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Feeling angry, frustrated and fed up!

Put in to claim on a trauma policy we have!

SAH is under the stroke definition BUT they have denied me stating I didn't have neurological sequlae for > 24 hours!!!

Insulted!!

I may not of been in a coma or had issues with speech or paralysis but 5 months on I still have daily headaches and concentration issues making it impossible to work! How is this not having neurological sequalae for > 24 hours!

Having glandular fever at the same time has complicated issues the insurance company has conveniently only picked up on parts of the medical report mentioning this and ignored all else! They are blaming my symptoms on the glandular fever!

Going to appeal - they've made me so angry, case manager made me feel stupid as if nothing wrong with me!

Tried to get in to see specialist to get a letter from him stating symptoms related to SAH but he's on hol for a month!!!

Anybody got any links for good articles I can use in my response?

Just the knock back I didn't need at the moment.

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Hi! Reading your note riles me up! I've just been through all this and know what it feels like!!

I think they turn almost all of us down the first time. Many BTGers say you have to appeal. Our poor Gill was made to go through a tribunal. They want to make us feel like frauds. My GP says 'nice fraudulent brain scan you had'! :lol:

I hate their forms and how they make us run around and gather information from all over the place. We are ill!

I appealed like everyone else. I sent them another letter from my GP, all my GP chart notes, chiro chart notes, a letter from my massage therapist. They approved my claim one week ago but it's only for a number of weeks. They expect me to be full-time working by august 12 which I won't be. I've managed to extend to August 26th.

It's really hard to be made to feel like a criminal. Remember, you aren't making this up. You didn't ask for this. You never asked to be struck by lightening and have your life put on hold. Your symptoms are real. You have paid into the program and now you should be covered in your time of need. Don't give up. Appeal.

Thinking of you and wishing you didn't have this worry while you are in recovery. It's so ironic, I'm sure my return to work would be further along if I didn't have the stress from the insurance company.

Sandi K. Xo

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Hi Sicknote,

I am so sorry you have to go through this. I have been in the same situation where you are right now. Thankfully, after 2 agonizing months my claim was approved. I have a very supportive GP and physiotherapist and I think that really helped my cause.

My GP was asked to send all consult reports, chart notes, medical tests, CT's and MRI scans I have had. We sent everything and more. I guess after seeing the finding in my CT that states: "extensive SAH and mild hydrocephalus" that sufficed. In addition, I was seeing my GP every 2 weeks as stated in the reports. My case manager "interviewed" me twice. The first was terrible as I wrote on a previous entry. I felt belittled and I badly wanted to phone him back. My husband being my sound of reason reminded me that it was the case manager's job to do so.

I also recall my case manager saying that my stroke was not like the "common" type and that I do not have any neurological defects. I believe I told him to look up SAH because although it is not the common type it is as severe and as devastating as any stroke.

Hang in there and like Sandi said do not ever give up!!! I will be thinking and praying for you. Be strong!

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  • 1 month later...

Just wanting to bring this forward and again say to everyone never give up.

Once my claim was finally approved it was only for a limited time. A few short weeks. Thankfully it included 3 sessions with a return-to-work psychologist who has been marvelous at helping me understand how to pace myself. Of course we aren't finished after 3 sessions but we have made progress.

My GP and the psychologist recommended that I'm not ready for full-time yet but I will get there. I telephoned the insurance company a week before my claim was to end and they said they would let me know the next week. Of course I heard nothing until the very last day. I find that very inconsiderate and unprofessional and almost cruel. What can you do? It amazes me.

I am happy report that my claim is continuing though but the best news is that I'm now going to get neuropsychology and rehab. This is such a huge relief. I see lots of you on BTG writing about Headway and other programs and Rampmama from Calgary who spoke of brain programs and cognitive therapy and I was so certain this was going to be out of my reach. I'm highly functioning and my GP says I'll be fine without it but I know I'm not functioning at the level I was before. My comprehension and ability to focus just are not the same. My psychologist agrees with me that this is where I'm disabled. I look and sound ok but I need help in this area where I'm able to hide it pretty well and even joke it off most of the time.

Don't give up, dont walk away. Keep asking, keep filling out those darned forms. Do whatever they ask. In the end you want to get better. Maybe we won't be the same person we were before the SAH, but we have every right to as many services as are available to try and get there.

Sandi K. Xo

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  • 1 month later...

Hi there

Sorry I've not been on her for a while but I just wanted to update this thread and give anyone else going through insurance companies/claims some hope!

It took 4 months of fighting, which to be honest I could of done without but I won - my trauma claim was eventually approved!!

They wriggled and squirmed but thanks to my neurosurgeon, who ended up having to provide 3 reports to them, all stating the same thing they approved the claim!

So to anyone else there who is fighting at the moment - keep fighting, dont take their first answer, don't let them get away with it. You pay your premiums and deserve to be paid out when you meet a claimable condition!

Keep fighting!

Kate

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