
JUMANNE of North brunswick , nj on Aug. 30, 2010
On Wednesday, June 16, 2010, I had an abdominal Mymectomy performed to remove multiple fibroid tumors. I was released from Mountainside Hospital on Friday, June 18, 2010. I was instructed by the physician who completed the surgery that my recovery time was to be between 6-8 weeks. I completed the necessary paperwork as instructed by the Human Resources Department at Comcast Cable and received written approval from Liberty Mutual for short term leave from 6-11-10 to 8-11-10. I was also approved for 360 hours of FMLA.
Prior to my surgery, I received a telephone call from assigned case Manager, Catherine *** (Dover, NH office) advising that my benefits would begin on 6-23-10. On July 9, 2010, I completed a post-surgical medical appointment. On July 12, 2010, I received a telephone call from Ms. ***. I confirmed that the doctors appointment was kept on July 9, 2010. Ms. *** advised that she would be contacting my doctor's office for the operative report. I advised that I would call the doctors office immediately to inform them of the required information. On July 23, 2010, I received a letter (dated July 12, 2010) stating Ms. *** contacted the doctors office and was unable to verify any information. I called Ms. *** and left a message. I received no return call. I contacted the doctor again. I was advised a restrictions form was sent as well as the operative report. The administrator at the doctors office stated she would send the information again.
On July 26, 2010, I called Ms. *** again and received an out-of-office message advising she would not return until August 2, 2010 (one week later). Following the specific instructions left on Ms. *** voice mail, I dialed 0 to be connected to another case Manager. A case manager named Heidi answered and helped me tremendously (unfortunately, this was 14 days after the original telephone call I received from Ms. ***). Heidi verified receipt of the paperwork from my doctor. Heidi provided the time frame of 7-10 business days required to review the documents. I waited the time frame given.
On August 12, 2010, I received a letter (dated August 6, 2010) denying benefits past July 9, 2010 (three weeks after being operated on!) I contacted Liberty Mutual again. I left Ms. *** yet another voice mail message. I received no return call. I called back and spoke with Erica. Erica was not helpful, only advising that Liberty Mutual's medical staff was still evaluating my paperwork. I explained that the 7-10 day time frame had passed and my finances have been negatively affected by this decision. Erica remained silent. There was no empathy expressed on behalf of your company representative.
On August 16, 2010, I was released by my doctor to return to work. While at work, I contacted Liberty Mutual again and spoke with Heidi (again). Once again, Heidi was very helpful. Heidi and I spoke in length about my case. Heidi advised that Liberty Mutual was unaware of the specifics surrounding my surgical procedure which included a severe headache, terrible gas, dizziness, tenderness and numbness above and below the incision site and that I had been prescribed the pain medication Percocet. Heidi explained that because Liberty Mutual has no record of this information, it had been determined that I had this miraculous surgery with zero complications and was able to return to work. Heidi went on to explain that if I contacted my doctor and asked her to forward a letter including the symptoms I was experiencing she would ensure that this information was sent to your medical department for review. The last thing Heidi stated was that Liberty Mutual lists the recovery time of an abdominal Mymectomy as four weeks. Even if this is accurate, my benefits ended after 13 days? This is contradictory.
On August 24, 2010, my doctors office administrator contacted me and verified that a letter had been faxed to your company. On August 27, 2010, I received a telephone call from Catherine ***. Ms. *** verified that the letter had been received. To my surprise, Ms. *** stated that I needed to approve the paperwork that was faxed by the doctors office before Liberty Mutual will begin the appeal. I find this a bit odd since I am not a medical professional and I do not work at Liberty Mutual. How do I know if the letter from Doctor Peace is sufficient for Liberty Mutual to overturn Liberty Mutual's decision? This does not even make logical sense. Here is a direct quote from Liberty Mutual's website:
"If your claim is approved, your case manager will work with you on a recovery plan and return to work goals, as appropriate. Sometimes we may need to contact your doctor to better understand your condition and potential for recovery. We also have a team of dedicated medical and vocational staff that may assist with review and rehabilitation efforts for your claim. Liberty Mutual's case manager (Catherine ***) assigned to my claim does not return phone calls. Liberty Mutual's case manager (Catherine ***) assigned to my claim has not worked with me during my leave.
This entire ordeal has been unreal. The only time I heard from Ms. *** is when she contacted me regarding my post-surgical appointment and today. I made myself available at all times while I was recovering. Ms. *** was never available when I called and she never returned any of my phone calls/messages. Liberty Mutuals dedicated medical staff, according to the letter I received, was a Disability Nurse Case Manager. I find it very difficult to believe that a Nurse can over-ride a Physicians instructions."
I have worked for Comcast for 13 years and have never needed to utilize our company's short-term disability benefits. I get sick, require a medical procedure and hospital stay and have to prove to Liberty Mutual's medical expert that I was temporarily disabled and unable to perform my duties at Comcast between 6-11-10 and 8-11-10. Today, Monday, August 30, 2010 I once again contacted my doctor reported to her office to review the papers/documents that were sent to Liberty Mutual.
Ms. *** has advised that my appeal will not begin. When I do review the letter/documents and contact Liberty Mutual with the resolution what happens next? What if, once the letter/documents are received by Liberty Mutual and Liberty Mutual's medical experts still decide they require more information? Then my appeal is denied and you close the books on me? How is this fair to someone who did nothing wrong except get sick? What a way to run a business.