Huh?

So, today I go to a new doctor... hoping for some answers and paying cash.  I tell him my abbreviated history and what my continuing medical issues are.  He looks me in the eye and says, "Whoa, you got screwed really bad."  "They didn't see the fractures in the MRI?"  "4 months?!  You're lucky you can walk."  "So, you lost your job, have no insurance, and no money(of your own)?  Well... not even the Georgia Medical College will take you without insurance.  I can give you a referral to a lawyer."

Sigh... oh the frustration of an impoverished, marginalized, minority.  Sucks to be disabled.  I guess that means I won't be getting any medical care there.

Seriously, true story... scared yet?

What a fine mess...

The last time I left you, there was still a glimmer of hope on the horizon... well that ship has sailed.  

I had "Family Medicaid", and my son and I had reasonable coverage(it paid for some things and it was an act of God or Congress for others), but we had it.  My son turned 19 on February 6th... according to the Gods of Social Services, to whom we must bow, act as a court jester, and contortionist in order to receive the most minimal of help.  I digress.  My son and I lost our insurance on February 28th, 2011, even though our caseworker documented as on our insurance cards we were approved until June, at which time we would have to submit to a review to make sure yours truly was still a indigent cripple. 

I was told I had to contact the supervisor because my caseworker had retired.  I called the supervisor six times and she did not return my panic stricken phone messages when I received the cancellation letter which had a date 5 days from mailing which was 3 days from receipt saying it might be a mistake or I could file a appeal but it had to be done by that date.  Off the the Social Services office I go.  I waited for over an hour in the office to speak to her, get this... this is the kicker.  I was called to the front desk after an hour, the woman at the desk is holding a phone out to me and says that the supervisor is on the phone for me.  She proceeds to say, I'm sorry... I am training a new person and we are going out to lunch so I need to do this over the phone.  WTF????  Seriously... I am disabled, going to PT 3 times a week, a new Neurologist who was in the process of ordering new CAT scans, a therapist once a week, my doctor, my son is going to a Neurologist, the doctor every 2 weeks for lung capacity testing and liver enzyme checks... combined my child and I are on $3,000.00 a month worth of medication and you can only imagine how much in doctor visits and are losing our health insurance...6 phone calls, 35 minute drive, 1 hour wait... "I am going out to lunch and we have to do this over the phone."  Okay.

So, I ask what is going on, we were approved until June, 2011 at which time we have to submit to a review.  Supervisor says, yes... unless your child turns 19 years old during that time.  I say, Ummm... doesn't it say in the file what my son's birth date is?  Supervisor says, Yes... yes it does.  I say, Okay... why were we not told this when we applied, and why in God's name were we approved until June when it was clear to all that he turned 19 in February...  it is even stated in the Medicaid rules handbook we still receive coverage until his 21st birthday (unless I or he make any money).  Even in the "word definition" section, "child" is described as anyone under the age of 21.

Supervisor says, Well Family Medicaid stops at the child's 19th birthday and then the child's file is sent to Raleigh for evaluation to see if he qualifies for another medical coverage program.  I say, That is not in the Handbook, nor was that ever spoken about or explained to me... I was told "you are covered until June, then a review".  I am disabled and go to the doctors 4 sometimes 5 times a week, and my son is in need of extensive medical care at this time... our combined just medication, which is not only medically necessary, but the only reason either of us are functioning at all, is almost $3,000.00 per month.  Supervisor says, I'm sorry... I guess you'll need to go to as many doctors appointments as you can this month.  I say, it's the 12th and I have until the 28th... and that doesn't help with the medication situation after the 28th does it.  Supervisor says, No... but, you can go to as many appointments as you can.  Well, I've got to go.  Sorry I can't help you.  Bye.

Yes... yes... every bit of that is true.  Is your mouth open?  Mine is again, as I re-tell the story.

My son almost died in October... he was in deep coma for 2 days, then started to rally on the 3rd day, and sorta woke up later in the 3rd day.  He was in the hospital for about a week.  The doctors said he was a miracle, they said they had never seen anyone survive what he went through, let alone restored brain function.  He brain is damaged, miraculously not showing any signs... his lungs are damaged but healing, his liver is damaged but healing... he is in need of regular testing and medication.  He has no insurance now.

I as you know, am totally disabled.  I had just changed Physical Therapy centers and Neurologists... the PT center was starting to get an idea of what was going on.  They believed it was not only my nerve damage, but that from what they were feeling and my symptoms, it was an almost certain conclusion that when they strap your arms down to moving tables and splay you out like a crucifixion during surgery they had also torn my rotator cuff.  So, with that conclusion they were using new methods and I was moving towards some mobility.   All the while they were saying it was crucial to continue because as soon as I stopped I would slide all the way back and possibly lose any chance of getting any mobility back.  The Neurologist thought that on top of the C-6 nerve root damage and possible rotator injury, they never addressed the presence of blood in my brain over a week after my fall.  Do to my other symptoms, like the stabbing pain in my right eye and my right side migraines as well as my continuing symptoms of loss of sensation that it was a distinct possibility that I could have peripheral neuropathy or trigeminal neuralgia and that we needed to do some more tests.  He said he wanted to do a CAT and that if that didn't show enough he could do an MRI because he could do it high enough so that the titanium in my neck would not cause an echo.  I lost my insurance before we could do any tests.  I also cannot go to physical therapy anymore.

So... if that isn't enough, I have lost my apartment and have had to move back to Georgia.  Since I was denied SSI/SSDI... of course, my Medicaid was cut off, and have no more avenues to pursue.  My mother could not afford to let me stay there anymore and there was no more reasons to have to stay.  As well as finding out that my Landlord had been defrauding me to the tune of almost $5,000 in the almost 2 years I've lived there since my accident.  Oh, and that is another story I'm not even getting into.  

So, dear ones... I am ruined.  I have no hope of getting better.  By the time I go through all of the appeals with Social Security and if I even get it, we are talking years.  I will have become irreversably chronic.

Am I going to sue... if I can find a lawyer who thinks that there is "money in it".  Am I going to continue to fight these types of injustices for others... damn right!  I may be a lost cause, but I am merely a cog in the wheel, there are people in this now, people that will be here some day... I am going to fight for them!!!  I hope someone reads this damn blog... I hope they are outraged by it.  I hope they tell their friends to read this and read Rob Delsman's blog and revolt, write letters, protest, yell it from the mountain tops, and help make legislation that holds these contemptuous bastards to task as well as change legislation that allows our Government programs to throw disabled people away or hold us off until we hopefully die or give up.

Fight with me... fight with all of us!

This is from an ally's website... and from an employee of Sedgwick CMS, does this say anything to you?

http://www.gesupplydiscrimination.com/files/htm1/More%20Tales%20of%20Sedgwick%20Terror.htm

Anonymous Physician that treats sick and injured ATT Employees and other victims of Sedgwick CMS

"You have a moral compass with superb navigation of our system  to define inequities in disability mismanagement.  You will change public opinion of the process.
I only wish I had one master- my patients. My time is so encumbered by process that I have no time to advance my clinical knowledge, get reasonable and timely consultations and treatment from equally encumbered colleagues. The patient is always the looser!
How did we get here?  Why do we remain in bondage? When will the medical revolution begin? Will we always be slaves to the medically untrained decision makers in politics who view patients as cost centers with voracious consumer appetites?"

Wow... I guess they aren't as innocent as they say huh?  With this kind of practice one would wonder why people are not receiving the benefits they deserve, if their own employee's feel this way.

Big Business... Big Trouble: My Plea To All That Want to Make a Difference!!!

Big Business... Big Trouble: My Plea To All That Want to Make a Difference!!!

My Plea To All That Want to Make a Difference!!!

This is a story of people, American's, with no hope... nowhere to turn, and no representation.

I will relay this story in my perspective, fore I cannot speak the words of others suffering, but my story is the story of many, many American's. Maybe our maladies are different, our employers, our states, and our situations... but the result, the pain, the loss is the same. I heard a story about two alcoholics, one was a homeless man and the other a lawyer. These two men were at a meeting of Alcoholics Anonymous, struggling with the disease of alcoholism. The lawyer had been sober for some time and reached out to the new man, the homeless man. The homeless man said to the lawyer, “How could you know how I feel? You are wealthy, have a home, a job, and a family.” The lawyer said to the man, “Before you came here, did you sit with a gun in your hand wanting to pull the trigger to end it all because you could not live one more day in this agony?” The homeless man looked at the lawyer shocked and replied, “Yes.” The lawyer said to the man, “I guess we are the same then.” This is what I am relaying to you.

I am a 36 year old woman, a single mother. I have worked since I was 14 years old. I became employed at AT&T on July 7^th, 2008. August 2^nd, 2009 I fell down my back stairs while doing laundry. It hurt, and I had thought I had given myself quite a jolt, but I thought little of the incident. As the days went by I started having more and more pain, nausea, numbness... yet I kept going to work. Finally, the following Saturday I was at work and in so much pain that after each customer left, I would go into the back office and lie on the floor holding my head and neck and rock. I felt as if I were being stabbed in the right eye, that there was a shoe string pulling from my eyebrow to the back of my neck, the right side of my neck, shoulder, and arm were numb yet screaming in pain. My Assistant Manager told my Manager that I needed to go to the hospital, but she said I was a closer and she had plans, I had to stay. By the time I managed to get home that evening I couldn't think... the pain was so bad, I couldn't manage to get up and get to the hospital. I laid in my bed and cried and rocked... by Sunday evening I could not stand it any longer and drove myself to the hospital. I could barely see to drive and had to bring a plastic garbage can because I would have to pull over and vomit every so often. They sent me for a CT scan and gave me a prescription for pain medication, I ended up going back and forth to the hospital every couple of days. I was a Union Employee and my mother came from Georgia to help me and read my contract. She said, “You are supposed have been furnished by your manager information to file for Short Term Disability.” I called my manager over and over, left messages and she didn't return my call. I called my Local President and he called her and left her a message. After being out a week, I received a text message with a phone number and nothing else. It ended up being the Disability department which was run by a 3^rd Party company named Sedgwick CMS hired by AT&T to deal with these types of benefits.

I filed a claim. I called my case worker day after day and he was never in his office, and never returned my calls. I spent at least $200 in obtaining and faxing medical records to them. I would be accepted, then terminated, then appeal and wait 45 days for a determination without pay going back and forth to the hospital, trauma clinic, Neurosurgeon, General Practitioner, and Physical Therapy. On November the 12^th I went in for surgery and what they had thought were to severely herniated discs turned out to be two shattered vertebra with fragments lying on my spinal cord, embedded in my C-6 nerve root and had to have a discectomy, cadaver bone implant, and a titanium plate and screws. Sedgwick demanded a copy of my surgical notes to be faxed by me the next day. I was quarantined at home following my surgery due to the very high risk of infection. They would not send for them. I had to have them faxed and could not leave the house. Needless to say Sedgwick “manufactured” statements from my Neurosurgeon, my Doctor of Physical Therapy, and my Internist and printed them in a letter denying my disability on the basis of these fabricated statements. When I supplied letters from these doctor's directly denying these statements and proving these to be complete fabrication to my case worker's supervisor, she did nothing. So I went to her supervisor, then to my manager, my benefits coordinator, and the CEO of AT&T Mobility Division Randall Stephenson. Also, all the while trying to get my Union to represent me all the way to the National office in Washington D.C. without so much as an email response or returned telephone call.

My last disability check was the second week of January, for $145.00(minus Union Dues). I appealed on the basis of misconduct and provided the medical documentation to support my inability to return to work, the length of time from injury to surgery led to some serious nerve complications. On April of 2010 I was sent a final denial letter, Sedgwick said their “doctors” reviewed my documentation and determined, despite that my Neurosurgeon, Dr. of PT, and Internist deemed me disabled and unable to return to work at that time, and despite the misconduct, and blatant lies by my caseworker, that I was not disabled and if I did not return to work Against Medical Advise by May the 3^rd, I would be terminated for “Job Abandonment”. I sent emails to Randall Stephenson, my Manager, my Benefits Coordinator, and the CWA District President, pleading that they investigate the misconduct, review my documentation and reinstate my benefits. I received one email, from my Benefits Coordinator. She apologized and said there was nothing they could do and I would receive my last check within two weeks.

During all these months without pay I tried to access my Paid Time Off days and my two weeks of vacation pay and was told I could not because I was technically still on disability. When two weeks had passed and I still had not received my check, I called payroll and they said they “thought” the check had been mailed, but could not tell me anything, that I had to go through my Manager. So, again I attempted to contact my Manager and my Benefits Coordinator. My Benefits Coordinator emailed me back informing me that my vacation time had expired and so did my PTO and I would not be receiving a final check.

I have written to the President, called my Congressman, contacted the NC Insurance Division, wrote to MoveOn, to NOW, to newspapers. I was informed by the NC Insurance Division that there is no government entity that oversees these 3^rd party companies and that I would have to get a lawyer. The rest, well... I never heard back from any of them. There is one lawyer in Asheville that deals with ERISA law and she costs $200 per hour and told me that it would be a minimum of 3 hours just to review my medical records. I was told by all the other lawyer I contacted, that “There was just no money in that kind of law.”.

My son and I lost our insurance and I had to go without treatment for 2 months while the state of North Carolina determined whether or not I was eligible for insurance. I obtained food stamps, but those were cut off because someone in the office made a clerical error and took a “Contribution” form that was supposed to go to my Food Stamp worker and gave it to my Medicaid worker. I cannot get Unemployment because I was informed by ESC that I am not employable and that AT&T says I quit. I cannot get welfare because my son is 18 and I am not pregnant. I cannot get financial assistance from non-profit organizations because they only give you $100 towards your rent, but only if you can prove you can come up with the rest of it, I cannot get help with my utilities because they are in my landlords name even though she wrote a letter and I brought a copy of my monthly invoice stating that I am responsible for them. I applied for SSI/SSDI in March and it is now October and I still have heard nothing, my caseworker says it is still in determination. Then I went to the pharmacy to get a vital prescription filled to find out that within the last month Medicaid has made changes and that medication has to be pre-certified. That my doctor has to fill out a form to explain the medical necessity of the medication and then someone behind a desk in Raleigh will determine whether I really need it or not. This is a two week process and I can only refill this medication on my last day... so I had to borrow $200 from my best friend to pay for my prescription, yes... it cost $200. I will not be reimbursed because I didn't wait for someone to say yes or no. My doctor did not even know this change.

I have nothing. I cannot help my son, so he had to move to Georgia with my mother. My mother is retired and had to get a job to pay my bills and care for my son. Why don't I move to Georgia you ask? Because I would have to apply for all of these things all over again.

AT&T, Sedgwick CMS, CWA Union, and our government has ruined me. Our government is aware of the conduct of Sedgwick CMS because that company and several others like it have lawsuit upon lawsuit pending over this type of conduct, yet it continues to go unchecked. There is no government help, no non-profit help, no Union help... no interest in this whatsoever.

There are people out there, thousands upon thousands of them in my situation. However, I'd hazard to guess that less than 2% of them have families like mine. A parent that would put herself in financial ruin at the point in her life she is supposed to be able, after 40 years of teaching, to relax and enjoy her retirement... but has spent most of it, and gone back to work to support her disabled daughter and her grandson. If it had not been for my family and my best friend, I would not be writing this letter. I would be dead. At 36 years of age I would have taken my own life because there was nothing left and no one to turn to, only chronic pain and poverty. I wouldn't even have been able to live in my car, not only can't I drive... but I wouldn't have been able to pay a tag fee and my car would have been towed for being illegal.

So... whomever reads this letter, I beseech you, get this out. Look up Sedgwick CMS on Google, see what you find, read about the horrors this company has committed and all of the people suffering like me. Contact your local Government Officials, write letters to the President, to the newspapers, get the word out. Don't let these Big Business' destroy the fabric of this country, the people... we are people. We are not something to be dropped in a crack and walked over without thought or care... we are your sisters, brothers, mothers, fathers, aunts, and uncles... we are your children. Help us.

Bringing a Knife to a Gun Fight...

I have spent over a year fighting huge companies for my earned benefits... I have fought AT&T, Sedgwick CMS, CWA Union, State Senators, NC Insurance Division, National Labor Relations Board.  I have fought and written to News Papers, Blog Sites, Senators, the President of the United States, Congressmen, NOW, MoveOn, and every other agency, institution, and Civil Liberties organizations I could think up.  No one will respond to me, no one will write me back, to acknowledge me, no one will do anything...

The worst thing of all is that this isn't just about me... it's about all of the other people like me, but without families to help them.  People that commit suicide over the ruination of their lives and the devastation of their families, people that live in their cars with their children while they suffer in pain, chronic illness, loss of limbs, and worse without financial help waiting for the bureaucracy of the government programs like Medicaid, crossing their fingers hoping that in the 2 months of waiting they will be granted insurance... then to find out that the medication they need is on a "Pre-Authorization" list when they go to fill their prescription and have to go weeks hoping that Medicaid will not supersede their doctor's orders and deny the medication they need that costs $200.00 without coverage and have no money to pay for it.  Or getting a letter in the mail telling them that the one good thing they had, Food stamps, have been cut off due to a clerical error.  Now, not only do they not have medical coverage, prescription coverage, money, but no food either.  Then, after applying for SSI or SSDI in March... not word still in October... knowing that 90% of all people are denied the first time and that they will have to find a lawyer to represent them on contingency to help them to try to obtain a service they have worked their entire lives for... and that when they, or if they do finally obtain, the lawyer is going to take a huge percentage of their first check and that is after a year or more of waiting without income because they cannot collect unemployment, since they are disabled and cannot search for work and that when their previous employer terminated them for being disabled they did so under the cloak of the hired henchmen that sit behind desks and override the medical findings and opinions of medical specialists and determine that despite Neurosurgeons, Doctor's of Physical Therapy, and General Practitioner's determining that you are disabled, that in their opinion, you are not, and demand you return to work Against Medical Advise, despite your inability to due your job or you will be terminated for "Job Abandonment" which in laymen's terms means you quit... and again you will be denied something you have worked your entire life to be able to utilize if lightning strikes.

So... during this excruciatingly long duration that this person has no income, they go to non-profit organizations for help and are told that they will give them $100.00 towards their rent, but only if they can prove they can come up with the remainder... or sorry we don't have that kind of money, or sorry we don't pay for those kinds of prescriptions... and like everything else, they are turned away.  So, if they have family that are willing or able to help them, they go to stay with them... and they continue to fight for what is rightfully theirs, or they sleep in their cars until one morning they realize that they can't keep their families in a car and they are separated to stay in different shelters, if they can get in, for one night at a time with no guarantee that they will be able to get in the next night.

So... with this being said, it sickens me to think that no one is interested in this.  That no one cares.  That none of these so called "Liberal Organizations", or "Service Organizations" will respond, will take this to the press, will look into any of it, yet now that you have emailed them, they have your email and they send you requests for donations... and pretend any of the nastiness that is going on just doesn't exist and ignore your pleas for help... never respond to you at all and yet have the gall to put you on their mailing list for what they put in their subject lines as "Outrage", and ask for money for some weak agenda, some flavor of the day cause and act as if your plea never existed.

We don't matter.... none of us.  If we don't stand as one voice and shout at the top of our lungs at the injustice of this, we will continue to be nothing other that something that has fallen in a crack and walked over daily without thought.

Ok... so here it is.

It seems those wonderful people at Sedgwick CMS and AT&T have won.  They have lied and denied me into the poor house.  They are starving me out.  They are actually disregarding current medical documentation that states my current condition as being unable to return to work.  I mean after I had this damn surgery they told me average 4 to 6 months before any improvement is evident and it can take a year to a life time to be comfortable and healed again.  So... I was aware of the bumpy, painful, and frustrating road to recovery that lie ahead for me.  I just didn't think that the worst part would be to get the benefits I am entitled to under my employment contract.

I honestly would be farther along in my healing process if it weren't for the exorbitant stresses put on me by my employer and it's hired thugs.  Which is so ironic.  I mean if they would have been honest people, and just went by the documentation provided by the professionals attending to my injury, and provided me with my disability.  I would probably be back to work by now.  But because even as hard as we try to not let the stress into our consciousness, our bodies react to it.  It's an instinct, it's called fight or flight.  We have no control of this and when you have the kind of injury I have, the last thing you need is to have your body be a clenched fist.  No healing of any kind is able to happen.

So... as I was saying.  It looks like I am going to have to return to work AMA(Against Medical Advice), which not only makes me a liability to my company, but puts me at risk of worsening my condition to the point of it becoming irreversible.  Nice huh?  For a sales job.  Because, it was made perfectly clear to me not long before my accident, that the promises made in training and by management, that I was going to be educated and groomed for another position more suitable to my professional resume was just another lie they told me.  Because, not only couldn't I get a release to even apply for new positions, but there has been no classes provided to put me in a forward direction.  So, essentially boys and girls, I am going to have to risk permanent problems, problems that I would not have had to worry about with a full treatment regiment and the blessing of my medical professionals, for a lousy sales job that is so beneath my credentials... it's embarrassing to tell people who know me what I do for a living.

Thank you Sedgwick CMS and thank you AT&T for caring so much about me.