When will I become homeless?

A year and a half ago, I wrote to Social Security and CMS:

Risk is stressful

About three months later, I received a postcard saying my letter was being referred to another office (in New Mexico):

My response from Medicare/CMS

Yesterday in the mail, I received a letter from the Social Security Administration in Kansas City, Missouri:

“We sent you a letter telling you that we were going to review your disability case. However, we do not need to review your case at this time. Therefore, we will not contact your doctor now. We will keep any information that you have given us. We will contact you later if we need to review your case…”

Uh, no, you didn’t send me a letter saying you were going to review my case. I sent you a letter and I never received a response to any of the issues discussed therein. Nothing. Nada.

I always feel anxious when I receive anything from Social Security, just like when I received letters from Unum, my ex-long term disability insurance provider. Since Unum terminated my benefits, I keep waiting for Social Security to do the same. See, disability providers believe that if you’re not taking medications (and seeing a doctor regularly), you’re not disabled:

My worst fears coming true

The DEA and CDC have taken away the most successful treatment for chronic pain. Doctors will no longer treat many pain patients. Medical cannabis programs, where they exist, are too expensive for many of the disabled. So, who has the money and access to see a doctor regularly? Is that a requirement to be disabled? And if you aren’t seeing a doctor, you get kicked to the curb?

No wonder so many people believe in conspiracy theories. Use the drug war to kick people off of disability. Genius.

Checking my mail is a stressful activity. When will I get that letter cutting off my disability benefits? When will I become homeless?

Go ahead, screw me over

Thu, Feb 25, 2016 8:39 pm
Re: Letter dated 2/25/2016
From: painkills2@aol.com
To: vistasmanager@crhmi.com, vmanager@corerealtyholdings.com
Cc: customercare@crhmi.com, egoodman@crhmi.com, dmorehead@crhmi.com, dougmorehead@crhmi.com, info@corerealtyholdings.com

Dear Ms. Buchman:

I am in receipt of your letter dated 2/25/2016, regarding my request for an extension of the Notice to Vacate. Funny, even at this late date, you have refused to cite the reason for serving me with this notice. I guess it would be hard to state for the record that you have no adequate reason for throwing a disabled, paying tenant out onto the street.

And now you’re demanding that I pay a doctor to complete a Reasonable Accommodation Request Form in order for you to consider an extension. Let me remind you (from my email of 2/14/2016):

“Even though my long term disability benefits were recently terminated (because I couldn’t afford to see a doctor), and my Social Security Disability benefits did not increase this year, I had no choice but to accept Ms. Buchman’s renewal terms (because of the cost to move).”

You know that I am unable to satisfy this request, which is undoubtedly why you made it. Unless you’re offering to pay for me to see a doctor to fill out your 3-page form? Because even Unum (my former long-term disability insurance carrier) refused to do that. And we all know why — because it saves them money. But this isn’t a question of money, is it Ms. Buchman?

I spent 25 years being addicted to the medical industry for pain management, and breaking those chains almost took my life. And now you (and Unum) want to push me back into this quagmire of expensive and useless doctor visits? I can’t tell you how much I want to describe, in full detail, what you can do with your form.

I also can’t tell you how painful and long the process is for receiving disability benefits. And yet, Social Security’s decision isn’t good enough for you? You require more proof that I’m disabled?

Do you remember, Ms. Buchman, when we used to be friends? When I brought you and your staff Crispy Creme donuts and home-baked goods? I’ve tried to make this relationship work, but it’s not my fault that you refuse to do your job. (And I have the photos to prove it.)

I had a dream that I was living in another apartment while I took you, CRHMI, and CUBS to court. (And considering the amount of additional pain and agony that you’ve made me suffer, I’m thinking about suing you personally, too.) It was an awesome dream, and I have to wonder if it’s a portent of things to come. Wouldn’t that be just freaking fantastic?

Go ahead, Ms. Buchman, screw me over. I can’t wait to take pictures of the police removing a poor, disabled white woman from your premises.

Johnna Stahl

Dear Mr. Corporate America

February 14, 2016

Mr. Doug Morehead
CEO and Vice-Chairman
CRHMI Management Group
1600 Dove Street, Suite 450
Newport Beach, CA 92660
info@corerealtyholdings.com

Re: Vistas at Seven Bar Ranch Apts., Albuquerque, New Mexico

Dear Mr. Morehead:

I am seeking your assistance regarding a Notice to Vacate, which I received a week ago from your Community Manager, Kara Buchman.

Ms. Buchman and I argued about a renewal increase that she told me was mandated by your company. Even though my long term disability benefits were recently terminated (because I couldn’t afford to see a doctor), and my Social Security Disability benefits did not increase this year, I had no choice but to accept Ms. Buchman’s renewal terms (because of the cost to move). Along with my acceptance of the renewal terms, I reported an old maintenance issue (still outstanding as of this date) and my intention to send a more complete list. I also requested a response to my constant and unanswered questions regarding CUBS and how I’m being charged for certain utilities. More on that saga can be found on my blog, here:

Community Utility Billing Services (CUBS)

The CUBS saga continues…

Two days after I made the first payment under the renewal terms — and before the lease was prepared and signed — I received a Notice to Vacate taped to my door. No explanations. No complaints of rules being broken, now or in the past. It has taken me this whole week to get over the shock and prepare this letter.

My first thought after receiving Ms. Buchman’s notice was that I was going to be homeless. I believe homelessness is also a problem in your state, so in case you’re wondering how it happens, now you know. It’s a fear that many of the disabled live with, and one that increases pain and stress levels.

Perhaps two months is what the rental industry calls a reasonable amount of time before beginning eviction proceedings, but I’m not the average renter. I’m disabled. In light of my disabilities (and deeper slide into poverty), I am requesting more time under the Notice to Vacate.

I suppose Ms. Buchman thought that the Notice to Vacate would scare me enough to stop complaining — stop trying to encourage her to do her job. I’m also guessing that Ms. Buchman believes my removal will keep her from having to respond to the CUBS issues. However, there is a dispute over the balance on my CUBS account, one which I intend to fight. As far as I know, the discovery process in a lawsuit is the only way to obtain the information I’ve requested about my CUBS bills. And since I can’t afford an attorney or filing fees, I’ll just look forward to responding to the lawsuit CUBS will undoubtedly file against me.

I am also requesting that the monthly rental amount remain unchanged — if not restored to the previous rate before the renewal contract was broken — until I’m able to move. I promise that I’m doing everything I can to find another home and move as quickly as possible. After all, I don’t want to live where I’m not welcome.

I think I’ve been pretty reasonable in my responses to dangerous activities on this property, like the unleashed dog that attacked me last year. And years ago, when Ms. Buchman put out a newsletter requesting that tenants report outside hallway lights that need replacing, I did so. But to this day, the light I reported has yet to be fixed. Because Ms. Buchman has been understanding about my reduced circumstances up to this point, I’ve let a lot of things slide. Since I told her this would no longer be the case, I believe the Notice to Vacate is retaliatory in nature.

So, I don’t think I’m asking for anything unreasonable — maybe just a little compassion. And speaking of compassion, if you’d like to donate to my moving fund (which will get me out of your hair that much quicker), a nice friend of mine set up a GoFundMe site for this purpose, which you can find here:

https://www.gofundme.com/of4oms

I hope you had a nice Valentine’s Day, Mr. Morehead. I appreciate your time and consideration and I anxiously await your response.

Johnna Stahl
Albuquerque, New Mexico
painkills2@aol.com
(No phone)

copies to:

Kara Buchman, Community Manager
Vistas at Seven Bar Ranch Apts.
CORE Realty Holdings Management Inc.
vistasmanager@crhmi.com

Also posted at https://painkills2.wordpress.com/

Link for blog post inserted in contact form at:
http://www.crhmi.com/contact.html

Addition:  Error message found when trying to post link at CRHMI website:  “Not Found. The requested document was not found on this server. Web Server at crhmi.com”

In my search terms

“will medical marajuana hurt my unum disability claim”

No one really knows the answer to that question. I asked Unum for “all documentation which shows Unum’s position on medical cannabis.” But the corporation refused to respond. I would have to hire an attorney and file a lawsuit to have access to the documents I requested here:

Letter to Unum 10/24/2014

However, if I had to guess, I would say that, considering the effort Unum expends to deny benefits, it would definitely use your treatment choice against you —  not that they would ever reveal that information. But since Unum requires medical updates, you have no choice but to tell them. Unum has access to all of your medical information, so if you want to keep your marijuana use a secret, just don’t tell anybody (including your doctor).

Problem is, how are you treating your medical condition? Without proof in your medical file that you’re being treated by a doctor, insurance companies will question if you are really disabled. So, keep seeing your doctor if you can afford to, just tell him or her about all the other treatments you’re using, leaving out the use of cannabis.

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.

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.

Well, it figures…

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

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.

The Color of Debt: How Collection Suits Squeeze Black Neighborhoods

https://www.propublica.org/article/debt-collection-lawsuits-squeeze-black-neighborhoods

In Dora Byrd’s case, MSD went after her bank account. She’d been living primarily off of a monthly $600 Social Security check. It’s illegal for federal benefits to be garnished, but at the time, she had both a checking and a savings account, and only the money electronically deposited into her checking account was automatically protected. As a result, MSD was able to seize $645 from her savings account, more than a third of the money in her accounts, according to bank records…

Even if Turner had appeared, it’s unclear that it would have done her any good. With an attorney, however, she might have gotten the case dismissed. That’s because the statute of limitations on Turner’s loan under Missouri law was four years, a period that had long expired by 2013…

My comments:

painkills2 5 hours ago
How long does it take ProPublica to approve a moderated comment? Oh, just forget it, I’ll post it on my blog.

painkills2 13 hours ago Pending
So, debt buyers don’t know the race of their customers? Can’t ascertain race by any of the information in the file? Like where they live? Or from a credit report? These places don’t use data brokers? Well, when you work for debt buyers, I guess lying just comes naturally. And shame never enters into it.

It should be illegal to file a lawsuit after the statute of limitations has passed. None of the lawyers who I’ve worked for would do that — it’s unethical and should be considered malpractice. Where is the State Bar? I guess State Bars don’t want to lose any of their membership fees. And I guess there are plenty of lawyers who don’t know what shame is either.

The lawyers that work for these creditors know that the debtors don’t have the legal know-how to defend themselves. Easy pickings. Of course, everyone knows that the legal system only benefits the rich, while screwing the poor. When my long term disability insurance company (Unum) terminated my benefits after 7 years, I needed an ERISA lawyer, but it’s not like I’ll ever have access to one.

Perhaps corporations (and universities, etc.) should divest from these types of creditors, just like they’re divesting from the oil and gas industry. Or maybe that would be impossible, seeing how most of these creditors are funded by Big Banks.

Casper The Ghost #2

Casper the Ghost

Note:  As of today’s date, no replies to these emails (above and below) have been received.

Wed, Jul 15, 2015 8:16 am

From: painkills2@aol.com
To: Dr. Steven Jenison (stevenjenison@windstream.net)
Re: An alternative to suicide?

Dear Dr. Jenison:

I was happy to hear of your reinstatement to the Medical Advisory Board for the Medical Cannabis Program, and your successful efforts so far, especially on behalf of chronic pain patients.

I am writing to you because I am in desperate need of help. I’ve written to the Department of Health, Lynn Hart (formerly with the State Medical Board), all of the Producers in the program, the Drug Policy Alliance, Medicare, the Social Security Administration, and Dr. Katzman at the UNM Pain Center — all to no avail. (See links below.)

I have suffered from intractable pain for 30 years. I moved from Texas to New Mexico for the Medical Cannabis Program, but after a year as a member, I could no longer afford the program. The move and a year in the program have wiped me out financially. I couldn’t even afford to see a doctor to update my Long Term Disability insurance, and my benefits have since been terminated.

While I understand I now only have to see one doctor for re-certification, that annual expense will reduce my ability to pay for the medicine I need on a daily basis. Why pay to join the program when I can’t afford to pay for an adequate amount of medicine? Not to mention that during the year I was in the program, 80% of my purchases were not strong enough to treat my chronic pain.

And my medical records (MRIs, etc.) are over five years old, which appears to mean that I will have to pay for updated tests to be eligible for New Mexico’s program. In my letter to Medicare, I’ve asked if these expenses would be covered, but it’s been over 4 months and I haven’t received a response.

Since I was approved for Social Security Disability, why can’t that be good enough for the Medical Cannabis Program? Why must I continually have to pay for doctors to review my medical records to prove once again that I am disabled by intractable pain?

Even with my very limited financial capabilities, I’ve been trying to save money to move to Colorado where the cost of medicine is more affordable. I really thought I would be able to suffer through this period without any way to manage my pain, but I now realize that will be impossible. And do you know how I know this? Because I’m sitting here thinking about buying a gun. It’s a sad fact that it’s easier and less expensive to purchase a gun in New Mexico than it is to purchase medical cannabis.

So I find myself once again begging some stranger for help and/or advice. Thanks for reading this email.

Johnna Stahl
Albuquerque

To Dr. Joanna Katzman, University of New Mexico

Another response from Dr. Katzman

New Mexicans don’t care about each other

This Is What Desperation Looks Like

(Photo taken 2/19/2015.)

Community Utility Billing Services (CUBS)

June 23, 2015

Community Utility Billing Services
PO Box 1530
Hemet, CA 92546-1530

Re: *****

Dear Customer Care Department:

I am in receipt of your letter dated June 1, 2015 regarding the alleged delinquent balance on my account. This will notify CUBS that this is incorrect.

My agreement with the leasing manager, Kara Buchman, is that my rent and utilities are paid on the 3rd of every month, as that’s when I receive my Social Security Disability check. Late charges that CUBS is continuing to accrue on my account are not only excessive and illegal, but also in direct violation of my agreement with Ms. Buchman.

I understand that Ms. Buchman explained my recent loss of long term disability benefits and the difficulty I’m having trying to pay CUBS before the 3rd of every month, as it recently demanded when I was told to start paying the utility bill directly to CUBS. She informed me that CUBS agreed to delete these late charges.

Additionally, my questions regarding exactly what I’m being charged for in regards to utilities have never been answered, even though I’ve been asking the same questions for years. Prior responses from CUBS and Ms. Buchman have been woefully inadequate.

Although the apartment manager told me at one time that she was in the middle of completing a review and audit of CUBS billing practices, she has refused to inform me of the results. My latest request in May of this year stated:

“And although I’m working on collecting information to prove that CUBS is over-charging for utilities, I haven’t been well enough to complete this task. Additionally, I’ll need you to provide copies of the bills for this building, so I can see exactly what I’m being charged for and how the charges are allocated. As I mentioned to you before, even though I’ve cut back on my water usage, my bill continues to climb.”

Since Ms. Buchman is refusing to provide this information, I am now requesting it from CUBS. Please see to providing this information to me as soon as possible.

I am also requesting an explanation of the increase in CUBS’ monthly service fee from $3.50 to $4.00, as well as what the service fee includes. I would like to know why I have to pay for a billing service chosen by the apartment manager when CUBS should be charging the apartment complex instead of me for this service. Fees for contractors such as CUBS should be covered in my rent. It’s an added fee for certain utilities that, for instance, I don’t have to pay to the electric company.

One of my neighbors informed me that CUBS charges an additional fee to make a payment online. This also seems like a questionable practice.

I think it’s interesting that CUBS is not accredited by the Better Business Bureau. In fact, its rating is an F. And there are other complaints similar to mine listed on the BBB website, including overcharging for water and its service fee.

I was unable to find very much information on CUBS through a Google search. Therefore, I am posting this letter to my blog at painkills2.wordpress.com, so that other people experiencing the same problems with CUBS and their apartment complex can find it on the internet.

Regards,

Johnna Stahl

cc: Kara Buchman, via email

My worst fears coming true

This is a post by Zoe about how Social Security Disability believes that if you’re not taking medications (and seeing a doctor regularly) that you’re no longer disabled.  (Just like Unum.) Since I wrote to both Social Security and Medicare explaining my current situation, I expect they will cut off my benefits any day now.  Social Security Disability is the only income I have, so when these benefits are gone, I will be homeless.

Sure, I can fight a ruling that terminates my benefits, but I imagine that’s going to be rather difficult when fighting from my car. And how many months or years would that take? I won’t even have enough money to put my stuff in storage. I suppose I’ll have to load my car with as much of my belongings as possible and then throw away the rest.  Anyone want to buy a sofa?

https://trashdiaries.wordpress.com/2015/04/29/you-are-full-of-shit/

“In fact, I wouldn’t doubt they hoped I’d finally kill myself (successfully.)”

To Dr. Joanna Katzman, University of New Mexico

Mon, Jun 8, 2015 2:31 am

From:  painkills2@aol
To:  jkatzman@salud.unm.edu

Re:  An alternative to suicide?

Dear Dr. Katzman:

I have suffered from intractable pain for 30 years. I moved from Texas to New Mexico for the Medical Cannabis Program, but after a year as a member, I could no longer afford the program. Because my case is so complex, I am writing to you in the hope that you can help me. Right now, I’m looking for an alternative for pain management other than suicide and a lawsuit for the right to die as a non-terminal patient.

My pain was treated with prescription medications for 10 years before I was abandoned by my doctor. Prior to moving to New Mexico, I suffered through a cold-turkey detox, and now, I no longer take any prescription medications. I have developed my own home treatment program, but without medical cannabis, it is no longer sufficient. In other words, I am in agony.

With Medicare, I may be able to afford treatment through a doctor. But as a long-term pain patient who’s tried just about everything (including surgery), and considering the escalation of the war against pain medications, my options for non-invasive treatment appear to be few and far between. In fact, I don’t think I have any options through the medical industry, especially since the treatments I suffered through before choosing drug therapy just increased my pain levels.

I’m sorry to use email for communicating with you, but I don’t have a phone. The move and a year in the Medical Cannabis Program has wiped me out financially. I couldn’t even afford to see a doctor to update my Long Term Disability insurance, and my benefits have since been terminated.

Since you’re the top pain management expert in New Mexico and the Director of Project ECHO, what do you think I should do?

Johnna Stahl
Albuquerque

Unum’s final denial letter

There was never any doubt in my mind that the appeal for Unum to reinstate my LTD benefits would prove successful.  I mean, there was never any reason to delude myself into thinking that all of my arguments would make a difference to Unum, a multi-billion-dollar insurance company only interested in profits.

I received its final denial letter last week, but the letter is dated April 29, 2015, and the postage on the envelope is dated April 30, 2015.  I haven’t read the letter — why get even angrier and more upset?

But I think it’s interesting that I didn’t sign the updated Authorization and Release for the appeal until April 30, 2015, mailing it the same day.  As I mentioned in my last letter to Unum, the appeal had already been decided long before this administrative process was put into motion. Because Unum demanded an updated Functional Capacity Examination and wouldn’t pay for it, and knew that I couldn’t afford to pay for this expensive report, I am in violation of the contract and Unum wins again.  Poverty is the reason I no longer have long term disability benefits. Ironic, isn’t it?

Should I try to find an attorney to file an ERISA claim against Unum in court?  Well, there’s no such thing as an ERISA attorney who works pro bono.  Meaning, what would be the point? Unum knows I can’t afford to pay a retainer for an attorney to represent me, so it has no financial reasons — possible financial exposure or consequences — for denying my appeal.  And potential ERISA lawsuits aren’t even a valid reason for Unum, as they also provide no financial exposure or negative consequences for this corporation — our politicians and Attorneys General have seen to that.

Unum Taking Advantage of a Federal Law

http://www.kantorlaw.net/News/Unum-Taking-Advantage-of-A-Federal-Law.aspx

At issue are cases such as that of Laurie Hindiyeh, who was forced to quite her job as controller of a real estate company because of an inner-ear ailment. For two years, the long-term disability coverage she had from Unum helped to offset her lost income. But then the checks stopped. Unum declared her fit for work, based in part on surveillance videotapes. It cut off her benefits about a year ago, she said…

Because she obtained coverage through her employer, her ability to contest Unum’s decision is sharply limited by the Employee Retirement Income Security Act. The 1974 federal law, according to subsequent Supreme Court rulings, exempts employee benefits, such as disability insurance, from state regulation. As a result, Hindiyeh and thousands of similarly insured Americans are not covered by state consumer protection laws and are not entitled to take most claim disputes before a jury…

In fact, the insurance companies often are the only arbitrators of such disputes. Only after the insurer has denied an appeal are policyholders permitted to go to court, where they may receive a hearing before a judge. At that point, policyholders who fall under ERISA are still not entitled to compensatory or punitive damages, even if they prove the insurer knowingly cheated them out of benefits. All they may recover is the amount of the benefits in dispute, and the burden of proof is high. For a policyholder to win, a judge must conclude not only that the insurance company made the wrong decision but that is also acted in an arbitrary and capricious way.

“As a practical matter, you have lost all of your rights, ” said Ray Bourhis, a San Francisco lawyer who represents Hindlyeh. “You can’t even call the California Insurance department and ask them to investigate because they have no jurisdiction. You have nothing, and, as a result, you have no leverage.”

Bourhis and other insurance lawyers say they believe Unum has exploited the ERISA shield in its handling of employer-provided long-term disability coverage. Bourhis cited the insurer’s own internal memos, which he obtained in previous lawsuits, describing the company’s plans to use the federal rules to reduce its payouts to policyholders…

Few lawyers accept ERISA-related disability matters because even if they win, the awards usually are so small that they do not cover the cost of preparing the case…