Disability Insurance Horror Story
David Egglesfield had the boss from hell.
As a pharmacy technician at the Rouge Valley Centenary Health Centre in Toronto, he was constantly subjected to her regular physical and mental abuse.
"She'd give me the worst jobs and she'd say, 'I'm talking you off the schedule, you're going to do what I tell you to do!" says Egglesfield. "One day, she actually came up to me and said, 'You know, I think you're a fag.' What kind of boss is that?"
Thankfully, she's currently out of a job, but in a sense, she took Egglesfield down with her, and he has never been quite the same.
"I had to go see a psychiatrist," he admits. "I didn't know what was wrong with me. I was throwing up just getting up in the morning and I was throwing up on the subway on the way to work. I was sicker than a dog once I got there and I was shaking. It was anxiety, but I had no idea, so I ended up going to the hospital many times."
The doctors gave him demerol and other drugs, but nothing seemed to work. He was crying and passing out at random. Then, he saw a gastroenterologist, who finally told him, "There's nothing physically wrong with you. You have anxiety."
After the specialist's diagnosis, and with nothing else wrong in his life, it quickly became apparent to Egglesfield's family doctor that his boss was the main source of his health problems, but once she left, his crippling symptoms never abated, and he was forced to leave work and go on disability.
"I tried going back to work many times," he insists. "But, as soon as I got there I was sicker than a dog. As far as work goes, my psychiatrist already said that in the condition that I am in, there's no way I'm going to work anywhere. I've been on benzos for two years already and those aren't something you can just stop, you have to be weaned off of them slowly."
At the time of his injury, Egglesfield was able to qualify for short-term disability through the hospital's group disability provider, Desjardins Insurance, which paid him his full salary of $25 an hour for eight weeks. However, even with his doctor's full support and his accompanying explanation that Egglesfield could not work anywhere else for the foreseeable future, the insurance company rejected Egglesfield's initial application for long-term disability, pouring salt on an already festering wound.
"When they denied it, I went back to my doctor and said, 'Look, I have to go back to work. I need money. I have to at least try and do something.' And he said, 'I know you can't do it, it's only going to make you worse.'"
His endorsement didn't help, and his application is currently under review by the insurance company after the first decision was contested with more forms and detail from his doctor. "The first time, the way my doctor worded things, the insurance company believed I could work somewhere else," says Egglesfield, "I was shocked. They just don't understand what I'm going through."
What Egglesfield doesn't know is that the confusion on the part of the insurance company has nothing really to do with the medical reality of his specific situation and everything to do with the definition of "disability" under the hospital's group insurance plan.
LSM's Take: There are three definitions of 'disability insurance,' and they are, 'Any Occupation,' 'Regular Occupation,' and 'Own Occupation.' It sounds like David Egglesfield's plan has the worst of the definitions, which is 'Any Occupation.' This means if Egglesfield can do any work, he won't qualify for a disability claim. Whereas, if it were 'Regular Occupation,' as long as he can't do his regular occupation as a pharmacy technician, he would qualify for the disability insurance claim. The problem is the definition of 'disability.' He has a group plan, and with a group plan that recognizes 'Any Occupation' disability, you could also apply for a supplementary plan that has 'Regular Occupation.' It's common for group plans to include 'Any Occupation' after two years. It may very well be that the insurance company is still putting the screws to him, but if he would've had the 'Regular Occupation' definition, then this wouldn't have happened.