OK LTD Company investigated me!

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esoR
Veteran Member


Date Joined Jan 2007
Total Posts : 4147
   Posted 4/15/2011 8:26 PM (GMT -6)   
My goodness it has been a harrowing day. Today I got the files from my LTD ins. co upon which they based discontinuation of my benefits. Regardless of what anyone says, writes, or thinks, I am simply not up to resuming full time teaching. Period. That is just how it is. This ins co actually spent a LOT of money on private investigators to stake out my house, many times early in the a.m. as they thought I was working and defrauding. I had made it clear to them that I need 10 hours of sleep per night (hence no early rising for me). So they had some investigator sitting outside my house many days at 6 a.m. I get up around 10:00 a.m. and am not out the door until around 1:00 p.m. to do errands, etc.

PLUS, yes I have been traveling WHILE I STILL CAN (God forbid, but with gut adhesions in remission one never knows) so had they paid attention to the dates of my being away traveling or visiting they would have known I was not even home.

THEN they followed the lawn mowing man to his apartment thinking he was my boyfriend and thought I would be awaiting his return at his apartment.

Plus apparently they were on my property looking into and behind my garage. Sometimes they did register with the police other times they did not.

I called the ins co analyst and I said I would have been happy to just sit down and speak with them about how taking a vacation is not like full time teaching....12 hour days and so on. They also did find that I had some info on some web site about gut adhesions but so, yeah, I have experience with that.

My whole being injured medically, then all the "it's all in your head crap" then being investigated like I am some type of criminal is beyond belief! All I can say is that I better NOT get billed for the investigators they hired to investigate me. Can anyone top this? I am absolutely beside myself. Rosemary

Disneynut66
Veteran Member


Date Joined Apr 2009
Total Posts : 587
   Posted 4/15/2011 9:19 PM (GMT -6)   
Rosemary, that is awful. Can you appeal? I know there are people out there who are fraudulent, but it must be so upsetting to you because you know how sick you have been. I am thinking of you and hope things get better.

Oh, by the way, my friend who was a school psychologist had to fight when they denied her disability that she had through her school. She won and is still on disability...that was many years ago.
Diagnosed 2006. 1st step of 2 step j-pouch 1/3/11. 2nd step April 4, 2011. So done with this disease.

esoR
Veteran Member


Date Joined Jan 2007
Total Posts : 4147
   Posted 4/15/2011 9:47 PM (GMT -6)   
I am doing my appeal letter now. I end with analysts and doctors can write what they write. But only the patient knows how they feel and what they are up to and not up to. The iatrogenically injured patient has to fight for their life. Then it seems they have to fight politics for the rest of their life, however long that may be. Please consider my appeal.

Then I accounted for my sleeping late, the guy mowing the lawn, and the green vans which were the DPW pumping out my flooded basement. Oh, lordy. I am appauled at what people do to one another. Each time I go to write my book, some worse thing comes along. I have NO CHANCE at winning this appeal, but at least I am trying. I keep it civil and actually compliment the rep I am dealing with as she is at least empathetic. Thanks for your message. Rosemary

2b ColonFree
Veteran Member


Date Joined Nov 2008
Total Posts : 2603
   Posted 4/16/2011 2:12 PM (GMT -6)   
oh no, Rosemary, i hope it works out for you. they refused me too and i appealed. i also don't feel i'm able to go back full time and need help for a while. my appeal helped some. now i only need to find a part time job. maybe in about a year or two, i'll be able to do full time.

good luck!!
Hodaya
06/05/2007 - STARR procedure
colonic inertia w/pelvic floor dysfunction
08/16/2009 - total colectomy w/ileorectal anastomosis
07/08/2010 - loop ileostomy

esoR
Veteran Member


Date Joined Jan 2007
Total Posts : 4147
   Posted 4/16/2011 2:28 PM (GMT -6)   
Thanks Hodaya. I just finished the investigation rebuttal and am proof reading it. What a thing. I just gotta stay OK. Once a patient gets injured by a doc they are toast for the rest of their life politically if not physically. If someone is hit by a car or has an honest dieseas they are regarded more highly. I could never move far enough to get away from the stigma. It is all such a nightmare, RJ

Gilda
Regular Member


Date Joined May 2009
Total Posts : 194
   Posted 4/16/2011 2:30 PM (GMT -6)   
Hi Rosemary, I think it is a crime that they are "investigating your actions" instead of trying to make retribution for the terrible harm they caused your body (mind, spirit). It always seems that the only people who really believe our stories are the ones who have actually experienced the trauma of it all! I think you are a very strong and smart lady. Keep doing what you are doing and maybe you can at least "get them out of your life!" You deserve much more than that though and I hope you get some compensation. In the meantime, just try to enjoy the good days!

Gilda

2b ColonFree
Veteran Member


Date Joined Nov 2008
Total Posts : 2603
   Posted 4/16/2011 3:05 PM (GMT -6)   
i know what you mean. you'd think they will have compassion for all you've been through, but it's like you're being investigated as if YOU were a criminal.... as Gilda said, what THEY'RE doing is a crime. keep us posted.
Hodaya
06/05/2007 - STARR procedure
colonic inertia w/pelvic floor dysfunction
08/16/2009 - total colectomy w/ileorectal anastomosis
07/08/2010 - loop ileostomy

esoR
Veteran Member


Date Joined Jan 2007
Total Posts : 4147
   Posted 4/16/2011 7:31 PM (GMT -6)   
Thanks Gilda and Hodaya. IF I ever get to write my book, it is going to be about the road one can go down IF the surgery they have goes awry or they unknowingly tangle with bad medical practices. I was always so naieve and thought, if something happens it can be fixed. I am lucky to be alive the best that could be fixed and I am grateful. BUT the whole political scene that follows is something I don't think any potential patient is even aware of. It is like being punished for being seriously injured by a wrong surgery, done wrong, then no follow up.

RiddleMeThis
Regular Member


Date Joined Nov 2010
Total Posts : 269
   Posted 4/17/2011 4:02 AM (GMT -6)   
Is there anyway you can get an archive of your posts here on HealingWell? I'm just thinking you can use it as evidence about what you have to go through everyday. By showing posts of you sharing your experiences on here may hellp some, at least I'd think. Also, if you had any trouble with proving you were home, all posts are time stamped...that could possibly help?!

I find it completely outrageous! I mean I do understand that insurance companies need to cover the butts, but really? I'd give them hell :)

2b ColonFree
Veteran Member


Date Joined Nov 2008
Total Posts : 2603
   Posted 4/17/2011 5:24 AM (GMT -6)   
my gosh Rosemary..... yes, it is so so sad..... i'm sorry you have to experience all of this. hope your appeal works and they give you the help you need so much!
Hodaya
06/05/2007 - STARR procedure
colonic inertia w/pelvic floor dysfunction
08/16/2009 - total colectomy w/ileorectal anastomosis
07/08/2010 - loop ileostomy

esoR
Veteran Member


Date Joined Jan 2007
Total Posts : 4147
   Posted 4/17/2011 5:32 AM (GMT -6)   
Thanks Riddle. I appreciate your thoughts. BUT I could actually be politically screwed over MORE if these posts were ever found. It is me being PUBLIC about my case. In fact one of the people who investigated me said they Googled my name and found that I had made a post about post-op adhesions. No big deal, but I have also posted about my case, likely not smart of me to have done that, but there comes a point where you have to have the support you need to survive, hence my joining this site. PLUS, I have info on the medical political world that I honestly feel others should be warned of or be made aware that it exists.

As far as proving I was home, I could have done these posts from anywhere in the world on any computer. There is an old saying, "Anything you say can and will be used against you in a court of law." That applies to anyone who has been injured at the hands of the medical world. Sunday, today, I am vowing to finish up my defense of this silly undeserved investigation, merge it with a chronology of my whole ordeal, a copy of my law suit, my final claim appeal, an article about how horridly Iatrongenically injured patients are treated even politically even if they get their life saved, cc the whole thing to my atty and to my school, and end with a closing statement, "I would challenge anyone to go through what I did and be able to resume the rigors of full-time teaching as though nothing had happened to them. I know that I cannot. Respectfully submitted, Rosemary" send it to the ins co, Then the chips will fall where they will.

Then off on my next vacation. If I was totally secure that I would remain physically OK this would all not get me so much, but the truth is I could reobstruct of some left over adhesion at any second, would die, and nobody would give a flying hoot that I am dealing with; the "system" would just say "one less." It's a truly scary world. BUT with the better scenario I will stay OK, enjoy life as much as I can, successfully sue, then hopefully be able to affect some sort of change. I want to work toward getting better legislation to get repeatedly sued surgeons out of the OR. My defendants do the same procedure as they did on me twice per week. The lucky patients end up with bags and the unlucky just die. This goes on twice per week. This is criminal medicine for profit and there is no vehicle to prevent it. Even if I win my suit and recoup all lost benefits and so on, my defendants will keep on doing this. The Med Board is FOR doctors, not patients. I talked to an iatrogenically injured man and he said we need a patient board of medicine in each state where repeat offender docs are dealt with. What I learned is that unless a doc breaks a law as in drug abuse, sexual molestation, non-payment of taxes and so on, they are immune from consequence. This I have found to be true. My defendants have a team total of 13 suits and 5 claims on them, that is way tooooo many. Any doc can have one or two suits in a career but 13 is over the edge. They may even have more, but 13 is all I can find.

So thanks for your ideas, I wish there were a vehicle to get injured patients not to be viewed as the criminal, but they are, sadly, plus WE get investigated. Thanks for your ideas and understanding, Rosemary

andorable
Veteran Member


Date Joined Jun 2005
Total Posts : 981
   Posted 4/17/2011 8:55 AM (GMT -6)   
I am so sorry to hear all thats happening to you Rosemary, what they are doing to you is criminal. I have adhesions and know how extremely painful they are too. Your in my thoughts and please keep us posted. Good luck and take care
Doreen

frostyboy
Regular Member


Date Joined Mar 2011
Total Posts : 272
   Posted 4/17/2011 9:33 AM (GMT -6)   
Just wanted to say that I am thinking of you Rosemary!!!  :-)

esoR
Veteran Member


Date Joined Jan 2007
Total Posts : 4147
   Posted 4/17/2011 11:05 AM (GMT -6)   
Thanks everyone for your cheers. I know this will do NO good at all, but I am going to go for all it's worth and enclose with my appeal information on the white coat wall of silence and how I have been smeered and slammed by some docs, the insurance co, I'm going to do a tell all. I simply don;t care anymore. All of it is true, I am creating nothing, it are they who are creating things to use against me because they have nothing to use against me. This may be the book I've had in me to write. My suit is all public information, so submittting to them that info as it stands, is something they are privey too anyway. WIsh me luck. You may see me on 20/20 yet! Rosemary

blueglass
Veteran Member


Date Joined Dec 2010
Total Posts : 3332
   Posted 4/17/2011 11:33 AM (GMT -6)   
Good luck Rosemary, and let us know when the episode is going to air! I think it's always good for us when we act with integrity, even if others can't or won't hear it. This is incredible, and very scary. Nice to know where our insurance dollars go.... hang in.
48 years old, female.
2004 dx indeterminate colitis. Many drugs, minimal success.
2010-11 Official dx Crohn's colitis. Crazy complications -- cutaneous Crohn's, Erythema Nodosum, marginal keratitis, high fevers. Out of good drug options, tired of scary drugs.
Feb 2011 -- proctocolectomy with permanent ileolostomy; abscess, blood clot. Still healing, still glad for the surgery

esoR
Veteran Member


Date Joined Jan 2007
Total Posts : 4147
   Posted 4/17/2011 12:32 PM (GMT -6)   
Thanks blue. I am going to have to send my atty a copy of everything I send the ins co as it would not be good if he did not have all copies of all my communications. He may not be thrilled, but none of what I am saying is untrue and I support everything I say with attached articles, documentation, copies of xrays, etc, etc, etc. Then with their investigators not seeing me around in the early a.m. it was like I told them I have to sleep a LOT. So they paid this PI company $750 per session to sit and watch my house as I slept. Yeah, I see what you mean, our insurance dollars at work. If my suit is dropped for any reason, I will be going to the media, as this is now WAY over the edge. I did just write the tell-all. It's all factual and I have all articles. It is sort of like doing my thesis all over yet again. BUT, just gotta do some copying and developing of pictures, then get ready to send off. I could not get out of bed until noon. This is seriously depressing, but I feel better now that i have acted with integrity as you say. SOme times you just have to tell things like they happen and be upfront. I am sure all of this will be used against me should my case go to trial. BUT the defendant depositions keep getting postponed off and off. Even my atty says sometime it is my firm who postpones them which makes no sense. BUt out for a walk as it is a nice day. And one to be lived not mired. Will let you know when my story airs. Glad I'm going away

Another UC wife
Veteran Member


Date Joined Jun 2007
Total Posts : 2111
   Posted 4/17/2011 1:22 PM (GMT -6)   
Good Luck ... it is not easy taking on "the big guys" for sure.

We have been 100% in the right a few times over the years in various circumstances (nothing like what you are experiencing however) and regardless of all the facts and details we were armed with it was a lost cause. The hardest part is dealing with the fact when you know you are right and still perceived as in the wrong, not telling the truth or whatever. The personal angst it leaves you with is not fun when you are a victim of circumstance(s) and you feel your integrity has been diminished.
64 yr old male suffered with UC & in May 06 had a severe flare & hospitalized 6 days...various prednisone treatments leading to steroid dependence and osteopenia, 12 asacol, 200 mg Imuran, failed remicade infusions Jan-May 2010 Dependence on pain meds. Made decision 6/10 to have surgery which was on 12/17/10 (total proctocolectomy & ileostomy - unable to have the j-pouch) and no longer in pain.

esoR
Veteran Member


Date Joined Jan 2007
Total Posts : 4147
   Posted 4/17/2011 3:06 PM (GMT -6)   
Exactly right UC wife. I have a new slant on this now. I am still going to file my claim and clear up all of the lies told by the investigators proved out with pictures and so on. However, I am thinking as long as my LTD ins co told me they have doctors on staff that look at all these things, I may just do a letter asking the appeal reviewer to ask their reviewing doc why I have the residual chronic fatigue, lightheadedness, dizziness, limb weakness and so on that is now the disabling factor that is preventing me from working. IF they are so interested in me returning to work, why not look a the records with an eye toward diagnosing cause then prescribing cure for my residual issues of what I have been through. My local docs have not been able to do this.

Maybe I will just turn the tables and say if you can get me feeling normal again, then I would go back to work. As long as I do not feel able then I can't. There may be a way to play this yet. More ideas welcomed. RJ

esoR
Veteran Member


Date Joined Jan 2007
Total Posts : 4147
   Posted 4/17/2011 8:41 PM (GMT -6)   
Did it! Tuned the tables. Provided correction to 7 of their errors in THEIR reports. Provided pics of my house that did not match the description of the one they gave in the surveillance reports. Also said as they did not see me about in the early a.m. it means I really do sleep late. Guy mowing my lawn means I can no longer mow it. Then they listed people as my "associates" that I don't even know. Then said I may have 2 residences which I do not. I didn't really have to work too hard once I got into all their paperwork as they made so many errors it just strengthened my argument for LTD.. THen went with my idea of, if none of my docs can solve the riddle of the lightheadedness and chronic fatigue maybe they can find one who can and make me ABLE To work again as that would benefit all of us. Not as hard as I thought once I saw all their errors and lack of logic. cc to atty was a nice touch too. I cannot believe they paid PI's ALL that money to survey me then they did not even see me as they came when I was sleeping. In a way this is sort of funny if viewed in the right light. NONE of it is funny, but what they paid the PI's would have equaled many months of continued benefits they could pay me. RJ

esoR
Veteran Member


Date Joined Jan 2007
Total Posts : 4147
   Posted 4/19/2011 2:48 PM (GMT -6)   
OK so after spending all weekend on the rebuttal, my ins rep says they have closed the investigation satisfied that I am not working and collecting, then says if I turn in all this stuff it could retrigger investigation. I'm like WHOA! BUT I did send in the most pertinent stuff, pic of my garage with remote door opener as in I cannot lift a garage door like the investigator implied when he said mine was a manual door. Then I sent in before and after pics of me before orignal injurious surgery and after when I'd completely lost all muscle mass and pics of my stoma, bag, bag full and in need of emptying which could not wait in a teaching situation where I could not leave the kids. Plus my claim appeal I had already sent in. So who knows, just too bad I spent all weekend on this. Oh, well, at this point, am just going to take a nap. Rosemary
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