About My Disability Case Against Lincoln Financial Group

About My Disability Case Against 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.

Gotta See a Man about a Tumor

Gotta See a Man about a Tumor

True story: There’s a medium-security federal prison on I-70 in Greenville, Illinois. You can see it from Interstate 70. You can also see a sign situated in front of it that reads “If you lived in Greenville, you’d be home by now.”

“Oh my God, Dan. Did you see that?” I asked through my laughter. “Who puts a ‘you’d be home by now’ sign in front of a federal prison?”

“Why, the great citizens of Greenville, Illinois, I do reckon.”

“It makes me wonder if someone has the best sense of humor ever or if someone is uncommonly oblivious.” And then I paused reflectively for a second. “Doesn’t matter I guess. I can’t decide which would be funnier.”

We were on our way to St. Louis to see my doctor about my brain tumor, a Grade 2 astrocytoma nestled all up in my brain stem.

***

I had a full day of doctor things at Barnes-Jewish Hospital. It started off with an MRI. Then I had labs done to check my counts and make sure I was in good shape to start back up on chemotherapy, and then I had a visit with my neuro-oncologist.

The nurse who installed my IV for the MRI contrast immediately made my day. “Are you going to have other labs at the 7th floor location? If so, I can leave this IV in, and the nurses there can use it to draw blood. One stick today.”

“YASSSSSS!” I cheered. I’m a hard stick now that I’m a cancer patient. Like, my-veins-are-sentient-and-burrow-into-my-bone-marrow-at-the-scent-of-an-alcohol-swab kind of hard stick.

emily suess

When it was time for the draw, the IV wouldn’t give up the goods though. In all, they stuck me five times yesterday. And that just sort of scratches the surface of the list of Things That Were Hard About Yesterday™.

My MRI appointment didn’t show up in my patient portal thingy, so I went to the wrong location. We had to walk to another zip code to get to the right place. And the sign-in process there was senseless. Requiring bouncing around on three different floors. I don’t know if y’all remember this, but walking is hard for me.

I managed to get it done without a wheelchair because I’m stubborn and had my rollator.  (My legs cramped up all night long. Today I can hardly stand up and there’s a spot on my to-do list in all caps “APPLY MAGNESIUM LOTION AND SIT IN YOUR DAMN RECLINER ALL DAY.”)

The MRI itself was the best one yet. “Imagine” played on the headphones while the magnets jiggled the table and lulled me into a relaxing sleep. When I wasn’t dozing in the Skinny Tube of Loud and Screechy Noises, I was able to keep my eyes open. I am officially over all MRI fears.

Die in a tire fire, claustrophobia.

***

Despite an extremely draining six outpatient hours at the hospital, I feel good about the outcome. The MRI told the doctors that my brain tumor is still stable—a comfort considering any active treatments were postponed while we waited to figure out what was happening with the Temodar.

According to the nurse, my blood counts were “beautiful” following my treatment hiatus, meaning I’m in a good spot to resume treatment.

I don’t have to go back on the Temodar!

My doctor has prescribed a new chemotherapy pill, and this is one of those rare cases where “the evil that you know is better than the evil that you don’t know” just does not apply.

When my doctor said, “We’re very concerned about what happened to you on the Temodar,” I was so relieved.

My doctors are still listening to me and they are concerned about my quality of life. They care about me as a whole human person. I’m not just a tumor incubator with the potential to land them on the cover of Brain Tumor Slayers Monthly.

***

So here’s the plan:

  • My new chemotherapy is still a pill that I can take at home. No infusions.
  • The name of the medicine is gleostine (also called lomustine, Ceenu).
  • I take it for one day and have six weeks off, as opposed to the five-day regimen for Temodar.
  • Fatigue seems to be a certainty as far as side effects go.
  • One dose of chemotherapy costs $110. (That’s in addition to my monthly premium of $350 for health insurance, so here’s where I plug my YouCaring fundraiser page again.)
  • I will resume weekly labs to make sure my blood counts are good, or at least passable, but I can do them here in Urbana.
  • My doctor gave me a new script for PT/OT. I have to check with insurance to see if I can even afford it. But I’m hoping it will be possible and that it will help me get over some pain and numbness that’s overtaking the left side of my body lately.
  • My dexamethasone dosage is being reduced from 2 mg daily to 1 mg daily. (Fingers crossed, I can stay active but a little less hungry on this dosage. I gained another 10 pounds since my last doc visit.)
Did Someone Order a Chaplain?

Did Someone Order a Chaplain?

Let’s see. So far today I have:

  • Filled out paperwork for the allergist’s office
  • Emptied the dishwasher
  • Cooked macaroni and cheese
  • Paid some bills
  • Written a few thank you notes

It might not seem like much. In fact, compared to my pre-cancer lifestyle, it doesn’t seem like much. But I’m doing what I can, trying to take more steps without my mobility devices, and looking for ways to take some of the domestic burden off of Dan. (Dude’s got his own chronic illness to contend with.)

We’re a real pair.

So, while taking a breather in my new recliner this morning, I recalled a vivid memory of my days at Barnes-Jewish Hospital back in February.

Not sure what brought it to mind, other than that I have a lot of time to contemplate and reflect these days. Weird stuff pops into my brain, typically unsolicited. (And the stuff I actually want to remember? Nowhere to be found.)

Anyway. Several times during my visit, I was asked by hospital staff if I wanted the hospital to address any religious or spiritual concerns on my behalf. Each time I was asked, I told them no. So I was surprised to awake one day from a drug-induced nap to find a hospital chaplain standing at the foot of my bed.

He smiled and offered an introduction. Immediately, I recoiled. I told them no, I thought to myself. Do not want. I don’t need last rites. I am not dying. YOU’VE GOT THE WRONG HOSPITAL BED, MOTHERFUCKER.

My defiance is genuine, and thankfully well-contained. He was just letting me know who he was, and had no intention of being pushy or nosy. When he finished, he stepped over to my roomie’s bed and asked her if she would like him to pray with her.

She said yes.

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