What I learned about dealing with a disability insurance company

The first and most important thing is this:

In the eyes of the insurance company, you are a ‘scammer’ and you will spend every minute trying to prove otherwise.

Mental health issues in particular are the worst because they are hidden. They can only be felt and experienced. The only evidence to their existence is the patient’s word. Sure, the claim decisions are based upon the opinions of medical professionals, but the insurance company seems to think that they are stupid, gullible people who will believe anything they are told.

Believe it or not, I was totally ignorant of this whole process and you’ve never seen anyone as shocked as I was when I received my first disability check eighteen months ago. I had just exhausted my Employment Insurance claim and believed this would be the end of my own personal income. Then, a joyous, happy surprise came in the mail!

The insurance company makes sure to keep ‘their hand in’ and dictate what should be done and when, regardless what the medical professionals say. In every instance since the beginning, I would start a relationship with a counsellor, psychiatrist, etc. only to have it soured when the insurance company began communicating with them directly – questioning every decision and diagnosis.

Be careful what you agree to do and who you agree to see. From the very beginning, it was very difficult for my doctor to get me in to see a psychiatrist as there is a huge waiting list in our area. The very first psychiatrist I went to see was in the first few months and my anxiety and PTSD got the best of me. I ended up sitting alone in an unkempt waiting room, having been told she ‘would be with me as soon as possible’. I sat there for a while, getting more and more anxious, feeling nauseous, and finally, after what seemed like an hour (but was more likely only 5-10 minutes) I had to leave. I just walked out, went home and retired to my bed to try to avoid an increasingly painful migraine. Thereafter, this wasn’t seen by the insurance company as a symptom of my conditions, but as my own willful refusal of treatment.

At about this same time, my doctor recommended I see someone at Community Mental Health. Again, I was very uncomfortable and stressed, highly anxious, but I did manage to wait and got in to see her. She saw me for perhaps a total of 15 minutes and in that time asked me several questions. I answered them honestly. Her recommendation was for me to attend group counseling sessions and I looked at her in disbelief. Did she not realize why I was there to see her? What was there about my symptoms and conditions that made her believe I could go through group counseling sessions? So, I walked out disheartened yet again.

Shortly after seeing this counselor I started getting feedback from the insurance company. All of a sudden they believed I was an alcoholic, had been secretly earning an income, and believe it or not, had quit my job!

None of this was true, but when I thought back to what I could remember of the short session with her, I realized that she got a lot of things wrong.

I can only think her idea that I had been earning an income came from my telling her about blogging to keep myself busy at home. I was making just enough to pay for the expenses of running the blogs – no net income. The insurance company requested bank statements ( in this case, Paypal) and I forwarded them, never hearing another word about it. Did I get an apology? No.

Then I was accused by the insurance company of excessive drinking, causing my treatment to not be effective. Mark and I have always enjoyed a glass or two of wine in the evenings. We rarely drank at all before we started making our own wine. So, when asked about alcohol consumption, I mentioned that we liked our wine in the evenings. How this led to an impression that I was an alcoholic I have no idea.

And finally, I received a phone call from my claim agent out of the blue asking if I’d quit my job? I never had. I’m still on a priority list with the federal government for when and if I’m able to return to work. I can only assume that when I talked about going on disability during this session as ‘when I left work’, she assumed I meant quit. So, now they had to investigate with my employer to see if I had quit completely. Again, no apology was received.

With each mental health professional, the most recent being a local psychiatrist, everything seemed to go fine. They made their diagnosis, all of them agreeing that I was incapable of working outside the home. I had been honest and up front from the very beginning, saying I would have no problem functioning if I could work at home. My issues affect my ability to be outside my home, in public, and dealing with other people, including friends I never see anymore – and not for lack of trying on their part (God bless ‘em!). This last psychiatrist wrote a report to my family doctor and the insurance company stating he could not see me being able to return to work in the foreseeable future.

Then comes the first communication from the insurance company and everything changes. My last session with the psychiatrist consisted of my being scolded and questioned at every turn, with the letter from the insurance company sitting in front of him the whole time. I mention my recent 35 pound weight loss and instead of encouraging words, he said (paraphrasing here), “But that’s not enough. You have a long way to go.” When he mentioned the possibility of my returning to work, I reluctantly agreed to try, knowing full well it wasn’t going to happen. I still can’t even see friends, so how am I supposed to return to work? Then he gets to the disability benefits, saying (again paraphrasing) that my reluctance to return to work was a result of the incentive of the disability income.

I was offended – and upset! I have lived every month expecting to not receive any income because the insurance company had decided I was scamming them. I told my family doctor that it was more stressful dealing with the insurance company than anything else and when it came right down to it, I would rather give up the money so I could be helped without their influence.

One good thing this last psychiatrist did was make me request an appointment with the Ann Davis Transition Society. I had my first appointment two days ago and liked her a lot. Get this, she said she would have to consult with a senior counselor as she felt I have too many issues of a serious nature for her to handle alone. (I refrain from going into detail because I want to keep some things private. I’m uncomfortable enough as it is just discussing all this, but feel someone needs to start talking about how we’re treated.)

So, my next appointment with the psychiatrist will be my last. I will tell him exactly how I feel about his treatment of me during our last session. The insurance company can go right ahead and cut me off. I simply don’t care at this point because my mental health is much more important than the money and I want to attend the sessions at the Ann Davis Society for myself, to get help, and to avoid any poisoning of the situation by the insurance company.

It was great to know this counselor feels the same and I’m finally able to hope I will be getting some help.

The bottom line of all this is that the insurance company is only concerned about their ‘bottom line’. This makes them see everything through a veil of suspicion, question everything, and instead of allowing the professionals to decide treatment, interfering at every turn, only exacerbating the symptoms and conditions.

THE INSURANCE COMPANY SHOULD NOT BE ABLE TO INFLUENCE TREATMENT! They should be there as a support to the patient to ensure the treatment prescribed by the professionals can be afforded and is available – that’s all!