You need a lawyer who can help you NOW to get the insurance company to put everything in writing. You need to do things like print out the scientific studies which show that the surgery that they are demanding will almost certainly make your disability worse, and may very well kill you. Then those need to be notarized and sent to the insurance company medical director in such a way that he has to sign for them.
Basically, what you have to do with the insurance company is to stop acting like some poor hapless victim who has to do whatever they say. Instead, your attitude should be hardheaded, "don't push me around, I'm very carefully collecting evidence so that I will OWN you after the lawsuits!" And "Look, buster, it'll be better for all of us if we stop the insanity BEFORE it happens!"
>From the disability insurance company's financial point of view, the
best thing that could happen to THEM is if the surgeon kills you. Even
if they are carrying a life insurance policy on you, too, usually those
company-provided life insurance plans aren't for much, and compared to
years and years of disability payments the life insurance payout is a
bargain.
This is why you absolutely need a lawyer. You need to find some way for it to be so expensive for the disability company to kill you that they will make the hardheaded business decision that keeping you alive and paying your disability payments is the most economical path.
If the issue is purely one of diagnosis, then there may be a chance that a lap which is purely for diagnosis would be acceptable. And it IS possible to have one of those so that you a small (but not zero) chance that things will get worse. But again it is important that any surgeon going in understands that if he gets any bright ideas about converting to a laporotomy and "cleaning out" all those adhesions, and then you end up in worse shape, well if that happens then you and your ambulance-chasing lawyer are gonna OWN this surgeon's porsche and big house and kids' college funds...
Part of legal threats is that they work best as deterents. Maybe your local ACLU would like to be involved in a civil rights lawsuit over the issue of a company forcing you to have surgery which is life-threatening and probably will leave you more disabled.
At Wed, 24 Jul 2002, Rita Steele wrote:
>
>Karla,
>Thank you so much for giving me the info. on Dr.
>Kruschinski. I'm really in a bind right now. I will be
>taken off disability if I don't have surgery ASAP. My
>employer needs a firm diagnosis just saying I'm in
>pain doesn't cut it with them. Isn't it amazing with
>all the technology, no one can measure pain! I can't
>afford to lose my job (health insurance, too) & I
>can't survive without my disability (small though it
>may be). So I'm between a rock & a hard place.
>Thanks again,
>Take care,
>Rita in AZ
>--- Karla <ifirgit@new.rr.com> wrote:
>> Rita,
>>
>> I would check around to find out about Germany.
>> There is the new clinic
>> that just opened in Frankfurt that is using the
>> spraygel. The doctor's name
>> is Kruschinski and I have heard that he is
>> wonderful. The following was a
>> site that was given on this board in connection with
>> Dr. Kruschinski...I
>> didn't check it out so I don't know if it is his
>> website or not, but perhaps
>> it will give you information you might need. I find
>> it a little hard to
>> believe that a new clinic is backed up that far. I
>> do know that such is
>> probably close to the truth about Dr. Korell. My
>> feelings are that given
>> our situation and how much worse each surgery makes
>> us, participating in any
>> of the studies is not worth the chance. If we were
>> to participate in this
>> study we would have a 50% chance of getting the
>> Spraygel...but also a 50%
>> chance of having things made worse. Not worth the
>> odds to me. I would
>> rather either go to Germany to a doctor who I know
>> IS using the SprayGel or
>> wait until SprayGel is approved here in the states
>> and you are guaranteed
>> its useage. I am not trying to make decisions for
>> anybody, I just want to
>> prevent people from ending up like me. Pain is an
>> awful thing.....but death
>> is worse. Give me pain any day versus having to
>> live with the knowledge
>> that you are dying and there isn't a damn thing
>> anyone can do about it.
>>
>> God Bless!
>>
>> Karla
>>
>> Somewhere up in the stars.................
>> My angel and me!
>>
>> http://www.geocities.com/karlasfamily2001
>> http://www.geocities.com/princessd82000/BraydensHaven
>
>>>> ----- Original Message -----
>> From: "Rita Steele" <steelerita@yahoo.com>
>> To: "Multiple recipients of list ADHESIONS"
>> <adhesions@mail.medispecialty.com>
>> Sent: Monday, July 22, 2002 7:46 PM
>> Subject: Re: A second study - involving Spray Gel -
>> by Confluent Surgical
>> Inc. - is being conducted at Atlanta, Georgia!!
>>
>> > Has anyone applied & been accepted by any of these
>> > studies? I called about the one in Sandy, Utah but
>> was
>> > told it was only on lower abdominal adhesions.
>> I've
>> > contacted Dr. Lyons on this second study & I'm
>> waiting
>> > for a phone consultation with him. I don't know if
>> my
>> > insurance co. will pay for this surgery because
>> it's
>> > out of state, but I'm going to call tomorrow &
>> find
>> > out. Dr. Lyons said their are 500 people on the
>> > waiting list to have surgery in Germany with
>> Spraygel.
>> > I'm scheduled to have "Diagnostic Laparoscopy with
>> > Lysis of Adhesions" on Mon. July 29 in Phoenix,
>> AZ,
>> > but the surgeon does not use any barriers but I
>> can't
>> > stay on disability unless I have this surgery! I'm
>> > hoping by some miracle my insurance will cover the
>> > clinical study surgery if I'm accepted. I'd like
>> to
>> > hear from anyone about the clinical studies if
>> they
>> > did or will participate in them? I've never been
>> to
>> > the South, I was born & raised here in AZ, but
>> I've
>> > never been to Germany, either! If I have to have
>> > surgery I'd rather take my changes that I might
>> get
>> > Spraygel instead of knowing I won't get anything.
>> > Take Care,
>> > Rita in AZ
>> > --- Helen Dynda <olddad66@runestone.net> wrote:
>> > > A second study - involving Spray Gel T by
>> Confluent
>> > > Surgical Inc. in Waltham, Massachusetts - is
>> similar
>> > > to the FDA -approved Adept study.
>> Qualifications to
>> > > enter this study are listed at this Url:
>> > >
>> > > http://www.thomasllyons.com/studies.htm
>> > >
>> >
>> > http://health.yahoo.com
>> >
>> > To remove yourself from the
>> adhesions@adhesions.org mailing list please go
>> > to the unsubscribe form at
>> http://www.adhesions.org/forums/listcmds.htm
>> >
>>
>> http://www.adhesions.org/forums/listcmds.htm
>
>http://health.yahoo.com
-- cathy :-)