Sunday, December 26, 2010

Gently Closing the Door ...I'll Leave the Light On For You

An aside: Happily, today is my last blog in this series. I have so enjoyed knowing that people from over twenty-five countries have visited the blog. I know that nothing leaves the internet so more visitors will come. I invite you to contact me at if you are interested in learning of the outcome of my lawsuit against Coventry or of any other positive developments. If you have any insights to help me as I continue to advocate for the mentally ill. If you just want to stop by and say, "God speed."

With many leave-takings there is often some final words; I desire to share a few stories. The first story is of a wise priest who many years ago shared his belief that someone from Carelink would testify in my defense by the time my case came to trial. I have always wondered who that would be as I had no doubts that this wise priest was anything but right.

What has remained a secret to a very few until now is the identity of that "whistleblower," the Carelink employee who must have sent shockwaves throughout Coventry Health Care and the law firm of their defense attorneys. Meet Mr. Patrick Dowd, defendant and former CEO of Carelink Health Plans, Inc. of West Virginia who revealed his sad self in his deposition while testifying in August 2010 under oath.

The crux of my case is that Mr. Dowd falsely accused me of fraud, of impersonating an official of the West Virginia Insurance Commission, of never indicating my real identify in that phone call. My claim is that Dowd knowingly discriminated against me, a person with a disability, thus violating a law of the state of West Virginia.

In questioning Dowd, Mr. Paul Tucker, my attorney, revealed records that indicated that a policy of Carelink Customer Service requires the Coventry agent to ask a call-in consumer for the insurance identification number which verifies the name and address of the caller. Mr. Tucker provided evidence that Carelink records show that Christine Stenger placed the phone call in question to CSO in late October 2005.

Shocking news. It mattered not to Dowd that his hands were caught in the cookie jar during the deposition. Rather than admit his wrongdoing, he attempted to justify it by saying in effect, "I don't care. She was bothering my employees and wasting valuable time with all her questions... Writing that letter was the only way..."

And so the 2nd motion to remove my case to federal court followed. More delaying tactics causing me more emotional pain. But ultimately, Coventry will lose in the first Circuit Court of Ohio County. Those close to the case know this.

I honestly pity defense attorney Grant Shuman as he must explain to a jury of my peers why Dowd committed such a ruthless deed.

“And Humpty Dumpty fell off the wall and all the King's men and all the King's horses could not put Humpty Dumpty together again.”

The same priest, a modern-day prophet, predicted that I would do extraordinary things as I pursued my right to hold people accountable for ruthless actions. Know that I am determined and have persevered at great cost. But I do so, gladly and with eyes now wide open, with an understanding that injustice and grace can empower an ordinary citizen to help, with others, create positive change.

The most remarkable reality of my five year journey is that I am ordinary is so many ways. While my roots are rich in heritage, I have lived through the suicide of my father, a respected local attorney who suffered from bipolar illness at a time when it took a pharmaceutical company twenty years to produce an ordinary salt, lithium, a wonder drug for treatment of bipolar illness because there was not much profit in producing this drug. Tragically, using eminent domain my father lost his beloved camp following what was reported by a respected family member, an attorney, as a call having been made by a local coal company to the White House. I believe that that coal company is now owned by BP.

Sadly, I had to live through more injustices until it was my turn to make my own decisions to bring Carelink to court. Up until this case, it was my husband who made the decisions about our experiences with injustice.

Today, because of the earlier injustices, my family's net worth went from .5 million dollars in the 1980s to living on the brink of bankruptcy for decades. We sold our 70 year old family business last year and are using the proceeds to pay off a sizeable debt. We sold the company real estate this year and our net proceeds were zilch. At that time, due to the need for an SBA loan seven years ago, the bank had a lien on our home and we lived for years with the reality of losing it at any time. A tragic situation that too many other Americans face today,

So, I do know pain that comes from the knowledge that despite being named the number one copier dealer in our division for two straight years in the US market in the 1990s, despite being respected for integrity in our market locally for decades, despite many incentive trips to places like Japan, Greece, Rome, we were unable to bring the guilty to court because they had deep pockets. Twice my husband cut his losses and moved on, hoping to save his family business. Ultimately, that could not happen, although he did save all his loyal employees jobs – a valiant effort.

Although some would think living on two social security checks would be painful, it is not. After a year of our son’s working with our local bank, a deal was reached and the lien to our home cancelled. We own our home and we are free.

Real miracles have happened in our lives during our travels these last five years. I now advocate for the mentally ill who would have no chance to receive the justice I will receive in the U.S. court system. To the holy men, my friends, who have accompanied me on this painful but just journey, Fr. Jim O'Brien, Fr. Michael Greb, Fr. Jerome McKenna, Bishop Emeritus Bernard Schmitt and Fr. Jerry McSweeney, may I say that we all owe you a debt of gratitude, for together we are shedding light on evil. Our efforts will soon be rewarded.

Be well, my friends.

"People grow through experience if they meet life honestly and courageously. This is how character is built." ~Eleanor Roosevelt

This year I came home for Christmas.

In the wee hours of a wintry morning last week, I lay somewhere between dreaming and awakening. I heard a soft voice, “You have won, Penny!” And from that moment on there was an indescribable peace. I sensed that I no longer must play games.

In 1982, in a state of emotional and physical pain from living with a mental illness that would take years to diangose, the highs and lows of bipolar illness, I committed to becoming the healthiest Penny I could become. My goal was simple: I desired to be a healthy, happy active 92 year old. And I began to exercise, to study the Bible, to develop positive thoughts, and to learn how to pray and be grateful.

And then, in 1998, driving 55 miles per hour on a heavily traveled interstate, I fell asleep at the wheel. When I awoke I had crossed the median. I somehow slowed the car, turned the car around, and drove back onto the highway. I did not look to see if I there was any traffic.

Something was very wrong. It took me 14 years, five doctors, including specialists, a Complaint against my former HMO,Carelink Health Plans Inc of West Virginia, and 8 sleep studies to have my health restored... Until I met a man of integrity, Dr. Robert Rogers, DMD,  of Wexford PA, who designed an oral appliance to successfully treat my apnea.

It was Dr. Rogers wife, Mary Ann, who contacted my former HMO to receive authorization to treat my apnea, with this less invasive, far less costly procedure than surgery. Carelink Health Plans Inc of West Virginia denied this benefit on the spot though there existed Final Order 06-Ap-024 that ordered them to first investigate the need for a requested benefit to insure thoughtful consideration. Highmark Blue Cross Blue Shield of Pittsburgh quickly authorized this benefit.

A denial of a $3000.00 has brought Carelink and me to today. Neither of us would have wanted to be in this place in this time about to face each other in a courtroom after five long years of costly efforts. How sad. How so very sad.

But let's return to 1998 when I could have kiiled someone. There were so many cars on the highway that day as I slipped into a spot that may not have been there. It was this memory that drove me to fight for medically necessary surgery to treat severe sleep apnea in 2005. It was the severe sleep apnea and my dream to be a healthy 92 year-old that brought me to Carelink Health Plans Inc of West Virginia, my former HMO, for help.

These last five years, 2005-2010, fighting for my rights, have taught me much about law, justice, family, church, evil, and myself. I had to lose everything to discover that I had a voice, and that I need no longer play games.

While I like games, I have not enjoyed the persona I had to create to deal with the reality that our justice system is oftentimes a travesty as it has been for me personally. I believe there is little justice for the mentally ill. No speedy trials. No compassion.

But there is integrity within me and there will always be.

I began writing blogs in 2005 as I had been frustrated to learn that while Coventry promised to promote health, they ignored my serious health condition. I learned that a federal law E.R.I.S.A. protected them from a law suit for damages. They could, in effect, and did, ignore me, violate every commitment in their rules of governance, even promote themselves falsely as “excellent” and the law protected them.

I did not know that when I placed a phone call to Carelink’s Customer Service in late October 2005 that E.R.I. S.A. protected Patrick Dowd et al. I only wanted to have my surgery before I suffered a stroke or heart attack. I wanted to live to be 92. I only asked for a benefit that was rightful at that time but would take me, a disabled person, 22 months to receive.

That late October day I spoke with Civentry Customer Service, a concerned agent, Ruthie Simpson, who promised to speak with her boss. All I wanted at that time was an apology and a willingness to look into my case. I told Ruthie that I would be writing a blog detailing my journey with my former HMO.

Four days later I received a ruthless letter falsely accusing me of fraud. Former CEO Patrick Dowd thought he would be able to use this letter to convince the West Virginia Insurance Commission that Carelink had the right to terminate my coverage. He could not. And the rest is history, tragedy at its most intriguing,

On Veteran’s Day 2005 I began writing my first blog Untied4justice,  I would write for well over a year. Recently, I reread a few of these first tales. There was no anger. No games. I quietly told the truth, believing that this blog would help me receive my medically necessary surgery.

With for-profit insurance companies, there are far too many games. Games supported by deep pockets. So, at the insistence of my spiritual director, Vicar General Fr. Jerome McKenna,of the catholic Diocese of Wheeling-Chraleston (WV) I began Tuesday’s Tirades and Tales in June 2008.

What started as an attempt to speak the truth, which I did with honor from the first blog to this final blog, became my catharsis. For five years, other than regularly seeking wisdom from holy people, my family was in so much pain, so frightened for my mental and emotional health, that they silenced me.

They loved me so deeply that they had to distance themselves from this issue. And so to deal with deep emotional pain I entered Carelink’s game, blogging so I could live.

And, I admit that I did have fun. With so much evidence against Carelink and Spillman Thomas Battle, the Charleston WV law firm that represents them, it was all too easy to attack their positions.

But I am tired of games. The persona I created as I wrote each blog is so far from the truth of who I am and who I have become that it is time to silence that person. Her role is over. This act ended.

It’s time to put this wonderful friend to rest. It is time for you to meet my true self.

Will I win my lawsuit against Coventry Health Care Inc of Bethesda MD? I have no idea. But I no longer care. Justice is not found in the court systems. It is no longer available in this blog.

But I remain more hopeful than ever. In the last five years I have met many people like myself who are working for reform of health care. They have each quietly supported me, waiting for the moment to join together.

That moment may well begin with a bus trip to Washington D.C.

I just learned that for under $20 I can travel directly from Pittsburgh PA, an hour away from Wheeling, to Washington, D.C. roundtrip on Megabus. I can reconnect with my cousin Tony Ames who is the head percussionist with the National Symphony. I can visit the headquarters of organizations that support the mentally ill. I can visit my representatives in Congress, one of whom I once called "Friend."

When you have lost everything, freedom results. When you suffer deeply, your spirit can rise from ashes.

Finally, Eleanor Roosevelt has been my mentor throughout this ordeal. Her “chutzpah.” Her love for the downtrodden. For boldness and eccentricitiy. So much more. Mrs. Roosevelt helped me find my voice.

Know that I am not bitter. I have no hatred for those who continue to inflict pain on me. Only concern for others who have no knowledge of the games for-profit health insurance companies play this very moment.

I have invited Grace into my life. How could I not with so many holy men honoring my courage, my "chutzpah." And outside of a few hours each week, when I sort through justice issues, I celebrate the ordinary things of life, the beauty around me. The simple, ordinary things of life.

I have won. I am home.

No comments: