As the news of my brain cancer and Lincoln Financial Group horror story garners interest, more people are asking how they can help—even complete strangers. I’m really grateful, but not always sure what to suggest. I figured if I created a list, people could pick what works best.
Ask a journalist to cover the long-term disability industry.
Share Your Stories
If you work for (or used to work for) Lincoln Financial Group, Professional Disability Associates, or Reliable Review Services and have first-hand knowledge of business practices, contact me or reach out to ProPublica.org.
If you have a related story you would like me to share, whether you have brain cancer or another disability or illness, send me the link.
If you or someone you know has a story that needs to be told but need a place to publish it, contact me.
I mean, let’s be honest, we all knew this was coming. At 11:09 this morning, Lincoln Financial Group sent me this email. What’s next? I don’t know yet, but when I do know, I’ll probably tweet about it.
At some point I will get around to uploading the supplemental documents I added to my second letter and the letter itself. I figure if nothing else, you should see what exactly LFG gets away with ignoring and why any premuims you pay them are probably a waste. (Like I keep saying, if they can deny paying me? What cases do they even cover?)
Lincoln Financial Group’s Email
We have completed the review of your appeal for Long Term Disability benefits. The determination is unfavorable and we will be upholding the denial. A letter is being sent to you via email with the decision.
You have a second level of appeal available if your disagree with this determination.
Sherri [Last name redacted] Claims Specialist Lincoln Financial Group
I have hired an attorney to help me with my appeal. The process takes forever, and I still have not completed my second appeal against Lincoln Financial Group. To date, they have not paid me the benefits I am owed for approximately 8 months. I urge everyone to avoid buying policies with LFG. They are a horrible company making billions off people who are vulnerable and sick.
(If you’d like to share your own long term disability horror story here on emilysuess.com, please comment or send me a message through my contact form.
Even I find the candor of the article a little jarring. It’s one thing to tell your story, it’s something else entirely to hand it over to a relative stranger. I mean, historically, that hasn’t gone well for me, you know?
As vocal as I have been about what’s happening, there are certain things that I have avoided discussing. Deciding what to tell and how it gets told is really the only power I have in this. Letting go of that control for the PW article was terrifying, even though I had confidence and faith in the motives of the people responsible. Nonetheless, I am thankful that PW’s editor Kerith Gabriel and journalist Courtenay Harris Bond decided it was time to turn the lights on the proverbial cockroaches in my life.
On my first attempt to read the piece, I was a living, breathing ball of cringing and wincing. Fuck this is traumatic; no matter how strong anyone thinks I am. So traumatic, that 24 hours later I still haven’t read the whole thing through. Maybe I never will.
As far as I did get, I noticed that there were a couple of places the details seemed obscured or misinterpreted. I second-guessed whether I’d done a good job answering questions and laying out the facts. I started to sweat it a little, but then reminded myself I didn’t start this fire, and I don’t control this story. The larger it gets, the more interpretations of it will exist in the Universe, and that’s not something I’d have the power to change, not even in a perfectly abled body.
So I’m letting go of this step of my fight and regrouping. I know that an official decision from Lincoln Financial Group on my appeal is imminent, and I know that if it’s bad I’ll go through about five to seven days of depression where I just lie in bed, refuse to eat anything nourishing, and have imaginary arguments with the people paid to gaslight me. I’ve got some self-care to do before that happens to try and minimize the downward spiral.
I remember when Anne, a representative at Lincoln Financial Group first told me that my disability claim was up for review. She explained that after 24 months of receiving long-term disability benefits, things were changing. I was leaving the “own occupation” period and entering the “any occupation” period.
Or, put another way, instead of proving I could no longer work as a technical writer, I had to prove that I couldn’t work at all. Funny they don’t put that on the brochures, but I figured, Whatever. This changes nothing. I’m not any more abled in 2019 than I was in 2017. Let them do their review. No big deal.
Anne assured me the any-occupation review process would be conducted by an independent medical team. I swear she called it a “team” though I can’t prove it, because she said it in a phone call. (If I had one do-over to spend on this insurance stuff, I’d refuse any and all phone communication and insist they put every last word in writing.)
In reality the “independent” review was conducted by one dude: Brian L. Samuels MD, and he worked for a company called Professional Disability Associates (PDA). Brian’s report was an insult to medical practitioners everywhere. An utter failure to provide an objective, fact-based summary of my abilities. So I looked him up, discovered he didn’t seem to be doing much in the way of clinical work anymore—and that he was paid more than $29,000 from pharmaceutical companies in 2016 alone—and concluded he was probably just collecting some easy money before he completely retired.
I also looked up PDA, to see who in the hell would hire such a careless medical consultant. That’s when I confirmed what I instinctively knew to be true—that there was nothing independent about any of this bullshit.
PDA’s business profile at Inc.com describes it as “a consulting company that provides specialty risk resources including medical and vocational consulting services to disability insurers and self-insured employers.” If you wipe the bullshit spin off that statement, what you’re left with is something like “We sell medical opinions for cheap to help you get out of paying claims.” And it’s not like PDA denies that this is what they do. On their own website they explain: “We are trusted advisors dedicated to providing expert opinions that help companies make better decisions.”
I made sure to point this out in my first letter to Lincoln Financial Group. Not that they cared. In response to my appeal, they paid for another sell-out doctor’s opinion. The new guy, Lee P. Hartner MD, doubled down on the Samuels nonsense. But instead of lazily focusing on errors and omissions in my medical records, Hartner really went for it. He read a disability determination written by my actual doctor and decided—even though she had conducted a complete medical examination and he possessed nothing more than documents—that he knew what was really up. Now, not only was I fit to work full-time, I was also, to my complete surprise, in remission.
A perfunctory online search for Lee indicated he wasn’t any better than Brian. Though he’s reported significantly less money from pharmaceutical companies, he pops up in morecourtfilings. Always the “independent expert” for a big insurance company, though not always in connection with the same review outfit. Whether Lee had to move companies because his opinions always led to lawsuits or whether he was just trying to cash in on every available opportunity is anybody’s guess. But neither scenario paints a particularly noble picture of him. Especially when you remind yourself that his paid opinions are stripping disabled people—stroke, brain cancer, and leukemia patients, for example—of their financial security in a health care system so broken they’re probably already drowning in run-of-the-mill medical debt.
For my appeal review, Lee was contracted by Reliable Review Services out of Boca Raton, FL. Bloomberg’s profile of the business describes them thusly: “The company caters to employers, third party administrators, and disability insurers.” So, yeah, there’s no chance I’m being screwed by any of these guys. No chance at all.
I guess I’m writing all of this for a couple of reasons. Firstly to my fellow disableds out there fighting a similar nightmare perpetuated by unscrupulous doctors who see us as medical records and not people: what’s happening to you is wrong. What they are doing may be legal, but it is not ethical. Don’t let them convince you that you’re a faker or a taker.
Second, to my doctors and to my primary physican in particular: I’m sorry you spent so much time trying to do right by me only to have some pissant sellout halfway across the country deny you the professional courtesy of presuming you know what you’re talking about.
This is an open letter to Castle Connolly Medical, published at: emilysuess.com/open-letter-castle-connolly-top-doctors
I am writing about a concern I have regarding Lee Hartner, a doctor named in your Top Doctors list at www.phillymag.com. If there is a better place to direct this communication, please let me know whom I should contact, and I will write them directly.
My name is Emily Suess, and I am a disabled brain cancer patient who lives in Urbana, IL. In March of this year, my long-term disability insurance carrier, Lincoln Financial Group, cancelled my disability claim and stopped paying my benefit. Following the cancellation of my benefit, I, as the claim holder, have been forced into a lengthy appeals process while I go unpaid by my insurer.
During that appeals process, Lincoln Financial Group acquired the services of Reliable Review Services (RRS). In exchange for payment, RRS provided a doctor to support LFG’s denial of benefits. That doctor was Lee Hartner, MD, PA – MD423656.
That Dr. Hartner accepted money to wrongfully claim my brain tumor is not disabling and I am able to return to work not only has consequences that are devastating to me financially, it calls into question the reputation of Castle Connolly and the “Top Doctors” designation.
the report Dr. Hartner was paid to provide, he casually dismissed my primary
physician’s determination of disability–which is meticulously supported and
documented in progress notes–and told the insurer that I am able to return to
Dr. Hartner’s report claimed that I am in “remission.” Having never heard this from any of my treating physicians, I was shocked to first see it in a report which attempts to discredit my primary physician’s observations so that Lincoln Financial Group can justify cancelling my claim.
in his report for Lincoln Financial Group, Dr. Hartner noted phone calls he
made to my primary physician in relation to my case, presumably to lend
credence to the assumption he would complete a thorough review. However, after
playing phone tag with my primary physician for a bit, he eventually told her
office staff that he “did not need to talk with [her] at this time.” He never
spoke with her, and this is documented in written correspondence between me and
my primary physician’s office.
There did seem to be conflicting information coming from my oncologist’s office at the time of Dr. Hartner’s report that was contrary to my primary physician’s findings. However, Dr. Hartner made no good-faith attempt to investigate further. When I had a chance to ask my oncologist’s office about it, a written statement deferring to my primary physician’s opinion on the matter (citing the infrequent visits required by medical oncology and my primary physician’s familiarity with my full history as reasons for his statement) was provided.
Even if Dr. Hartner wasn’t sure of my primary physician’s disability determination, and he was too busy to bother looking further, I would have expected a finding of “insufficient documentation” or “conflicting reports.” Certainly nothing so ridiculously biased in favor of Lincoln Financial Group as his report turned out to be. Even my own oncologist had the humility to acknowledge he didn’t have the most informed opinion on the matter.
My purpose in writing this letter is to ask that Castle Connolly be made aware of what has happened to me and that your physician-directed research team thoughtfully review whether it is appropriate for Dr. Lee Hartner to keep the designation of Top Doctor. While what he did appears to be legal, I believe—based on the information you present on your website—that you hold those who make your list to a slightly higher standard.
I also ask that you inform me if and how this matter will be addressed, as I believe patients who use your list for finding physicians should know to what extent they can trust it.