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Old 12-27-2006, 12:14 PM   #1
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Cool Guys, I am at my wits end. Need your help!!!

Hello everyone. Just when you think things couldn't get any worse, they do. I will try to make this as short as possible, but I really need to vent, so here goes-
OK most of you know my situation, but for those who don't here's the "readers digest" version. I have had 2 back surgeries in the past 12 years (laminectomys (sp) for herniated disc at L5/S1, in September of this year, I woke up to severe back pain that radiated down to my left knee. Went to Doctor, then to specialist, had MRI, EMG, and discogram. As a result of all te tests, Level 2 fusion L4/L5/S1 was recommended. Surgery was initially scheduled for Dec 14th. 2 days before my surgery I was notified that my surgeon had taken a "Leave of absence" and that my surgery was canceled. They said they would find me a surgeon ASAP, which they did (5 hours from where I live) anyway I met the surgeon, he conquered that a level 2 fusion was needed and scheduled the surgery for Jan 10th (that was the quickest he could do it) anyway, although I was totally depressed about this situation, at least I knew that it would be done and at the same time I had a second opinion. I applied for and was approved for FMLA, so I was relieved that I would still have my job when I recovered. I also applied for a benefit through my employer, The State of Kansas, called Share Leave. If your not familiar with it, it basically allows other employees to donate sick and vacation leave to employees that are experiencing health problems that keep them from returning to work for extended periods of time after they have exhausted all thier leave. It is truly a terrific benefit for someone suffering from a disability such as this while waiting in limbo land for SSD or LTD.
Anyway, after fighting with my human resource manager about them not sending my application to the committee for 2 weeks, I finally had my wife fax the application to the committee personally. A week later I was notified that my application was denied. No reason was given. After a dozen phone calls, I was told it was because my Dr, did not fill out his portion appropriately. So it was disapproved. I asked what it was that he did not fill out, I was told that although he had stated that I would have a Level 2 fusion, and that my recovery would be at least 8 weeks after the surgery, he did not describe what exactly my recovery would entail? I was flabbergasted, I tried to explain what I would be going through with physical therapy, but that was not good enough, that information needed to come from my physician. Now they want that information to be given to them AFTER my surgery, not before. Here's the real messed up part of all of this- FMLA is good for 12 weeks, my FMLA was approved Oct 18th, I may have counted wrong but my FMLA will expire on Jan 10th, the day of my surgery, therefore I will be subject to termination! I am terrified that I will lose my job because of all of this. I have ten years invested with my job, and in Sept 07 I will be vested in the State retirement benefit, but if I am terminated...? I can not believe after 10 years, that they would do this to me. I have appealed thier decision to deny my application, but thier time limit to review my appeal will exceed my FMLA expiration date. I have to pay my insurance premium myself now, the state no longer has to pay thier share. I wonder how they expect someone to pay that much without an income? My wife paid it once, but it completely broke us. Because she has an income, we are not qualified for any state assistance (we do not meet the federal poverty level) what a crock!. I know it sounds like I am having a "pity party" for myself and I know that I am surely not the only one going through the "ringer" so to speak, but I really needed to vent to people who I know understand what this type of disability does to a persons life. Not only physically, but emotionally and financially. I dont Know how people are supposed to survive while waiting for SSD, or LTD to become effective during this lengthy ordeal.
I sent an e-mail to the Governor, explaining my situation and asking that she review the policy to see if indeed I qualify for approval. I pray that she will look into it as I am sure I meet the requirements per the policy. Again I apologize for whining, but had to get it off my chest, and this is far better then calling the people in charge, and chewing them out (which is really what I want to do) I am sure this would have the exact opposite effect that I want to happen. Sorry this is so long, so I will stop. I ask that you pray for a favorable outcome in my appeal to the Governor.

Porter

 
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Old 12-27-2006, 12:35 PM   #2
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Re: Guys, I am at my wits end. Need your help!!!

Porter, I am so sorry you are going through this and pray that the Governer and/or his staff is able to help you out.

 
Old 12-27-2006, 12:49 PM   #3
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Re: Guys, I am at my wits end. Need your help!!!

Porter, I think you need to start thinking about a title for that book you could write about all this! I don't know what to suggest except maybe to also call your local representative, your congressmen, etc. I know some people have gotten other types of problems dealt with by having their congressmen intercede for them. Maybe someone else on the board has dealt with a similar problem and can give you some suggestions.

Financially, I can relate. We moved here three years ago, started the ball rolling to build a house, and figured I would take a year off work while we were in temporary housing to be able to deal with selling our old house 200 miles away, keep up the homeschooling, and take care of all the technical stuff of relocating and building. During that year, I got so much worse. Now we have this house that we figured on two incomes to pay for (well, one and a half, since I worked part time), and it's starting to look like I won't ever work again. Now our insurance is telling us that the individual "cap" for out of pocket expenses doesn't include this or that related to my surgery, so we're getting a ton of medical bills that we thought would be covered. I just keep trying to peck away at the debt, but every time I think we've made a little headway, we get another major bill. I don't know how much longer we can stay afloat before we have to start thinking about selling this house. And that just overwhelms me, to even think about packing and moving in my condition!

Thanks. I needed to vent a little.

I hope things get straightened out for you before you go in for your surgery. Can you get the FMLA dates changed due to the unexpected change in the date for your surgery? Can you call and ask for a waiver, or ask to talk to the next higher up person in the chain and keep going until you get to the top? Our local paper did a story a while back on health insurance companies and their policies and practices. The shocking and maddening part of it was that the companies routinely deny different things and just hope that the patient won't follow through and argue. And most people don't! If they knew it, there's a chain the patient can go up to dispute the insurance company decisions. And you can't stop at the first link. The companies admitted that only the people who were relentless and refused to accept the insurance company's decision finally got what they wanted. But those people did get it! I know it's not the insurance company that's the problem right now for you, but what's true for the insurance companies is probably also true for a lot of other organizations. Call everyone you can think of to get some action on your behalf. Be the squeeky wheel! And squeek as loud as you need to.

Let us know how things go. I hope you get some satisfactory action!

Blessings,
Emily

 
Old 12-28-2006, 06:17 AM   #4
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Re: Guys, I am at my wits end. Need your help!!!

Quote:
Originally Posted by BlueAtlas
Be the squeeky wheel! And squeek as loud as you need to.
Sometimes this is the only way to be heard!!

 
Old 12-28-2006, 11:00 PM   #5
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Re: Guys, I am at my wits end. Need your help!!!

Porter I agree with all advice offered here and hopefully can offer some from my experience. I am in KS also. I had never heard of gangstalking before this post - so i searched it and wow. I am positive thats what the local big phone co bosses & some employees did to me during my disabling phase a few years ago - and I had 13yrs in. creeps. anyways maybe this can help you - do you have a medical leave management team (or some similar name) that administers your FMLA (who you would be faxing requests, reports, or doc would faxing/sending reports to) to check with on filing an extension on your leave? (you may have already exhausted this, I don't know) Also I recommend calling the EEOC and ADA people (Title VII of the Civil Rights Act of 1964 and the Americans with Disabilities Act (ADA) cover all private employers, state and local governments, and education institutions that employ 15 or more individuals. These laws also cover private and public employment agencies, labor organizations, and joint labor management committees controlling apprenticeship and training.) as you maybe should also file complaint there (unfortunately for me I waited too long---after this type of thing happens you tend to sink into a depression so if you cannot do it then ask a friend/relative/partner/advocate to start it going for you because for me the timeframe passed so I sat moping more doing nothing) I believe that for those of us who become ill/disabled a lot of employers (especially the one I had 13yrs with) will become a vulture on your neck and do anything to get you out of there because they decided we are burdens to their office/dept. hence the gangstalking reference and possibly why you were denied the shared leave thing - they know you are near out of time and they are working it! I would also fax in a complaint/grievance, appeal to your share leave committee with the info you wrote here about HR not sending in your app and delaying it for 2 weeks, and I would have your doc address the facts to your recovery (i don't know does HIPPA apply as to who and how much info he is required to spell out) on a memo or a "revised" application /fmla/shared leave form to fax in along with your request BEFORE surgery even though they "say" not till after (again they are working your time away for you). I agree SQUEEK now and loudly while you still have time (as in still employed during this) because after they escort you out the door and they will find ANY lil ol reason no matter that its related to your being impaired/disabled - its usually locked tight! I pray God sends the angels to intercede and help you Porter as I know exactly what you are going through right now. God Bless and Good luck with this!!

 
Old 11-29-2011, 11:07 AM   #6
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Re: Guys, I am at my wits end. Need your help!!!

Call your Senator and actually speak to him or the assistant. I did this to get my SSD and withing days between my attorney, medical records, and the senators office I had my deposit within a week.

Last edited by hb-mod; 11-29-2011 at 11:59 AM.

 
Old 11-29-2011, 01:58 PM   #7
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Re: Guys, I am at my wits end. Need your help!!!

I will pray for a favorable outcome for you, i am sorry you have had to go through so much , it is horrible when you are sick and in pain that things go wrong , 10 years is a long time , and for this to happen is a shame.

 
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