Health over Wealth
February 21, 2018
Dear (Insurance Company Name),
I am writing to inform you that I will not be attending the Medical Examination on March 5th, 2018. I believe it is immoral and unjust to harass someone the way (Insurance Company Name) has treated myself and my mother in the management of my claim, not only in these past four months since you (Case Manager) took over my file, but since inception, where we had to justify to you in the fight of three appeals why I deserved to be paid this claim – which you yourself approved after the third appeal and I was put onto Long Term Disability in March 2016. Since then, we have gone to my family doctor to send you updates as you requested, and spoken to your case managers and rehabilitation specialists, again at your request. We have been subjected to at least six conversations and two letters written to you in the past four months. Four of these interactions with the case manager, one with a rehabilitation specialist, one with the ombudsman and client relations department, and one with the director of your department.
All these interactions involved us having to yet again justify my condition to you – being interrogated at length again and again, answering and repeating the same answers and even having to continuously educate you about Chronic Fatigue Syndrome (CFS), which made it clear yourself, and all others from (Insurance Company) we have interacted with, know very little about this disease.
I have watched how aforementioned frequent and repeated interactions with you have put an even greater strain on my sole caregiver – my mother - who has had to participate in four out of six of these interactions on my behalf, because I was unable to due to my illness. I have had to listen to her justify my illness to you over, and over again. To revisit my entire illness from the beginning until now, in the face of your ignorance and incompetence of checking the information we have already provided to you over the course of these four years on file – along with numerous doctors’ reports that have supported my CFS diagnosis and ongoing symptoms to date. The emotional, mental, and physical strain you have caused her – a single mother taking care of her adult daughter’s needs in every single regard, other than personal care, because of how dehabilitated I have become by this illness - is disgusting to me.
There is no empathy, no consideration, for the toll your incompetence, inefficiency and willful ignorance of CFS is causing us. Your only objective is what you need to fulfill your “protocol” – which when we asked, is extremely vague in the frequency you can request such interactions and doctors appointments with no basis, whenever you want – as listed above. Even to the point of telling us there is no medical evidence to support my illness – expecting us to provide some – when no such medical evidence exists for CFS. It is diagnosed by an exclusion of all other illnesses, and the meeting of certain criteria, which I have met as evidenced by Dr. XXX’s diagnosis report from Women’s College Hospital in May of 2015, and further supported up to date by my family doctor, Dr. XXX.
I have felt the emotional, physical and mental effects of my mother’s distress in watching her engage with you, because I am unable to do so myself. If your interactions can cause a caregiver to feel this way – you can appreciate what it does to me – the patient, with an illness with symptoms that are exacerbated by any mental, physical or emotional overexertion and stress to my system - as has been continually repeated to you by my doctors, my mother and myself. I have had to write a letter to you on November 16, 2017, and repeat my entire history and answer an in-depth interrogation, yet again, to your Rehab Specialist on Nov 29, 2017. The strain of interacting with you in this way has caused me to experience setbacks in my condition both times, with the onset of severe fatigue, and a bedridden state for at least one week after, taking weeks to regain the level of energy I had prior to the meeting, if at all, before being hit down again by your continued interactions with either my mother or myself.
Now, just two months later from the meeting with the Rehabilitation Specialist, you are asking me to attend 2 more appointments with doctors selected by (Insurance Company Name), the first one with an Internal Medicine Specialist to “reconfirm my diagnosis” as it is “unclear what my illness is” and there is “no medical evidence on file to support my diagnosis” of Chronic Fatigue Syndrome, or that I still have it. The second mandatory appointment with a Psychologist to understand the psychological and physical components driving this illness. Like I said, it is clear you are all uneducated about Chronic Fatigue Syndrome as this is a physical illness that is not psychologically driven and has no medical evidence - and you can send me to every doctor under the sun, and none of them will be able to provide it to you, as it has not yet been discovered.
I will not attend yet another appointment to repeat the same traumatizing facts of my illness that began four years ago, and all the symptoms and the limitations it has caused me, and the fact that there is no research that proves any treatment or cure for all patients of CFS thus far. I already have a diagnosis from the specialists of CFS in Canada at the Environmental Health Clinic at the Women’s College hospital, and the support of all other medical specialists I have seen, whose reports you have on file, confirming this is no other illness, and that I meet the criteria of CFS and continue to, as proven by my family doctor, and repeated in our six interactions with you in the past four months. Attending yet another doctor appointment as this, with the futile intention you are sending me for, will only worsen my condition due to the physical, emotional and mental overexertion and stress it will cause me to not only leave my house and attend it, but to undergo interrogation and testing from a doctor for one hour and a half, recounting all facts and reliving the trauma of my entire health situation, and repeating my limitations yet again, and then the journey home. I am not willing to do that to myself.
I will not sacrifice the health and well being of myself and my family due to your willful ignorance about the nature of CFS, and your denial of my ongoing condition. As you said yourself, “you can’t be paying these claims forever.” Even if I am still clearly ill and am unable to work, with the support of countless medical doctors. This leads me to conclude based on my experiences with you from inception, that it is your objective to stop paying my claim at all costs, which is unjust and unfair to do to a healthy person, much less a sick person and her caregiver who do not have the stamina to fight you for it without jeopardizing their own health and well being.
It is not my job to prove to you that I have CFS. It is not my job to reconfirm my diagnosis, which is supported by my doctors until today. It is not my job to educate you about Chronic Fatigue Syndrome and its causes, symptoms and treatments or lack thereof. That is your job. And I will not sacrifice my health and well being because you aren’t doing your job. I won’t continue to fight this battle I have been fighting with you for nearly four years on the basis of repeatedly justifying my illness and my qualification for this benefit - that is completely immoral and unjust.
You are asking me to choose between my health and my financial well being that I rightly deserve – a choice no one should have to make.
I choose my health and my well being, I will not be harassed by you any further, and if that means losing my disability income benefits as stated in your appointment notice letter on February 18th, I accept that with a clear conscience.
My request is that you educate yourself as a company on what Chronic Fatigue Syndrome is and what patients and their caregivers have to go through, so you never harass another patient like me again, compromising their health with the intention of trying to get out of paying your claims – as you have done here with me over the past four years.
It is inhumane and unjust to treat someone this way and against the spirit of what your policy entails. Educate yourself about Chronic Fatigue Syndrome and choose to act from a place of integrity, not from a place of ignorance and self-interest at the expense of your claimants. Do this so you never have to ask a 26 year old CFS patient to choose between her health and her financial well being ever again.
I ask any next steps to be communicated to my mother regarding this letter and my decision not to attend the appointment on March 5th, 2018.
I learned we always have a choice. However difficult that choice may be. And I followed my heart and chose my health. Again, and again, I choose my health.
Thanks for listening. Talk again soon.