Tuesday, December 7, 2010

Mental Health Abuses

Tuesday’s Tirade
Shhh… An Arrangement Behind Closed Doors

“Can an Attorney represent someone he knows is guilty? Attorney client privilege applies. Some say the lawyer can't represent someone because the defense would be a lie. That is not really true. Why? Because, the jury determines the truth. Not the lawyer, judge or defendant . A lawyer is required by the cannon of ethics to zealously represent a client. It is their job to force the prosecution to make the case. They must keep their client's secret unless failure to reveal it would place another person's life in danger. (my emphasis) So, it is a lawyer's job to be quiet and allow the system to do it's job. They are not lying by doing so, in fact by forcing the system to do it's job correctly in the big picture by protecting the rights of the guilty, all of our rights are protected. This is our duty as lawyers and advocates and citizens.”
                                                                                                    ~ http://www.answerbag.com/q_view/363941#ixzz14Fysrbbg.

Has Spillman,Thomas and Battle, P.L.L.C., the law firm who represents Carelink Health Plans Inc of West Virginia in my civil lawsuit against Carelink, crossed the line into unethical representation of a guility client.? I have uncovered a lot of evidence that describes Coventry “egregious” treatment of a consumer.

 What happened to justice for the common man? My case is not just about me but really about the ability of the justice system to afford the mentally ill equal justice before the law. Oh, my, my, my. There are few people who could withstand the barrage of personal attacks, unconscionable delays, and many other abuses. Then, these thoughts are only the blubbering meanderings of someone who is mentally ill and cannot be trusted.

What follows in one of my favorite blogs, written in 2008; it has also drawn the attention of many other of my readers.

Are you interested in tracking down the truth? The truth teller always points to the correct road. He moves people beyond appearances to facts that are confirmed by others and official documents.

Just who is telling the truth about how health plans perform their functions? Coventry Health Care, Inc. of Bethesda MD or Christine O’Brien Stenger? Do Coventry records of financial success and happy customers speak the truth? Or do the accounts of my experience to which I link evidence, suggest something truly sinister?

Ultimately, you must choose and be correct. Soon. When it comes to quality health insurance, you better do your homework. Our world suffers while we choose to wait.
 Why should you believe me? I am not an expert, but I have thoroughly investigated my former HMO, inside and out, for a long, long period of time. Future posts will take you inside corporate headquarters and inside Carelink and Customer Service where I was trusted by key personnel. We both trusted each other.  But that was then. That was before I threatened to write a blog about shocking discoveries.

There are also many family documents that describe “what’s in my heart.” Here's a newspaper cliping of an interesting story. The text describes my family as being prominent in West Virginia history since the Civil War. It "has contributed doctors, lawyers, judges, and a newspaper editor." http://www.freewebs.com/courageoffaith/O%27Brien%20Family.pdf (Cut and paste in browser) I include my history, not out of pride as some connected with Carelink may think, but to present who I am and why I do what I do.

catholic Diocese of Wheeling Charleston http://www.freewebs.com/courageoffaith/Bishop%20Schmitt%27s%20Recommendation.pdf  followed by an appointment I recently received from the Diocese. http://www.freewebs.com/courageoffaith/Disabilities%20Council.pdf

Then begin to look at the evidence. Question where it points. Which evidence is indisputable? And remember, while Coventry publishes a lot of information, do not be swayed by the sheer volume. Advertising and repetition do not always create truth.

Web of Deceit

Each state and the District of Columbia has established an agency dedicated to regulating the business of insurance. The West Virginia Insurance Commission, Jane Cline, Commissioner, is responsible for monitoring the health insurance industry and enforcing applicable laws in West Virginia. As part of its monitoring and enforcement functions, the commissioner maintains a process by which physicians and patients can file complaints against health plans.

On September 28, 2005, I filed a formal Grievance with the West Virginia Insurance Commission against Carelink Health Care, Inc. of West Virginia, my HMO. This September marks my third full year of continual fighting against the the West Virginia Insurance Commission. My rights were violated as, shockingly, Jane Cline of the West Virginia Insurance Commission never enforced the Final Order 06-AP-024 that she signed on December 14, 2006. The same order the WV Consumer Advocate argued is essential to begin to clean up health care in our state. http://www.freewebs.com/courageoffaith/2007%208%2028%20Letter%20to%20Jane%20Cline%20re%20Carelink%20Defiance.doc (Please note that today, December 7, 2010, Ms. Cline is the President of the association of all insurance commissioners in the US...hmm)

Future Tirades and Tales will detail the many twists and turns of my path to justice with the Insurance Commission. They will expose the sad plight of West Virginians and health problems relative to other states. For today ponder these questions: Does this sound like corruption? Is there collusion between the Commisison and Carelink? Are their political contributions involved?

To clarify, Carelink and Coventry challenged the ruling of Judge Jack DeBolt, to authorize my benefit of medically necessary surgery to treat severe sleep apnea, all the way to the Appeals Court in Kanawha County, West Virginia. Final Order 06-AP-024 also mandates that Carelink review all initial inquiries fropm consumers or doctors, thoroughly review these medical requests, to avoid the “egregious behavior” towards me being repeated again and again. Once the final order was signed, Carelink was obligated to follow the order.

It was then that Carelink began a series of legal maneuvering to get the order reversed.

In a response to a civil lawsuit, Christine O Stenger vs. Carelink Health Inc, et al on January 2, 2008, Carelink revealed a secret. Something happened behind closed doors at the Commissioner's office and Carelink dropped their appeal. That was my only notification that Carelink and the Commission had worked out a deal. A document. A copy of a document intended to present Carelink's position in my cival lawsuit. I have sinced learned that Ms. Cline amended the final order to include solely requests from me. Hmm.)

Nafarious actions? Heinous Crime? Who knows? No one notified me of this key meeting. Don’t know but I believe that Jane Cline never had the intention of enforcing Final Order 06-AP-024 from the beginning. The web of deceit broadened. See last page 4, first paragraph: http://www.freewebs.com/courageoffaith/2008%201%202%20Defendants%20Response%20to%20Remand%20Motion.pdf

In the summer of 2007 three different physicians requested three different procedures for me. Each was denied on the spot. http://www.freewebs.com/courageoffaith/2007%2011%201%20Dr.%20Rogers%20Complaint%20%40%20Claim%20Dismissal.pdf (I have linked to one of my doctors complaints. There are two more doctors who details their complaints as I describe.) It only takes this one instance for Carelink to be in defiance of Final Order 06-AP-024.)

No thorough investigation as required. Had Carelink done an investigation as ordered by Final Order 06-AP-024, they would have authorized a procedure for me, a $3100 procedure to treat my severe sleep apena, much less than the costly surgery they have authorized. Most importantly, they would have learned that Dr. Bernard Costello, my surgeon, advised me a year ago that because of the continued stress in my life due to dealing with Carelink, he will not perform the surgery. Too risky. And so I wait.

Now I live from day to day knowing that I must have medically-necessary surgery. I know that the West Virginia Insurance Commission by WV State Code must intervene. I know that three different attorneys, inside and outside state government, have warned me of the corruption within the commission. And I know much more about the web of deceit in my state.

Tuesday’s Tale

…So for tonight we pray for
What we know can be.
And on this day we hope for
What we still can't see.
It's up to us to be the change
And even though we all can still do more
There's so much to be thankful for.

Look beyond ourselves
There's so much sorrow
It's way too late to say
I'll cry tomorrow
Each of us must find our truth
It's so long overdue

So for tonight we pray for
What we know can be
And every day we hope for
What we still can't see
It's up to us to be the change
And even though we all can still do more
There's so much to be thankful for…

~"Thankful" sung by Josh Groben

I have never tried to hide who I am, warts and all, and in the spring of 2004, I approached the Editor of the Wheeling News Register, Mike Myers, to help me begin to educate the public about mental illness and the vast stigma that inhibits too many from seeking help. Myers agreed, but he had a request, “First I would like to write a story about you.”

On March 25, 2004, Tammy Woods, Staff Writer, wrote the first of three articles about my successes living with bipolar illness and my commitment to advocating for the mentally ill. I share the second story today, not out of pride but out of belief in the potential of the human spirit to overcome adversity, even the adversity of character assassination by the defendants in my lawsuit.

Bethany Holstein
Health Writer, Wheeling Intelligencer

July 5, 2006

Wheeling – A life-changing illness has become a Wheeling woman’s path to empowerment through helping others.

Wheeling resident Penny Stenger, 58, has been coping with bipolar disorder for most of her life. Now that she has things in her life on track and a treatment plan that is working¸ she said her next goal is to spread awareness and education to help others who may be suffering the same disorder.

“I have had this for forty years, and it has not been easy. One of the many things that I have learned is that I have to take ownership of my illness,” Stenger said. “I am now working to promote the facts that will fight stigma.”

One of the ways she is looking to reach this goal has been through the formation of a Wheeling Depression and Bipolar Support Group. Stenger said the group meetings could be a lifeline for people who are out there suffering from an illness and lacking skills to deal with it.”

“You end up sharing ideas of how you life and that helps other people,” Stenger said “Primarily, what happens is you know you are not alone…Most people wouldn’t want to tell people that they are mentally ill, but it sets you free.”

And Stenger said the support group is a good way to able to tell the truth about a disorder without an accompanying fear because the people in the support group are in the same situation.

“This group is not only for people with mental illness, but also their caregivers,” Stenger said. “We want to grow this organization.”

According to Stenger, her bipolar illness went undiagnosed for about 18 years. She said being a part of a support group has really been a tremendous help to her, especially because it gives her a chance to talk to people who really understand what she is going through because they have already gone through it or are going through it, too.

“To be healthy and to be stable, you must attend a support group. “It is one of the things I did that helped me get my sanity back.”

Stenger described countless nights of insomnia, followed by days and days of laying in bed unable to fight the all-consuming depression that kept her there. She talked about the exhausting search for the correct medication and suffering through the numerous side effects each medication would bring.

“Until I had the right psychiatrist, it had not come together,” Stenger said. She added, too, that some of her hobbies, including painting, have served as a way to cope.

She said that now she feels she can really do anything she wants to do. She said she just has to remember to not put so much stress on herself.

Her goals not only include spreading education and awareness on the topic of bipolar disorder, but also to be an advocate to fight for justice on behalf of those with mental illnesses who cannot do it. She said that she was brought to this path by her own fight with her insurance company over a denied claim ¬– something she said that has made her sensitive to the issue of access to care for the mentally ill.

She said she hopes this group, the Wheeling Depression and Bipolar Support Group, can help her make some headway into advocacy and into spreading awareness. Stenger said the group meets on Tuesdays and Thursdays from 7:30-9 p.m. at Wheeling Jesuit University. For more information, call (xxx) xxx-xxxx.

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