To: Cheri Vander Biezen, Director, Associate Health Services Nationwide Insurance Companies
Cheri, at this point Nationwide Insurance seems to be systematically working to avoid paying my benefits. Furthermore, Nationwide Insurance has not helped me perfect my claim, though I have asked several times.
Two specifically applicable doctor’s orders which have been ignored since Jan 2010, are listed here.
- Return to work part time @home with restriction. My pay record will not show any part time work as a trial. Nationwide Insurance did not follow even the first part of my doctor’s orders to return to work part time to see “if goes well”
- My Doctor’s official letter letting Nationwide Insurance know that the “the paperwork return to work instructions [Pg 1, Pg 2, Pg 3, Pg 4] should take precedent over the faxed disability certificate [attached below].”
These medical documents clearly state that I was to return part time to test my ability to return to work full time. I have been disabled continually since 27. July 2009. It is hard enough to deal with a disability. To place additional financial stress on my family by withholding the benefits I secured in case of a life-changing event lacks moral fortitude. I truly hope you do not have to endure this mental torture.
In May/June 2012 I requested a copy of the denial for my benefits. I have a recorded message from Mary Miller stating, “there was no real denial”, summer 2012. I still do not have an official denial.
I was hoping for an internal remedy, but, at this date I must request you release the benefits I have secured though due consideration Otherwise, I insist that you send me a formal denial so I can proceed to the Federal Court for and administrative ERISA hearing.
Cheri, you have the power to make this right, or you can participate with Nationwide Insurance in systematically attempting to withhold my benefits.
In Dec 2009, I told the nurse case manager, Lovie Bhattal (Lovely Brar) that I conferred with my psychiatrist, and I was planning to return to work part time to see if I had the capacity for full time employment. Nationwide brought me back full time instead of part time. I told Lovie that I was not able to do it. I told the HR manager I was assigned to that I could not handle work, and especially a job search. You say, “The letter that you provided does not change how your case was handled back in 2009 and early 2010” and I agree. It continues in the same manner of mishandling.
The bottom line is that Nationwide ignored doctor’s orders, and did not follow the timeline set by my psychiatrist. Any substance I have brought to the discussion has also been ignored.
Nationwide sites the reason for this action is a prescription size piece of paper. The paper said I could “return to work 1/15/09”. My doctor’s office faxed this prescription size note to Nationwide the same day as they faxed the Nationwide Insurance Short Term Disability Forms. This form contains restrictions. Nationwide continues to assert that that small part of my doctor’s orders is all that matters.
That form was dated for my to return to work 1/15/09. I did not get sick until 7/27/09. There is no documentation returning me to work full time for any period from Jan 2010 through today. This is typical of the lack of due diligence and concern Nationwide has displayed continually toward me.
I look forward to your response.
David B Reese, M.Div
P.S. I received the packet of Plan documents. The document, Second Amendment to the Nationwide Insurance Companies and Affiliates for Your Time and Disability Income Benefits was missing. I did not receive copies of Form 5500 Series.