Tuesday, September 28, 2010


How crazy the last week or so has been. I have been too overwhelmed to share anything before today. To continue where I left off I'll give you the details of the denial letter I got from The Standard. Let me start by saying I was floored by what the letter had to say. I will admit that they did a somewhat decent job of recapping two years of medical history. There were a couple of things they left out but overall it wasn't bad. The conclusion to all of the medical information they had is really where they went completely wrong. They basically said that there was "insufficient medical documentation" to support the fact that I had Lyme, or anything else, that would keep me from doing my job. They basically stated that all of my issues (symptoms) are somatic. That basically means they are all in my head or that they may be real but they are all self induced. Are you kidding me? That is very hard to hear after you were already being told that because the doctors couldn't figure out what was wrong with you. They said they don't believe I have Lyme regardless of a positive blood test. (They don't like the lab I used) They don't believe I have Lyme after two different doctors said I do. They said I don't have the typical physical findings of Lyme. So first off, Lyme is a "clinical" diagnosis. Blood work alone is not supposed to be used to diagnose Lyme. Many people have negative blood work. Positive blood work could indicate a previous infection. My history is I have a known tick bite, there has been no other known cause for my deteriorating health, I had a positive blood test, and I am reacting to the mediation used to treat Lyme. I have almost all of the symptoms of Lyme. Physical findings are very hard with this disease. There is not a lot of physical evidence that supports muscle pain, joint pain, fatigue, memory issues, twitching, etc...You can physically see me sleeping a lot during the day, you can physically see me twitching, you can physically follow me into the bathroom and watch me get sick but you can't run a test that supports all of my symptoms. The Standard took issue with the fact that my diagnosing doctors for Lyme were a Lyme Literate Naturopathic Doctor and General Practice Medical Doctor. They said that it should be an Infectious Disease MD or a Rhuematologist. They didn't agree with the Fibromyalgia diagnosis because it was suggested by a Neurologist and supported or diagnosed by my GP and not a Rhuematologist. One of the first things I did when I got the letter was to call the claim rep and ask some questions. First I asked for some specific or detailed information on what would be considered "sufficient medical documentation"? The answer was there isn't any. It is individual to each case. So you can call what I have "insufficient" but you can't tell me what "sufficient" is. Okay. Now onto the diagnosing doctors. I asked for the policy or something in writing that stated I had to be diagnosed by a specific specialist. I was told there is nothing. So you tried to tell me you thought the diagnosing doctors, who are licensed mind you, were not qualified to make a diagnosis but there is nothing that states who or what kind of doctor must make a diagnosis. Doesn't seem like they have a lot to go on. As my doctor put it this morning, this is essentially bad faith on the part of The Standard. They have just said that a couple of licensed physicians with thriving medical practices are not qualified to diagnosis people. He believes I need a lawyer. I will continue on with my appeal. Nothing is being changed in my treatment. My doc did say he still believes I will end up on IV meds at some point but for now we will continue with my current treatment. To help my disability case he is sending me up to the L.A. area to see an Infectious Disease doctor. Hopefully it won't take much for her to support my Lyme diagnosis. Unfortunately I can't get in to see her until the 12th of October. Oh well.
So after all the frustrating news let me get to the WOW! I ended on a good note last time, looking toward the future with some excitement over how God would turn this situation around. I am not going to say it has been easy to stay hopeful. I have had some difficult moments and there has been this constant small worry in the back of my mind that has begun to take it's toll on me. I have continually tried to remind myself that God would come through. I had to have to faith. I have done the small things I can do but the timing is all God's and He may have a different plan. While I was in the doctors this morning I got a message from one of the guys I work with. I called him back and got some news that almost brought me to my knees. He had been informed of my current situation and after discussing it with the other guys on the department they were prepared to help however they could. He took the initiative to start talks with management about what they can do to help me and my family and he just wanted to try and put my mind at ease. They were doing everything they could. Of course I cried. I knew I worked for a great Fire Department but this goes above and beyond what I could have ever imagined. Fire Departments are typically extended family. My past experience has been that to be part of the family you have to be a firefighter and work in the suppression/medical side of things. I work in prevention and my interaction with the guys on the floor is different then the interaction they have with each other. To say that I am blessed to have the coworkers I do is an understatement. The support of the "guys" and their families is more than I could have asked for. I am confident going into the future that things are going to be okay. God has placed some amazing angels in my life and I am forever grateful.
Now I have got to find a special way to say "Thank You"!

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