Sandi K Posted April 14, 2011 Share Posted April 14, 2011 I heard from the insurance company today. They have declined my claim advising that I should be able to perform my duties. I'm not too concerned because so many of you have said this has happened to the first time and you have to appeal. My Occ Health advisor said it might happen too and I may have to send them more info when I appeal. It just seems so crazy. It's a brain injury, a brain hemorrhage! How can we be turned down when it's so serious! It's insane to think we can work at our regular level so quickly. I know it's insane, because I tried it, and it was insane. Sandi K. Quote Link to comment Share on other sites More sharing options...
goldfish.girl Posted April 14, 2011 Share Posted April 14, 2011 Aw Sandi, don't let that knock back belittle how things are for you now. I will be 3yrs post SAH in July. I never gave up & continued to try to work in the same job. I wasn't able to do the same level of work in support to management so did less. It has taken me 2yrs to understand that I can kind of do a lesser role as long as no-one interupts, no phone calls, no callers etc. I now realise that I cannot carry out an administrative role that suits management. My memory, thought processing & cognitive skills just do not work the same now. It took a nasty boss bullying me to make me see that I couldn't keep fighting to be as I was. I have been told recently that there's a circle of brain cells around where the bleed happened & damaged cells, that shuts down to preserve the surrounding healthy cells which is why the long term recovery may surprise you. My bleed was nearly 3yrs ago and this (apparently) means that the recovery time for the surrounding cells to 'wake up' again has passed. You are not that far on & things may keep improving for you. Don't give up hope yet! Lots of love, Michelle x Quote Link to comment Share on other sites More sharing options...
garyolly Posted April 14, 2011 Share Posted April 14, 2011 You get turned down Sandi because of one thing only.............you cannot see your injury ! It is sad but it is also the truth. Do you know that in this country, people that are diagnosed with bad backs will get more advice, treatment and benefits than someone whose head has basically exploded, and whose life has or is falling apart !!!! This, unfortunately, will always be the case because they is no way of mapping the brain and the human emotions that go with it. Stick with it lady.... Quote Link to comment Share on other sites More sharing options...
donnamarie Posted April 15, 2011 Share Posted April 15, 2011 keep your chin up and keep fighting my companies are the same at the min im getting no where and money issues are forcing me back to work donna Quote Link to comment Share on other sites More sharing options...
KelBel Posted April 15, 2011 Share Posted April 15, 2011 Hi Sandi Sorry to hear about your knock-back. It does seem as though cases are mainly declined in the first instance and re-assessed at appeal. It is so difficult to deal with anything after SAH, and knock-backs do seem to knock you back even harder, as you are already trying to deal with too many emotions anyway. I hope you can gather some further evidence that will support your appeal. Big hugs Kel x Quote Link to comment Share on other sites More sharing options...
Louise Posted April 15, 2011 Share Posted April 15, 2011 So true Gary.. yep stick with it Sandi, your insurance company maybe need to be told what has happened and what it means.... Quote Link to comment Share on other sites More sharing options...
winter Posted April 15, 2011 Share Posted April 15, 2011 I'm sure it must be so frustrating for you and the others who must continue to make appeals and fight for some kind of help. As Gary said, others with problems (that are more easily measured scientifically) seem to be able to get the help they need. In the US, this is also the case. While I was working at my old job, I saw many people obtain disability status - who just knew how to work the system and were actually fully capable of working! When I went back to work after the SAH, it was only for a few hours at a time, a few days a week. I applied for short term disability and was turned down. Because I was able to work (be it a few hours a week), this meant I was not disabled in any way. My disabilities were subjective and could not be measured except by my words and those of my co-workers who supported me. Frustrating indeed. I do hope you will keep up the fight as the others have. Hang in there and stay strong! It may take a while, but I'm sure they'll come around as they have for others. Staying positive for you Quote Link to comment Share on other sites More sharing options...
ann_calgary Posted April 17, 2011 Share Posted April 17, 2011 Hello all, I am experiencing the same thing. I have been losing sleep over my phone conversation with my insurance case manager. He kept saying that I have no cognitive deficits and that fatigue is hard to assess. He asked me what I do during the day so I said I sleep until noon and I try not to nap if I can help it. I am pretty sure I heard him chuckle. All throughout our conversation I felt my condition was diminished. I have been wanting to call him again but my husband believes it won't help my case and that the guy was just doing his job. This makes me so mad. My case is pending and they say if further "tests" whatever that means is required they will pay for it. If only we could afford living on a single income I honestly just don't have the energy for this bs. I am so sorry for ranting. I hope in the end it will all work out for us Sandi. Thanks for listening (reading) my frustrations. Quote Link to comment Share on other sites More sharing options...
goldfish.girl Posted April 17, 2011 Share Posted April 17, 2011 Hi Ann It's tiring enough just getting through the day without added stress. I had tests done by a neuro psycologist which highlighted what cognitive defects I had and the severity of them. Perhaps this is what your insurance company mean? It may be helpful for you know the results also. Good luck & don't let them get you down Michelle x Quote Link to comment Share on other sites More sharing options...
Sandi K Posted April 18, 2011 Author Share Posted April 18, 2011 Hi all, thank you for your replies. I'm not giving up! I was expecting to be turned down at the first round but wasn't prepared for feeling so down about it. Ann, it is true that they are just doing their job and they always say no at first because some clients will take that answer and walk away. But we can't give up. I've paid into that insurance for years and now I'm sick and need help. I'm going to persist and keep going until it's approved even if I'm back to work by the time it happens. It turns out my early return to work is what they are using to say I'm well enough to work. Because I went back early and continued to ignore my symptoms for weeks they think I should be able to continue on that path. But I was very sick and was only making it worse. So it seems you are punished for trying to go back too early. Sandi K. Xo Quote Link to comment Share on other sites More sharing options...
ann_calgary Posted April 21, 2011 Share Posted April 21, 2011 Thanks Michelle and Sandi! I was at my doctors' today to get more "evidence" of my illness. I am thankful that he was very helpful and understanding. I am crossing my fingers that the insurance company will follow suit. I do have an insurance question that I hope you can help me out. If my doctor recommends gradual return to work say a couple of hours a day would the insurance company pay the difference? I do not want to ask my case manager because it might give him ideas. Thanks in advance! Quote Link to comment Share on other sites More sharing options...
sonia Posted April 21, 2011 Share Posted April 21, 2011 So sorry to hear that you have been turned down Sandie,you keep fighting girl.I agree totally with Gary's mail. There is someone near me who has a bad back. They get a car, a parking space to put it in etc. But they can carry heavy shopping around and do things that you would not expect them to do. Thats me on the soapbox again,best stop before my BP goes through the roof. Love Sonia xxx Quote Link to comment Share on other sites More sharing options...
Sandi K Posted April 21, 2011 Author Share Posted April 21, 2011 My Occupational Health advisor who is supportive and wonderful and always available despite her own illness and family pressures suggested I call my GP's office and ask for the neurologist's report and fax it to the insurance company. You see, my appointment with the neurologist came after the package of medical information being sent to the insurance company. So they don't have the latest information. So I called the GP's office and spoke with the receptionist and explained. She said 'I'll have to call the doctor and ask if you can have the report'. Ok, maybe not such a big deal, but this really ticked me off! I held it together on the phone but I couldn't help but feel like this person was only being controlling and I wanted to scream at her. In Canada, any medical record with our name on it belongs to us and we have every right to a copy. What the heck is her power trip all about!? Her little ridiculous remark (which some sane part of my brain says 'leave it alone') is so out of line and inappropriate! She has no right to hold the report back from me! The sane and composed part of my brain realizes I have a scheduled appointment with my GP in a week at which time I can get the report. The 'other' part of my brain will have to be held back from making a very big stink about the receptionist and what she said. My head is ready to blow just from typing this! Deep breaths, it's just hurdles I tell myself. Sandi K. Quote Link to comment Share on other sites More sharing options...
Sandi K Posted April 22, 2011 Author Share Posted April 22, 2011 Hi Ann, I don't know if all Canadian insurance is the same but yes, my Occ Health advisor said that once I'm approved and begin a gradual return to work the insurance company makes up the difference. Sounds like your doctor visit went well, fingers crossed that your insurance company co-operates now! Sandi K. Quote Link to comment Share on other sites More sharing options...
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