The Blame Game

How did I get here? Shall we play the blame game?

I guess I would start with blaming 5 years of competitive gymnastics — a sport that taught me a lot, while punishing my body.

http://www.huffingtonpost.com/entry/internet-flips-over-college-gymnasts-sophina-dejesus-almost-perfect-routine_us_56b8faa2e4b08069c7a85806

I blame the medical industry and insurance companies for their ignorance about conditions like TMJ and chronic pain.

I blame 401(k)s, which take more money than they give. And I blame Unum, a corporation that terminated my long term disability benefits just because it can.

I blame politicians for their inability to understand every side of each issue, pleasing some people, while torturing others. I blame them for making laws that favor the rich, while punishing the poor (a shout out to ERISA).

I blame the State of Texas for only offering me prescription medications to treat pain, while outlawing cannabis. (I think the state should have paid for my move to New Mexico.)

I blame those who see disabilities as a quirk of nature, easily conquered by those who are suffering, instead of medical conditions that require treatment.

But most of all, I blame the drug war, because without it, I’m sure that a lot of these problems would not have brought me here — where I am today, in February of 2016.

https://edsinfo.wordpress.com/2016/02/06/opioids-as-scapegoats/

http://www.huffingtonpost.com/entry/fbi-dea-chasing-the-dragon_us_56b52445e4b08069c7a767a7

Last week, the FBI and DEA released “Chasing the Dragon,” a documentary that paints an honest, unforgiving picture of opiate addiction’s devastating, often deadly consequences…

Johnna Stahl · Albuquerque, New Mexico
I don’t understand how anyone can comprehend the wonders found in the cannabis plant, while looking down at the wonders found in the poppy plant. Yes, cannabis can’t kill you, but pain can, don’t ever doubt it. When you discriminate against one drug, you discriminate against all of them.

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Well, it figures…

https://painkills2.wordpress.com/2015/11/29/department-of-labor-proposes-lowering-bar-for-erisa-disability-claims-requests-public-comments/

The comment period for the proposed regulation “Definition of the Term ‘‘Fiduciary’’; Conflict of Interest Rule—Retirement Investment Advice” (RIN 1210-AB32) and proposed exemptions (ZRIN 1210-ZA25) closed on September 24, 2015. The Department no longer is accepting comments for consideration…

Department of Labor Proposes Lowering Bar for ERISA Disability Claims, Requests Public Comments

http://thoughtsaboutme.com/2015/11/18/department-of-labor-proposes-lowering-bar-for-erisa-disability-claims-requests-public-comments/

In order for the DOL to move forward with enacting the proposal, it is crucial that it receive comments from the public in support of the proposed changes. Even just a few dozen public comments could tip the scale. If there is no expression of support from the public, that will substantially decrease the likelihood of the proposal being put into place because it is a near certainty that disability carriers and representatives of employer organizations will provide comments opposing these regulations, lobbying to retain the status quo that favors them so heavily. The easiest way to provide comments is by email to e-ORI@dol.com. Comments have to include “RIN-1210-AB39” (best placed (also) in the subject line) and the agency name, “Department of Labor.” Comments need to be submitted within 60 days. Please note that all comments will be published online without redactions; therefore, do not include any sensitive information…

Sun, Nov 29, 2015 12:03 am

Re:  Department of Labor, RIN-1210-AB39
From:  painkills2@aol.com
To:  e-ORI e-ORI@dol.com

Dear Department of Labor,

I’m going to start by saying that I don’t have a complete understanding of the ERISA law. But ever since Unum terminated my LTD benefits (after 7 years), I’ve been trying to learn about this law. Unfortunately, everything I’ve learned has pointed to the fact that since I can’t afford an attorney to fight Unum, there’s nothing I can do.

What’s ironic is that Unum terminated my benefits because I also couldn’t afford to pay doctors to provide updated reports for Unum’s files. All perfectly legal under the contract — even though Unum could have chosen to pay for these updated reports instead of terminating my benefits. If Unum thought it could find a doctor to prove I wasn’t disabled, I’m sure it would have been glad to pay for these useless medical reports. And I’ll just point out that, as a 30-year intractable pain patient, tests like a Functional Capacity Evaluation are not beneficial or healthy for me — in fact, they’re quite painful, as well as being expensive.

All this to say that I find it sadly ironic that I’m too poor to be disabled.

I’m going to rely on the expertise of others who say these changes to the ERISA law will be good for disability claimants. But these changes won’t help me, or the thousands (millions?) of other disabled people who have been kicked to the curb by insurance companies like Unum.

Experts also say that Attorneys General should perform a market audit on the disability insurance industry, but it appears that politics and apathy for the disabled will keep that from happening. Perhaps this is something the Department of Labor can request?

If ERISA was meant to help someone like me, it has been a miserable failure. And I am miserable because of its failure. Thankfully, I’m not as miserable as those who have chosen suicide to rid themselves of both their pain and this whole process. But I think it’s important to add that I’m an advocate for right-to-die laws.

Johnna Stahl
Albuquerque, New Mexico
(Also posted at painkills2.wordpress.com)

EDIT:   The correct email address is e-ORI@dol.gov, not .com.

In my search terms:

“can a politician in my community help me fight unum for my ltd benefits”

Wow, this is a really hard question to answer…  (Please note sarcasm.) I guess that depends on how much money and influence you have. I mean, anti-drug advocates spend a lot of time and money on politicians, and it obviously works.

Unfortunately, the problem with Unum and LTD benefits exists in the federal government, not state or local governments. It’s all about the ERISA law, which no one really understands. Basically, ERISA should be renamed to something like URFUCKED.

Monsters

“Monsters are real, and ghosts are real too. They live inside us, and sometimes, they win.” Stephen King

“Everyone carries around his own monsters.”  Richard Pryor

“Whoever fights monsters should see to it that in the process he does not become a monster.” Friedrich Nietzsche

“There are very few monsters who warrant the fear we have of them.”  Andre Gide

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Inside Corporate America’s Campaign to Ditch Workers’ Comp

https://www.propublica.org/article/inside-corporate-americas-plan-to-ditch-workers-comp

STANDING BEFORE A GIANT MAP in his Dallas office, Bill Minick doesn’t seem like anyone’s idea of a bomb thrower. But backed by some of the biggest names in corporate America, this mild-mannered son of an evangelist is plotting a revolution in how companies take care of injured workers.

His idea: Let them opt out of state workers’ compensation laws — and write their own rules…

The investigation found the plans almost universally have lower benefits, more restrictions and virtually no independent oversight.

Already in Texas, plans written by Minick’s firm allow for a hodgepodge of provisions that are far different from workers’ comp. They’re why McDonald’s doesn’t cover carpal tunnel syndrome and why Brookdale Senior Living, the nation’s largest chain of assisted living facilities, doesn’t cover most bacterial infections. Why Taco Bell can accompany injured workers to doctors’ appointments and Sears can deny benefits if workers don’t report injuries by the end of their shifts…

Unlike traditional workers’ comp, which guarantees lifetime medical care, the Texas plans cut off treatment after about two years. They don’t pay compensation for most permanent disabilities and strictly limit payouts for deaths and catastrophic injuries…

The plans in both Texas and Oklahoma give employers almost complete control over the medical and legal process after workers get injured. Employers pick the doctors and can have workers examined — and reexamined — as often as they want. And they can settle claims at any time. Workers must accept whatever is offered or lose all benefits. If they wish to appeal, they can — to a committee set up by their employers.

In many cases, ProPublica and NPR found, the medical director charged with picking doctors and ultimately reviewing whether injuries are work-related is Minick’s wife, Dr. Melissa Tonn, an occupational medicine specialist who often serves as an expert for employers and insurance companies…

Two months later, Pinckard said, he was pulling a cart loaded with frozen French fries when he slipped on some ice in his trailer and suffered a hernia. He had previously had two hernias on the job that were covered by workers’ comp and figured this time would be no different. But the denial letter said the plan for Reyes Holdings, which owns Martin-Brower, only covers two types of hernias — not the kind Pinckard suffered.

“The only way it was covered was if it was directly under my belly button,” he said. “Mine was slightly above my belly button.”

In this instance, as in others ProPublica and NPR found, the costs of the injury were shifted to the employee, group health or government programs…

Minick was a young lawyer for one of Dallas’ oldest firms in 1989, when some of the firm’s business clients, gambling that the cost of any lawsuits would be cheaper, began dropping workers’ comp. The senior partners assigned Minick and several colleagues to come up with an alternative. They found it in the Employee Retirement Income Security Act, a federal law passed in the early 1970s to protect workers as employers were shedding their pensions.

ERISA had been applied similarly to other worker benefits, such as health plans and disability policies. Minick and his colleagues decided it could provide a legal framework for plans covering on-the-job injuries.

Texas courts agreed, even though, compared to workers’ comp, the ERISA-based plans gave employers critical advantages. Under ERISA, appeals are heard in federal court, rather than state workers’ comp courts. And in general, judges could rule only on whether a denial was reasonable — not whether it was fair. This gave employers far greater control…

The fine print of opt-out plans contains dozens of opportunities for companies to deny benefits. Employers can terminate workers’ benefits for being late to doctors’ appointments, failing to check in with the company or even consulting their personal doctors…

Under workers’ comp, employees can’t be fired in retaliation for a claim. But employers that opted out argued that their workers weren’t entitled to that protection, and in 1998 the Texas Supreme Court agreed.

Gillespie, of the insurance association, said such provisions blatantly shift costs to taxpayers, in the form of Social Security disability, Medicare and Medicaid. Some plans state it explicitly: The plan for Russell Stover Candies said its benefits are secondary to all other sources of benefits. Home Depot requires its employees to “take whatever benefits are available,” including enrolling in Social Security disability…

“Sometimes I have to make a choice,” he said, sitting uncomfortably on his worn sofa. “Do I buy my pain meds or whatever other medicine that I need or do I buy groceries?” …

Many companies have further limited the risk by requiring employees to sign arbitration agreements. Instead of going before a jury, workers’ disputes are handled confidentially, out of court, before an arbitrator, typically a former judge or defense lawyer. A 2010 survey of large employers with opt-out plans by a Stanford law professor found that 85 percent used arbitration agreements…

But there’s one big difference. Benefits under opt-out plans are subject to income and payroll taxes; under workers’ comp, they’re not. As a result, 80 percent of the plans actually provide lower benefits, ProPublica and NPR’s analysis found…

Under comments:

abinico • 7 hours ago
During the dark ages people unable to work starved to death – looks like the dark ages are coming back.

https://painkills2.wordpress.com/2015/10/03/pain-patients-on-workers-comp-are-screwed/

Ex-Wife Lies to Unum, Results in Denied Disability

http://www.lawyersandsettlements.com/articles/first_unum/interview-unum-lawsuit-insurance-28-20746.html?securead=1&utm_expid=3607522-8.uTwqV-N-RqmmAyO2kCf6lA.1&utm_referrer=https%3A%2F%2Fwww.google.com%2F

Arlington, VA: Kevin was diagnosed with multiple sclerosis in 1998, one year after he took out an Unum, or Unum Provident policy. After a messy divorce, Kevin says his ex-wife told Unum that he had MS in the 1980s, which meant he had a preexisting condition and would be denied Unum long-term disability benefits…

“They saw that I suffered from migraines before I took out the policy and said they would never have underwritten my policy had they known…

Unum is demanding that Kevin pay back $300,000, which amounts to the long-term benefits he received until Unum stopped paying him in 2006…