Just popping in briefly to share some good news with you all. Though I shared already on Facebook and Twitter a couple of days ago, I just realized I forgot to make an announcement on my blog! I won my long-term disability appeal against Lincoln Financial Group!
My attorney called me last week to let me know that after a
full year without paying my benefit, Lincoln Financial Group finally reinstated
claim. Of course, with all that’s going on right now, that news was VERY
Over the course of…well, however long it takes me, I will be endeavoring to post and compile resources for everyone else out there still fighting or about to fight an unjust cancellation of benefits. The best way I can think to help others is to share what I’ve learned. To keep telling my story.
In that vein, I have posted a couple of resources already—12
Tips for Long-Term Disability Insurance Recipients and Long-Term
Disability Appeal Timeline. But this is just the start. As you can probably
imagine, I have quite a bit to say on the matter.
In the meantime though, I hope you will reach out to me if you
have questions. DM me on Twitter, use my contact form, whatever.
I know I can’t realistically fix this system that was
designed to rip off of vulnerable people, but by empowering individuals,
perhaps I can help shorten the long arc of justice and make it bend a little
more sharply toward justice.
So, help me celebrate the fact I won my long-term disability appeal against Lincoln Financial Group by telling someone you know that sometimes the bad guys are actually forced to suck it. Sometimes the good guys win. If you know someone right now that could use a friend who’s been through it, point them in my direction. If you don’t know anyone fighting this batter, tuck my info away in the back of your mind for later. Because you never know when you or a friend or a family member might end up fighting a similar battle one day.
Wash your hands, stay home, and please don’t take medical advice from Trump. Even if I don’t like you, I don’t want you to die.
For my posts on this topic, see the category Lincoln Financial Group.
The legal assistant assigned to my disability case against Lincoln Financial Group called me at the end of last week. She said they just needed a couple of signatures from Dan and me and a copy of my SSDI award letter. Then they’d be ready to ship off the entire appeal. This month is the deadline.
She gave me a quick rundown of everything they are submitting with my file, and—whatever LFG decides on this second appeal—I feel better just knowing there are people out there to push back against the insurance company’s lies and the lies of the doctors, like Samuels and Hartner, who shill for them.
It’s also been really nice not getting any emails or phone calls from the claims specialists that work for LFG since I found legal representation. I don’t know how employees like Ann and Sherry can do what they do to people in my situation. HR at Lincoln Financial must offer certified empathy extraction benefits along with vision and dental.
One thing the disability attorney managed to nail down was a sworn statement from my neuro-oncologist at Barnes-Jewish. “It’s going to be submitted as additional documentation after the deadline,” the legal assistant explained. “But he’s been out of the country for a while, so our hands were kind of tied.”
I’m stunned. Absolutely stunned that they are getting this from Dr. A. He’s good at the cancer stuff, but kind of impossible to pin down. I’d say 95% of my interactions with his office, including treatment and follow-up visits, at the cancer center have been with his NP, his nurses, and his office coordinator. I know that’s normal, but it’s far from ideal—even when you’re not fighting insurance.
Anyway, I asked the legal assistant how much time Lincoln Financial had to reach a decision on the appeal. I couldn’t remember. The answer is 45 days from the date of submission, but with a caveat. Since the sworn statement from Dr. A will be arriving later, LFG may request more time to review the additional evidence and it could be up to 90 days before I hear anything.
“Lincoln isn’t bad for missing deadlines—some other companies we deal with are terrible—but we’ll file a formal ERISA complaint if we don’t hear from them by their deadline,” the legal assistant said.
Do I think LFG will take another 45 days just to review one statement from my doctor? Yes. Yes, I do. Every day they don’t pay a claimant is another day they can earn interest on the stockpiles of cash they make from hoarding money that is supposed to be disbursed to disabled policyholders but isn’t.
My dad, who has always been really good at money, doesn’t pay his bills too soon before the due date for this same reason. “It’s silly to pay the bill as soon as I get it when that money could be making me more money,” he says.
The huge difference of course being that Dad isn’t holding someone else’s money. If he were doing what LFG is doing, we’d all be calling it theft.
Something to keep in mind, because the process for appealing cancelled disability claims is so stinking confusing, is that the appeals process is not anything at all like an actual lawsuit. There’s no independent third party, like a judge, weighing the evidence yet.
Both of my appeals of LFG’s egregious decision (the first one I made on my own, and now this one with my attorney) are appeals to the company itself. It’s nothing more than me saying, “Hey, you guys are wrong. Here’s why. Change your mind or be sued.”
LFG’s employees use language to try and make us all think the appeals process is about reviewing facts and making the right call. They’re spraying Febreeze on a pile of bullshit, guys. Being disabled as defined by your policy isn’t enough to win a disability appeal. You also have to convince them it’ll cost them more in the long run not to pay you.
I knew this in my gut from the day LFG cancelled on me, but I was so blinded by rage in the early stages that it was hard for me to wrap my brain around it. With a little more mental clarity, I see the appeals process for what it really is. Me saying, “Hey, bitches. Look at all this stuff I’ll be taking to the judge when it’s time to sue. Sure will cost a lot of money for you to prepare your defense and then lose anyway.”
Knowing Lincoln Financial will be holding my money hostage for at least another three months, seems like a good time to plug my serial memoir, Who You Gonna Believe.
Last Saturday there was another writeup on my continuing
saga with Lincoln Financial Group. This time the article was published on Relation
State, a blog run by a good, progressive-leaning friend of mine who wanted to assist
me in my mission to warn people away from LFG and its products.
READ: Lincoln Financial Group Scams Cancer Patient
In a goodwill effort to reach a larger crowd, my friend shared
the post on the Relation State Facebook page. For the most part, people
were sympathetic. But there’s always that one guy, isn’t there? This time, the
guy’s name was Bob.
Bob, bless his heart, seems to think he’s immune to the havoc a billion-dollar company like Lincoln Financial can wreak. He commented, probably without knowing I was in the audience, that whatever the insurance company had done, the fault was with me. “I got what I paid for,” and “I should’ve read the fine print,” he said.
It’s almost cute how Bob believes Lincoln Financial discloses their misdeeds in writing at all, let alone before a customer pays her premiums.
But some people, and I think it’s safe to assume Bob is one of them, cling to an oversimplified, conservative notion of capital-P, capital-R Personal Responsibility. They prefer believing they’re better and smarter than the rest of us over acknowledging that shit can happen to them too. Lincoln Financial Group counts on people like Bob to keep their secrets safe.
Bob’s comments reveal the crux of his personal philosophy:
his fortune isn’t fortune at all—it’s superior intelligence. By his logic, I’m just
gullible or stupid or both, and that’s the real crime here.
Despite the insults we attract from people who don’t get it,
it’s important for me and people like me to keep telling our stories. Why? Because
when we talk in generalities, the information doesn’t stick. The world stays
complacent. Someone else gets brain cancer and instead of accessing the safety
net she paid for, an insurance company records an immorally large profit, profiteering
doctors like Brian
Samuels and Lee Hartner
line their wallets, and a disabled woman with a brain tumor forgoes medicine
and racks up additional debt just to keep the lights on.
We can throw a wrench in the works, slow—maybe even halt—the
conveyor belt carrying our money to liars and racketeers.
But not if we’re content to be like Bob.
Things are changing around here, and I’ve been meaning to update you all on my Lincoln Financial Group appeal for a while now. Better late than never, right?
The first thing I have to report is that last week I signed a retainer agreement with a law firm, and I now have legal representation in my fight against the jerks at LFG. It took me a good long while to find an attorney. I’m too tired to explain why lawyer shopping feels like such an insurmountable burden, but just trust me: it is. Having brain cancer doesn’t help, but that’s not even the only reason why it’s so hard.
The important thing is that now there’s someone else out there to deal with the Anns and the Sherris of the world. Those loyal, dutiful insurance company employees who (I assume) must pretend every day that they wouldn’t be scapegoated in a heartbeat by their corporate overlords.
Ahem, sorry. Promised myself I wasn’t going to give in too much to the anger today.
In the meantime, I’m going to try to enjoy the fact that I no longer have to restrain myself from signing off every email to Ann or Sherri (or whoever the hell it is this week) with, “Thank you for your kind attention to this matter. Now get diarrhea, you miserable cow.”
(I probably don’t need to say this if you’ve been reading my blog for a while, but if you’re new here you should know that my Lincoln Financial Group appeal doesn’t exactly bring out the best in me.)
OK. So. I think I’ve mentioned it before, but I’m not actually able to sue LFG yet. I have to complete a second appeal before that can happen. (But I got an email with the subject line “Suess, Emily v. The Lincoln National Life Ins Co” and thought it would make a nice blog title.
Anyway, if they win the appeal for me, my benefits will be reinstated, and the law firm will deal with LFG representatives from here on out. I never have to talk to them again. (Sounds nice, right?)
However, if this appeal is denied too, then I can sue. (That’s the way my long-term disability policy is written.) At that stage these kinds of things typically get settled out of court. I’m no expert on why that is, but having been around the block now a time or two, I’m reasonably confident they settle because 1.) it’s cheaper, and 2.) THEY FUCKING KNOW THEY’RE WRONG.
But this isn’t really about right and wrong for the insurance company, is it? It’s about shareholders and CEOs and making easy money off the backs of the sick, poor, and disabled.
Quick aside: This is your daily reminder not to give your money to Lincoln Financial Group.
Moving on to thing two: I have a new oncologist. She is local to me here in Champaign-Urbana and part of the same health system (Carle Foundation Hospital and Physician Group) that employs my primary physician.
I’m not so much dropping my first oncologist as I am just adding a new one. I will get MRIs and the results here locally, but she will confer with the guy who, at this point, knows my tumor better—you know, if the need arises.
Although the drive to St. Louis wasn’t impossible—and everyone I’ve dealt with at Barnes-Jewish was pretty amazing—it was hard to make that routine trek to Missouri. Plus, finding the money for traveling even just a few hours is a problem when you’re unable to work and the disability benefits you’re owed are revoked by insurance company clowns and the profiteering MDs they find to make false claims about your health, MDs like Samuels and Hartner.
So Dan and I met with my new oncologist, Dr. P, on Monday, and although I was a little nervous about it (I have anxiety issues when it comes to doctors as a result of some terrible experiences) I really liked her. Dan did too. As a result of the consult with her, I’m picking up yet ANOTHER doctor.
Tomorrow morning, at Dr. P’s suggestion, I will be meeting with a palliative care doctor. When Dr. P first said the world “palliative” I was like, Ack! No! But it was because I was mistaken about what it meant. I thought it was terminal care, but it’s actually getting help with managing the symptoms of a serious and complicated illness like cancer.
On the drive home, I wondered out loud to Dan why my other oncologist had never mentioned this to me before. But, you know, maybe he did and I just was so overwhelmed I couldn’t or wouldn’t consider it? Or maybe they assumed I was already getting something like that at home? I honestly don’t know. But maybe the palliative care doctor will have some ideas about helping me with the laundry list of chronic symptoms I’m always dealing with. I’d kind of given up on that sort of thing. Most of the time when I tell a doctor that I’m in chronic pain or my nerves don’t work right or I have migraines, I just get shrugs. Maybe this will be different.
Did you go through a Lincoln Financial Group appeal? How did it go?
Dear Penn Medicine Doctors,
If Lincoln Financial Group was paying, would you say a woman with an inoperable, malignant brain stem tumor was “not disabled” and in “remission” despite her attending physician’s professional opinion to the contrary?
If the price was right, would you pretend you know best when even the patient’s own oncologist defers on the matter of her disability?
If the paycheck was fat enough, would you attest to a lie that stripped a disabled person of the long-term disability insurance benefits she paid for?
At least one of your Penn Medicine colleagues would. Shoot, he’d probably even say you don’t know how sick or disabled your patient is if the gig paid enough. I mean, it’s so easy for him to do when he never has to look anyone—doctor or patient—in the eye. He just fills out a report et voila! Robs another cancer patient of her financial security, pads his own wallet.
I wonder if, when typing up his misleading report about me in May, Dr. Lee Hartner figured I’d be too timid or weak to hold him accountable for his profiteering side hustle.
(He should’ve Googled me first. I’ve been writing open letters, blogging about cancer, and just generally sticking up for myself for years.)
Anyway, because individual bad actors like Hartner make it possible for Lincoln Financial Group to rip off disabled consumers and besmirch the good name of do-no-harmers everywhere, I asked Dean J. Larry Jameson to comment on the issue. The way I see it, this is a matter of public interest. If this sort of behavior is the kind of thing Perelman School of Medicine looks for when hiring faculty, maybe patients and med students ought to know.
Unfortunately, Jameson won’t even acknowledge I exist. I guess he can’t be bothered to comment on how Hartner’s lies reflect on Penn, on the Perelman School of Medicine, and on the profession.
Crazy, right? I mean, if Dean Jameson thinks Hartner’s behavior is above-board and medically ethical, why wouldn’t he just say so? And if he thinks it’s unethical, why wouldn’t he release a statement quickly, before the Hartner Stink™ had a chance to get all over the rest of you?
Sorry for the tangent. Back to the original question, which is: Would you do it too?
P.S. Maybe you can help me out with another question I have: Why is it only insurance fraud if the patient lies?