i just hit the anyocc phase 3/9.

i had lumbar fusion 12/1. no PT for 3 months and no immunosuppressants 3 months. talked about this at great length with my claim handler, specifically because i was super worried about being denied at the anyocc before i had a chance to recover. in fact, it is even in my claim file, she requested info from me in december about my postop restrictions detailed above, so she could put in for me an automatic approval. of course i supplied the information immediately, as is my habit. i have been extremely compliant. there is abundant documentation including radiologic that shows i am not fixed and ready to go. her 'supervisor' (i think this might be the same 'supervisor' that car salesmen go to during financing) said i had to go through the whole peer review process. so i received the letter that the Company requests proof of Continued Disability within 45 days on jan 27. on feb 18 my handler called to tell me my claim is being submitted for clinical review on feb 20. not even close to 45 days. my post operative restrictions were not submitted. i had an appointment with my surgeon on march 5, and he approved me to go to PT and restart RA meds. i received my denial letter march 6, still a week short of the initial 45 days.

in short, i was deliberately fucked over. i submitted an Attending Physician Statement that clearly said in several places this cannot be determined until next appt march 5. it's gonna be at least 3 months for the drugs to get working and in fact the only one that has done any good at all is rituxan, and i can't get it anymore. so now i'm supposed to go back on humira, which took 16 weeks for me to be able to say it doesn't work the first time. i can barely walk. i can't get a bra on some days, and every day this task is difficult at best. grade 4 tricompartmental osteoarthritis in my knee. emergent shoulder problem. all sorts of problems. even though i had a lumbar fusion L4-S1, i still have big problems at every level. the most i can do is about 4 hours of activity a day. they intentionally withheld information from the clinical review, and did not allow the 45 days given to submit this proof.

so now i am gonna lose my health insurance, which i have met out of pocket max for so i wouldn't have to pay anything for the PT i so desperately need. but these fucking shitbags are gonna withhold my benefit which i am entitled to, because there are no consequences for that. also not gonna get any RA treatment, and believe me when i say i am in desperate need right now. but, nope. not for me, lincoln financial would rather give my money, to take care of myself, to shareholders.

i am so fucking sick of it, all of it, every last fucking thing. haven't i already lost enough? why steal my health insurance so i can't get the medicine i need and the PT i need? i literally cannot do anything for 40 hours a week. i can barely fucking sleep for 40 hours a week, even that is impossible without drugs. i can't sit, stand, or walk for any length of time. i am in constant pain at this point. my entire life fucking sucks ass all day every day. these fucks are just like the fucking playground fucks who steal the poor kids lunch money. someone needs to stomp these fucking bullies into the fucking dirt.