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Unbelievable.  It is 2013.  Mother was obviously in an altered state in her favorite rocking chair for the past few years…. Mother had thought by now that perhaps she would be able to give this post a more upbeat title than before (see here).  Not so lucky, or in reality it’s not about luck.  Things just suck.  Still?

Mother never in her life thought of herself as a “victim;” instead, Mother showed disdain for such types.  Even now, as the toilet continues to flush on Mother’s life, she considers herself less of a victim and more of being intertwined in a lot of bad shit.  The more complex things in life are, the more time it takes to get things worked out.  Such is the case with Mother’s ongoing battle with Cigna (or as one of Mother’s friends calls them “Shit-on-ya”).  Ruthless, malicious, unprofessional, lying, despicable are all kind ways to describe this so-called disability insurance company.  You know the old phrase, “the check is in the mail?”  Cigna used this one on Mother.  Of course she had her doubts, but after sufficient assurances, she actually thought Cigna was going to life up to their side of the agreement.  Wrong.

A few bits of information about Cigna, and disability insurance that are employer-sponsored.  First off, this is NOT medical insurance, so there will be no useless political rants about Health Care Reform (Mother does not support the bill that was passed), although some of the disability insurance companies like Cigna also have health insurance plans.  Second, and probably most important, Employer-sponsored disability insurance plans  are protected under Federal laws, namely ERISA, the Employee Retirement Income Security Act, passed in 1974, and one of the most complex and convoluted bills still in existence.  Mother asks right away, “do you see anything about ‘insurance’ or ‘disability’ in the title of this bill?” NO!  This bill was created to protect employee pensions at a time when there was legitimate concern that companies would not be able to pay out when people retired.  Right before the bill was sent to the president for signature an amendment, never argued or discussed in Congress, was inserted, adding ambiguous language that has since been the cornerstone of ERISA.  Mother is not a lawyer so she will not provide any further detail; it is up to you the reader to do a little homework and research.  There is a mountain of information on ERISA, disability and how these insurance companies are protected by the law and as a result, abuse the shit out of people.  The gist of it all goes something like this:

You work for a company with an ERISA Disability Plan, usually provided free of charge.  In the event you find yourself unable to work due to medical reasons, you can apply for short term disability benefits (usually up to six months) and if you are disabled for beyond this time period, you apply for long term disability benefits.  The plans usually pay a percentage of your salary; as time goes on, the percentage goes down.

As part of the process, you have to release your medical records to the insurance company; they contact your doctors for information, test results, etc.  After all of this information is received, the insurance company “reviews” it – usually a claims manager, a nurse and the so-called doctor at the company – and they give you an approval or denial.  If approved, they almost never give you the amount of time your doctor recommends.  If denied, you must go through an appeals process, directed by ERISA rules.  This can takes months to years, especially if you are denied more than once.

If you chose, you can sue the insurance company for the benefits you are due.  This is where things really start to suck.  In adherence of ERISA law, the suit can only be filed in a Federal Circuit Court; no suit on the State level is permitted.  You cannot sue for anything other than the benefits you are due.  You cannot sue for interest, punitive damages, hardship, etc.  In most cases, you cannot sue for legal fees, either.  Do you see what’s going on here?  Do you see why the disability companies have next to nothing to lose if they deny your claims?  They count on the one who is suffering to bail out, due to lack of funds, which is the case more often than not.  And even if the Court rules in your behalf, the amount your are given is usually a pittance and goes straight to legal fees.  In some cases, the Court will send the claim back to the insurance company to do another review of your file, possibly leading to another denial and dragging things on even more.

How ERISA as it stands can go unchallenged for all of these years is beyond belief.  Mother’s saving grace is that she found lawyers who are willing to follow through with everything despite Mother not being able to pay them yet.  Aside from this, Mother has used all of her assets, is losing her house, cannot pay her utilities and owes money to so many people she has to keep a list.  Most claimants are in the same boat and end up filing for bankruptcy and dropping legal proceedings.

Which leads Mother back to her opening thoughts.  It is hard for Mother not to feel victimized; if anything she feels that she is a victim of a very bad law initially created to protect people in their retirement years.  So much for that.  Other than this, everything is GREAT!

I’m sure many of you are familiar with The Onion.  Sometimes they hit the mark, sometimes not.  That is often the case with satire.  However, not only does this satirical article hit the mark, it hits the bullseye.  This article may be fictitious, but it names real names of CIGNA execs who deserve the ball-busting they are given in this article, so please check out “Insurance Company Celebrates 50 Billionth Fucking Over of Customer.”

nightmares of the Pristiq dolls

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Have you ever seen the Pristiq commercial featuring the creepy doll, infomercial music, and medicated gazes by the lead actress?

Me And My Dolly

Watch the unadulterated commercial here. Or watch a much more amusing version:

This duesy has been around for a while.  Every time Mother is forced to watch it, she starts cursing at the TV set.  She curses out the actress in the commercial who had the nerve to appear in Hot Pockets and Walmart commercials.  The sacrilege.

Then Mother saw this.

Why is the doll sitting on that lady’s counter at the antique shop?.  Mother knows which version she prefers.

Mother doesn’t know about you, but when she first saw this commercial, all she wanted to do was to sing “It’s A Small World After All.”

Mother knows that many people benefit from antidepressants, so hold yer horses; she’s not out to knock anything.  But the damned doll.  The sickening music.  How ’bout this.  Instead of popping the pills go talk to someone, like maybe one of these famous facilitators:

Don't slip

Let's sweat it out together

In a world filled with idiocy, with good people constantly being taking advantage of, with those who always feel entitled crying “victim” every ten seconds, Mother figured out a long time ago that doing your homework not only helped you get a good grade, it helped you get even.

Self-explanatory.

One of Mother’s best investments was to sell her musket and pick up one of those new-fangled all-in-one printers.  When Mother’s health and money problems began, she started getting lots of things in the mail.  Nasty things, junk mail based on Public Records, and lots of correspondence from the aforementioned DTA and Office of Social Security.  Whenever Mother received something from a public assistance office, even if it was to notify Mother that their hours changed, Mother immediately scanned it and saved it.  This way, whenever one of the assholes handling her case would say they never received anything, she was ready with the evidence.  If you ever find yourself in the unfortunate position of having to apply for any sort of public service assistance, remember these things:

  • It is your word against theirs, and even though they are incredibly inept they have the advantage.
  • For this reason KEEP COPIES OF EVERYTHING
  • If you can, get a lawyer that specializes in disability applications and denials.  There are many that are willing to help and make financial arrangements.  It is at least something they are willing to discuss.  Mother found people  to help her.
  • And perhaps the most important point: if, like Mother, you worked all of your life, was a good, responsible citizen, paid your taxes and (basically) obeyed the law, YOU DESERVE THIS HELP.  It is your money that has been invested and redistributed to to other people, many who are deserving, but some that are NOT.  Here’s an example of the latter…

Last summer, after Mother was dumped by the Evil Empire known as CIGNA, Mother was so broke she started selling things on Ebay and Craigslist.  Prior to her getting a lawyer, too embarrassed to ask anyone for help, Mother listed a bunch of things for sale online.  One of her Craigslist posts was all of her lawn equipment.  Mother wasn’t able to take care of the lawn and garden anymore anyway; RA did away with that.  She listed a lawn mower, wheel barrel, wagon, leaf blower, etc.  She received many inquiries.  One guy, “Mike” was very interested in just about everything Mother had for sale.  He lived pretty near by, so he said he could hop in his car and he would be over soon.  A little later, a brand-new SUV pulls into Mother’s driveway.  Mother could see in the back seat that there was a dog inside of a dog crate.  Out comes Mike.  He was well-dressed, and appeared to have no issues with mobility.  Within two minutes, Mike started talking non-stop about all of his problems; anxiety (that’s why he had the dog), depression, problems with allergies, his elbows, you name it.  He relayed anecdotes of everyone who had screwed him over, from former landlords after he complained about mold in his apartment, girlfriends, his dog’s vet, even people at the grocery store.  He also told Mother due to his anxiety he was on Social Security Disability.  He would not shut the f*&k up.  He did purchase just about all of Mother’s lawn equipment, and paid cash.

"Hi, I'm Mike, nice to meet you."

Even Mother knows not to judge all situations on face value, as they often are not what they seem.  But in this situation,  Mother saw the word SCAM all over it.  A new car.  New clothes.  A youngish guy who could walk, move, lift (and scam) better than Mother ever could. She gladly took Mike’s money, because it was HERS!  It was her taxes paying for this lazy-ass bastard’s disability benefits.  Just like a tax refund, right?

After the Mike Incident, Mother got over her pride and embarrassment.  She is now fighting for what is rightfully hers.  And she has copies of everything to prove it.

Aside from all of this bullshit, do you know what bothered Mother most? It was what Mike had to say concerning his dog.  While preparing to leave Mother’s house, effortlessly lifting the lawn mower and other equipment into his new SUV,  Mike claimed that he, the guy with a thousand disabilities and ailments, was personally training his dog to be his Therapy Dog.

Mother was so sickened after Mike shared this last bit of information that she went inside the house and locked the door, and hugged and kissed her wonderful, well-trained canine companions.

Mother Is Back.

Mother is officially back.  Yes, it’s been a bit longer than she would have liked, and she certainly must take a moment to thank her #1 fan, (and possibly only fan) Kathy  for asking, “where’s Mother?”

Mother never got around to posting her “The Disaster That Was 2009″/”Part 2” end of the year address. Who cares anyway.  Mother’s troubles have continued, although she has tried to soldier on.  When mediocrity and a**holes are in charge, why bother to even put up a fight?  Mother will tell you why it’s almost always worth it.  If you don’t speak up, write that letter, make that phone call, you will always wonder what would have happened if you had not otherwise taken action.  Just don’t waste your time on energy on things you can’t change.  Given Mother’s advanced age, she has learned what to leave alone, and what to fight.  More on this topic a little later.

First, Mother must give UCB, the makers of Cimzia, an award for the “Tastefully Done Advertising Campaign for a Dangerous but Helpful Medication.”  Unlike other biologic medications that treat Rheumatoid Arthritis and other chronic conditions, UCB’s Cimzia packaging and campaign is smart, diverse, uniform and inclusive.  Even the syringes were designed with the help of OXO Good Grips.  Mother asked her doctor if she could re-purpose them as kitchen tools (i.e., mini turkey baster, perhaps).  No kitchen suggestions were made.

Cimzia syringe and turkey baster

A lot of things have happened since last year.  Mother likes to steer clear of all of the political garbage and will continue to do so.  However, she will note from first hand experience that there are no magic fixes concerning so-called health care reform, loan modifications, or any other “historic” bill that has passed that will supposedly help Us All.  Bullshit.  Mother has experienced first-hand how getting help is all about how the game is played; it is not based on who deserves it.

Despite cringe-worthy embarrassment, Mother finally dragged her sorry ass into the Department of Transitional Assistance.  Transitional, my ass.   If it was transitional, why would people be on it for a lifetime?  Mother did not want to be a “lifer.” Mother is sure that many people feel the same way she does, but when Mother went to her first appointment at “DTA” to meet with her “Caseworker,” she could not believe the attitude of some of the people applying for help.  She has worked and paid taxes since age thirteen.  As Mother walked into the office, she passed a young woman who defiantly walked up to the window, banged on it until someone came to the window, and she yelled at them.  She DEMANDED help IMMEDIATELY.  The person behind the window told her to wait and she would have someone come out to speak with her.  The young woman then walked out of the building to have a cigarette and talk on her cell phone incessantly.  Real classy.

Real Classy

A manager came out, calling this woman’s name; the woman finally came back inside – but not until she had finished her cigarette and concluded her phone call.  Oh, and BTW aren’t those smokes like $7-$10 a pack?  And this bitch has the money to spend on a disgusting habit while coming to a public agency, asking for financial and medical assistance for FREE?

Mother was fuming by the time she was finally called to meet with her caseworker.  Mother had prepared all of the requested documentation to her meeting, hoping benefits would be begin soon.  Not so fast.  There was one item missing; the medical report.  Since Mother has to travel five hours to see her rheumatologist, she asked the caseworker if she help her arrange for a local MD to give her an exam, and the case worker flatly said “no.”  OK, so Mother is applying for health coverage and “emergency disability cash assistance” (glorified term for f-ing welfare), is not able to afford a doctor’s visit or transportation to see her doctor, and the DTA isn’t going to help?  Mother requested an extension to see if she could get to see her doctor so she could have the medical forms completed.

Mother planned a visit to her doctor.  Then Mother gets sick.  Again.  Anyone that takes Tumor Necrosis Factor (TNF) Inhibitors like Cimzia, Enbrel, Humira, Orencia, etc. knows there are risks.  Mother won’t bore you with them.  Just visit any of these drug websites and insomnia will be cured.

What is truly asinine about all of this is that all of this paperwork is based on forms from the 1970’s.  Nothing is computerized.  Whatever computer system used is similar to an old DOS-prompt mainframe.  And none of these systems are compatible with one another.  Mother filled out a shit load of paperwork for Social Security, including a Pain Report, a Function Report, and a Function Report.  ALL by Hand.  Mother HAS RHEUMATOID ARTHRITIS IN HER HANDS!  What do they expect you to do?

Mother Writes

Mother used to do calligraphy, music manuscript copying, professional lettering.  Now she can’t even hold a pen for more than a few minutes (yeah, boo-hoo to Mother).  Filling out all of these forms took days and days.  Mother received some help with the writing.  After all of this was done, agencies lost Mother’s paperwork, required duplicates, and basically pissed Mother off.  To be continued.

You all thought Mother was long gone, long dead.  Wrong.  Well, since Mother technically isn’t among the living as we might think, you may have an argument there, but not one worth going up against Mother and her Derringer.

Yes, months have passed, seasons have changed, shit has happened.  As a matter of fact, A LOT of shit has happened.

Mother is officially referring to 2009 as The Year of Being Flushed Down the Toilet.  Not even the Tidy Bowl Man could have helped Mother.

Mother’s least favorite question to be asked: “How are you?”  Such a seemingly innocent question, yet 95% of the people asking this question really don’t want an answer other than “Everything’s great!   Mother uses the tactic of answering the question with the question: ” How are you?” “How are you?” Ugh.

Mother has not been great.  Mother has not been fine.  Mother has been flushed down the toilet.

The Big Flush

Mother has been battling disability insurance company CIGNA, since the summer.  CIGNA in their infinite wisdom, proclaimed Mother to be a perfectly fit as a fiddle woman, ready to return to work, despite her doctor-specialist’s opinions to the contrary.  And of course, Mother’s medical files were reviewed by only the best at CIGNA; claim managers that are not doctors, nurses that are not doctors, and doctors who are not doctors, at least not specialists in the diseases their claimants are suffering from.  As it turns out CIGNA has quite the lame-ass reputation.  Everyone hates them, from patients/claimants, real doctors, even other insurance companies.  Check out this dandy report that aired on ABC’s Good Morning America in 2008:

Of course CIGNA disputed the information in this segment, vehemently so.  But there were more complaints, and Good Morning America did a follow-up segment.

Normally, Mother doesn’t get involved with public discussions of health issues, politics, and religion, but having had a very similar first hand experience to many of the people in this video, Mother can honestly say that CIGNA is Full of Shit.

Says it all.

Mother has held lots of jobs in her lifetime.  She worked as  a telephone solicitor (rated G you bastards), in a bakery (while drunk sometimes), a Greek diner hostess, on the family ice cream truck (this equaled many years of therapy) and many other jobs, including working for an organization that processed health insurance claims for it’s members.  Mother’s point is that she has been around the block and then some, by horse and buggy, on foot, bicycle and car.

No shit, Sherlock.

She learned from Sherlock Holmes to dig and dig until you uncover the facts.  (By the way, no matter what, Mother will always prefer Basil Rathbone and Nigel Bruce to any newfangled adaptation.)  You tell the truth.  You work hard no matter what.  And you call out bullshit when you see it.  It was with this mind set that Mother finally succumbed and acknowledged that her illness was keeping her from leading a normal life.  To try and get back on track, Mother applied for short term disability coverage through her job.  Mother’s doctor, a top rheumatologist at one of the top rheumatology hospitals in the country (hear that, CIGNA?) agreed that Mother needed to take a load off and supported Mother’s decision 100%.  What started as a way to provide Mother with some rest time turned into a summer/fall/winter-long nightmare fight.  CIGNA badgered Mother’s doctors non-stop, requesting information that had previously been submitted multiple times.  CIGNA badgered Mother non-stop and essentially told Mother they didn’t believe her.  CIGNA sent Mother numerous grammatically-challenged letters with misspelled words, poorly written and poorly thought out.  CIGNA denied Mother coverage after only two and a half months, which put Mother in limbo.

All gone.

Unable to work, with no income and unable to collect unemployment, Mother emptied out her mattress of her life savings to pay her bills and now she has nothing.

And Mother just learned that her employer has given her an ultimatum: return to work or be let go.  Mother’s employer made some half-assed attempts to work with her to try and save her job, but in the end, business is business.  Mother only wishes that her employer really understood what has happened to her  – they don’t.  So demoralized Mother has had to turn to what she has always dreaded:

Public Assistance…

Goodbye, home.

Anything Gluten Free Available?

Is that turn left or turn right off of the exit?

Le Grande Flush

Yet, despite all of these problems, all of this nonsense, Mother’s final flush happened on Thursday, November 12, 2009, when she lost her best friend…

Handsome Prince

To those of you who don’t understand, screw you, go away, and don’t read Mother’s Rants.  To those of you who understand, you know what it feels like to lose someone so special.  Mother can only hope the flushing is over with for this year and that 2010 is better.  Stay tuned for Part 2 before the end of the year.

Three strikes and you’re out – right?  In baseball, violent crimes, driving offenses, drug arrests, school screw-ups, parental discipline, you name it.  So, wouldn’t this rule also apply to pharmacy f*&k-ups?  Mother thinks so.

Mother takes medicine.  While not as much as one of her cronies, who refers to her breakfast as “pills and toast,” Mother indeed has a daily pill-popping ritual.  She even gives herself a shot every other week (read Mother’s post about Rheumatoid Arthritis).  Like many people, Mother has a prescription drug card through her insurance company which somewhat reduces the cost of her medications.  However,  Mother didn’t know that regardless of having insurance or not, people who work in certain pharmacies these days have reduced levels of intelligence, including the the people filling the prescriptions.

Like a good mechanic or beauty parlor, finding a good pharmacy/pharmacist takes time and once you do, you don’t switch.  Well, screw that.  Mother’s loyalty to her pharmacy – the closest location of a chain – no names mentioned, but it’s three letters, Crappy Vacuous Service, has officially ended due to three strikes.  Mother has been a customer for many years, shopping in the store area while waiting for her prescriptions to be filled.  She enjoyed getting Bonus Bucks for future purchases, the store brand Deluxe Mixed Nuts on sale, and she liked sifting through the clearance shelves.  Then, about two years ago, something began to change.  The pharmacy area was redesigned.  The free massage chair and free check your blood pressure seat were moved to a corner.  Mother always enjoyed these amenities.  But after the redesign, a large “Pick-up” sign was installed from the ceiling above to cash registers.  To the right are two “Drop-off” booths, where presumably, you drop off your prescriptions and are able to ask questions about the pills you will be popping.  The “pharmacy technician” (i.e., fancy name for a cashier who works in the pharmacy) is tasked with taking your personal information and insurance information when you’re a “newbie,” and verifies this info when you pick your pills up.  This is where things have gone terribly wrong.

STRIKE ONE

Tallulah was a cougher

Tallulah was a cougher

Recently, Mother came down with Pneumonia.  Her voice sounded like chain-smoking Tallulah Bankhead from Lifeboat along with the cough of one of Marge Simpson’s sisters.

Peggy and Selma Light Up...and Cough

Peggy and Selma Light Up...and Cough

After talking with her doctors, they prescribed the incredibly expensive Levaquin to zap the bastard bacteria in Mother’s right lung.  The prescription was called into the Crappy Vacuous Service Pharmacy.  Mother waited an hour and called the pharmacy to see if the medicine was ready.  She was put on hold for 30 minutes before hanging up in frustration.   Mother decided to haul her feverish ass over to the pharmacy and wait.  She headed straight for the pharmacy “Pick Up” area and was greeted by a young Girlie-Woman(GW).  Mother gave the GW her name and the GW began to look for the prescription.  After spending about 20 seconds looking for it, the GW went over to one of the “Drop Off” booths and began typing into a computer.

Gold Plated Relief

Gold Plated Relief

At the same time, she yelled over to Mother:

“Is your address 1313 Mockingbird Lane?” (fake address but you get it)

“Yes.”

“Is your birthdate January 1, 1901?” (fake birthday but you get this too)

What the hell?  Mother was furious.  She responded, “Thank you for telling the entire store my address and birthdate. ”  The GW stared blankly, even after a co-worker reproached her for yelling out a patient’s personal information.

STRIKE TWO

Mother felt better after about a week, but she needed two more prescriptions.  One was a cough medicine to calm down the hacking.  The other was Diclofenac because Mother was in pain.  Mother’s doctor’s called the prescriptions in and she headed over to the Crappy Vacuous Service Pharmacy.  Back to the “Pick Up” area.  The GW greated her.  Mother gave her name again.  The GW found one prescription and then said, “hold on a minute.”  From behind a high counter, a Crochety Old Pharmacist (COP) appeared.  He yelled, “do you have an allergy to Codeine?”  Everyone in the immediate vicinity stopped and turned.  Mother responded, “I don’t know, I’m not sure.” The COP crossed his arms and looked at Mother as though she ran a Meth Lab.  “Are you allergic to Codeine?”  Mother again said she didn’t know.

ANSWER THE QUESTION! Are you allergic to Codeine?

ANSWER THE QUESTION! Are you allergic to Codeine?

At this point she just wanted the damned prescription so she could get away from this idiotic Perry Mason exchange.  Finally the COP just said, “Oh Well!” and handed the GW the cough medicine, which Mother deduced had codeine in it.  Fine with Mother; now there was no need to mix up her nightly moonshine cocktail.

STRIKE THREE

Mother took her two prescriptions out of the bag from Crappy Vacuous Service Pharmacy and looked closely at the NSAID pill bottle.  The prescribing doctor was not hers.  It was a male while her doctor is female, and the doctor is in a completely different state.  Mother picked up the phone and called the Crappy Vacuous Service Pharmacy.  GW answered the phone and after Mother explained that she did not know who the doctor was on her prescription, GW said, “hmmm….that’s weird….do you want to speak to the pharmacist?”  Mother said “should I?” GW connected her with the COP.  The COP was a little nicer, which Mother could only attribute to him having had a good exit after a Milk of Magnesia dose.  Mother explained that she did not know who the doctor was on the NSAID prescription.  The COP asked for the Rx number and Mother then heard papers shuffling.  “Ohhhh…I see what happened….they (who is “they”) wrote down this doctor because his name sounds similar to the name of the person who called the prescription in from your doctor’s office.  Don’t worry; it’s the correct medication.”  Mother said, “well, I want my doctor’s name to appear on the prescription, not this other physician!”  The COP said, “all right, I’ll update it so it should be all right when you come in for a refill.”

Now thankfully Mother didn’t get the wrong medicine, and nothing really bad happened as a result from Strikes 1-3.  This is true bulls&^t.  The only consolation from all of this is that Mother got high as a kite from taking the cough medicine and Diclofenac together.

As in baseball, three strikes, and:

O-U-T

O-U-T