Re: My DisIns Appeal

New Topic Post Reply Printable Version
36 posts in this thread.
Viewing Page :
 1  2 
[ << Previous Thread | Next Thread >> ]

Lynnwood
Forum Moderator


Date Joined May 2005
Total Posts : 7018
   Posted 7/9/2008 12:42 PM (GMT -7)   
As some of you have been following, my private disability insurance policy, which I've been living off of since the Lupus dx, canceled my payments a couple of months ago. Since then, I have been working with an attorney to file an appeal. The slowdown has been completing neuropsych testing -- I am scheduled to see the neuropsych on the 17th to see what the results are from that testing.

But I just received this from my attorney...

My DisIns Attorney said...
Essentially, Dr. (Neuropsych) indicates that you would have significant cognitive difficulties completing work. The next step is to get Dr. (new Rheumy) to see if he agrees with the neuropsych report. The trick is going to be to get him to say that although he believes you can work 4 hours per day, any work would be limited by the restrictions and limitations contained in the report.

We'll speak more next week. This is an excellent start to your appeal.


...so guess I just got the results! haha.

So at last progress is being made and I'm not so conflicted about what the heck the next right step is. What a relief! And it's nice to know that I am not crazy, that there really is some impairment beyond old age.

More news as it arrives....

Lynnwood, Co-Moderator: Lupus Forum
SLE(’00), Sjogren's Syndrome, Raynaud's Syndrome, SAD, Depression, Herpes Simplex 1
Piroxicam, Plaquenil, Prednisone(was 15mg, now 8mg), Cellcept, Xanax, Trazodone, Boniva(3mth shot), Wellbrutrin SR, Valtrex
Links: DIAGNOSING LUPUS (4 of 11), LUPUS INFORMATION, LUPUS RESOURCES, Donate to HealingWell, Drug Interactions


Trying2BFree
Regular Member


Date Joined Oct 2005
Total Posts : 251
   Posted 7/9/2008 2:06 PM (GMT -7)   
That is both good and tough to hear, I'm sure. I hope they will get this resolved quickly for you. It makes me so mad that the insurance companies can do this to people. You shouldn't have to jump through all these hoops!
Jeannie 
SLE diagnosis 10/05 now changed to RA 3/06, Endometriosis 5/05, PCOS 1990
Meds: Metformin ER 1500mg (PCOS); Loestrin BCPs (Endo); Methotrexate 15mg (RA); Metanx 5mg (RA); Orencia 750mgs (RA); Lunesta 2mg (as needed); Prevacid


AlwaysRosie
Veteran Member


Date Joined Jan 2005
Total Posts : 8616
   Posted 7/9/2008 3:41 PM (GMT -7)   
((((((((( Lynnwood ))))))))

*long sighhhhhh* I'm glad the neuro was able to confirm what you already knew . . . but I'm sorry you have any impairment at all.

I hope this giant step is enough to quickly move things forward. . . and that Dr. New Rheumy says the magic words.

I'm glad you have an attorney to help you . . . . but I am hoping there is some way to collect his fee from the insurance company who laid down the big road block.

Will be watching for updates.

Blessings!

In His Grip

AlwaysRosie           "We can't control the waves, but we can learn how to surf!!"

Psalms 139

Co-Moderator - Lupus Forum

UCTD, Inflammatory Arthritis, Diverticulosis, (recent dx - Sjogrens, Crohn’s 4/08)

Clickable Links:  Lupus Resources    Lupous.Org   Lupus Criteria (4 of 11)   Lupus Chapter Locator


jhmom
Veteran Member


Date Joined Oct 2004
Total Posts : 2244
   Posted 7/9/2008 4:23 PM (GMT -7)   
(((( Lynnwood ))))) I hope this report gets things moving quickly now and checks start back up. I know this has been a stressful time for you, hang in there. Keep us updated as you can.
Stacie

Trust in the Lord with all thine heart, and lean not unto thine own understanding ~ Proverbs 3:5 ~

DX: Hashimoto's, Celiac Disease, Raynaud's, Lupus and Sjogrens
RX: Imuran, Plaquenil, Methotrexate, Flexeril, Piroxicam, Levoxyl, Folic Acid, Lortab (as needed) and magic mouthwash (for mouth sores)


hippimom2
Veteran Member


Date Joined Jul 2005
Total Posts : 5403
   Posted 7/9/2008 5:04 PM (GMT -7)   
Lynnwood, I'm glad to hear that the disability insurance appeal is going well, but on the other hand, I'm sorry to hear about the neuropsych stuff. What a mixed bag - it's nice to have validation but the whole thing just stinks. I hope the new rheumy will support what the neuropsych says. Keep us posted. Take care
Diagnosis:  UCTD (lupus) 2006; Raynauds 2006; Sjogren's 2006; lupus symptoms began 2003; UC 2008; CFS 1991; Mono 1985
Meds:  Plaquenil 400mg; Prednisone 5-10mg; Tramadol 100mg 3-4x daily; Doxepin 25-50mg; Prevacid; Evoxac; Steriod Cream and Mouth Rinse for tongue and mouth ulcers; Hydrocodone 5/500 prn for severe pain; Artificial tears

 

Clickable:  LUPUS INFORMATION & LUPUS RESOURCES.

Please allow HealingWell to continue helping others by donating: http://www.healingwell.com/donate/

 

Co-Moderator: Lupus and CFS Forums



Audrey Ann
Veteran Member


Date Joined Jul 2005
Total Posts : 815
   Posted 7/9/2008 5:57 PM (GMT -7)   
Lynnwood,

It sounds like you have the start of a great case. This is wonderful news. Isn't it crummy that the insurance company can just pull the rug right out from under you at it's whim?

On the other hand, I am sorry to hear the results of your neuro is such that you really couldn't work if you wanted to do so. I can tell from your posts how intelligent you are and this result must be annoying, at best.

Many (((((hugs))))) to you, Lynnwood! Also, can you feel the many prayers coming your way?
Prayers,
Audrey Ann
 
Lupus and RA and LOTS of Medications!
 


 


Lynnwood
Forum Moderator


Date Joined May 2005
Total Posts : 7018
   Posted 7/9/2008 6:58 PM (GMT -7)   
Thanks to everyone for the kinds words and thoughts.

I feel quite relieved know that I'm not crazy or a hypochondriac -- my brain really is different -- but at the same time it certainly isn't a result anyone wants to hear. Fortunately I have had some time to get used to some of the changes, as in fall of '06 my dysfunction was very significant -- the course of treatment with Cellcept really did miracles for my cognition and things are much, much better now -- just not like they were before diagnosis.

I have no idea at all if doctors will say this is permanent, temporary or they just don't know -- I'm betting on the "they just don't know" outcome. I haven't seen the neuropsych report itself yet (not till the 17th) but hopefully it will contain details that will answer some of these kinds of questions. I know I'll be bored silly if I don't find something satisfying to do with my time and what's left of my brain.

As for what it does for the disability insurance appeal -- yay! I'm so relieved to find out that we do have solid evidence to show I am deserving of the funds. It was very easy to me to flip over into the self-sufficient bullheadedness of my family - that everyone can and should be totally self-reliant and never, ever need or ask for help from the government or anyone else...and thus feel guilty for even applying for the disability in the first place!

I don't anticipate any problems getting the new rheumy to sign on to this -- and the attorney will get a percentage of what back pay he's able to collect. I doubt the possibility of collecting any damages or attorney fees outside of the back pay will be possible, but one can always hope!

It's just so freeing to be moving rather than standing still and waiting for answers....
Cheers,

Lynnwood, Co-Moderator: Lupus Forum
SLE(’00), Sjogren's Syndrome, Raynaud's Syndrome, SAD, Depression, Herpes Simplex 1
Piroxicam, Plaquenil, Prednisone(was 15mg, now 8mg), Cellcept, Xanax, Trazodone, Boniva(3mth shot), Wellbrutrin SR, Valtrex
Links: DIAGNOSING LUPUS (4 of 11), LUPUS INFORMATION, LUPUS RESOURCES, Donate to HealingWell, Drug Interactions


mom46
Veteran Member


Date Joined Dec 2004
Total Posts : 8198
   Posted 7/10/2008 7:16 PM (GMT -7)   
Lynn,
  I'm glad to hear you are finally getting somewhere with all this now. I know it has been a tough road for you lately. Please keep us updated and take care. You are in my thoughts and prayers.
                                                                 Babs
 
Dx: Lupus,RLS,RA,Asthma,Fibro,Sjogren's,Raynaud's,Divertic, Stroke,Atherosclerosis,Seizures,Neuropathy,CAD
Meds:arava,prednisone,plavix,aspirin,protonix,,zanaflex,xanax,
mirapex,advair,foxamax,Vytorin,folicacid,lunesta,Tramadol
 
JOB 5:18 For he wounds, but he also binds up; he injures, but his hands also heal.


cured4real?
Veteran Member


Date Joined Dec 2005
Total Posts : 1944
   Posted 7/10/2008 8:52 PM (GMT -7)   
Lynn--
Glad things are working out and hope you get the support from your rheumie you need.
Love, Marji
--Sometimes I think the surest sign that intelligent life exists elsewhere in the universe is that none of it has tried to contact us. Bill Watterson (1958-) cartoonist "Calvin and Hobbes"
Ills--Sjogrens-Lupus-like AI Disease, Hashis, Vitiligo, spinal stenosis/fusion with plate, salivary/lymphectomies, Diabetes, NAFLD, COPD, RLS, neuropathy, trigonitis, hystero, diffuse brain atrophy, GI nightmare
Meds--Plaquenil, Evoxac, Metformin, Synthroid, HCTZ, Estradiol patch, Prosed, Detrol, Klonopin, Ultram, Vicodin, Restasis, Albuterol, steroid injections and pred prn


redrose77
Veteran Member


Date Joined Sep 2005
Total Posts : 2573
   Posted 7/10/2008 9:03 PM (GMT -7)   
glad to hear you got the results that you need but also very sad at the same time. I know what it is like to have changes in cognative function. A lot of it is managed by the imuran for me, but I still struggle some days. Worse, going off imuran is impossible if I want my cognative function to stay what it is now.
Dx:fibromyalgia 2002, systematic lupus 2005- definate CNS involvement dxed late 2005, psoriasis 2006, rheumatoid arthritis 2006, PTSD 2007, multiple allergies 2005, migraine, compression fractures T11 & T12, Sjögren's, damaged periphrial nerves 2007,
Tx: plaquenil, Enbrel, Tramadol, Singulair, Skelaxin, Baby Asprin, Imuran, Procardia, Prilosec, Evoxac, Celebrex, Darvocet when things get too bad


joinery
Regular Member


Date Joined Oct 2007
Total Posts : 323
   Posted 7/11/2008 3:13 AM (GMT -7)   
Lynn.. This has being going on to long for you, I hope you get something soon. It ashame that they put us through so much knowing how sick we are!!!!! Good Luck.... Debbie
Asthma,Lupus,H.B.P.,Dermatomyostis,Gastrparsis,Acid Reflux   
                Panic Attacks,Osteopenia,Thyroid  
  Reglan,Protonix,Synthroid,Plaquenil,Quinacrine,Flexeril,Zetia,Zoloft,Xnanx,Celebrex,Abuterol,  
  Advair,Diovan,Actonel,Prednisone on and off Eye Drops,VitaminD.     
 
 
 
 


oldhippyrebel
Regular Member


Date Joined May 2008
Total Posts : 58
   Posted 7/14/2008 12:10 PM (GMT -7)   

Lynnwood

 

about 3 years go I started having cognitive problems, I started getting tested by my Neo, I can’t remember what they called it but they hooked my head up with a bunch of wires and then I was being sent for a MRI.

 

Before I even had the MRI, I got a call from the Dr. office to come in now. She started me on Namenda, It did help some. But I did keep going down hill. I got were when I was on the computer I couldn’t remember how to do things but I knew I use to be able to do it.

 

But I want you to know that I’m seeing a mark improvement now. I still have problems when I get too tired but now I feel my brain is working almost like it use to now it is just the body that doesn’t want to do what I want it to do, but I can deal with that.

 

So, Lynn I just want to let you know while it may get worse, give it some time and it will get better.

 

Oldhippyrebel  


Fibro since 97, Lupus since 99, neuropathy and other nerve damage.
On to many Meds to list, Finally got a date for SSA of July 1 after to many years of fighting for a hearing.


PattyLatty
Veteran Member


Date Joined Mar 2006
Total Posts : 2570
   Posted 7/15/2008 7:38 AM (GMT -7)   
Lynnwood,

Talk about a catch-22. The good news is that your have cognitive impairment???? and the bad news is having to fight the bureaucratic system.

So many people abuse the system that the government and private insurance are forced to work hard to weed out those people. The problem is that folks like you, for whom the system exists, have such a hard time getting help. My hubby is an attorney who sues insurance companies all the time. It's so sad to see people who've been paying their premiums all their lives, have to sue to collect on a valid claim. Really makes me mad. It makes him mad too, which is why he works so hard.

The past ten years have been hard for me, Lynn, both emotionally and physically, but I feel like I'm coming out of the dark hole into the light again. That will come for you too but the question is when. Hang in there girlfriend and lean on all of us whenever you want. You have my email address so please write me. I'll be there for you.

((((Hugs))))

Pat
Lupus, Sjogren's, osteoarthritis, fibro, renauds, restless leg, hiatal hernia, double vision, migraines, costocondritis.
cellcept, neurontin, prednisone, plaquenil, synthroid, triamterene, tramadol, actonel, tri-est, imitrex, cymbalta, lunesta, multivitamin, calcium w vit D, fish oil, aspirin


Lynnwood
Forum Moderator


Date Joined May 2005
Total Posts : 7018
   Posted 7/15/2008 9:24 AM (GMT -7)   
When it rains it pours -- fortunately I can read a book and disappear into another worry-free world!

My health insurance changed slightly July 1, and they didn't get my deductible (the fact that it was met) transferred correctly....so I need lots of med refills but can't get them until the insurance gets things straight & pays for the meds. They claim I can refill & pay myself & they will reimburse, but I don't have that much extra $$ floating around, plus I don't trust the suckers!

One day all these crazy insurance mess-ups will get straightened out and this will become an amusing story....

Glad to hear your husband is one of us "fighting the good fight" -- a shame that attorney's have to be our only champion's, but thank god they exist!

Lynnwood, Co-Moderator: Lupus Forum
SLE(’00), Sjogren's Syndrome, Raynaud's Syndrome, SAD, Depression, Herpes Simplex 1
Piroxicam, Plaquenil, Prednisone(was 15mg, now 8mg), Cellcept, Xanax, Trazodone, Boniva(3mth shot), Wellbrutrin SR, Valtrex
Links: DIAGNOSING LUPUS (4 of 11), LUPUS INFORMATION, LUPUS RESOURCES, Donate to HealingWell, Drug Interactions


MJLD
Veteran Member


Date Joined Jul 2007
Total Posts : 1048
   Posted 7/15/2008 9:30 AM (GMT -7)   
Lynnwood,
I know what a nightmare it all is. I've been right where you are. It is horrifying! I wish I had some magic solution for you. Hang in there girl! You are in our thougths and prayers! God Bless You, Judy

redrose77
Veteran Member


Date Joined Sep 2005
Total Posts : 2573
   Posted 7/15/2008 10:03 AM (GMT -7)   
Local churches, the Salvation Army, and other groups may be able to get your meds refilled for you at least once.

Dx:fibromyalgia 2002, systematic lupus 2005- definate CNS involvement dxed late 2005, psoriasis 2006, rheumatoid arthritis 2006, PTSD 2007, multiple allergies 2005, migraine, compression fractures T11 & T12, Sjögren's, damaged periphrial nerves 2007,
Tx: plaquenil, Enbrel, Tramadol, Singulair, Skelaxin, Baby Asprin, Imuran, Procardia, Prilosec, Evoxac, Celebrex, Darvocet when things get too bad


Lynnwood
Forum Moderator


Date Joined May 2005
Total Posts : 7018
   Posted 7/15/2008 10:22 AM (GMT -7)   
The health insurance should be fixed in a day or so.

Lynnwood, Co-Moderator: Lupus Forum
SLE(’00), Sjogren's Syndrome, Raynaud's Syndrome, SAD, Depression, Herpes Simplex 1
Piroxicam, Plaquenil, Prednisone(was 15mg, now 8mg), Cellcept, Xanax, Trazodone, Boniva(3mth shot), Wellbrutrin SR, Valtrex
Links: DIAGNOSING LUPUS (4 of 11), LUPUS INFORMATION, LUPUS RESOURCES, Donate to HealingWell, Drug Interactions


AlwaysRosie
Veteran Member


Date Joined Jan 2005
Total Posts : 8616
   Posted 7/15/2008 6:12 PM (GMT -7)   
AHHHHHHHHHHHHHHHHH!!!!!!

Audrey Ann
Veteran Member


Date Joined Jul 2005
Total Posts : 815
   Posted 7/15/2008 7:46 PM (GMT -7)   
((((Lynnwood))))

Stay strong - you certainly know how to fight the good fight!
Prayers,
Audrey Ann
 
Lupus, RA, and (Maybe) Fibromyalgia and LOTS of Medications!
 


 


Lynnwood
Forum Moderator


Date Joined May 2005
Total Posts : 7018
   Posted 7/23/2008 11:16 AM (GMT -7)   
Status:

1) I just got news of a Social Security Disability Hearing Date!!! YAY! August 12th!

2) Saw attorney yesterday for my Private Disability Insurance Appeal -- should be ready to send off as soon as Rheumy signs off on it! (Appt w/Rheumy August 4th!, so should go off that week!) Keeping fingers crossed that this new rheumy doesn't mess anything up!

3) Health Insurance -- still messed up....

But overall great news....so from filing appeal requesting hearing to getting a hearing: 2 years, 7 months. And time to the actual hearing on August 12th is 2 yrs, 8 mths, so there is a 32 month wait list to get a SSD hearing in Georgia right now!!! I hope nobody is waiting...Ga is supposed to be the most backlogged in the nation right now.

Lynnwood, Co-Moderator: Lupus Forum
SLE(’00), Sjogren's Syndrome, Raynaud's Syndrome, SAD, Depression, Herpes Simplex 1
Piroxicam, Plaquenil, Prednisone(was 15mg, now 8mg), Cellcept, Xanax, Trazodone, Boniva(3mth shot), Wellbrutrin SR, Valtrex
Links: DIAGNOSING LUPUS (4 of 11), LUPUS INFORMATION, LUPUS RESOURCES, Donate to HealingWell, Drug Interactions


AlwaysRosie
Veteran Member


Date Joined Jan 2005
Total Posts : 8616
   Posted 7/23/2008 1:24 PM (GMT -7)   
YEAHHHHHHHHHH !!!! Finally! Oh my gosh Lynnwood . . . I was beginning to think that your file fell in a deep dark hole!

I hope things go well for you Lynnwood . . . and I'm glad the hearing date doesn't give you another 6 months to fret about it.

I hope you'll post and let us know how the Dr. appt goes. Maybe he'll man-up and get this right.

Blessings!

In His Grip

AlwaysRosie           "We can't control the waves, but we can learn how to surf!!"

Psalms 139

Co-Moderator - Lupus Forum

UCTD, Inflammatory Arthritis, Diverticulosis, (recent dx - Sjogrens, Crohn’s 4/08)

Clickable Links:  Lupus Resources    Lupous.Org   Lupus Criteria (4 of 11)   Lupus Chapter Locator


Butterflake
Forum Moderator


Date Joined Jun 2006
Total Posts : 1547
   Posted 7/26/2008 5:27 AM (GMT -7)   
Hi Lynn. I'm so glad your SSD hearing date is finally set and it's soon! You sure are having a hard time with all this and I know you're worried and frustrated. I'm sending you lots of positive energy. Love, Butterflake 

Dx: SLE ('05), depression, diabetes, fibromyalgia, gerd, sleep apnea, hypertension, IBS Tx: CellCept, plaquenil, prednisone, lisinopril, actos, lipitor, nexeum, prozac, seroquel, celebrex, actonel prn: arthritis tylenol, neurontin, promethazine, ambien.  multi vit, C, flaxseed oil, acupuncture
Donna
 


Audrey Ann
Veteran Member


Date Joined Jul 2005
Total Posts : 815
   Posted 7/26/2008 8:36 PM (GMT -7)   
Wonderful news! I wish you nothing but the best! Thank you so much for keeping us updated.

Audrey
Prayers,
Audrey Ann
 
Lupus, RA, and (Maybe) Fibromyalgia and LOTS of Medications!
 


 


PattyLatty
Veteran Member


Date Joined Mar 2006
Total Posts : 2570
   Posted 7/27/2008 7:31 AM (GMT -7)   
That's good news Lynnwood. Keep plugging away!

Pat
Lupus, Sjogren's, osteoarthritis, fibro, renauds, restless leg, hiatal hernia, double vision, migraines, costocondritis.
cellcept, neurontin, prednisone, plaquenil, synthroid, triamterene, tramadol, actonel, tri-est, imitrex, cymbalta, lunesta, multivitamin, calcium w vit D, fish oil, aspirin


Lynnwood
Forum Moderator


Date Joined May 2005
Total Posts : 7018
   Posted 8/14/2008 9:39 AM (GMT -7)   
Finally...just found out that the appeal to the long-term disability company went out Tues, 12th -- same day I suffered through the SSD hearing ---

And both are supposed to reply within 60 days...so maybe there is an end date looming on the (far) horizon. Trying to make sure I don't count those hens before they hatch!

Of course, there is always a windmill to tilt at -- my health insurance is *still* screwed up. Like I really want to deal with billing departments for 5 different drs offices.....sigh.

Lynnwood, Co-Moderator: Lupus Forum
SLE(’00), Sjogren's Syndrome, Raynaud's Syndrome, SAD, Depression, Herpes Simplex 1
Piroxicam, Plaquenil, Prednisone(was 15mg, now 8mg), Cellcept, Xanax, Trazodone, Boniva(3mth shot), Wellbrutrin SR, Valtrex
Links: DIAGNOSING LUPUS (4 of 11), LUPUS INFORMATION, LUPUS RESOURCES, Donate to HealingWell, Drug Interactions

New Topic Post Reply Printable Version
36 posts in this thread.
Viewing Page :
 1  2 
Forum Information
Currently it is Friday, December 02, 2016 9:39 PM (GMT -7)
There are a total of 2,731,950 posts in 300,977 threads.
View Active Threads


Who's Online
This forum has 151137 registered members. Please welcome our newest member, Country girl2.
283 Guest(s), 5 Registered Member(s) are currently online.  Details
Katie95, dacarte3, Fairwind, poohcheez, otheym432


Follow HealingWell.com on Facebook  Follow HealingWell.com on Twitter  Follow HealingWell.com on Pinterest
Advertisement
Advertisement

©1996-2016 HealingWell.com LLC  All rights reserved.

Advertise | Privacy Policy & Disclaimer