Kaiser’s 2,600 mental health workers strike in California


Meanwhile, more than 18,000 Kaiser nurses and nurse practitioners in Northern and Central California are planning to strike Jan. 21-22…

8/27/2014, Pain Pills: Chronic Pain Sufferers Speak


A study in 2007 sampled 15,000 veterans with chronic pain (Edlund et al.). They were all given opioids, and only 2% abused his or her medications. I have read other studies like these for chronic and cancer pain in which the addiction or abuse rate is always extremely low…

A neuropathic pain study published in 2003 by the New England Journal of Medicine found that opioid pain medication only gave 36% pain reduction at the highest dose possible before side effects of the drug were intolerable. Those with such extreme pain continue to feel pain; therefore, how can there be a medicated euphoria? Maybe this is why there is a much lower rate of addiction in chronic and terminal pain…

Just a side note, in my research I learned that a doctor’s office can be thought of as a “pill mill” if 50% or more of its patients are treated for pain management, even if they offer physical therapy, biofeedback, counseling, acupuncture, interventional pain therapies, etc. If the doctor is chief at the local hospital, she still runs a “pill mill” up the road because she primarily treats people with chronic pain or cancer pain. Nice, right? CDC Pain Clinic Regulations…

Addiction, Drunk Driving, and Suicide:

The Struggles of Audrey Conn, Founder of ‘Moderation Management’


It is important to note that the Substance Abuse and Mental Health Services Administration lists MM, in conjunction with a web-based program called moderatedrinking.com, in its national registry of evidence-based treatment programs. A.A. is not included.

Stahl v. Unum

(Transcribed directly from Unum-provided documents.)

Activity (log)

Response: Kertay, Les P 02/27/2004 14:27:00:

Ms. Herbert’s analysis as presented in the 2/24/2004 review, as it pertains to psychiatric issues in the claim, adequately and succinctly captures the essence of our discussion and my review of the relevant data. I concur that the records available in the file, over a number of years and multiple providers, are suggestive of psychological factors that likely contribute to the claimant’s perception of pain and her reactions to it. However, there is no current documentation of treatment, evaluation, or clinical formulation that attributes impairment to psychiatric condition, either alone or as it might contribute to a general medical condition. I will be glad to discuss further or to respond to any questions.

Les Kertay, Ph.D., ABPP
VP, Medical Director
Licensed Health Services Provider (TN, GA)
Diplomate in Clinical Psychology, American Board of Professional Psychology


Date of first Unum denial letter: February 27, 2004

Gruber v. Unum (Maryland)


The same psychologist later responded to a UNUM questionnaire, in which he noted that the “causation or precipitating factors” leading to Plaintiff’s psychological symptoms were: “history of lupus, aggravated by stress, neck injury, low immunity.” An April, 1995, report from Plaintiff’s rheumatologist diagnosed Plaintiff with lupus, fatigue, and depression. A July, 1996 report diagnosed Plaintiff with “lupus, arthralgias, headaches, spine, depression, and fatigue;” a secondary condition of “depression” was also identified…

Internal UNUM staff notes and memoranda throughout the administrative record identify Plaintiff’s disability only as major depression, depression, or depression and post-traumatic stress disorder… At no time does UNUM categorize Plaintiff’s disability as “medical.”

Plaintiff alleges a violation of the Employee Retirement Income Security Act (ERISA), 29 U.S.C. §1132 (Count I), breach of contract (Count II), and breach of fiduciary duty (Count III)…

I’ve only reviewed parts of my Unum file, but I’ve noticed that Unum doesn’t like to list TMJ and degenerative disk disease as part of my disability — although it does, but usually close to the end of the list.  “Mental” conditions are usually at the beginning of the list, like depression and anxiety.

The order of the list puts more emphasis and importance on the items at the beginning, so that it looks like most of my symptoms are psychiatric.  And I’m guessing that Unum thinks including chronic pain in this list — usually before and after mental conditions — also makes pain look more like a a mental condition, like this:

Depression, chronic pain, panic attacks, fibromyalgia, TMJ…

It’s kinda like capitalizing certain terms to make them look more important — like some anti-drug advocates capitalize the words “heroin” and “god.”