[MsVickie]

Ok im fed up and need a vent.

My seizures have had me out of work since May20th. I have been going back and forth with the short term disablity people about getting in the proper forms documents etc. Yep today is July 2nd. I have been though this before. I knew what to expect and how to stay on top of it. I started with the initial phone call starting the claim. Giving them the Drs phone numbers fax numbers and addresses. This is somthing I learned from the first time I filed. Get it together. I would save a week or so them trying to get them all. They would fax a request a realse for records and have it back within 15 days which is a state law in Virginia. I called them 7 days later to see if they needed anything else to process the claim or if I needed to call and tell them to send somthing else.

I was then told I didnt have a active policy and needed to contact the middle person life times benefits to see why. I had paid my premiums which come out of my check. Upon calling them they had a glitch in there system saying yes I had coverage but when I went to part time in March they didnt know how to apply the money? WTF? I got that straigthed out and was told it would be fixed and within 7 days it would show up in Prudentials policy that a lapse of coverage never occured.

So I call them in the 7 days and find out since it was a problem my claim was denied. So it had to start over but they still had all records and would attach them to the new claim. After 3 days I call and say is there anything else you need....well yeah etc........etc......... etc...... I make the call get it took care of. Call three days later and repeat what do we need now ok we need...... etc........etc......... etc...... Ok im freaking out
I go download the form they will be sending me out they need from me....... but it wont be sent out for 4 more days from there office. I say nope let me down load it and fax it to you. I did so. They get everything they say they need. Then this past monday I make another call. They have EVERYTHING THEY NEED and I should hear somthing Wend. ok I wait until 2pm that day. Call them and find out they need more from my employer ........the last day worked the first day of disability. I say ok I called Human Resorces and had them call. I wait until this evening to call because one nice person there told me If I could get it handled buy today I could get my money going because they would be closed Friday for the up comming Holiday.

The claims manager finally called me back..... telling me the following..........

You have a date to return to work as of Nov 1st at the earlyist why is that? MmMm because the Dr told me That was the earliest he would release me. Why cant they get you in quicker to UVA for the testing before Oct1 st? This was the date I was given and am on a cancellation list to be seen earlyier if they have one. Then she tells me the following........I can tell you now they will not let me pay you short term until Nov 1. The records we have now do not support you being out that long ( even though they have all of them) She states then to look at it from there side of things. I said mam listen.....I pay my premiums incase somthing like this happens. I do not like the return date to work no better than yourself but right now its what I am told. She decided to pay me my back pay....... until June 29th. Then hold it until my Drs are recontacted and sent a speical request form for more detailed information about my seizures. I personally give her their phone number the fax numbers and addresses. Then it will be sent to the big bosses of the company and they will detirmine if they will pay or not????????? Then at that time if I am owed any back pay they will send it.

Then the lady ask me exactly why I feel I cant work.
Well I cant drive its 18 miles one way however my spouse had drove me to and from work since November. In the state of Virginia I cant drive for 6 months after my last seizure .She states that is not a good reason. We have no public transportation here. That is still not a good reason. Im in the boonies. I didnt tell her that part.

Then explaining the seixures to her she felt that was no big deal what so ever and said well its gonna take more than that......... even though I have seized at work and not knew it until im coherent again. Then comes the sleepiness for hours I have to sleep after one. Im a pediatric nurse. She said ok that still dont matter ...... They have tried alot of meds and the only one that seems to work to any extent im maxed out on....... dont matter....... she still thinks I will be denied any more benefits?????????

You all have seen me express my wanting to work and hating to not work or cut back hours. Its depressing as hell. I have tried to keep all of this to my blogs but didnt this one. I took this insuance out in case of anything GOD forbid to happen to me while working so I would be able to atleast feed my family and pay bills. Its only 60 percent of your check but its somthing. I said mam I realize its gonna be past the 5 month mark of my coverage and I do have long term disablity to she said I dont think you will get past 4 weeks paid myself. Yes she was snooty and then above all esle tells me this..............We have processed your claim SUPER fast. I said what from May 20th until July 2nd is fast she said yes. We have up to 45 days.

Not that its gonna help much unless a miracle happens with the above....... I did call the Long term place and they told me how long ahead of time to submit and get a claim started so it wouldnt leave me broke trying to get them paying. Somthing tells me if this dont go though I will have to get a lawyer. The same ones that fought Mikes Social Security Disabilty claim. Im skilled in this disablity area so this lady I do think is probally overworked and looking foward to a long vacation. I try to look at the best of everything but this really pissed me off today. Emensley!!!!!!!!!!!!!!

You ever seen a news piece doing a survey on if you lost your job tomorrow and had absoluty no money comming in how long would you last? I think I found out.

Thanks for the rant.......... Im still having seizures and seeing a thearpist for sleep problems........other than that im fine. If you see me driving though PA stop me im heading for the Prudential office LOL!

[Trulykath]

I just love you.....I hope you get it all worked out....thing is, Why are you seizing...do they know?

[kitty56]

I am so sorry that you have to go threw this and hope everything works out soon for you.

[MsVickie]

They dont know. It can possibly be brought on my stress etc......... not enough sleep etc............ after today and getting so mad we shall see. I dont go to the ER everytime I have one. Why? Because its a mandate 2 day stay in ICU if they have a bed for you. Scans xrays MRI etc. Ok the scans and stuff dont bother me. Then 2 more days for them to let you go home. I might have to go on purpose to get this back in the records who knows.

They have never found out why I have them or What triggers them. If they would have I wouldnt be going though this right now. I dont want them . I dont want to have them. Because I dont remember them and if I do its just pieces of it. I zonk out for hours.

Now think about this as much as I have and see what yu would think or do

You walk into Drs office lets say any im in peds. And you have a nurse call your name who is having small tremors without knowig it. aka shaking a bit. They bring you back getting a medical history and they just stop talking may fall out of the chair may not.... strart rubbing the chart or her clothes or patting them. Any thing you say to this person they dont respond. For ever how long it takes then when they Wake up...... they have no idea how you got back there who you are and what you have asked them. Or going taking a patient down the pharmacy and sitting down the patient goes on and finds it because im not answering them. I set there who knows how long doing who knows what until someone touches my arm and ask if im ok. Me being coherent is like waking up somewhere I had no idea how i got there or what I was doing. Or walking you down the hall to your room and the nurse keeps hitting the wall to one side running into it because she has no balance. Yes all the above have happened.The one med that helps me im maxed out on the dosage. Keppra 2000 mg twice a day. It controls them the best it can. The other one my dr placed me on the neurologist pulled me off it stating it breaks down inthe blood stream as fhenabarbiytol anddoes not want me taking it. To much of a sedative. It didnt help the week I was on it anyways. When I first had them I went to the ER placed in ICU and the test began. The Mri showed a neuromia in my putitary gland. Its large. The followup MRI in March showed it had not grown or shrunk any.The endrocrnoligst says its a big one and we will watch it. So yall know as much as I do.The Dx they have on my records right now is Partial Complex seizures with no know prognosis at this time. My hands are up in the air now. Im very mad........over the disability and i mean mad.

[Kenyar]

i know its easier said than done but dont worry. it will work out. insurance ppl dont care. a claims manager doesnt want to care--after all your claim is making her work HARD before a holiday weekend. she cant really tell you it willbe denied. the NURSE should be speaking directly with your dr regarding this. so, so far you have a case if need be. its being mishandled from the get go. i think sometimes ppl at the claims office get off on the power they THINK they have...another one of those things that just SUCK. im sorry...
i know its tough but in the end you will get all you are due. hang in there.

[dixieladybug]

I am so sorry to hear that you are having such a hard time. It is seems bad things happen to such good people sometime. I hope they get this straighten out soon. You pay for insurance hoping that you wont have to use it then when you do they don't want to pay it??? That is just so wrong.. hang in there tomorrow will be a better day I pray. (((hugs))) dixie

[MsVickie]

Thank you all for the kind words and encourgement. I know your all are right but as steaming as I am over this witches comments to me today I cant be soothed. The hubby huggs me when I start crying ands tellls me Im doing all I can and then stays away from me for the rest of the time. Smart man considering the day.

This is exactyly why upon completing school I had a job with Athem BCBS . They tole me I was hired but had to ask me one more question to be sure I could do it. it was this.....

When your given a claim and its not somthing we do not cover or find they cant come up with a good enough reason why per say why they need more chemo and we have to deny it would you feel ok to tell them no? I said I need to keep looking for a job and left. I dont play GOD and that was the postion I felt at the time they put me in. The turn over in those type jobs are high needless to say because you have to go home at night and sleep with your decision you made that day.

[4Kate]

Vent away. I have not to deal with your exact situation but I have other ones like it. Just document everything and dont stop fighting! Hang in there, it will all work out!

[waitingintn]

Vickie-hang in there and keep fighting. Seizures are scary and can be so dangerous for the patient. You have always been such a huge supporter of me---I hate that someone is doing this to you. What do you drive so I can watch out and make sure you are not heading to the Prudential office wouldn't want you to go "postal" on anyone--even though I understand the feeling sometimes!

[MsVickie]

Keely your a nurse I think....... what do you think about this. When the two Drs you see all the time tell you you cannot work what so ever until they find out more and are trying to then the short term place tells you what they did me. ? Being a nurse you know what you can and cant do at work when regarding somthing like this.

Well i dont drive so dont worry......... it was a vent nothing more LOL. Sure make you feel like it somtimes.