Thursday 5th of April 2018 08:26:04 PM
As an 18 year employee with Verizon Wireless I am very angry that my employer contracts with the insurance company MetLife. On February 5th, I left work as I was unable to perform my job functions due to problems with severe muscle and joint aches and pains, constant fatigue, and my inability to focus on my work. I was diagnosed with Fibromyalgia, Chronic Fatigue Syndrome, Hypothyroidism, and Gluten Intolerance. I began treatment with a doctor who treats holistically in all areas and when his treatment is not effective then he resorts to drugs. The first claim that I submitted was on February 6th and it was denied therefore I was not paid anything from February 5th to August 5th, 2012. The basis for the denial was I did not provide objective medical evidence of my illness and did not provide any documentation to support my inability to perform my job function. Since Fibromyalgia and Chronic Fatigue Syndrome does not have diagnostic tests proving their existence and according to MetLife's skilled medical board the Hypothyroidism was not severe enough to be interfering with my job I did not have a valid claim. It did not matter that at times I could barely walk and I was sleeping up to 18 hours a day even though every month my physician increased my Thyroid Sublingual. I had also begun to see a Neurologist, who with some testing, diagnosed neuropathy in my legs. In order to protect my job my employer placed me on a Work Place Arrangement in which based off of the medical information I provided them they would put me on an "Unpaid Medical Leave of Absence". So ironically, Verizon Wireless placed me on "Unpaid Medical Leave of Absence" with the same documentation that was submitted to MetLife. In July, I received a call from the Verizon Employee who managed my Work Place Arrangement Claim telling me that unless I returned to work on August 5th, 2013 I would lose my medical benefits for myself and my family because I wasn't paying into my benefits as I was in an "Unpaid" status. Even though I was not able to be awake for more than 6 hours at a time and I was in constant pain from Fibromyalgia I attempted to return to work on August 5th. To return to work, it meant that my day started at 4:30am as I work 60 miles from home and have to begin working at 7:00am. My day does not end until around 8:00pm which is when my granddaughter, whom I have physical legal custody of, goes to sleep. On my first day back to work, August 5th, when I came home that evening, I was unable to prepare dinner or be involved in my granddaughter's homework due to my severe pain and fatigue forcing me to go to bed at 5:30pm. I worked August 5-7, 2013 and on August 8th I called MetLife advising them I was not able to work and that my previous claim needed to be reopened. Prior to returning to work, because I was so emotionally taxed by dealing with MetLife and following up with my numerous doctors, dealing with creditors who were not getting paid as I was not receiving a paycheck, filling out mortgage modification papers to address my non-payments, borrowing money from family and friends to keep my utilities on and filing a request for Food Stamps so I could at least feed my family, I finally had to seek psychological help. I called Verizon EAP (Employee Assistance Program) who referred me to a counselor who I began to see on July 16th, 2013. Since my illness caused such a catastrophic domino effect with my finances, dealing with family who did not believe I was sick, and constantly having to give up activities or not being able to participate with my family because I was in pain or tired, I was diagnosed with Chronic Depression and Anxiety. So when I reopened my previous claim and MetLife saw that I was now seeking counseling, they closed my prior claim and reopened a new one due to the counseling. Within a couple of weeks my claim was approved all because I was seeking psychological counseling. So now from September 16 thru December 16th, 2013 I went to the same doctors and still maintained the same medical diagnosis with no notable improvements; however my claim was approved and I did get paid. Unfortunately, each month I had to make sure that after every doctor appointment I had to call MetLife advising them that I just saw a doctor and requested they send a request for updated information so that when my claim manager reviewed my claim for extension, he would have all the doctors, counselor, and psychiatry office notes. The month of December proved to be a challenging month as MetLife was slow to approve my claim to extend my claim out until December 16th and with no approval Verizon Wireless would not put me in an active status therefore I was not paid. I did not have any money to pay for doctor's co-pays, medication or gasoline to go to my appointments and I was forced to move my appointments to dates that I believed my case would be approved and I would have money. Now because I moved the appointments I could not get my documentation to the case manager until December 18th, 2013. On that day, I called MetLife to request they send a request for records to my doctor and I wanted to verify that they had received documentation from the neurologist, counselor and psychiatrist. They said they had not received anything even though I called MetLife the day I had each appointment requesting they send an updated records request. I called my doctors/therapist and they said they never received a records request! So I called MetLife back and they said that they had sent out the records request three times to each of the doctors but did not receive anything back from them. My doctors said they either did not receive the records requests or did receive the records request and sent out the necessary documentation but MetLife claimed they did not receive any records. This kind of activity was constant in my history this last year therefore I was never free to be stress free or to focus on my recovery because I was bouncing back and forth with the documentation issues. The final conclusion was MetLife was not being forthcoming to me when I called them to send out the records request or to verify they received documentation. I spoke with my case manager on December 20th to go through the normal "Who did you not receive documentation from" review and was told that my primary doctor who treated my fibromyalgia had not sent any office notes from my December 11th office visit. I advised my case manager then that my doctor's office did send the requested documentation three times and that since there was a challenge with MetLife's fax system, I would send him the documentation to his email. He provided me his email address with no contest and I immediately sent him the doctor's notes from that visit via email. So now all I could do at that point was sit back and wait for the approval. Of course, it meant that I did not have money to have Christmas for my granddaughter or other family members and I had to find money to pay my utilities. By January 6th, 2014 I had not received any information on an approval or denial of my case so I called MetLife to get updated on my case. Since I was never able to call my case manager directly, I had to wait until he received my message and then he would call me back. He called me back on January 7th and advised that my case had been sent on for further review by the clinician and that he did not have an answer for me at that time. My question was how come my claim did not have any activity on it from December 20th until January 7th? Then when I finally did get the call that my claim was being denied how come they waited until 3:30pm on January 10, 2014 to advise me? AT this point, I was not going to be paid up to December 16th, 2013 nor was I going to be extended until January 16th, 2014. When I received the denial letter I saw one interesting fact... The case manager did not mention he received the documentation from my Fibromyalgia physician even though I had emailed it to him on December 20th. The denial letter stated that "There was no medical documentation provided to indicate with sufficient severity, any abnormal exam findings..." So now I was very upset because my prior claim also was denied based off the documentation yet ALL the documentation MetLife received was the same and showed that I was still being treated but was not able to work due to my anxiety, depression, severe pain and chronic fatigue. When the second claim was approved I knew the approval came because of the psychological information they received but now that I provided the psychological information they did not have any medical documentation (which they did not feel was sufficient enough to approve the first claim!). They denied the claim. How can anyone stay mentally well dealing with this kind of blatant abuse? I use the word abuse because the whole time I have been dealing with them they never once showed sincerity or apologized for any confusion I was experiencing. They didn't care nor did they wish to work with me in helping my claim become approved. So how could my employer continue to contract with such an abusive disability company? While I have much anxiety in dealing with an illness that has put a one time "hit the ground running" person to one who can barely get out of bed, I have also been dealing with MetLife who has basically insinuated to my employer that there is nothing wrong with me. I was an exemplary employee who had perfect attendance which meant no tardies, did not use my sick time and was always "leading" in my job performance. I feel I did not get to 18 years of employment with Verizon Wireless if I was an employee who lacked integrity or had to be monitored because of suspicious job performance. Yet my company allows their outside contractor to virtually place me into a category of being unscrupulous. Additionally, while I have been trying to protect my reputation with Verizon Wireless, anytime I was faced with MetLife's scare tactics and abuse, I had no advocate within Verizon Wireless to be a liaison between them and MetLife which left me constantly not knowing what my next step was going to be. Sadly, because I can no longer afford to not be paid, as my home mortgage company is threatening foreclosure, ALL of my credit accounts are in write-off or collections status, I have not been able to continue with my medication because my mail order pharmacy who I have to get my prescriptions through because of my health benefits will not provide me anymore medication unless I pay my outstanding balance (which is money I don't have because I haven't been paid!). I will be returning to work tomorrow February 3, 2014. I am saddened because my employer of 18 years does not care about me as their employee to help me in dealing with MetLife, but rather they (my employer) hide behind contracts and generally allows MetLife to abuse their (Verizon Wireless) employee. All I have ever wanted was time to get better physically but this last year has done nothing but cause my physical state to worsen due to the stress (which is a trigger of Fibromyalgia). Also, my mental state has developed into an area in which I never believed someone of my integrity and work ethic would ever have to see. Honestly, several times I have wanted to end my life and since I have gone that far in my mental thinking it has brought me to a level of thinking I would have never gone to on my own.My motive to write this complaint is to see if there is anyone out there who can help me understand why two large corporations (MetLife and Verizon Wireless) are allowed to continue with such practices/treatments. To force a person into financial hardship and continually abuse them by their scare tactics is unacceptable and unethical. I want to understand how this cannot be stopped as I know that I am not the first person to be driven down this path of destruction.