ATT Freedom Fighter News
Special Report: February 3, 2009
Filed by Jose
Carol's Story
On August 28, 2008 I was so overwhelmed with work and family issues that I became anxious and suffered from major depression. At this point I could no longer perform my work tasks or take care of my family. I contacted the AT&T Employee Assistance Hotline, spent an hour on the phone with Bob, and was told that I should seek medical help. I then made an appointment for September 2, 2008 (the first available appointment) with my family doctor who ran a number of tests to rule out any physical problems and then started me on medication. In addition he told me that I was not able to work and told me to apply for short term disability.
On September 2nd I contacted the AT&T Integrated Disability Center, managed by Sedgwick CMS, and applied for short term disability. My initial claim was denied on September 30, 2008. I then placed another call to the EAP office, spoke to another representative, and was told not to return to work and see a psychiatrist and a counselor. My family doctor referred me to both a psychiatrist and a counselor and I was seen by both by the end of October. Both the psychiatrist and counselor told me I was in no condition to work and should stay home and allow the medications time to work.
I then sent a letter to Sedgwick CMS on October 7th stating that I was appealing their decision and would provide further documentation from my health care providers. During the third week of October my supervisor phoned me and insisted that I return to work disregarding my doctors’ orders not to do so stating that “Sedgwick” had “released” me to return to work. I then called Sedgwick back on October 26th and was informed that they hadn’t released me to return to work. They also stated they had not received my letter of October 7th, so, I then resent them my letter dated October 7th stating that I was appealing their decision to deny my claim, I also added a request for a copy of their complete file on my claim, and informed them that I would be forwarding additional medical records for their review shortly
On the 28th of October I saw the psychiatrist who diagnosed me with major depression and he forwarded his diagnosis to Sedgwick. I then saw a psychologist who agreed with the psychiatrist that I was experiencing major depression and that I should not return to work.
For the next couple of months I saw the psychologist and the psychiatrist once a week. Even though I had requested my file, and the law requires that they forward it to me within thirty days, I never received my file which was needed for me to file a more detailed appeal. My doctors, however, were sending Sedgwick CMS weekly updates on my condition.
In late November my file was reviewed by Sedgwick CMS doctors and my appeal was formally denied on December 12, 2008. Although I had requested that Sedgwick CMS schedule me for an Independent Medical Exam, Sedgwick CMS refused to act on my multiple requests.
On approximately December 15th my supervisor called me and directed me to report to work or face termination for “insubordination”. He also sent a certified letter, with the same message, that I received later that same week. My doctors, however, were still adamant that I was in no condition to return to work. As we were unable to pay our bills because as I had not received the disability benefits that I was legitimately entitled to, and I was afraid of being terminated, I reluctantly “returned to work” on December 22nd by “taking a vacation day”.
Even though I was “on vacation” I was e-mailed a package stating that I no longer had a job assignment (“being surplused”) and that I had 60 days to find a new job or my employment would be terminated.
At this time, the months that I was too ill to work (and ordered by my doctors not to work) were subtracted from my years of service and my Net Credited Service Date (used for pension calculations) was adjusted. The effect of this adjustment was that at the end of the 60 days that I had to find a new job, unlikely at best, I would be just short of the 30 years required for a full service pension. If my NCS date had not been adjusted, I would, at the expiration of the 60 days allotted to find a new job, still be eligible for a full service pension. I believe that my supervisor and Sedgwick CMS colluded with one another to terminate me and deny me a full service pension. Although I had 29 years of excellent attendance and performance reviews, my new supervisor, of only a few months, was determined to “get rid of me” as he was all of the employees that he had “inherited” during the acquisition of AT&T by SBC. He had made this perfectly clear during the individual “one on one” meeting we had when he became my supervisor. He also made it clear to other “legacy employees” that, if it were up to him, all of them would be terminated.
On January 7th I received a letter from Sedgwick CMS stating that they had received my original request (which I had sent on October 27th 2008) for a copy of their file of my claim. The letter stated that they had received my request the same day I had sent it, October 27th, 2008. It also stated that they would respond within 14 days of the receipt of this letter (as required by law). This, however, was impossible, as the required response date had long since passed. Currently, I believe that Sedgwick did not comply with ERISA (the applicable federal law) and that my claim was not legally processed and, as a result, my appeal was illegally denied. I’m working with an attorney to develop a path forward.
The final chapter in this big fiasco and heartache is that when Sedgwick received my first request for their file on my claim, they mailed it out to another (represented, I am an exempt employee) employee by mistake. Sedgwick now claims that it was sent in error on January 12th, 2009. The file they “mistakenly” sent to another employee contained considerable “very personal” information” including all my recent medical records and my Social Security Number. The employee, that my file was sent to in error, contacted their Union Steward and turned the file over to them. Sedgwick will not tell me who these individuals are nor will they tell me, exactly, were the missing file is.
To “protect” me from someone assuming my identity now that my personal and confidential file has been inappropriately “distributed”, Sedgwick has “graciously and generously” offered to give me $100 to allow me to subscribe to an “identity theft watchdog service”. They, of course, are doing their best to not take responsibility for their illegal actions. I refused this magnanimous offer and am currently waiting for a call from the next higher level of Sedgwick “management”.
There is a lot more to my story, including a call Sedgwick made to summons the police and an ambulance to my home without my knowledge or permission. As a result of this call, from Sedgwick’s distant location, the police were confused about exactly what was taking place, and during the confusion, they placed my husband in handcuffs while he was in our own home. Well get to that “chapter” later.
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Interview by Mimi
Q: Eric, you don’t feel that Sedgwick has been very helpful since you became sick and were no longer able to work do you?
A: Originally I thought that I had a disability “benefit” but after a couple of years it became increasingly clear that Sedgwick was not looking to help me with my health and financial issues but was only interested in administering the plan in such a manner that they could find some reason to terminate my benefits.
Q: What happened to cause you to think that Sedgwick wasn’t interested in helping?
A: I can’t remember exactly but I In early 2006 I wrote Rick Hernandez at Sedgwick to express my concerns about the antagonistic attitude of their case manger that was assigned to me. I never got a response to my letter which surprised me I didn’t pursue it because for the time being, they left me alone and the checks continued to arrive. Then I completed another one of the questionnaires Sedgwick periodically requires you to complete to continue your benefits. As the doctors I had been seeing really could do nothing for the pain except prescribe narcotics, which we all agree are not a good option for me due to many physical and emotional side effects, the doctors and I saw no reason for me to visit them more than once a year. The best approach for me seems to be to manage my activities and just “deal with it”. One good thing about my type of pain is that it does, most of the time, allow you to sleep. So I can often escape the pain by sleeping. Unfortunately I sometimes lose weeks using this approach.
Q: What happened after you completed the questionnaire?
A: I completed the questionnaire in late May, 2007 and Sedgwick noted that I hadn’t been to the doctor since November 2006. They then sent a letter saying that I hadn’t been “under the care of a treatment provider” and that if I didn’t make an appointment within 30 days they might suspend or terminate my meager benefits! As it happened, I had just begun a severe “episode” that lasted several weeks and had just gone to the doctor right before I received their “threat” to discontinue my benefits. I sent them documentation of my appointment and included the fact that I had started an antidepressant that sometimes helps with chronic pain. It was rather new on the market and we hadn’t tried it before.
Q: Did they stop your benefits when they received the documentation you sent them?
A: No, I continued to receive my benefits.
Q: Well, then everything worked out OK then?
A: No, I didn’t see it that way. The questioning of my condition and the treatment plan my doctors and I have agreed upon by “case managers” with no medical training was frustrating to me. In addition they had asked for direct access into my bank account, and I felt that the questionnaire was intrusive and included lots of questions that weren’t germane to my condition such as my hobbies, my income from all sources, and other issues that I felt were none of their business. I was particularly upset with the fact that they were trying to dictate how my doctor and I managed my condition by forcing me to make and pay for unneeded visits to my doctor.
Q: OK, so what did you do to try and improve the situation?
A: On several occasions I offered to take the initiative, and provide them regular updates and if they provided a list of questions that they’d like the doctor to address during my visits, I’d make sure my doctors addressed these issues as part of my updates.
Q: That sounds reasonable.
A: Apparently they didn’t think so as they never accepted my offer.
Q: So, did you drop the matter as you continued to receive benefits?
A: No, I began contacting AT&T Managers and Executives trying to inform them of how Sedgwick was treating me and others.
Q: Did you keep track of who you contacted?
A: Yes I did. Here is a list of the Managers and Executives I reached or sent e-mails to.
Q: Did anything happen as a result of these exchanges?
A: No, they all said that Sedgwick was the plan administrator and that they were the ones to address my concerns.
Q: What did you do next?
Q: Did any of them accept your “offer”.
A: No! No one in their right mind would accept my offer as it was modeled after the way I was being treated by Sedgwick.
Q: So, did anything change regarding your treatment?
A: Well, I was scheduled for two additional Independent Medical Exams. We’ve already discussed that Sedgwick and AT&T refused to allow me to record the exams as they apparently don’t want a factual, unbiased record of the exams. I refused to be examined by the first doctor because he wouldn’t let me record the exam, which is a right, guaranteed me, by California law and my benefits were then terminated.
Q: Was there anything else that happened during this period?
A: No, I tried to share what happened but there’s a lot more to the story than we have time for. One thing that I found “curious” was that on one of the e-mails I received from Janet Vincencio, Associate Director AT&T Human Resource Services had the following quote: “I can be changed by what happens to me but I effuse to be REDUCED BY IT!!!” I thought that was ironic because that is exactly my attitude! I have a devastating illness, a good portion of my days are spent in agonizing pain, and I refuse to give up. I work very hard at living life to the fullest within my limitations, and sometimes exceeding them, forced upon me by this illness. My doctor’s think I have a great attitude and encourage me to live as normal a life as possible. I really enjoy being alive some days and seeing my two boys grow and mature.I am proud of my two sons as one is doing very well in a highly rated and difficult engineering college and the other is presently on active duty in the United States Marine Corps as a third generation Marine. He is scheduled to deploy to Iraq in early April. He has already been promoted twice and is proud to be a United States Marine and I very proud of him! In my Sedgwick file, my case manager instructed the IME explore a number of topics. She feels that because “he….voices a clear future-orientation in hopes for and pride of his son graduating from college, and other life issues” my doctors’ diagnosis’ and my disability to be “uncertain” in her mind. This just “boggles” my mind. I’m apparently not permitted to have any hopes!
Q: Well this has been quite an interview. Is there anything else you’d like to say?
A: I just like to mention that I’ve contacted three attorneys in the legal department of AT&T. The first was Claude Sisson as his name was mentioned in a letter I received from the Federal Department of Labor. Claude never responded to my e-mail. I also spoke with a Stephanie Tillman who promised some one would get back to me but I can’t recall that anyone ever did. Finally I spoke to a Thomas Giltner. Mr. Giltner stated that he was Claude Sisson’s supervisor. He said that it was his understanding that Sedgwick “had reached out to me” and tried to resolve the issue of the IME exams. When I explained that this was not the case he agreed to look into the issues further. We agreed that I should call back in a week. When I called back, he did not answer his phone so I left a voicemail. He never returned my call. I think he was either misinformed by his subordinates, a good actor and liar if he truly knew the truth, or some combination of the two. In any case, there is no doubt in my mind that AT&T executive know exactly how the people that they’ve promised benefits to under ERISA are being systematically abused and their legitimate entitlement to benefits denied.
It’s interesting that there is case law that says that an insurer can’t hire one person that finds you disabled and then hire another person to find you not disabled and ignore the findings of the first party they sent you to. I think that is exactly what Sedgwick tried to do to me. They sent me to the Social Security Administration in the hopes that they would find me disabled, which they did. This allowed AT&T reduce the benefit they paid my by about 75% as they deducted the amount I was now getting from SSDI. They then scheduled me for two additional IMEs in the hopes that their doctor would find me able to work. Then, I’m sure, they planned to terminate my benefits. I didn’t realize it at the time, but being approved for SSDI the first time you apply, as I was, is highly unusual. The “disability standard” to receive SSDI is much higher than most private insurance or ERISA plans. Sedgwick is really clever in manipulating the system to their and their client’s advantage. No matter the cost to the individuals they have pledged to serve.
Finally, I’d just like to know why Sedgwick and AT&T want me treated like a criminal and essentially “confined to house arrest”. I’d also like to know why Sedgwick and AT&T don’t want to have a factual and unbiased record of the exams conducted by the doctors they contract with. Maybe someone will be able to get an explanation out of Sedgwick and AT&T as I sure haven’t.
Mimi: Well thank you Eric for your time and giving me the names of all those you’ve contacted at AT&T and a copy of your “tongue and cheek” offer to select AT&T executives.
AT&T Managers/Executives that I’ve spoken with or corresponded with:
Cyndi Alden-Empoloyee Relations Manager
cynthia.alden@att.com (925)823-1617
Janet Vicencio-Associate Director AT&T Human Resources
Jp2191@att.com (916)972-5100
Rebecca S. Sanchez-Associate Director AT&T Human Resources
Rd2785@att.com (847)248-2340
Lee Williams-Senior Benefits Consultant
lee.williams@att.com (214)7573184
Susan Colburn-Vice President Benefits (retired)
Helen Peavler-Director
Hp6019@att.com (205)321-1800
Executives that I made my “Tongue and Cheek Offer” to accompanied by a letter explaining my problems dealing with Sedgwick CMS:
Dick Sibberenson-Human Resources Consultant
Dick.sibberenson@att.com (404)216-3940
Randall Stephenson-The Big Kahuna
randall.stephenson@att.com (they don’t give out his phone number)
Susan Colburn-Vice President, Benefits AT&T
AT&T Attorneys that I’ve contacted:
Claude Sisson-Attorney
claude.sisson@att.com (214)757-3314
Stephanie Edwards/Tillman
Stephanie.edwards@att.com (404)927-2877
Thomas Giltner-Attorney
thomas.giltner@att.com (214)757-8090
Others have contacted:
William Blase-Executive Vice President Benefits
william.blase@att.com
Attention AT&T managers: I will pay you $700 per month until May 1, 2016 (some restrictions apply).
Act soon this is a limited time offer.
Current restrictions (fine print):
Your employment will permanently terminated will little/no chance of reinstatement.
You must agree to the following restrictions/challenges to your freedom and integrity:
1. You may not travel further than 60 miles from home or spend the night away from home without my expressed permission, and each request will be determined on an individual basis.
2. I will be the sole judge on your ability to travel. Your doctor’s thoughts/recommendations will not play a significant part in my decision making process. “Denials” are guaranteed to increase your isolation from your family members.
3. I am under no obligation to explain my decision criteria to you or the legality of these restrictions.
4. If I deny your request, you have the right to appeal. I, however, will not share the appeals process with you.
5. You will be subjected to continuous questioning of your medical condition by administrators (me) that have no medical training, are not qualified to treat your medical condition, and cannot recommend treatment.
6. You must agree to be seen by your doctor more frequently than your doctor and you agree are necessary.
In addition:
After demonstrating employable functionality by:
1. Requesting permission twice to travel beyond the 60 miles radius and staying overnight with family members at their homes (once to attend a medical conference on your disease and once to be with family during the holidays as opposed to remaining home alone as you have for the past several years as you were too ill to travel).
2. Planning these trips so that you can ride in the back of your van (lying down to minimize intense pain riding in a bouncing vehicle can cause you).
3. Although you have not actually completed the requested trips, you will be informed that, because of your “demonstrated” functionality, you will be required to submit to for a second exam by an IME (“independent” medical examiner) paid for by me (so the good doctor may not be entirely independent and her/his continued employment is contingent on telling me you are fit for employment allowing me to reduce my losses as a result of your illness). My IME will, in all likelihood, not have the qualifications required to express an enlightened opinion on your disease.
In your course of seeking treatment for this disease you will have seen the world’s foremost authorities on your disease (who concur in their diagnosis), have endured eleven surgeries to try and correct the problems (including brain surgery and one operation with no anesthesia), and will have survived nearly 20 years enduring a disease that is “generally considered the most painful affliction known to the practice of medicine” and is known as the “suicide disease”. In addition, a few, intellectually challenged doctors (including my “I”ME) will attribute your illness to psychological factors in spite of the definitive, post operative diagnosis, by two of the worlds most experienced neurosurgeons specializing in this disease in particular and peripheral/central neurosurgery in general. My doctor’s and a few of your own doctors opinions are guaranteed to increase your stress and pain levels. In addition you will have been evaluated by 3 Ph.D.s, specializing in pain management, who are simply amazed at your ability to cope.
My plan is modeled after the AT&T Long Term Disability
plan which has been evaluated and determined to be fair and equitable by AT&T’s Plan Administrator, AT&T’s HR Consulting firm, and AT&T managers.
Act now as there are a limited number of openings available. In addition, if you act now, I will waive the requirement that you spend the rest of your life with a devastating disease and all your days will be spent in pain.
For more information contact:
Eric A. Marquardt
20 years with AT&T
(805)526-5277