Dear Sir or Madam,
I have been an NJEA member and a teacher for 25 years.
I lost my job due to layoff this past May. Despite the fact that I was diagnosed with celiac disease with IBS in 1996, and my condition has continued to worsen, compounded with related ailments emerging through the years (diabetes, diverticulitis, thyroiditis with tumors in my nodules) and work related injuries and illnesses that befell me in 2005 and 2008, I CONTINUED TO WORK. The illnesses occurring in the workplace are PTSD, anxiety/panic disorder, and occupational asthma.
With the myriad of health problems I have, and the reality that a 50-something teacher, top of the pay scale, would be unemployable, I decided to retire on TPAF disability, which I should have done in 2008. I submitted my retirement packet in May, the day I was diagnosed with an ulcer with a laparoscopy. No-one at TPAF even bothered to send an acknowledgement, so I assumed my documents were in order, since I followed their instructions on the website for TPAF to the letter.
On July I was sent to a psychologist, but NOT to a gastroenterologist, which is the MAJOR part of my most crippling disability. The only communication I got from TPAF was when Senator X offices got involved in AUGUST, and only then I got an email telling me the hearing was Oct 8. Before Sen. x got involved, the numbers on the TPAF website were either not answered, or automated machines came on saying “we can’t take your call. Call back later.”
I learned from Board Secretary that my disability was not approved. I was told to immediately resubmit all of my doctors notes, and in detail, since the forms from the TPAF website did not have enough detail, “could not be read” and “incomplete”. She was the only person at TPAF that showed any compassion or kindness.
The 3 doctors were gracious enough to re-write the letters, and my attorney for my 2005 and 2008 Workers Comp case gave me many doctors letters describing the disabilities caused by my job. The 2008 case is still in the courts, awaiting settlement. Who knows how long that process will take.
Secretary resubmitted my claim on October 21, and told me on October 29 that I will be sent to a gastro by the Pension Board. This means my claim is still open, and my benefits should still be intact.
On October 16, I got a letter from SHBP dated October 8, mailed October 15, telling me my benefits were terminated November 1st. To keep the benefits, I MUST give them $3500 by November 1st, and $1800/mo until the mess they created is rectified. Using their own meeting calendar, the TPAF's next two meetings are December 2 and Jan. 7. It took their doctor six weeks to write the first letter and send it to the Board. Another doctor will examine me, send my report to doctor 1, and if the Lord is willing we might make the January meeting. This means I must come up with $10000 to stay insured, IF this moved quickly. However, my experience with these people tells me I will be dead before I get my pension and benefits.
My benefits have been cut off, despite appeals to the Chief of Benefits, Senators, and a long list of attorneys, agencies and people in the know. These two sides will not budge.
The TPAF people are the main cause of this mess, esp. their adamant refusal to assist the people who own accounts in their fund. What would it have taken to pick up the phone, and ask someone to resubmit forms? Why wouldn’t these people return calls when messages are left? One woman in particular, named R, never answers her phone, never returns calls- I lost track at 6 times I called and she blew me off. Are these people dead, out to lunch, or playing with computers all day? When I asked Secretary, she said, “some people don’t like talking to people, some are overwhelmed”.
I also spoke with Chief's assistant, who has done everything but lock the man in the office and make him read the emails. She told me, “You are by no means alone. Many others are in your shoes.”
I am wondering if the State Health Benefits and TPAF are in collusion to keep disabled people from getting the benefits they need and have earned. He finally returned the many faxes with a letter. I responded with an appeal to his common sense and decency, and he got attitude on me. The letter is at the end of my story.
I am just squeaking by with what my husband makes. My 2 sons are in college, and I am saddled with a ton of bills from my 2008 disability, stacked up on credit cards. I qualified for unemployment, but it will run out soon. Even when I had SHB disability insurance, some of my meds were too expensive for me to afford. My inhaler was $37, my Januvia for my diabetes was $88- I haven’t taken them because of that.
With our tax bill coming due soon, and car insurances, Christmas, and everything else, I am simply overwhelmed, and my symptoms are worsening.
All that has to be done is this TPAF has to send SHB a letter or some communication that my status is "under review", not "denied". I do not know if the 2 sides are not speaking, SHB is too stubborn and inhuman, or if the 2 sides are in collusion, since neither have any government oversight, esp. TPAF.
All I am asking is for my insurance to be reinstated, and my pension review given a shove. My retirement was to have begun July 1st.
Please, can you help??
This is the response to my final appeal to this inhumane monster:
----- Original Message -----
From:
Sent: Friday, November 5, 2010 3:24:33 PM
Subject: RE: Please reconsider and reinstate my insurance
Ms. :
Your attacks on the integrity of this Division are inappropriate and unprofessional. The employees of this Division that serve our members are professional and courteous in their dealings with our membership and to malign them is unacceptable.
As to your situation, I cannot justify continuing the coverage of someone who has not paid for the coverage that they have already enjoyed. Your application for disability retirement has been denied by the Board of Trustees and you are no longer eligible for continued health coverage. In addition, your appeal could take months, if not years to resolve.
I reiterate, I wish my response could be more positive for you but I must administer this program based on the rules and regulations that govern it.
CEBS
Manager, Policy, Planning and Operations
NJ Public Employees' Health Benefit Programs
(NOTE: his Lexus/Nexus forms concerning continuing my insurance supported MY position, not his.)
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