worried, with good reason–I have been repeatedly traumatized by doctors, after all–that they have said grossly untrue things about me in their communication with Lincoln Financial Group. That I will have to add my own doctors to the long list of impossible things I have to fight every day: brain cancer, the “healthcare” system, Lincoln Financial Group, collections agencies, etc. And that I will, once again, have to find start searching for a doctor I can trust. I know from experience doctors don’t change their opinions on things with new information. Instead they double down on them.
  • On a second read through of the original notice from LFG, I found this line: “After review of the documentation contained in your claim file and a telephone call with [my oncologist], Dr. Samuels has opined that you have minimal decrease in functionality.” So yeah, I already don’t want to return to my oncologist’s office in July. He’s apparently talking about me as if I was an able-bodied person before cancer treatment and that, because my platelets are back up, I am no longer disabled.
  • I’m scared the report contains prognosis information in it that I have worked very diligently to avoid. I don’t know how long doctors have given me, and I don’t want to know. Even if it’s a long-ass time. I can’t live with someone’s best guess being the only thing my battered brain obsesses over. I know some people won’t get this. Some people have to know. But this brain tumor, and this life are mine. I should be calling the shots. There’s so little else I can control. I need this one thing.
  • I’m afraid that if I ask Dan to read the report first to protect me from the shock, that he will come across detailed prognosis information and it will change everything for us. Again. I’m afraid this new information could cause him to treat me differently, and that in trying to protect me from it, he will reveal information that I cannot handle. (Lots of people have called me strong through this because I haven’t completely fallen apart. I’m not strong so much as I am good at avoiding things I know I can’t deal with.)
  • I know that reading the documents will remind me how overwhelming and impossible this battle with a giant-ass insurance company is for someone like me. I’m scared the stress and anxiety are going to throw me into another depressive episode, and that the next one will go on for even longer than the last one. I already know that my oncologist said that I am “not expected to improve.” It’s so weird to read something like that while living inside this broken body, knowing that the same person also said I can work 40 hours a week. Not even “she could do something part-time” but “she can work 8 hours a day.”

Part of me wants to curl up in a ball and just give up. Not part of me. Most of me. I am so tired. Mentally. Physically. Emotionally. I can’t control anything. I’m just out here spinning my disabled wheels while overworked doctors who see me for three minutes every 8 months tell profit-driven sharks I’m totally capable of walking 30 minutes and climbing shit.

I gotta wrap this up. More updates when I know something. Mom and Dad are coming to visit us tomorrow and I have a new appointment on the books to talk with my primary doctor about this whole mess. I feel like if I have any chance of beating this thing, it’ll require her going to bat for me. As much as I want to believe she will, I don’t know that she will.

Appealing Lincoln Financial Group: An Update

Appealing Lincoln Financial Group: An Update

So here’s a little update on what’s happening with the long-term disability appeals process. Publishing my thoughts on appealing Lincoln Financial serves a few purposes:

  • It helps me keep track of where I am in this ordeal. (It’s hard to keep my shit together when I don’t have to worry about how we’re going to pay the mortgage.)
  • It serves as a reference point for sequencing events when my memory inevitably fails me. Based on the horror stories people have shared with me about their own long-term disability claims, I anticipate this will drag out forever.
  • It gives me a place to point people who want to know how things are going. As much as I’d like to be able to answer individual questions right now, I have to ration my energy.

My working goal right now (it could change, as these things tend to morph into different monsters over time) is to keep sustained pressure on Lincoln Financial Group throughout the process. If someone there was like, “You know, maybe doing this to a brain cancer patient wasn’t the smartest decision we made” and they just reversed the decision, that would be nice.

But I know nothing matters to them that doesn’t affect their bottom line. So the single greatest thing you lovely random internet people can do to help my case, is just help me spread the message about what’s going on. Retweet a tweet, reblog a blog post, tag them in social media and tell them why you’re not buying any of their insurance products. That kind of thing. All those actions are significant.

In the past couple of days, Lincoln Financial Group has contacted me by phone twice. Just a couple of perfunctory messages. One to see if I received the policy cancellation letter, and one to notify me that my appeal letter was received. I’m all like, yeah you received it. I sent it by email, fax, and snail mail, after all. (LOL! I spent a few years working in government. I know what happens inside large bureaucratic organizations. I’m taking no chances.)

I let those calls go to voicemail though. I don’t communicate with them by phone anymore. It’s too risky that I’ll slip up. My brain doesn’t process spoken language like it does written language with this lump of cancer sitting on it. Yes, I probably should have taken this approach from the beginning, but hindsight, you know?

Anyway pro tip: if you don’t answer their calls long enough, Lincoln Financial Group will eventually send an email. And they did. In their acknowledgment letter, they said that I have 30 days to collect and submit additional documentation, and they seemed very eager to know whether or not I planned to submit any additional documents. Noting they could just “start the review of my appeal immediately.”

Not at all amused that they’re trying to rush me while it took them ten days just to send the official cancellation notice. But I digress.

When I read that part I was thinking, Bitch, you still have to send me the documents I requested! Until I know what you used to make this judgment, I can’t tell you what I will or will not do. I mean, in case they’re not aware PEOPLE MAKING JUDGMENTS WITH LIMITED INFORMATION IS WHAT STARTED THIS WHOLE FUCKING MESS.

So I reserved my right to submit stuff without committing to anything specific.

Meanwhile, I have an appointment with my primary doctor set for April 16. Originally, it was just supposed to be for my yearly physical, but now my needs are a little more complicated. I’ve called her office to see if this stuff can be handled then too, or if I need a separate appointment. Waiting to hear back on that, and I expect they’ll probably give me an answer in the next day or two.

Whatever I do as far as submitting additional documentation, Lincoln Financial Group has said I have 30 days to do it. (I don’t know if 30 is a number they made up or if that’s part of the legal code that outlines how these things are supposed to work, or what. But that’s the deadline I’m working with right now.

To prepare for my visit with my primary doctor, I’m generating a list of things that need to be spelled out specifically for the insurance assholes. But, again, until I see what they’re working with, I can’t know everything that needs to be documented. I’m just trying to be prepared. I never know when I’m going to be sidelined by the next catastrophe.

My gut feeling is that part of what’s going on here is that Lincoln Financial Group is using the absence of information in my patient records to say that I am able to do a certain thing. For instance, I would bet none of my doctors ever wrote “cannot work 8 hours a day” in my chart, so Lincoln Financial’s asshole doctor used that opportunity to twist the narrative into something that suited their bottom line. Something like, “patient is able to work 8 hours a day.”

But again, I am just speculating. It’s possible my own doctors are making bullshit claims about me too. Until I have the report in front of me, I don’t know what justification that asshole Dr. Samuels has for making such absurd claims about my abilities.

No I don’t expect him to know the finer points of my case. I know that brain tumors and brain cancer don’t effect every patient the same way, but in my estimation, that’s an extremely solid argument for a doctor to say, hey, I think I need to hear directly from the patient before I sign my name to this decision y’all are making.

One last thing before I go. A couple of strangers have hinted (in discussions about me, not with me) that I should be nicer to the individual players in this who are just trying to make a living. Maybe I shouldn’t be so hard on them.

To those people I say:

You know what happens when individuals aren’t held accountable for their actions? Absolutely nothing.

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