Reflex Sympathetic Dystrophy (RSD and CRPS) Reflex Sympathetic Dystrophy (Complex Regional Pain Syndromes Type I) and Causalgia (Complex Regional Pain Syndromes Type II)(RSD and CRPS)


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Old 05-31-2010, 05:17 AM #41
gabbycakes gabbycakes is offline
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Originally Posted by bernclay2 View Post
Hi Jim.

I am sorry you are having such a rough time with your case. I just wanted to throw in my two cents here. You are doing the right thing by staying involved with your case, and not just expecting the lawyer to take care of it. In my experience (I won an 8 year fight for workers comp / disability) the more you know about your case the better. Some people can’t handle the stress and so they stay out of it. But if you can handle the stress, then it can only help you to be your own advocate, and your wife is very lucky to have you involved. Even the best lawyers (I had a good one) can make mistakes, be overworked, have conflicting priorities due to other cases, or just plain forget things. Staying involved and being a squeaky wheel is the best way to ensure the best results from the lawyer. Also, at least in my case (although I would imagine this is rare), by assisting the lawyer enough to make their job easier, they accepted a lower fee when the case was done. Best of luck with your case, and God Bless You.

Bernclay-

Jim,

Congrats....Everything will start going in the correct direction.

As far as her medicare I received mine immediately because they go by the on-set date, which from what I can tell is over 2 years ago.

Congratulations again....Keep us posted.

Gabbycakes
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Old 05-31-2010, 09:40 AM #42
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Originally Posted by bobinjeffmo View Post
Welcome to the gates of hell known as SSI. Here you are 4 years into the process and still getting the run around. Well I'm sorry to say, you're far from done with it and one of the areas is regarding Medicare.

Even after you finally do get your SSI through, I think you'll find that your local state Medicaid program will be your only medical insurance solution for no less than the first 2 years. Only after being on disability for 2 years does a person qualify for Medicare and then you'll have the $110 payment for Part B coverage plus if you don't buy a supplement during the brief 7 month window (3 months before Medicare kicks in, the month Medicare kicks in and 3 months after it kicks in) you have no guarantee of ever being able to get any kind of Medicare supplemental from then on which you're going to need badly since Medicare is usually 80/20, meaning you'll still owe 20% of the bill. Actually after January the 1st, because of Medicare dropping down the amount they're paying the doctors, the supplement also kicks down meaning most patients now owe an additional 3rd bill for the difference the first two insurance plans didn't pay. In other words, once you're on Medicare you can plan on paying $110 for Part B, plus a supplement for around $150 plus Medicare Part D that costs around $35 a month with a $310 deductible (averaged out together that means most are now paying around $65 a month for Part D drug plan coverage). There's a lot of people who now have both Medicaid and Medicare together. If you want more info, contact either SHIP (a nationwide Medicare help organization that's simply wonderful) or me and I'll help you through this part of your challenges at hand.

The average person is paying around $300 just for their insurance and there's still things that Medicare won't pay for which you'll be left financially on the hook for. The fact that Medicare won't kick in till after you've been on full disability for 2 years is the other thing that hurts most people the most.

On a positive note, even without SSI, you might be able to qualify for Medicaid right now.

As far as why you were denied one more time, I'd like to think it's just another slight accident on their part, but I've become to cynical in my old age. The reason you've had so many roadblocks is not because your wife isn't disabled, it's because of there being so many people who've abused the system to death and now they've run out of money plain and simple.

I'm so sorry that you couldn't apply for SSD instead of SSI because it would have made a world of difference in both the amount your wife will eventually get plus there are so many restrictions regarding assets and total monthly income for those who are on SSI.

Best of luck. Contact me if you need more info on the insurance side of your problems. Bob.
Thanks for the response Bob. I'm a little confused with the terminology. In my state when filing for SSDI one has to apply for both SSDI and SSI at the same time. We knew going in that she would not qualify for SSI or medicaid because we have too many assets. She worked nearly 30 years, and paid into the system. Our monthly out of pocket monthly health insurance bill was around $150 per month through my wife's company. When she was terminated I picked my insurance from my work at $1000 per month out of pocket. With the ecomomy slowly crumbling my kind of specialty work was being outsourced more and more the last 5-6 years, my income dropped 40%. Soon my employer went chapter 7. My wife and I have worked our butts off for decades, we lived the american dream. Within a couple of years we now live the modern american nightmare because it is only here in the states that if a member of a family, where it takes two now to sustain a home in expensives areas where we were born and raised, when a company goes bankrupt COBRA coverage is not and never will be available. My only choice was to cover her through Hipaa at $2600 a month or $1600 per month through BCBS with no coverage for 10 months. We could not afford this. Our savings are gone and selling the house is very difficult with this economy.
So, my point Bob is even with those medicare co-pays and suplements its much better than what my wife has now which is no insurance. I'm employed and cover her out of pocket which is less out of pocket costs than picking up traditional insurance. To me an extra $400 per month through medicare is a bargain.
As far as the two year wait for medicare, I've been led to believe by my wife's representitive is the two year wait is retroactive. Another words if one applys for SSDI over two years ago then is approved, its retro, you'll qualify immediately.
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Old 05-31-2010, 10:44 AM #43
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Quote:
Originally Posted by bernclay2 View Post
Hi Jim.

I am sorry you are having such a rough time with your case. I just wanted to throw in my two cents here. You are doing the right thing by staying involved with your case, and not just expecting the lawyer to take care of it. In my experience (I won an 8 year fight for workers comp / disability) the more you know about your case the better. Some people can’t handle the stress and so they stay out of it. But if you can handle the stress, then it can only help you to be your own advocate, and your wife is very lucky to have you involved. Even the best lawyers (I had a good one) can make mistakes, be overworked, have conflicting priorities due to other cases, or just plain forget things. Staying involved and being a squeaky wheel is the best way to ensure the best results from the lawyer. Also, at least in my case (although I would imagine this is rare), by assisting the lawyer enough to make their job easier, they accepted a lower fee when the case was done. Best of luck with your case, and God Bless You.

Bernclay-
Yes the stress! The only time in my life when I've experienced something similar was when I was a kid, an unfortunate family incident that stretched to 4 years duration that I had absolutely no control over. I feel like I have no control, that my wife and I's destiny is set to be stuck between a rock and a hard place. This is not something I can tolerate and will and can not except. If my wife is denied again I'm going to sit down with family and hash out the most articulate and controlled angered letters to my senators and will not stop there. This whole episode has effected my health in that I now take medicine for blood high pressure and an irregular heart beat. Thanks for the advice Bernclay.
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Old 05-31-2010, 11:08 AM #44
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Originally Posted by gabbycakes View Post
Jim,

Congrats....Everything will start going in the correct direction.

As far as her medicare I received mine immediately because they go by the on-set date, which from what I can tell is over 2 years ago.

Congratulations again....Keep us posted.

Gabbycakes
Good morning gabbycakes and thanks for congrats! I believe you, the lawyer told us the same thing that she will receive medicare after her approval because 2 years have gone by. The medicare coverage is the most important aspect not the retro pay, she needs that coverage. It just kills me sitting here in the most powerful city in the world just outside of the city of Washington in which I grew up, to think without paying a hefty ransom per month to some rigged mumbo jumbo nonsense like hipaa my wife can forget any kind of security coverage for her health. Seems like we are in the bazarro world. What has all of this nonsense done to countless other tax paying couples in the past? What choices did they have but to divorse so the sick spouse can collect all those pennies and dimes from welfare. How again is that good to this nation and to the economy as a whole? To weed out those who are fraudulent is something that needs to be done but this isn't the way to do it, I'm not buying it for one second. When it comes to raking in the money for this central government from those americans who have a long history of working- they're very efficient However it seems when its time to pay out there is always a huge lag unless you're those poor saps on Wall Street who needed their trillions NOW.


I've gotta watch my blood pressure!
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Old 06-01-2010, 12:23 AM #45
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Dear Jim,
Please take care of yourself as you so faithfully take care of your wife..It's so hard to keep from the boiling point when you are dealing with the humiliation and frustration of trying to receive the help, treatment, and intervention the two of you deserve.
Hope4thebest
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wswells (06-02-2010)
Old 06-01-2010, 04:31 AM #46
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Jim -

We have to keep something in mind, while the polity as a whole is so much worse than we know, we choose with every breath to remain caring and sentient until the end, so it's okay.
Pete Townshend: Meet the new boss, same as the old boss!
The Who, Won't Get Fooled Again, Who's Next - 1971
http://s0.ilike.com/play#The+Who:Won...c94b6dccc92059

Jean-Paul Sartre: There are two ways to go to the gas chamber, free or not free.
Quoted by Pema Chödrön, When Things Fall Apart: Heart Advice for Difficult Times (2002)* at p. 188.
Mike


* A wonderful book and a strong recommendation.
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Old 06-01-2010, 08:31 AM #47
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I'm so sorry that you've had to go through this - my heart really goes out to you. There are so many sad, heart wrenching stories on this board. I know I never imagined that I would end up like this at my age, my illness has wreaked havoc on my family and our finances. And the stress is killing us, both my husband and I.

Who would have ever imagined???? I never, ever thought when I we first were married that this is what life had in store for us....

Ketamine has helped me a lot, and I plan to return to work in 3 weeks. It will take a while for our finances to recover. And the WC court has still not approved the treatments. I've learned the hard way that life is just not fair...

Please hang in there!! Much love and peace, Sandy

Quote:
Originally Posted by Jimking View Post
Yes the stress! The only time in my life when I've experienced something similar was when I was a kid, an unfortunate family incident that stretched to 4 years duration that I had absolutely no control over. I feel like I have no control, that my wife and I's destiny is set to be stuck between a rock and a hard place. This is not something I can tolerate and will and can not except. If my wife is denied again I'm going to sit down with family and hash out the most articulate and controlled angered letters to my senators and will not stop there. This whole episode has effected my health in that I now take medicine for blood high pressure and an irregular heart beat. Thanks for the advice Bernclay.
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Old 06-02-2010, 07:09 AM #48
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Hi again Jim.

I just wanted to add something to my original reply. Your posts really struck a cord with me. You reminded me of my 8 year legal battle and I can really identify with what your going through. I can really feel the stress and prolonged suffering.

The 8 year legal battle I went through was so long, and so damaging, and so deeply wounding to me, that it completely changed my life and how I see the world. I still feel the effects of it now, even 5 years after I won my case. It was just insult to injury, over, and over, and over again. I had never before felt so unjustifiably attacked in such a callous and hyper-repetitive manner. I had been physically attacked before, but this was worse, it was institutional, endless, unjustified, and on top of that it was by the very institution that was supposed to be helping me.

What I wanted to say, was that if I had to go though it all over again, the one thing I would do differently (the only thing I could do differently) is to create boundaries, to separate the stress of the prolonged legal battle from the rest of my life. Without boundaries, the prolonged legal battle, which was so invasive, and so on going, ended up permeating every aspect of my life.

After 8 years, I ended up with post traumatic stress from the endless stress and emotional trauma that my legal battle caused. This was made worse since I was in severe physical pain the entire time I was fighting my legal battle. It also didn’t help that I was increasingly isolated due to the treatment, surgery, and worsening CRPS.

To this day, even with the knowledge that I won my case, I still cannot turn on a computer, check my mail, look at my desk, go to certain places, or do any number of other things without feeling the lingering effects of the post traumatic stress relating to my 8 year legal battle.

So my (long winded as usual) point is, if I had to do it all again, I would try to make separations between my life and the legal battle as early as possible. I would do this to try to prevent the legal battle from contaminating the rest of my life with negative associations.

If I had to do it all again, I think I would try to have a space set aside, that I only used to fight my legal battle and for nothing else, so that I did not associate all my living space with the legal battle. I think I would delay opening my related mail until I was in that legal battle space, so that I did not associate opening all mail with the legal battle. I also think I would only work on my legal battle at designated times, so that all my time is not associated with the legal battle, similar to people who work at home and separate their work time from their home time.

I did eventually do all of these things, but I did them too late and many years into my legal battle and CRPS treatment. But if I had to do it all over again, I think I would try to do these or other things as early as possible, to try to protect myself from the lingering negative association and post traumatic stress that I still suffer from today.

I sincerely hope this may have been helpful, at least the idea if not the actual suggestions. Best of luck to you and your wife, and may God Bless You.

Bernclay-
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