Category: Disablity insurance

Insurance Appeal, a Friend with HIV/AIDS, and a Happy Ending

Those who have been following me since last November, know that I’ve been working as legal power of attorney for a good friend who is HIV positive. He’s disabled and can’t work. For the past two years, he’s been receiving disability from an insurance company. In November, the insurance company canceled his long term disability and said he was ready to go back to work.

So he asked me to help him appeal the case, which I did. And then I hired an attorney to help because I didn’t want to take any chances. This is someone who is truly disabled, and I thought it was important to make sure everything was done correctly.

And this week, after six months of dealing with a grueling appeal, my friend was notified that his disability has been reinstated. Though we went through tons of paperwork while filing the appeal, I took my friend to an IME (insurance medical exam) that was set up by the insurance company a few weeks ago. This doctor works for the insurance company, and all she had to do was go over his past history and give him a basic exam and she could see he was in no condition to work.

It’s a happy ending, yes. My friend is finally able to relax for the first time in months. But it would have been so much easier all the way around if the insurance company had just set up the IME six months ago.

Update: My Friend with HIV; Disability Insurance

I’ve received a few e-mails about the posts I did regarding my friend with HIV and his disability appeal. I had to take the posts down for a reason. Due to the fact that this is so important to my friend, I hired an attorney to help me out with the appeal and she advised me to take the posts down until a later date. I will put them back up again. But for now, I have to listen to the attorney and trust her experience.

But I can’t stop thinking about all the other people out there with HIV/AIDS who are in the same position as my friend, but don’t have anyone acting as legal power of attorney who can hire a lawyer and do these things for them. And it goes beyond being an lgbt issue, because this involves everyone.

The entire experience also reminds me of when my friend was first admitted to the hospital and no one knew what was wrong with him. He’d been misdiagnosed by his doctors for over a year, and then rushed to the emergency room in the suburbs with what was later diagnosed as PCP Pneumonia. As his acting power of attorney at the time, I had to deal with everything. It reminds me of the insurance disability issue because the doctors at the community hospital knew as little about HIV/AIDS as the insurance company I’m dealing with right now. I found myself constantly fighting them to give him the right treatment and to support him through the experience. I did this by contacting an HIV/AIDS specialist in Philadelphia, who helped and supported me through the experience. One doctor at the community hospital, what they call a “hospitalist,” (you don’t want to know more about these guys, trust me) wanted me to sign DNR (do no resuscitate) papers, which would have been insane at the time. Another absolutely refused to even touch my friend, for fear she’d be exposed to HIV/AIDS. The horror stories go on and on. And I can’t help wondering how many other people are going through the same thing, without the help and support I had.

But more than that, how many other lives are lost because bad, ill-informed doctors are making huge mistakes.

And to this day, I’m still amazed at how little people (doctors especially) know about HIV/AIDS, and how people with HIV deal with it on a daily basis. The most important thing I learned is that there are no set rules; everyone with HIV is a different case and they all experience different things. It’s getting better every day, with ARV’s and different methods of treatment, but there’s still too many people who have not been informed correctly.

I will post an update about my friend and his disability case. Right now the first appeal is being reviewed and we’re waiting for a decision. But I can say one thing for sure, now that I’ve inserted my teeth into this case, I’m not going to stop until my friend wins. As legal power of attorney, I’ve been through a lot worse than this.