Tuesday, March 31, 2009

Coventry Health Care and Irreparable Harm

Tuesday’s Tale
A Daughter’s Voice for Justice

“Courts agree that denying medical benefits constitutes irreparable harm." (Erissa Litigation, 2008)

Sunday, March 29, 2009.

I thought about Dad today. A lot. He, too, was abused by an unjust system. He, too, suffered with bipolar illness. Injustice drove him deeper into his insanity and forty-four years ago today, Dad held a gun to his head and killed himself. I am his voice for justice.

My father was a hero to many. A lawyer who was born into a prominent West Virginia family, Dad applied his knowledge to reach out to those “little people” who most needed his services but could not pay him. He had much for which to live: a beautiful family whose children were already showing signs of bright futures, a rich spiritual life, and a hideaway, “Camp,” which became his retreat. Over many years it was his beloved Camp that comforted and restored him. Dad, too, had discovered grave injustices in the legal system. Camp was Dad’s “almost heaven.”

As Dad’s bipolar illness unleashed its ugliness on Dad’s mind, he learned that the West Virginia Department of Highways needed some of his twenty-eight acres of camp property for a new interstate to be built. Some say Eminent Domain is an abuse of powers. But, in 1964, a very troubled soul who lived with excruciating emotional pain did not have the will to fight.

It was a last minute change in the route of Interstate 70 through Dad’s property that stabbed the heart of a man who was already vulnerable. Records at the West Virginia Department of Highways reveal that a coal company, I believe Valley Camp Coal, had contacted the White House. Within a short time, the route was changed. The consequences of that call shattered Dad.

Living with a mental illness, bipolar illness, has reminded me of just how challenging it has been to seek justice. How many people living with a mental illness could tolerate the corruption and obstacles within our court system? Fighting a former Fortune 500 company that is filled with deceptions, evasiveness, relentless questions, intimidation and discrimination. It has been a painful four years, but images of my loving father inspired me to relentlessly pursue my rights.

This past Friday Carelink attorney Grant Shuman deposed me. Under oath, I gave oral testimony to the events of this past four years in answer to Shuman’s questions. This was not so much about me and my evidence as about evidence that might put Carelink actions in a positive light.

Three hours of testimony. Mr. Shuman was kind and very considerate, but too many times I felt like my back was against the wall. Shumen would rephrase questions until, it appeared, he was satisfied with my answers. That happened many times, but as he might say, “That’s my job.” Personally, I found the process legally manipulative.

Flashback 2005 and 2006.

I spoke with Ruthie Simpson, Carelink customer service representative at 11:00 am on October 27, 2005. I was frustrated by the many attempts by Carelink to block my medically necessary surgery. By October 2005, I was especially frustrated as a key person to this process, Patrick Quinn, Head of the Appeals Department, would not take my phone calls.

My spiritual director, in encouraging me to fight for justice told me I must be ingenious. “Is writing a blog ingenious?” He gently nodded and United4justice.blogspot.com was born in the fall of 2005.

When I spoke with Ruthie, she appeared to be very understanding and cooperative, as I had experienced on prior calls with her. Although mad internally, I was not angry with Ruthie and my records show that I did not demonstrate anger, only frustration. I asked Ruthie to phone Quinn and request, for the fourth time, that he phone me about my appeal. I added what now appears to have been threatening information, “Tell Patrick that I am writing a blog about Carelink.” Ruthie promised to phone Quinn. It was my understanding that the phone call would be made immediately.

By November 1, 2005, irreparable harms due to the denial of my medical treatment had taken its toll. While my benefits would be authorized in April 2007, the damage emotionally had been done. It gets far worse.
In an act of discrimination and intimidation, former CEO Patrick Dowd accused me of fraud on November 1, 2005, In a despicable act against someone living with a severe mental illness, Dowd, I believe, wanted to terminate me.
In his letter, Dowd portrays Ruthie as having received a call from me where I may have presented myself as West Virginia Insurance Commission agent, Dena Wildman. If true, the action is fraud and termination would result.
Why this desparate act? Dowd likely had the knowledge that my investigation of Carelink revealed serious activities and I would be describing these activities in a blog. Like so many others, Dowd had little understanding that those with mental illness do recover to lead full lives as I.

On Friday I was shocked to learn of the existence of a document that details Ruthie’s e-mails that day. Ruthie allegedly sent an e-mail to Quinn advising him of a phone call from “Diane” Wildman with the insinuation that I placed that call. It was about 11:20 a.m.

This is not the Ruthie I experienced on several prior calls. However, it is within what I believe to be the devious mind of Quinn to orchestrate this accusation. Is it real? In the form of a piece of paper with words on it, I had to agree to Shuman’s question, that certain words did appear on a record. But, we all know there are many ways to manufacture records.

It is public record, however, that Carelink went to objectionable means to limit my access over several years, further discriminating and intimidating me. Thus I look forward to meeting Quinn and Ruthie again in the Court of Ohio County, before jurors, where it will be my word against Patrick’s. I believe Quinn’s record of deceit and evasiveness will indict him in the eyes of the jury.
I believe Ohio Country jurors will find Carelink and Dowd guily on all counts, including discrimination against someone with a disability and intimidation.

Before that there will be a lot of questions. A few come to mind: Would Ruthie not have contacted Quinn about this urgent matter within minutes of ending our conversation? Would not a top notch CSO question how I could lie when it my name and policy number is on the screen when she took the call? And how could Ruthie get Dena’s name wrong, identifying her as “Diane?” Why did not Ruthie take this problem to her supervisor first? Why did the supervisor discuss Dowd’s accusation in her office? Why did legal, as of that date, limit my access to speaking only with the supervisor?

It is Carelink Health Plans Inc of West Virginia who is on trial.

Fortunately, it may well be my word against Carelink’s word. My evidence from the administrative hearing before the West Virginia Insurance Commission in August 2006 that was not challenged by Carelink. There are incriminating documents. And there will be witnesses, at least one, I suspect, whose conscience will lead them to avoid perjury or additional perjury. A Coventry employee, I believe, will listen to his conscience and reveal Truth. I have no doubt of this.

Yet, the jury must listen to Carelink attorneys attempt to spin the facts and plant doubt about my integrity. And then it will be fun for me. Like Dad, I have devoted numerous hours to helping people in need in our community:

Founder of the Odyssey of the Mind program at St. Michael’s School, a program that over ten years was a force to develop knowledge, teamwork, and self-confidence in our young people.

Founder of “The Little Rock Bible Study” that developed group studies of the Bible in seven different locations and developed strong leaders for the church.

Founder of the first West Virginia chapter of DBSA (the 46th state to form a chapter) and facilitation of DBSA of the Ohio Valley for six years. Today there are 10 new groups in our state; hundreds of people living in darkness with a mental illness have found a home that uplifts and supports recovery.

As I walked through my life, I would not have envisioned my role in health care reform. Yet, it’s all so natural to me and I have received abundant graces from God. I desire to help people have a much better life which means access to quality health care. No. This lawsuit has never been about me. Nothing ever has been about me. It’s about the mentally ill who if given the right health care have an 85% chance of recovery. Understand the power of recovery on our communities and country. Then ponder irreparable harm when that care is denied a mentally ill person.

What price will an Ohio County jury place on irreparable harm?

Tuesday's Tale
Prologue to My Father's Legacy: Voices for Justice

The day began as the day before it and the day before that one. A black hole, so deep he wondered if he could climb out of bed. ‘I’m only a shadow of myself,’ he thought. Was this just an evil trick of his brain or had he changed so much? When did his present struggles begin? His mind raced upon awakening. No stopping the noise. Now he was afraid of himself.
This day would be different, he reminded himself. He had plans. He knew there was a way out.
Dressing for the day, he chose a blue suit with white shirt and a favorite red tie. It was too obvious that he had lost weight. He didn’t dare stare too hard in the mirror. The reflection suggested worry and weariness.
His financial problems began when he left the family law firm. It appeared to be a positive move, founding another firm with two of his friends. But something snapped. His life was a whirlwind of activity and creative ideas. He was empowered and moved mountains, spreading joy to those he met. Or so he thought.
But then he suddenly fell into a dark chasm of depression. No choice but to go to the hospital for psychiatric care. Six long weeks. People shuffling around like zombies most of the day. Sleepless nights. Gray days. Too dark to move.
His doctor prescribed medication that would bring him back to reality. That’s what the doctor had said. Only he had to be patient. “It takes time for medication to work,” the psychiatrist told him. “It takes time for the medication to be effective. But it will be better…someday.”
And so he waited in darkness for three months. Despair. Deep despair. His thoughts drifted to “what-ifs.”

What if he could return to his family’s law firm? What if he did not have such deep financial problems? What if the State Road Commission of West Virginia had not seized his beloved camp of 20 years though eminent domain, in his eyes an abuse of power that took a slice of his heart? What if his new law partners would allow him to come back to the firm now instead of waiting for a complete recovery? No, No. No…This is madness.
Breakfast was simple: a bowl of shredded wheat, milk, O.J. He had little appetite of late. Nor interest in conversation. He said nothing to his wife. His three children had already left for school. He sat and remembered. He cried within. No one understood his pain. No one understood his behavior. There were snickers and hushed talk on the rare occasions he left his safe house.
He kissed his wife goodbye that Monday morning. The signs of spring were in the air as he drove his Chevrolet up the avenue. Instead of turning left as was his routine of late, he turned right. The car knew the way. Although he might be missed at the bank where he did routine legal work for half a day, people would know: it’s another bleak day.
There was no flash of better times, no signs of new life that he saw out his window. There was irony. Springtime is a time of new beginnings, of hope, of desire. In his depressed state of mind spring reminded him of the what-ifs, and he continued driving without thought, only darkness.

Many factors triggered his gloom. He had begun to deteriorate rapidly. He fought to save his Camp as best he could in his crippled mental state. Camp was not only home to him; it was respite from the ills he experienced daily, the imbalance in the legal system he had so proudly represented. He wept at the injustice done to many and rejoiced in the success of a few. Camp was his piece of heaven, where he enjoyed peace and solace.

Justice was on his mind that Monday morning. He was obsessed with visiting the Camp one last time before it was torn down for the new Interstate. Justice? There had been a last minute maneuvering, a change in routes for the planned Interstate. The State Road Commission of West Virginia chose a second option, one that would destroy Camp. He no longer had the energy to fight, but he had plans.

It was a late Monday morning when he drove off the country road and onto his property. Camp appeared sad and naked. Everything had been removed the day before except for a few items. He felt empty as he thought back to November. He had taken a stance: Justice in the guise of a stop sign. He impaled the sign in the ground in a futile attempt to stop people from trespassing. Or was it a futile attempt? Maybe it was an act of defiance by a deeply troubled but just man. Someone had removed the stop sign. He had no voice.
He proceeded into the now empty house and walked with purpose to the closet. A “what-if” came to his mind. What if the family had not left the guns yesterday when they cleaned out the Camp? Sick in mind, body, and spirit, he slowly walked up the steps to the attic. With no more thought he aimed the gun at his head and pulled the trigger. He found his way out. He quit.
On a dreary Monday in March 1965, he left a legacy. A rich legacy. One that continues as his spirit rises from ashes and guides others today. It’s quite simple. Stop: it’s time for all of this to change. It matters what we leave behind. Justice is attainable. Our lives do make the difference.

Now it’s my turn for I am my father’s daughter. I am involved in a legal battle against a giant in the insurance industry, who made the big mistake of not understanding my roots nor appreciating the nature of mental illness. Additionally, I have filed a claim against the WV Insurance Commission for damages for obstruction of justice. No time for “what-ifs.” In West Virginia we are “Open for business.” Well, I have business to do, too, as I have discovered that just maybe West Virginia is a little too open to business.
Dad’s stop sign is now replaced with this book. My work is words and the truth will set us free.

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