We’ve seen it many times in the insurance industry – workers who’ve dedicated years of their life to a company, only to have their full benefits declined when they fall ill. It’s a terrible feeling, to not only suffer through a disease but to feel discarded by the company you were once so loyal to. This was the case for our client, Sheila, who reached out when her insurance company denied her full-time benefits after she was diagnosed and could no longer work.
Sheila started working at a large food manufacturing company when she was just 20 years old. She began as an administrative assistant, but worked her way up to a logistics manager position.
Although she found the work fulfilling, her job could be stressful at times; she managed over 50 people within the company. Sheila felt pride in her position, knowing she was responsible and efficient. She had two young children at home and she wanted to work as hard as she could to give them all the opportunities possible.
Sheila Began Falling Ill
Sheila began falling ill frequently. She noticed she was getting coughs, colds, and the flu almost back-to-back. This made her job all the more stressful, as she never felt like she was fully recovered. She felt awful and tired all the time.
She was never one to complain, and between work and the kids, she didn’t make time to see a doctor about her symptoms. Her husband, Clayton, became frustrated after watching his wife lose weight, suffer night sweats, and cough constantly. He finally insisted she go to her doctor, and she agreed.
Diagnosed With Stage 3 Of Hodgkin's Lymphoma
After her doctor conducted a biopsy, Sheila was diagnosed with stage 3 of Hodgkin's Lymphoma. The cancer had progressed to both lymph nodes on either side of her diaphragm, and her doctor insisted she stop working. She would need to receive chemotherapy and possibly radiation.
Instead of ceasing work altogether, Sheila decided to reduce her hours. Perhaps not totally facing her situation, she rationalized her decision to continue working: she felt beholden to the company she had worked with for so long. The survival rate for Hodgkin’s Lymphoma was about 89%, and her first priority was still to make sure her kids would be alright.
Working Became Impossible
Sheila did not anticipate how terrible the treatment would make her feel. She was vomiting frequently, lost most of her hair, and had terrible mouth sores and difficulty swallowing. It made working absolutely impossible, let alone taking care of her day-to-day responsibilities. Clayton helped as much as he could, but he was unable to take time off work and support the family.
Sheila applied for benefits during this time. As she had gone down to part-time work, her company’s insurance policy was willing to give her the health benefits of a part-time employee. Her last 20 years of working full-time were completely ignored. The insurance company was only focused on the fact she’d been working part-time – while cancer stricken – for six months, and decided that’s how she would be covered.
Devastated When Denied Full Benefits
Sheila was devastated. The only reason she went part-time was because she didn’t want to let the company down! And now, when she was sick and scared, they did not repay the favour.
Emotionally and physically exhausted, Sheila broke down when talking with one of the nurses while receiving a course of chemotherapy. She felt helpless and discarded – what was she going to do?
The nurse had heard about other patients who had struggled with this kind of situation before. Fortunately, she knew about Share Lawyers and their dedication to working for those who have been denied long-term benefits. The nurse gave Sheila a pamphlet on Share Lawyers, which she shared with Clayton, who called immediately.
Share Lawyers Challenged The Insurance Company
We at Share Lawyers know Sheila was entitled to her long-term benefits. Working with Sheila and her physician, we challenged the insurance company’s decision to deny her full benefits.
We are happy to say we were able to reach a favourable agreement, where the insurance company agreed to give Sheila the benefits she and her family needed while she recovered.
*All names and identifying details have been changed to protect the confidentiality of all involved.
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