I had been in limbo for awhile now. This summer, my LTD company informed me that it was "re-evaluating" my claim because I had been receiving benefits for 24 months, and there are some limitations in my contract. The limitations are for mental illness and "self reported" (anything not measurable by diagnostic tests, like pain and fatigue) symptoms.
In truth, I was expecting a denial because the LTD company contends that I have somatoform disorder, based upon the opinion of a shrink they paid to force me to undergo a "personality" exam (they refused to give me benefits unless I did this plus a full-day functional capacity test). So I figured I'd be able to beat this easily, as it is impossible to have somatoform disorder if you have legitimate physical disease present. The letter I got in the mail on Tuesday, though, completely blew me away.
It is 16 pages long! They do mention their "diagnosis" of somatoform disorder, but they also go through summaries of medical records from 13 different doctors I have seen and have essentially discredited every single one of them! They also went through my SSDI file and "proved" that the administrative law judge who approved me for Social Security was incorrect as well.
But the most damaging part of the letter is where they go over the records of an incompetent Sioux Falls rheumatologist whom I only saw once. Unfortunately, this guy had never heard of sero-negative Sjogren's syndrome and told me that I could be cured of fibromyalgia with vigorous exercise. Because he put in his notes that he felt I was not disabled (I found out later that he did this to lots of people who were very obviously disabled), the LTD company is using this as "proof" that I can do sedentary work.
I called my lawyer. He said that he had never seen a more lengthy, complicated denial letter. He also said that this is not the slam dunk case he thought I had, that the LTD company is unlikely to agree to settle and that it will probably have to go to court, which could take years.
This would be much easier to take if I truly had a negligible case. But I have very real ailments that go beyond the arbitrary "self reported symptoms" label. You can't fake a positive lip biopsy, or a positive EMG, or a sleep study, or a glucose tolerance test, or a gastric emptying test, or an endoscopy.
Yet it is entirely possible this LTD company may get away with denying my benefits. All because I am sick enough to go to 13 doctors who believe I am ill, but not sick enough to actually be dying of anything, so all the findings are distorted to suit a company that will do pretty much ANYTHING to save a dime. Getting approved for Social Security Disability was nothing compared to this.
This is not to say I'm giving up. The appeal has already been filed. And when it is denied, I will appeal again.
But I am absolutely exhausted at the thought of the uphill battle I have ahead of me. A battle that I shouldn't even have to be waging. I have done my part to prove I am not well, yet this company can arbitrarily decide to violate our contract so that my financial future is in jeopardy.
I do have an appointment set up with the Mayo Clinic. I will go into more detail about that in another post as this is already too long. But I really hate that this one hospital visit could make or break my ability to receive disability.
One thing I wanted to ask about here: the letter mentions my neuropathy and states that it is too mild to preclude light or sedentary work. This is the statement they are basing their conclusion upon: "June 22, 2004....nerve conduction study and an electromyalgram study with mild left extremity sensorimotor neuropathy, upper extremity normal except for a borderline prolonged median nerve intrapalmar latency." Does a mildly abnormal result on tests actually indicative of mild neuropathy, or is the LTD company being misleading?
I ask because my neuropathy gets far worse when I am sitting at a desk for long periods of time, as one would when doing a sedentary job. I need to change positions frequently, to elevate my feet multiple times per day to prevent edema, and to stretch. And despite these things, I still get the numbness, tingling, electric-shock type pain and other sensations that I do not believe are mild.
I will eventually get my head together and fight this latest setback. But for the moment, I need to grieve a little and ask the world for a pat on the head of sympathy. Even disabled warriors are human.
fanfaire
