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A periodic commentary from a fellow american on his personal trials with disability, the government, politics, and the general state of affairs in the US, with maybe some artists' news thrown in - who knows what you may find here - we'll see!
Tuesday, January 20, 2004
Becoming disabled in America.
About 18 months ago I came down with what I thought was a severe cold. It got so bad that I could hardly breathe so I went to the doctor. My doctor said I had pneumonia and prescribed antibiotics. I never got better so my doctor sent me in to see some specialists. The specialists discovered I had a hiatal hernia, chronic bronchitis, and emphysema. Basically I was told that I was not going to get better, these conditions are permanent.
Obviously this was not good news, but of course there's more, I was already suffering from some chronic conditions. In 1987 I was diagnosed with Rheumatoid Arthritis. My bones and joints had been deteriorating for years and I was beginning to have trouble walking and using my hands. You need only look at the protruding bones to see there is a problem. There was also some osteo-arthritis in my hands, knees, hips, and back from 25 years in the HVAC trade. The HVAC trade is also the likely culprit for my emphysema due to continuous exposure to sheet-metal dust, fiberglass, soot, and various chemicals. When I started in the trade there were no precautions for asbestos like there are now so exposure was frequent in those days. Yes I did smoke cigarettes too, about 10 cigarettes a day for 20 years.
There’s more. I had been in a couple of auto accidents which had given me head and lung injuries. I had problems with memory, long and short term, and suffered from periodic severe headaches. I had also had to have my right forearm reconstructed when I was 20 years old. Now more than 20 years later that forearm is deteriorating badly. I cannot control my fingers independently. Now you would think I had enough problems, right? Well I’ve been having problems with my abdomen too. The doctors can’t decide whether it’s Crones Disease or IBS (irritable bowels syndrome).
I had what I thought was a very good insurance plan thru my work. $20 co-pay for office visits, dental coverage, prescription hospitalization, short and long term disability coverage, the works. Things are never as simple as they seem. After a while I couldn't even come with $20 to see the doctor. He let me ride for quite some time. Once the co-pay bill got over $200 his CPA sent the bill collectors after me. My responses were congenial at first but if you've ever had to deal with bill collectors, you'll understand that it eventually changed to - "Get in line."
I was off work for quite some time while trying to get over the “pneumonia.” At one point I tried to go back to work, the bills still needed to get paid. I spent more time trying to catch my breath and either picking things up from the floor or getting up from the floor myself than I did working. I was forced to stop working again. I kept asking the doctor for solutions but the answers were not pleasant. I was not going to get better. I couldn’t walk up steps without losing my breath. I couldn’t go outside if it was hot or humid because I would suffocate. My right hand had become as useful as a club. I couldn’t stand for more than five or ten minutes. I couldn’t bend over or squat. I couldn’t lift more than 15 pounds without my back going out. And, if I was having one of those days I needed to be very near a restroom at all times. I am also frequently so ill that I am bedridden for weeks. I had become not only unemployable - I had become disabled.
So I figure no problem, I have insurance. So I apply for disability. The short term was no problem. The long term was something quite different. You see the insurance company gets to decide whether or not you are disabled - not you or your doctor. My coverage was supposed to be for two years. After a year of fighting I am still without. It was suggested that I get a lawyer. Well for insurance cases you have to pay up front. Excuse me, I’m unemployed because of this. The situation has stagnated.
The next thing is Social Security Disability Insurance (SSDI). You know, that money the government takes out of every paycheck in case you retire or become disabled. So I applied. They must train those people at insurance companies. Here’s the deal. It takes 120 days for the case to be evaluated (they use the whole 120 days). Then you are sent to doctors for evaluation. More waiting. Once the doctor sends in his report you case is decided. Unless you are 62 years old, blind, or missing multiple limbs, you are denied. Then you must appeal the decision. The appeal process takes as long as the original one did. The same thing will happen of course. Then you must appeal again and again. After two appeals you will be sent in front of a law judge. Anyway, you see the time involved. Again it was suggested I get a lawyer. Okay, lawyers will take SSDI cases no problem, for 25% of the take. That’s our government hard at work taking money from those who need it and giving it to those who don’t. But, of course I’m still waiting all the same.
So now I have a lawyer, my case will eventually be heard, so what do I do for my medical problems in the meantime? Well, after being off work for so long I was eventually terminated from my job. I can’t fault my employer. He had been paying my insurance premiums for more than six months. I got the paperwork for C.O.B.R.A. coverage. I just needed to pay the premium. I had been off work for a long time, and there was no money for that. I’m only 46 years old so I don’t qualify for medicare. There is Medicaid though. I applied for medicaid and discovered that in the state I live in, South Carolina, if you don’t have children, you receive Medicaid once you are given SSDI. Great!
So here I am. I live with my disabled aging mother (who can’t afford herself let alone me), I’m more than $20,000 in debt due to medical expenses, have had no income for over a year, can’t see a doctor or receive my medications and there’s no end in sight.
To be honest, suicide has become more and more appealing. Do you think that’s what everyone is waiting for, my death? - then no one would have to pay.
If any of this sound’s familiar to anyone, we can discuss it - or maybe just complain to each other. I’m sorry, I don’t do chat - I can’t type fast enough with one hand, but you can e-mail me at FalconBright@bellsouth.net. If you know of any congressmen, senators, or bureaucrats I can contact or bother about this I would greatly appreciate any contact information you have.
A funny note: The insurance company (Prudential Financial) said tha the doctors report said I should quit smoking. I said "I did". The representative said "So you should be okay now, right." Remember the part about my conditions being permanent, that was in the doctor's reports also. I don't know if the insurance companies personnel are brain dead or if they are hoping that I am.
I re-edited this thing twice - I guess it's time to post it. Hope there aren't toooooo many mistakes.
That's it for today - Luck to ya!
About 18 months ago I came down with what I thought was a severe cold. It got so bad that I could hardly breathe so I went to the doctor. My doctor said I had pneumonia and prescribed antibiotics. I never got better so my doctor sent me in to see some specialists. The specialists discovered I had a hiatal hernia, chronic bronchitis, and emphysema. Basically I was told that I was not going to get better, these conditions are permanent.
Obviously this was not good news, but of course there's more, I was already suffering from some chronic conditions. In 1987 I was diagnosed with Rheumatoid Arthritis. My bones and joints had been deteriorating for years and I was beginning to have trouble walking and using my hands. You need only look at the protruding bones to see there is a problem. There was also some osteo-arthritis in my hands, knees, hips, and back from 25 years in the HVAC trade. The HVAC trade is also the likely culprit for my emphysema due to continuous exposure to sheet-metal dust, fiberglass, soot, and various chemicals. When I started in the trade there were no precautions for asbestos like there are now so exposure was frequent in those days. Yes I did smoke cigarettes too, about 10 cigarettes a day for 20 years.
There’s more. I had been in a couple of auto accidents which had given me head and lung injuries. I had problems with memory, long and short term, and suffered from periodic severe headaches. I had also had to have my right forearm reconstructed when I was 20 years old. Now more than 20 years later that forearm is deteriorating badly. I cannot control my fingers independently. Now you would think I had enough problems, right? Well I’ve been having problems with my abdomen too. The doctors can’t decide whether it’s Crones Disease or IBS (irritable bowels syndrome).
I had what I thought was a very good insurance plan thru my work. $20 co-pay for office visits, dental coverage, prescription hospitalization, short and long term disability coverage, the works. Things are never as simple as they seem. After a while I couldn't even come with $20 to see the doctor. He let me ride for quite some time. Once the co-pay bill got over $200 his CPA sent the bill collectors after me. My responses were congenial at first but if you've ever had to deal with bill collectors, you'll understand that it eventually changed to - "Get in line."
I was off work for quite some time while trying to get over the “pneumonia.” At one point I tried to go back to work, the bills still needed to get paid. I spent more time trying to catch my breath and either picking things up from the floor or getting up from the floor myself than I did working. I was forced to stop working again. I kept asking the doctor for solutions but the answers were not pleasant. I was not going to get better. I couldn’t walk up steps without losing my breath. I couldn’t go outside if it was hot or humid because I would suffocate. My right hand had become as useful as a club. I couldn’t stand for more than five or ten minutes. I couldn’t bend over or squat. I couldn’t lift more than 15 pounds without my back going out. And, if I was having one of those days I needed to be very near a restroom at all times. I am also frequently so ill that I am bedridden for weeks. I had become not only unemployable - I had become disabled.
So I figure no problem, I have insurance. So I apply for disability. The short term was no problem. The long term was something quite different. You see the insurance company gets to decide whether or not you are disabled - not you or your doctor. My coverage was supposed to be for two years. After a year of fighting I am still without. It was suggested that I get a lawyer. Well for insurance cases you have to pay up front. Excuse me, I’m unemployed because of this. The situation has stagnated.
The next thing is Social Security Disability Insurance (SSDI). You know, that money the government takes out of every paycheck in case you retire or become disabled. So I applied. They must train those people at insurance companies. Here’s the deal. It takes 120 days for the case to be evaluated (they use the whole 120 days). Then you are sent to doctors for evaluation. More waiting. Once the doctor sends in his report you case is decided. Unless you are 62 years old, blind, or missing multiple limbs, you are denied. Then you must appeal the decision. The appeal process takes as long as the original one did. The same thing will happen of course. Then you must appeal again and again. After two appeals you will be sent in front of a law judge. Anyway, you see the time involved. Again it was suggested I get a lawyer. Okay, lawyers will take SSDI cases no problem, for 25% of the take. That’s our government hard at work taking money from those who need it and giving it to those who don’t. But, of course I’m still waiting all the same.
So now I have a lawyer, my case will eventually be heard, so what do I do for my medical problems in the meantime? Well, after being off work for so long I was eventually terminated from my job. I can’t fault my employer. He had been paying my insurance premiums for more than six months. I got the paperwork for C.O.B.R.A. coverage. I just needed to pay the premium. I had been off work for a long time, and there was no money for that. I’m only 46 years old so I don’t qualify for medicare. There is Medicaid though. I applied for medicaid and discovered that in the state I live in, South Carolina, if you don’t have children, you receive Medicaid once you are given SSDI. Great!
So here I am. I live with my disabled aging mother (who can’t afford herself let alone me), I’m more than $20,000 in debt due to medical expenses, have had no income for over a year, can’t see a doctor or receive my medications and there’s no end in sight.
To be honest, suicide has become more and more appealing. Do you think that’s what everyone is waiting for, my death? - then no one would have to pay.
If any of this sound’s familiar to anyone, we can discuss it - or maybe just complain to each other. I’m sorry, I don’t do chat - I can’t type fast enough with one hand, but you can e-mail me at FalconBright@bellsouth.net. If you know of any congressmen, senators, or bureaucrats I can contact or bother about this I would greatly appreciate any contact information you have.
A funny note: The insurance company (Prudential Financial) said tha the doctors report said I should quit smoking. I said "I did". The representative said "So you should be okay now, right." Remember the part about my conditions being permanent, that was in the doctor's reports also. I don't know if the insurance companies personnel are brain dead or if they are hoping that I am.
I re-edited this thing twice - I guess it's time to post it. Hope there aren't toooooo many mistakes.
That's it for today - Luck to ya!
