Do you know what most of the words above mean or what the acronyms stand for? If not consider yourself lucky. These are all terms that, over the past few weeks, I have become very familiar with. Trust me when I say it is a HATE/HATE situation...there is no love here. This entire journey has been a nightmare since day one, and not for the reasons you may be thinking.
If you were sitting here with me the best way I could explain my past few weeks would be to tell you to close your eyes, take a few long and deep breaths, picture a mountain but instead of rugged terrain it is a freaking mound of paperwork. As I say that last statement, WHACK I would smack your forehead. Come on, you remember that game growing up, right? Right? I can't be the only one who ever got sucked into it, though I believe we were told we were running through the woods.
Anyway, THAT is exactly what I am faced with. Paperwork, mounds and mounds of it. Really, it would not be so overwhelming if most of the papers were not denials of some sort. Way to make a girl freak out, people. The denials start with the original request for FMLA. DENIED! This denial lead to Joe getting "pointed" at work and at the moment he is negative enough that his employer can terminate his job at anytime. (Insert every expletive word you can think of here...and maybe even some you just combined or made up.) Silly me, I forgot to mention that the request was denied even though the doctor restricted Joe from work for 5 days pending his evaluation by the neurosurgeon. That there is BS at it's finest folks!
So yep. Our future is looking rather grim being that Joe will be having brain surgery next Tuesday, followed by just over a month of missed work. Here's hoping they don't terminate him!! I try my best to remain positive but secretly this scenario has really had me in a mood lately.
We are blessed that Joe's work offers paid Short Term Disability at a reduced percentage of hours paid. We gathered up all the information requested and STILL managed to get a letter this past Saturday requesting more medical documentation from the neurosurgeon. At this point my patience was extremely worn thin so I wrote them a short, precise and slightly snarky letter. I will share a bit of it with you, "Today I received an Intake Letter and Short Term Disability Claim Form, basically requesting the same information that the Certification of Health Care Provider for Employee's Serious Health Condition requested. I get that as a company it is your duty to try to not pay out claims, after all, how would you make money if you did but this seems a little insane." While it may not have been as eloquent and poised as my other letters, it sure felt good to send it. Best of all, it worked as we have received a phone call stating that his Short Term Disability Leave is approved. Sometimes I just venting a little pays off?!?! Please note: that was the most rude part of the letter. I do not like to make a habit of being an outright bitch to people as really, the person receiving the email most likely has NOTHING to do with it and I would hate to ruin their day just to make myself feel temporarily better.
This brings us to my evening tonight. Since denials seem to have become a regular ol' part of our life I decided to look up Joe's medical claims. Would ya know, there were 3 more denials there. So I did what any one would do, at least I think it is what normal people do, I printed out a "Designation of Authorized Representative for Appeal" form for him to sign. This form will appoint me as his representative since he does not need to deal with any added stress. Then I printed and filled out the "Member Appeal" form, typed up an amazing letter to the appeals analyst - only after reading his member handbook front to back to ensure I knew what I was talking about and had some good quotes to include. Finally, after getting the letter all prepped I scanned and printed copies of everything (and then some) to include with the appeal. We will be mailing it off tomorrow and I really hope they approve my request for an expedited hearing since his surgery is in 7 days and the denials all seem to be directly related to his hydrocephalus. 
Don't get me wrong, I am beyond thankful that Joe has medical insurance and has access to company paid short term disability. I am less than pleased with the corporate hoops we have had to jump through. I can see how some people would just give up as it seems like daily something new is being requested just as something else is being denied. There is light at the end of the tunnel however and I know that eventually, once everything is done and over with all the countless hours of phone calls, emails, mailed letters and research will be well worth it. Until that day, most likely you will find me with a mountain dew on my desk and 10 browser pages open as I trying to sort this mess out. 
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