After 30 Years...
After 30 Years...
Embedded Files
This site is meant to provide details on the many struggles I’ve experienced after having surgery for a torn rotator cuff. Being denied over and over the benefits that by contract I was entitled to. And ultimately being terminated when unable to perform my job, after 30 years of hard work and committed service at UPS.
This is VERY long, as I’ve tried to provide as much detail as possible. And I thank you for taking the time to read about my situation. Unless otherwise stated, all documents shown on this website were either sent from or submitted to one or more of the following: Aetna, UPS, Teamsters, Teamcare. Documents may have been mailed, faxed, or most often submitted electronically through a company website. For the purposes here, some personal information has been removed from the documents. Un-redacted copies may be provided to any relevant parties upon request.
(above photo taken from public sidewalk)
Very briefly, in 2016, I had been working at UPS for 30 years. I was very hard working, dedicated, punctual, never in trouble. I was proud of the work I did at UPS. And I’m confident that any of my supervisors would say I performed in the top 20% of their employees.
I’ve worked many jobs in the hub over 3 decades, including loader, pick, small sorter, air driver, hazardous responder. Most recently working in the sort aisle which required lifting packages up to 70lbs at a rate of about one every 2-3 seconds. As anyone who has ever done this knows, the pace of this work is very demanding. And many of these packages had to be lifted and sorted to belts ABOVE SHOULDER HEIGHT.
At this time I had been married for 11 years, and my wife and I had an eight year old son. Everyone in my family had always been covered by the healthcare plan included in my UPS benefits package.
I had serious shoulder issues that June. I sought medical treatment, and went on short term disability. I was eventually referred to a specialist, at which time it was determined that I would need surgery to repair a torn rotator cuff.
I did have that surgery, and Teamcare handled my short term disability. Initially, everything went rather smoothly. It wasn’t until the short term disability ran out and I needed to transition to long term disability with Aetna that I started having MAJOR PROBLEMS RECEIVING THE HEALTHCARE SERVICES DUE TO ME per my UPS benefits package.
My short term disability benefits were set to expire in December. But this document from my surgeon indicates that I would need to be off work well beyond that date.
At first, it seemed like the transition from Teamcare for short term disability to Aetna for long term disability would be a smooth one. At the end of 2016, I received the following letter from Aetna.
In this letter Aetna is letting me know they’re taking over my claim. Saying UPS has provided them (Aetna) with ALL THE INFORMATION THEY NEED. And there’s NOTHING I NEED TO DO. Aetna is telling me that they administer UPS’s Long-Term Disability. And they’re here to help! All very reassuring.
So by January I had been going to physical therapy appointments for my shoulder on a regular basis.
My wife had several medical issues, and she’d been doing what she needed to in order to manage them. She is epileptic and must see a neurologist regularly. She does require medication daily for this. She was being treated for severe migraines, in addition to some neck and back problems. And at the time she was also seeing a psychiatrist and taking medications for depression and anxiety issues.
Then my son had kind of a freak accident at school and suffered a concussion. It was months before we saw any improvement in his condition, which was VERY scary. We were taking him to see traumatic brain injury specialists. And he was in therapy for both physical and cognitive issues (thankfully, he did have a full recovery).
The following document shows the days my son missed school due to his head injury.
At this same point in time, all three of us in our family were experiencing some type of major health issues. We all had specialists to see in addition to therapy and various rehabilitation appointments. It was an awful lot to deal with, but we were managing.
I soon started to wonder why I hadn’t been receiving any disability payments in the new year. I had thought maybe it was just taking some time with the transition from Teamcare to Aetna. But at almost 2 full months into the year, there was still nothing. Nor had I received any additional communications from Aetna.
I did submit the document below to Aetna on 2/21/17 showing my estimated return to work was April of 2017. This document was from my most recent visit with the orthopedic surgeon’s office. It was a Teamcare document, as I was on STD at the time it was filled out. And I had already submitted it to both UPS HSRC and Teamcare. But I also wanted to make sure Aetna had this information, even though they sent me a letter in December stating that they have all the information they need from UPS. After sending in this document, I received absolutely no response at all from Aetna.
Soon after this, I received a COBRA notice from Teamcare saying I had the right to purchase continued health care coverage. This made no sense since I was off work for an approved medical reason. And per my UPS contract, I was entitled to continuing health care coverage at NO COST TO MYSELF. Not to mention the fact that they were asking me to pay $399 PER WEEK for something that was already a part of my UPS benefits package.
Then while calling to make an appointment for our son, we were informed by the Doctor’s office that OUR INSURANCE HAD BEEN TERMINATED on 2/28/17.
I went through all my paperwork and could find no reason this might happen. So I started making calls to find out why this was happening. On 3/9/17 I called UPS HRSC and THEY TOLD ME THEY COULDN’T HELP ME. And that I’d have to talk to Aetna about the problem.
I called Aetna and they told me their records showed my return to work date as 3/6/17. I told the Aetna representative my surgeon has my estimated return to work date as April. AETNA TOLD ME THEY HAVE NO RECORD OF THAT. I told them I am logged on to the Aetna website as we speak, and I am currently looking at the document I uploaded to them weeks ago, stating April as an estimated return. She told me she can’t see it. And then told me I needed talk to Teamcare about why my insurance is being denied.
I called Teamcare and she explained to me that they only provide insurance when UPS sends a payment. And UPS WAS NOT SENDING THEM A PAYMENT for my insurance. So I needed to find out from UPS why they weren’t sending the payment.
It just went round and round. UPS says it’s Aetna’s fault. Aetna says it’s Teamcare’s fault. Teamcare says it’s UPS’s fault. And NOBODY WILL DO ANYTHING TO FIX THE PROBLEM. In the meantime, there’s a 30 year UPS employee whose family is in desperate need of their healthcare benefits. And rather than doing anything to help, everyone is just pointing the finger at someone else.
On a later call to Aetna in March, I explained that our insurance had been wrongly terminated and I had submitted documentation to them in February. The representative said she could actually see that I had uploaded a document but her system didn’t allow her to open it until the person working the claim had processed it. It had been weeks since I’d submitted it and apparently nothing at all had been done with it. But the representative on the phone assured me she would send a message to the person handling the claim and get this all resolved.
Below is a screen shot of Aetna's website showing in fact that I had uploaded a document. The document Aetna representatives said they either couldn't see, or they couldn't open (depending on who I talked to). But I was completely able to click, view, and print the document from their website.
Around this time, I had doctor’s appointments coming up. I had physical therapy appointments. My son had appointments. In addition to her other appointments, my wife had a medical procedure scheduled. And not only are we finding out we have no insurance, but NOBODY SEEMED TO BE ABLE (OR BE WILLING) TO DO ANYTHING TO HELP. What do we do? Keep going to appointments not knowing if they’re going to be covered by insurance anymore? I couldn’t work with my shoulder in the condition it was in, and we were already falling behind on bills with just my wife’s income.
I then contacted Kyle Weldon (the UPS Business Rep) from Teamsters Local 20 to see if the union could help resolve these ongoing issues. I called him and began explaining the problems I’d been having with my benefits. He told me he didn’t really have time to talk to me, but asked that I email him about what’s going on. So I did send him multiple emails over the course of a couple weeks. I explained the situation and also sent him a number of documents that I had both sent to and received from Aetna. Kyle never responded to any of my emails, although he did eventually call me back and say he would have someone (Jackie) from Teamcare get in touch with me soon to help out.
Below is a message I sent Kyle at the Teamster's Local 20 describing the issues I was having and asking for his help.
The woman from Teamcare did end up calling me. She said, we sent you COBRA notices. Didn’t you see the COBRA notices we sent you? As if that was the solution. She pretty much said IF I WOULD JUST PAY THAT $400 PER WEEK, TEAMCARE WOULD BE HAPPY TO REINSTATE MY INSURANCE. Other than that, there wasn’t anything she could do about long term disability or the health care benefits I wasn’t receiving. If I didn't want to pay the $400 per week, I'd have to work it out with Aetna.
I went to my doctor’s appointment the end of March. I was still having a lot of pain and limited range of motion. He gave me a steroid injection which worked amazingly well at first. This shot was expected to give me relief for weeks or possibly even months. But its affects had worn off later that same day (which I communicated to Kyle at the Teamster Hall). As of this visit, the doctor had me off work into May. And IT HAD NOW BEEN ROUGHLY A MONTH SINCE I’D BEEN TO PHYSICAL THERAPY due to the still unresolved insurance issues.
So I again contacted Kyle at Teamsters Local 20 let him know I did hear from Jackie at Teamcare. And she let me know that short of me paying $399 per week for COBRA, there wasn't anything she could do to help the situation. But I didn’t hear anything back from Kyle.
Thinking things couldn’t get any worse, I received a call from my physical therapists office. They were informed that TEAMCARE WAS TAKING BACK ALL THE PAYMENTS THEY HAD ALREADY MADE earlier in the year for my physical therapy. And I was now going to be personally responsible for all those payments. I didn’t even know insurance companies could do that, take back payments already made. But apparently they can (and did).
My physical therapist canceled my upcoming appointments. I asked them to give me a week or so to get this corrected. Once the problem with my insurance was resolved, I said I’d reschedule my appointments and get back to my physical therapy. I really didn’t like missing any of my appointments, but I didn’t think it would take very long to fix. I wrongly thought it would be a simple matter of a few more phone calls, and I’d be able to get back to my rehab. I don’t know why I thought making more calls would make a difference. It obviously didn’t. Just more of the same runaround I’d been getting from everyone I spoke to.
We started hearing from more and more medical providers saying TEAMCARE WAS TAKING BACK THE MONEY THEY HAD ALREADY PAID. It became obvious that any money paid earlier in the year would eventually all be taken back. And we were now going to be held responsible for those thousands and thousands of dollars. We were getting calls and letters from more and more providers wanting money for past services.
It was the beginning of April, and I had been getting nowhere with Aetna on the phone (or anyone else for that matter), so I decided to submit a letter explaining the situation and asking for help. I thought unlike all my phone calls, if there was an actual letter explaining the situation attached to the case, it couldn’t be ignored. Keep in mind at this point I’ve sent multiple medical documents to both UPS and Aetna. And I’ve called Aetna, UPS, and the Teamsters multiple times asking for help with my claim. Still, the only communication I’d received from Aetna was the letter back in December when they told me I didn’t have to do anything. They have all the information they need. And they’re here to help. It’s been nearly 4 MONTHS AND I HAVEN’T RECEIVED A DISABILITY PAYMENT. My family's insurance is cancelled. And Teamcare is taking back medical payments already made. On top of our family having to deal with multiple medical crises, we now had a quickly growing financial crisis.
So early in April, I submitted my letter to Aetna. I explained that I’m not receiving the long term disability benefits I’m entitled to. And I mentioned the problems I’d been having with my claim and that I had sent Aetna a message asking for help. I stated that after 6-7 weeks, I’d still had no response from Aetna.
I also explained that I talked to an Aetna representative on the phone, who told me she would message the person handling my claim. But again, I’ve had ABSOLUTELY NO RESPONSE FROM AETNA. I told them my family is now without insurance and I tried to convey that this is really is becoming a dire situation. This was at a time when MY ENTIRE FAMILY WAS IN NEED OF MEDICAL TREATMENTS. And I again asked them to let me know if they needed anything from me to help remedy the situation.
Weeks start going by again without any kind of response from Aetna. Keep in mind, this is a time when WE ARE BEING DENIED OUR MEDICAL INSURANCE. We are in need of medical services. And we are getting calls and letters asking for payments for medical services that had previously been paid by insurance but subsequently were reversed. It made it very difficult to continue with most of our medical appointments. I had to stop going to my physical therapy appointments (my prescribed course of treatment) due to a lack of insurance. My wife also stopped her therapy appointments when Teamcare started taking back payments. Most of our medical providers didn't want see us until the insurance issues were resolved. And we just keep getting THOUSANDS AND THOUSANDS OF DOLLARS WORTH OF BILLS in the mail.
Then early in May, a full 4 weeks after my most recent request to Aetna for help resolving the situation, I receive a letter from them. The letter is from Jonathan Cruz, who I’m guessing was the person who had been (mis)handling my case for the last 4 months. In this letter (which is the first time he’s contacted me) he states that I AM RESPONSIBLE for my own healthcare benefits coverage. He says I HAVE TO PAY for my own insurance. And if I don’t pay, my benefits will be terminated. Will be terminated? I’ve been telling Aetna for months my benefits were terminated when THEY SHOULDN’T HAVE BEEN! I’ve been calling Aetna, I’ve been sending messages to Aetna, and I’ve submitted documents to Aetna both explaining that I should be on long term disability, I should have healthcare coverage, and asking for help. Asking what I need to do to resolve this. After 4 months with us unable to pay for treatments, unable to pay for therapy, and with bills piling up, I get a letter from Jonathan at Aetna telling me I’M NOT ENTITLED TO ANY HEALTHCARE BENEFITS?
This was so completely unbelievable! AETNA WON’T DO ANYTHING. UPS isn’t doing anything. The Teamsters aren’t doing anything. Not only was I being denied the benefits I WAS ENTITLED TO PER MY UPS BENEFITS PACKAGE. But this is was only response I had received from Aetna after months of pleading for help from the people who claim they’re “HERE TO HELP”.
By now I have absolutely no idea what’s going to happen with my insurance. Other than the fact that I no longer have any. But I’M STILL HAVING PAIN AND RANGE OF MOTION ISSUES. I went to my orthopedic appointment the beginning of May. I expressed my frustration to the doctor, as far as my recovery not being what I had expected. Of coarse it didn't help that my insurance was cancelled and I could no longer get physical therapy. Among other things, WE DISCUSSED THE POSSIBILITY THAT ANOTHER SHOULDER SURGERY MAY BE REQUIRED. This option was a completely impossible considering my health insurance had been cancelled. He ultimately ended up giving me a new prescription and scheduled an appointment for another steroid shot in June.
At this point it’s been over 2 months since I’ve been to my prescribed physical therapy appointments due to lack of insurance. Keep in mind that Teamcare has taken back payments for my physical therapy earlier in the year. The therapist’s office WOULD NOT SCHEDULE ME FOR ANY MORE APPOINTMENTS until the insurance starts paying them again. So as long as my health insurance is being denied, I am effectively being denied the course of treatment prescribed by my physician. As long as Aetna was not approving me for Long-Term Disability, and UPS WAS NOT SUBMITTING PAYMENTS FOR MY INSURANCE, I couldn’t receive all the healthcare services I needed.
The middle of May, I uploaded another letter to Aetna in response to the one I had received from Jonathan Cruz. I explained that I’ve been trying for months to find out what needed to be done to get my desperately needed healthcare insurance reinstated. And Aetna hasn’t yet responded to any of my requests for help.
I also told him I do have a QUALIFYING DISABILITY and my UPS contract does in fact entitle me to long term disability benefits. And I asked him again, what they need from me to correct this.
I included a page from the UPS Master Agreement stating that I am entitled to long term disability benefits. I wanted to make it very clear to Aetna that I WAS ENTITLED TO THE BENEFITS THEY HAD BEEN DENYING ME for so long.
Not expecting to get any kind of meaningful response from my letter, I tried calling Aetna once again. I explained the situation to the representative (Lashawn Oatman-Alleyne). And she told me they didn’t have the correct paperwork for long term disability. AFTER ALL THESE MONTHS WITH NO ONE DOING A THING to help. Talking to so many different people on the phone and sending in letter after letter. Was it that simple, wrong paperwork? She got me the paperwork that was needed and I got it filled out and returned to Aetna as quickly as I could.
We all know jobs at UPS are very physically demanding. Some of the documentation requested does attest to that. It was made clear to Aetna that I had an extremely strenuous job.
My job required frequently lifting 50lbs or more at shoulder height. And required that a rapid pace to be maintained.
This job is considered heavy labor, as described by a UPS representative. So again, there was no question that Aetna was informed that the job was very physically demanding.
The orthopedic surgeon’s office sent new paperwork into Aetna. This stated that I needed to remain off work, and would be returning to his office for a repeat steroid injection.
Aetna requested a capabilities and limitations worksheet to be completed by the surgeon’s office. The medical provider responded by saying that they don’t perform those types of tests. So there were never any tests done to determine if I would actually be physically capable of returning to my job. Looking at this worksheet, I can say THERE IS ABSOLUTELY NO WAY I’d be capable of lifting anywhere near 70 pounds, reaching above the shoulder, reaching forward, or continuous repetitive motion. Absolutely no way.
These types of things were the essential requirements of my job function as a sorter. Lifting up to 70 pounds. Sorting to belts above shoulder height. Continuous repetitive motion. AT NO TIME WAS I EVER TESTED for any of the requirements of returning to my job.
Luckily, the orthopedic surgeon hadn’t stopped seeing me due to lack of payment. But that wasn’t the case for most of our family’s medical providers. WE WERE RECEIVING BILLS, LATE NOTICES , and calls from medical providers who were waiting for payments. Some providers had insurance payments already made which were subsequently taken back from them. These went back as far as six months and totaled THOUSANDS AND THOUSANDS OF DOLLARS. Our physical and mental health was being greatly impacted by the denials and lack of service from both doctors and therapists. And also by our deteriorating financial condition. Our prescription medications were no longer being covered.
There was nothing we could do but wait and hope that after contacting so many people and getting nowhere, Lashawn would be the one who would finally get our insurance restored and we could finally continue with the healthcare services we so badly needed.
I had an appointment on 6/26 at the orthopedic surgeon’s office. At which time I received another steroid injection for PAIN AND LIMITED RANGE OF MOTION. This time the injection only gave me relief for a matter of hours. And I was in pain again soon after returning home from the doctor’s office.
It had now been about 4 months since I’d been able to receive my prescribed physical therapy due to insurance being denied. And being frustrated with the lack significant improvement in my shoulder, I decided to make an appointment with my primary care physician for evaluation and to see if he could come up with a MORE EFFECTIVE COURSE OF TREATMENT.
I was able to schedule an appointment to see Dr. Narra on 7/18. But at the time, the orthopedic surgeon only had me off work until the beginning of July. So I went onto the Aetna website to extend my leave until I could see Dr. Narra. There is an option online to extend your leave, but it wasn’t working for me. I ended up calling on 6/30 and leaving a message for Lashawn at Aetna, informing her of my upcoming appointment, that I needed to extend my leave, and that I STILL WASN’T HAVING IMPROVEMENT with my shoulder.
Since I had not had improvement after the second steroid injection and with the ongoing shoulder issues I was having, I let the orthopedic surgeon’s office know that I had made an appointment with Dr. Narra to look into different treatment options. He then provided a note having me off from work that would carry me through to the time I could be evaluated by Dr. Narra.
It had been two weeks since I called Lashawn at Aetna and left a message for her explaining that I was still having shoulder problems, that I had an upcoming appointment with Dr. Narra, and that I NEEDED TO EXTEND MY LEAVE.
Then on Friday, July 14, I received notice from Aetna that MY FILE HAD BEEN CLOSED! That I’m only entitled to benefits through 7/19 and that NO FURTHER BENEFITS ARE DUE. This letter came from Lashawn. The same person who just a couple weeks prior, I had left a message for letting her know that I HADN’T HAD IMPROVEMENT WITH MY SHOULDER and I needed to extend my leave.
Lashawn goes on to claim that my orthopedic surgeon has released me to return to my normal job functions. This is ABSOLUTELY NOT THE CASE! At no time did Dr. Assenmacher or his office ever talk to me about my ability to return to work at UPS.
I had no Idea what she was talking about. Dr. Assenmacher had NEVER CLEARED ME TO RETURN TO WORK! I hadn’t seen him since 6/26. And the last note I had from him had me remaining out of work until I was able to see Dr. Narra. Definitely not cleared to return. Both UPS and Aetna were informed about my upcoming appointment with Dr. Narra. It was well known to Aetna, UPS, Dr. Assenmacher, and Dr. Narra that I STILL HAD CONTINUING SHOULDER ISSUES. I was always in communication either by phone or submitted documents. So I couldn’t believe that this could be anything but yet another huge mistake.
All this happened on a Friday, so the following Monday morning I contacted Dr. Assenmacher’s office to figure out just what was going on. I told them that Aetna was saying the doctor had released me to return to work. I spoke directly to the person in the office who talked with Aetna on the previous Friday. She told me THEY NEVER RELEASED ME TO RETURN TO WORK, and she was surprised when I told her that’s what Aetna was saying.
She did go on to tell me that the Aetna representative DIDN’T LIKE THE WORDING of the doctor’s note they had provided earlier having me off work through my upcoming appointment with Dr. Narra. And she told me the doctor’s office was ASKED BY AETNA TO CHANGE THE WORDING, which they did. This is the revised note.
The revised note above does give more detail. But I also notice the wording change. Rather than “should remain out of work” as it originally said, it now says “will remain off work until 7/19”. Notice that this revised note was sent directly to Lashawn at Aetna on the exact same day she chose to close my file.
So I have to assume she is the person who called the doctor’s office just as they said, saying she needed them to change the wording to fit what she wanted. And then she immediately closed the case. Even though Dr. Assenmacher clearly stated, “PATIENT NOT RECEIVING ANY RELIEF”. Just what about that statement would suggest to Aetna an ability to return to normal job function?
The second note does say, Date of Visit: 7/14. I had no appointment on that date, nor was in in the doctor’s office. So “date of visit” must be referring to the date that Aetna called the doctor’s office.
My family and I had been waiting for about half a year for our insurance to be reinstated. Waiting to get back to the various treatments and therapies we all needed. While we waited we were becoming deeper and deeper in credit card debt. I was continually asking over and over both on the phone and through submitted letters what I could do to help get this issue resolved.
When my claim finally showed up on the Aetna website, it was listed as “pending” for several months (which effectively means you don’t actively have any benefits). Until July 14 when I received notice it was “closed”. It was never at any time listed as approved. What this means is that in the year 2017, the only time my family and I actively had health insurance was from July 14 to July 19. That’s the date my case was closed to the date Lashawn says I was no longer entitled to benefits. For the entire year, that’s LESS THAN A WEEK THAT WE ACTIVELY HAD ACCESS TO OUR HEALTHCARE BENEFITS. Less than a week. Less than a week that my family could actually seek treatments while having our insurance active.
It seems as though Aetna used the wording change from “should” to “will” as an excuse to close the file. AT NO POINT WAS I EVER RELEASED TO RETURN TO MY ESSENTIAL JOB FUNCTION as claimed by Lashawn at Aetna. Just the opposite. The note sent by the doctor to Aetna on 7/14 explains that I WAS NOT RECEIVING ANY RELIEF.
Not to mention the fact that I had informed Aetna in writing and by phone, in addition to Dr. Assenmacher’s office letting Aetna know that I had an upcoming appointment with Dr. Narra for these ongoing issues. But it would seem Aetna’s concern was in closing the case and not ensuring that I get the treatments I needed. I’D BEEN WAITING ALL THIS TIME TO GET MY INSURANCE REINSTATED so I could get back to my rehab, and I was now being informed the file is being closed.
So after contacting Dr. Assenmacher’s office, and not understanding why Aetna chose to close my file, I submitted a letter to Lashawn at Aetna explaining once again that I hadn’t had significant improvement in my shoulder, that I had an upcoming appointment with Dr. Narra, and that I needed to know what to do in order to extend my leave.
I went on to question why she was closing my file when Dr. Assenmacher’s office had not cleared me to return to work, and she had been informed that I wasn’t seeing improvement in my shoulder. And I again asked what I needed to do to extend my leave.
There was no response from Aetna on that day. The following afternoon I went to my appointment with Dr. Narra. At this point, I HADN’T BEEN TO PHYSICAL THERAPY FOR 5 MONTHS due to my insurance cancelation. He wanted me to get back into therapy right away, and he wrote an order for it. He also wrote a note having me off work until my next appointment with him in August.
Also, because there had been NO IMAGING DONE ON MY SHOULDER SINCE THE SURGERY, Dr. Narra wanted both an MRI and X-rays done to get an idea of what may be causing of my ongoing problems. He said we’d do the X-rays first and wrote an order for them. He said he would order an MRI if needed after reviewing the X-rays at my next appointment.
After my appointment with Dr. Narra I uploaded all documents having me off work, ordering X-rays, and ordering physical therapy to Aetna. I also contacted UPS HSRC with the same information. But once again, I was in the same position that I’d been in for the last 6 months. I had no way to pay for my or my family’s healthcare needs as Lashawn at Aetna had immediately closed my file. EFFECTIVELY LEAVING ME WITHOUT INSURANCE AGAIN beginning the very next day after my appointment.
I had been trying to get ahold of Lashawn at Aetna on the phone for several days. I finally ended up speaking with her. But SHE HAD NO INTEREST IN DOING ANYTHING TO HELP. I told her I’d been trying to add time to my leave, and asked her how I should go about that. She told me SHE CAN’T ADVISE ME ON THAT. Can’t advise me? She’s the one that was supposed to be helping my through all this. She went on to tell me she’s closed my file, and TOLD ME NOT TO SEND HER ANY MORE DOCUMENTS. She let me know she’s just flat out not going to do anything to help me to get the benefits my family needed. She’s disregarded what I’ve been telling her and what the doctors have said, and just closed the case. How did Aetna ever expect me to heal when all they did was consistently deny me any ongoing coverage for treatments?
I’d been fighting so long in an effort to get the healthcare I WAS ENTITLED TO. I’d been pleading with people to try and get the healthcare may family desperately needed. I WASN’T ASKING FOR ANYTHING MORE THAN THE BENEFITS DUE TO ME per the UPS contract. But most of the people paid to “help” were little or absolutely no help at all. This had all taken a huge toll on my whole family for such a long time.
After half a year of uncertainty, struggle, and both mental and financial strain, we thought it was about to be over. We thought Aetna was finally working on the case and we’ll finally have our medical insurance back soon. But all they did was let us think everything was going to be okay, only to then pull the rug out from under us.
For the year, we went from not having medical insurance because we’re not entitled to any medical insurance (as Jonathan at Aetna falsely claimed in his letter), to acknowledgement that we’re entitled to medical insurance but we don’t have any because the case is still pending, to we don’t have any medical insurance because the case is now closed, and we aren’t going to give you anything you need going forward.
We had certain HEALTHCARE PROVIDERS AND THERAPISTS THAT WOULDN’T SEE US anymore because of outstanding balances. There were treatments we hadn’t received, just waiting for this all to be resolved. I couldn’t afford the physical therapy I was supposed to have for the last 5 months, let alone to have the physical therapy and imaging done that my doctor was currently prescribing going forward. So what do we do now? Aetna was not going to do anything to allow us the treatments we needed and had been waiting so long to receive. SIX MONTHS OF LETTERS AND DOCUMENTS AND PHONE CALLS to Aetna, UPS, Teamsters, and Teamcare had gotten us absolutely nowhere. It was completely draining, both MENTALLY AND EMOTIONALLY.
I again contacted UPS HR about the situation, and Aetna did eventually approve and pay for the previous medical expenses we had for the year, but only those up to July. NOTHING GOING FORWARD! BUT GOING FORWARD WAS WHAT WE NEEDED SO BADLY. It’s what we’d been waiting for all this time. It’s great that they did finally pay the past medical expenses. I say great, even though those were actually benefits due to us and should have been paid months earlier. That was supposed to happen. But what WE REALLY NEEDED ALL THIS TIME WAS HEALTHCARE SERVICES GOING FORWARD in order to improve, to get better, to heal. That was something never given to us.
Just a couple weeks later, MY WIFE TRIED TO TAKE HER OWN LIFE. Not knowing what had happened, I found her on the floor in our bedroom with her body twisted. Her eyes were rolled back in her head and she was having a seizure. I tried talking to her, but it was as if she didn’t even know I was there. I called 911, but I don’t know if I was even making any sense. It was such an incredibly scary moment. The fire department did arrive, and she was taken to the emergency room, where we spent the night. She had regained consciousness (for lack of a better word). And it was at this time I learned that she had taken upwards of 30 pain killers in an effort to kill herself. The following morning she was transported to the psychiatric care unit where she was held for several days. I was only allowed very limited visits with her.
After she was released from the hospital, my focus understandably became 100% on my family’s home environment and well-being. I was doing everything I could to lower the stress levels that had been elevated for so long and brought us to this point. The Aetna/UPS insurance issue that had really gone nowhere over the last six months had to go on the back burner for a while. CARING FOR MY FAMILY WAS THE ONLY THING IMPORTANT AT THE TIME. And I tried to shield my son the best I could from everything that was happening, so his life would be impacted as little as possible by the serious problems we had faced all year.
After some time, my family was emotionally in a better place. Not great, by any means. But certainly better. I STILL HADN’T BEEN ABLE TO RECEIVE ANY KIND OF HEALTHCARE regarding my shoulder issues, but my wife was referred to a mental health provider that works with patients who don’t have health insurance. So I started compiling information to revisit these year long insurance problems again.
After going through documents, what I discovered is that after Aetna closes a case, an appeal must be filed within 180 days. And it was just barely beyond that timeframe by a matter of days. I definitely wanted to appeal. Lashawn closed my case after both myself and my doctors stated that I STILL WAS HAVING PAIN AND LIMITED RANGE OF MOTION in my shoulder. Had an upcoming appointment. Needed imaging done in addition to physical therapy. She incorrectly stated that I was released to return to work. It’s unthinkable that the case would be closed in the first place, and I would even have to appeal. But none of that mattered any more, it was too late.
Some people might ask why I waited so long to appeal. I wasn’t waiting. I WAS DEALING WITH THE FAMILY ISSUES that arose as a direct result of this whole situation. MY FAMILY WAS IN CRISIS, and there was absolutely nothing more important at that time. I’m sure anyone who has dealt with severe mental health issue can attest. It may feel never ending at the time, but 180 days can go by in the blink of an eye. Nothing else matters but being there to bring your family out of it. And don’t forget, this was all AFTER ALREADY HAVING SPENT HALF A YEAR TRYING DESPERATELY TO SIMPLY GET THE HEALTHCARE WE WERE ENTITLED TO. Half a year of office visits, phoning, faxing, and emailing UPS, Aetna, Teamsters, Teamcare, and doctors. Months and months of providers calling, mailing, and emailing DEMANDING PAYMENTS. It was absolutely devastating that I had just missed the 180 day window. Especially when virtually nobody seemed to care when I was being denied my healthcare benefits for well over 180 days.
As I’m trying to figure out what recourse I may have, I get a letter from Barry Bragton, the division manager at UPS. This letter incorrectly gives a return to work date for me, and asks for written medical documentation for my absence. BARRY GOES ON TO THREATEN ME WITH TERMINATION if I don’t provide the requested information to Todd Lawniczak within a day or two of my receiving his letter.
I wasn’t given much time to respond, so I emailed Mr. Lawniczak on January 18. I briefly explained to Todd that I was STILL EXPERIENCING SHOULDER PROBLEMS. That I was not receiving the treatments and diagnostics my doctor prescribed due to insurance issues. That I was BEING DENIED BENEFITS DUE TO ME. And that I was looking to resolve ongoing disability issues with Aetna. I gave my email address and I asked Todd to PLEASE CONTACT ME.
I was actually happy to be in contact with Barry Bragton and Todd Lawniczak at UPS. Thinking that a DIVISION MANAGER MIGHT ACTUALLY BE IN A POSITION TO HELP resolve what seemed to be never ending problems. At the very least I expected that they would put me in contact with someone who could help. They had THE PERFECT CHANCE TO DO SOMETHING that would make a difference. They had a chance to help a fellow UPSer who wasn’t getting the care and support he needed. But that’s not what happened. After I let them know of the struggles I was having, they didn’t ask if there was anything they could do. THEY DIDN’T TRY TO HELP. They didn’t check if I was OK. They didn’t care that I hadn’t received the benefits I was entitled to. They didn’t look out for my well-being.
What Barry Bragton did was send me another letter letting me know I WAS TERMINATED EFFECTIVE IMMEDIATELY. Not a single question about what was going on. No offer to help resolve the ongoing issues. Not even a referral to someone else at UPS who may have been able to help. It seemed Barry Bragton and Todd Lawniczak had no concern for a long time UPSer. No concern at all for making sure UPSer's get the healthcare benefits laid out in the contract.
I notice that Barry can cite the National Master Agreement when he’s firing me, but he didn’t seem to care about the contract when I explained to him that I WASN’T RECEIVING THE BENEFITS THAT I WAS DUE AS A 30 YEAR UPSer.
I did everything UPS asked of me for 30 years. I ALWAYS DID THE BEST JOB I POSSIBLY COULD. And if you ask any of my former supervisors, I think they would tell you I was always a top performer. I’ve come into work with a broken finger. I’ve come into work with tendinitis in my elbow, barely being able to move my arm. I’ve come into work with bursitis in my wrist. I never liked missing work, and was always there if possible. I know what I can do and what I can’t do, and I’ve never been afraid of hard work.
Unfortunately, with my shoulder problems, I just hadn’t gotten to a point where I was able to do all the heavy work that my job at UPS entailed. But what also bothered me, was the fact that I couldn’t even do a lot of the things with my eight year old son that my father did with me when I was a kid. I couldn’t throw a baseball with my son, or swing a bat. I couldn’t serve a tennis ball. I couldn’t swing a golf club. It was very hard not being as active with my son as I wanted to be. As any father should be. Not only was I unable to work, but I FELT LIKE I WAS UNABLE TO BE A COMPLETE FATHER.
But what if my insurance hadn’t been cut off, and I was able to continue with my rehab as it was prescribed? Would it have made a difference? We’ll never know. I was told (at the surgeon’s office) that it can sometimes take around a year of physical therapy after surgery to get back to normal. If I had a desk job, it probably wouldn't have mattered so much. I would likely have been back to work quickly. But I didn’t have a desk job. I had an extremely physical job. And denying my insurance coverage over and over MAY HAVE EFFECTIVELY DENIED ME THE CHANCE TO HEAL PROPERLY. Even as UPS acknowledged that I was entitled to such benefits going forward.
As I said, I know what I can do and what I can’t do. And after having my shoulder surgery, there’s no way I could go up in the sort isle and sort 70 pound packages to top belts at shoulder height. There’s no way. So it’s true that when Mr. Bragton sent me that letter, I didn’t have current medical documentation having me off work. But prior to that, I did send countless documents to UPS and Aetna, month after month after month. When I did have the documentation AND I WAS PLEADING FOR SOMEONE TO HELP so my family could get the healthcare services we desperately needed, nobody did anything to resolve it.
I don’t remember exactly when it was, but there was actually a point during all this when I was on the phone with UPS HR. And I asked her about retiring. I thought it was worth looking into the possibility of just collecting my pension rather than dealing with all the disability issues I was having. I don’t know who this came from. I was talking to an HR person but she went and spoke to someone else and then got back to me. But anyway, I was told by UPS HR that I couldn’t retire until I was 55 years old. I did have 30 years of service in, but they said I still had to be 55. So collecting a pension just wouldn’t be an option for me as I was only about 50 years old at the time.
So I turned 55 this year (2022). That magic number UPS gave me. Out of curiosity, I went online this summer and found that UPS actually started providing pension information on the UPSer’s website. This must have been something relatively new and was not previously available online. To my surprise, THE UPS WEBSITE SHOWED ME HAVING AN EARLY RETIREMENT DATE OF 2/1/2017. That’s February 1, 2017! This is five years earlier than the date UPS HR gave me over the phone.
So Human Recourses told me I couldn’t retire until age 55, but now the UPS website says I could have actually retired over five years ago? It shows my payments as being about $1975 per month ($23,700 per year). If this is correct, from what the UPS website is now telling me, from my early retirement date (2/1/17) until the date I ran the data on the UPS Retirement Calculator (6/30/22), I could have potentially received roughly $128,000 in pension payments. $128,000 IN PAYMENTS and UPS HR TOLD ME I couldn’t retire until age 55.
Before my shoulder surgery and ultimately being terminated, I had been earning at UPS in excess of $30 per hour, and regularly had overtime. By comparison a $23,000 per year pension would be just a fraction of what I had been earning. But the truth is that at the time IT WOULD HAVE BEEN LIFE CHANGING FOR ME AND MY FAMILY. I’ve expended virtually my entire life savings since this all began. Even a small pension would have mitigated the drain on savings, and lessened the financial strain my entire family was under. Not to mention the psychological strain we experience through the whole ordeal.
Obviously, the best case scenario would have been if my health insurance hadn’t been wrongfully denied. Or at the very least, reinstated when I first started communicating to Aetna, UPS, and the Teamsters that there was a serious problem. Perhaps if I’d been permitted to continue with my prescribed rehabilitation, after several months I may have actually been physically able to return to my job. AND BEEN BACK TO EARNING MY FULL WAGE.
I think it’s very sad that not all, but many of the people I’ve dealt with don’t seem to realize that what they do (or choose not to do) can have such a drastic effect on people’s lives and their families. The effects can be life altering. WHEN PEOPLE ARE IN NEED OR IN DISTRESS, THEY SHOULDN’T HAVE TO FIGHT SO HARD TO GET THE BENEFITS THEY’RE DUE. People were actually being paid to administer those benefits I was entitled to, and they failed to do so. I know my life has certainly changed forever. After working at UPS for 30 years, having a stable job, a wife and son, and owning a home, I would have never thought my life could have taken such a drastic turn so quickly. All three of those things are gone. I no longer have a secure job earning a decent wage. I no longer have a wife. I no longer own a home. And I’m now a struggling single parent.
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