Working with a Chronic Illness – Part 3: the Insurance Debacle

Last time I spoke to you, I told you how I’d become sick and lost my job, tried to make a welfare claim from Centrelink and, despite reports from two medical professionals, had been rejected because: a) I lived with my partner (even though we weren’t sharing finances) and b) my condition wasn’t “settled”.  I’d like to now tell you how it all got better but unfortunately, that’s not what happened.

Having been rejected for my Centrelink claim, the panic began to set in.  What was I going to do for money?  How would I pay my rent?  How would I buy food?  And more importantly, how would I pay for my myriad of doctor’s appointments and medication?  Sucking up my pride, I raised the subject with my partner.  At first he was furious with Centrelink.  How dare they assume he should support me just because we are living together?  I reasoned that if they did not have that policy, many couples would take advantage of the system.  He seemed to accept that but then became annoyed with me.  Why had I let myself be fired?  How sick could I really be?  Why didn’t I just “tough it out”?  He opined that I’d never liked the job or even working at all, and this was all an elaborate ruse to get me to stay at home on some kind of lovely never-ending holiday.  Anyone who’s ever had an invisible chronic illness will know these accusations.  Chronic illness defies the usual pattern: get sick, get diagnosed, get well.  When doctors, in whom we put so much faith, say “we don’t know what’s wrong with you and we can’t make you better” the people around us, trained and lay alike, start to get suspicious.

This arguing went on for some time, putting a huge strain on our relationship, but to his credit, my partner said he would not see me out on the street.  We came to an agreement, I would pay 1/3 of the household costs until I was back on my feet.  Not daring to push my luck, I agreed.  The only problem was, with an income of zero, how was I going to pay a third?

Things went from bad to worse.  Shortly after my Centrelink rejection I received a letter from my employer.  The letter not only confirmed my dismissal but added that I had actually been overpaid in excess of $1,000 and that I would have to pay that back immediately.

Through tears of humiliation, I emailed my old manager.  A man I’d previously had a fun and friendly relationship with.  I explained my situation, that I had no income, that I couldn’t even get benefits and that I was unable to pay a cent right now but would be willing to pay by instalments.  It is a sickening feeling when you know someone who has previously liked and admired you, pities you.  I went from being a capable, confident and attractive colleague to being a charity case.  The only difference was that our clients were probably better off than me as most of them received Centrelink payments!

Word soon got around of my demise and I received a few kind and thoughtful emails from my co-workers, one of whom suggested I might be able to claim income protection insurance through my superannuation.  A brilliant idea!  It had not occurred to me.  I’d never taken out an income protection insurance policy (and if you are in any kind of employment right now, I strongly suggest you do so immediately!!) but I was a new member of the superannuation fund for South Australian Government employees and part of their plan was to automatically include all members in an income protection insurance plan.

Elated, I downloaded the application form and began filling it out.  I discovered I already had all the documentation I needed from my doctors!  I checked the time periods and found that I had been a member of the fund long enough to apply and that if my application was accepted, I would be entitled to 75% of my salary for up to two years or until I was recovered.  I was thrilled!  75% of my salary would easily continue to pay my half of the bills and the relief of knowing I could take my time and heal without worrying constantly about money meant I would most likely get better sooner.  I was confident my application would be accepted, after all the insurance was intended to cover acute instances of illness, not “settled” conditions, like the Disability Support Pension I had been denied.  I posted my forms off and waited, quietly happy that my problems had been solved.

Then I got the rejection letter.  My application for income protection insurance, it said, had been denied due to “legislation”.  It did no further to explain what legislation, which provisions or why.  There was however, a name, email address and an invitation to contact them should I have any “further inquiries”.  I typed out my email, a polite enquiry as to which sections of which act/s were applicable and a reason for the decision to deny my application.

That afternoon my phone rang.  I can’t really explain what it’s like to be anxious to someone who hasn’t ever had the condition, but the notion of answering a phone to a private number when it may well be about something very serious, is terrifying.  The adrenalin racing through your body means you’re barely capable of constructing a coherent sentence and the likelihood of remembering anything that was discussed is slim to none.  Plus, being a lawyer and all, I prefer email over phone calls… I just like to have everything in writing.  I let it go to voicemail and listened to the message.  It was the lady from the super fund asking me to call her back.

I waited until the next day and wrote another email.  I thanked her for her call, apologised for missing it and asked if she could please reply to my query by email as I suffered from such severe anxiety at this time that talking on the phone was very difficult for me.  She did not reply.  I waited another week and emailed again, forwarding the previous message, and asking if she could kindly answer my questions by email.  Still nothing.  Two more weeks passed before I sent a third and final email asking if there was a reason no-one could email me?  This was a service for people who were unable to work due to whatever illness and I was surprised they weren’t more accommodating of each particular ailment.  If I was in a wheelchair, I said, they would hardly ask to me to walk up stairs to an interview room so why, with crippling anxiety, the very reason for my application, would they ask me to talk on the phone?  Still no reply.

At this stage, I was fuming.  I went in to law in the first place because I have a strong sense of social justice and this reeked of discrimination to me.  They knew I had anxiety, that was the symptom preventing me from working!  They knew I was uncomfortable with phone conversations and they knew how to very easily contact me by email or, heck, I would have even been happy with snail mail.  Society still has problems accepting mental health problems.  Those who have never had it or seen it first-hand seem to think its sufferers are either making it up, exaggerating or are “crazy”.  I was not crazy, my rational mind was functioning clearly.  I simply had adrenalin coursing through my body constantly and certain situations made it worse.  So why were they treating my ailments differently to “physical” ones?

Working in legal aid has taught me a few valuable things and one of those is to whom you complain when things aren’t going your way.  I wrote to the ombudsman about my situation, explaining everything in detail and declaring that I felt discriminated against.  They responded fairly quickly with a letter explaining that my application had been denied because I had not met the requisite time frame.  According to the legislation (which I had found on my own by this stage through research) an applicant had to be unwell for work for at least a week after their employer’s sick leave entitlements ran out, and only then would they be considered.  According to the ombudsman, the super fund was saying I had not met that threshold.

By this stage, I had been too sick to work for over three months.  I had no financial support from the government I’d happily paid my taxes to when well and now my own income protection insurance fund was trying to screw me- I was furious!  I wrote to them explaining in no uncertain terms that I most certainly did cross the threshold in that my sick leave had expired many months ago and since then I’d been living on sheer willpower.  Then the ombudsman started phoning me.

The second important lesson I have learnt from legal aid is to know when you’re defeated.  If you have already gone to the ombudsman, there is no higher authority to complain to, so if the ombudsman asks you to jump you either ask how high or get out of the contest. If they weren’t going to agree to email communications, I was at the end of the line.  Reluctantly, I returned the call.  Oh, now, I didn’t do it straight away!  No, that would be what a healthy person does.  I waited for a day or so, making notes of what I would say, outlining the relevant act and generally getting myself all worked up about it.  I dialled the number and hung up before it rang several times, like a teenager trying to call a cute boy.  Finally I worked up the courage to call and spoke to a polite young lass at the ombudsman’s office.

She apologised for making me use the phone but felt it would be “easier”.  I’m still annoyed by this statement to this day.  Of course it would be “easier” for her, that is what she wanted.  It was by no means easier for me.  In fact, considering the confusion regarding the facts and the laws, I felt it would have been much easier for any normal person to put the whole story in writing.  However, I had already done that and she still did not quite seem to understand the crux of my argument, so I suppose I must concede that for some people, written communication may not be very easy.  Although why they are working for the ombudsman in a quasi-legal role is another question altogether…

Anyway, the young girl I spoke to was very nice and genuinely tried to help, I’ll give her that.  The problem was, she’d never read the act and was unfamiliar with this kind of application.  The poor thing was probably new to the role and I had thrown her in the deep end.  We went over the problem again and again and she kept coming back with the same answer, you haven’t been sick for long enough.  I felt like banging my head against a wall!  I had been sick, too sick to work, and had doctors’ reports to confirm it, I said, for several months.  How on earth could that “not be long enough”?  Well, she looked into it and I looked into it and much to my dismay, one afternoon, I found my answer.  It was not in the relevant act itself, but the subordinate regulations… right down the bottom.  The way it was worded was unclear at first instance but after several readings it became clear, I was not entitled to any income protection insurance because I had lost my job.

I couldn’t believe it.  What on Earth is the point of income protection insurance if it doesn’t cover you in times of unemployment?  If I was still employed, I would have had an income and as such, would have no need for the insurance!  It was a complete catch-22.  If you don’t need help, you’re entitled to it but if you do, you’re not.  Ridiculous.  I was beside myself with anger but alas, that was what the law said and as I knew all too well, there is no arguing with the law.  I had lost and would not be getting any insurance payments.  I informed the ombudsman of my findings (I’m still not sure she really understood what had happened) and resigned myself to failure.  I was going to have to think of a new way to make money, something that suited my needs.

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2 Comments

  1. Mary said,

    August 31, 2012 at 8:19 am

    I am really enjoying reading your story


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