[TX] At the end of July, I got very sick once I returned from a vacation. I was struggling to work due to my symptoms and was eventually advised by my employer's HR team to go on FMLA and apply for Short Term Disability.
I was approved for the FMLA leave no problem during the first week of August. At the beginning of my illness, I took my paperwork to one of my doctors who determined I had “bad allergies” and “unknown symptoms that needed to continue to be investigated. He advised I work part-time, and did NOT pull me out of work. At the same time, I am seeing my neurologist, cardiologist, and ENT. I send all my paperwork to Broadspire, and I do not hear back from the claim manager for nearly 3 weeks. Even when I was calling every day, looking to speak to somebody, nobody knew how to help and kept encouraging me to leave her a voicemail. During this time, my ENT's nurse calls me to tell me it looks like I was dealing with MONO.
I am blowing Broadspire up trying to get in touch with my claim manager to give her this new information. 2.5 WEEKS LATER, I find out the claim manager was being HOSPITALIZED and nobody had reviewed any of my documentation because nobody had been covering for her. I ask to have my PCP redo the paperwork to reflect my mono diagnosis, and resubmit the new paperwork. Broadspire denies my claim for Short Term Disability because my PCP stated that she did not pull me out of work due to my illness. My PCP advises me to get the paperwork filled out by my treating provider, because even though she is “sure I am sick with something,” she does not want to “lie” on the paperwork.
This is my last hope, as Broadspire tells me if the paperwork done by my ENT gets denied, I will need to file an appeal. I take the paperwork to my ENT's office last week and beg them to complete it, as they saw how many visits I had with them, all the labs they ran, and just how ill I was when I first started experiencing the mono. Today, my ENT's office calls me back, and the PA informs me that they did not advise me to stop working while I was ill. And that the “mono” I was diagnosed with nearly 3 weeks ago was not an active infection, but a previous exposure… She continues on to say that they don't have the adequate medical support to have disabled me from working during this time.
I am at a complete loss, as I am having to accept that I very well may not be getting paid my last three paychecks now. Although I was being seen by multiple specialists, was sleeping from fatigue for weeks on end, in and out of the ER, getting MRIs and ultrasounds done, and put it so many new medications, I do not qualify for STD payments because my doctors are refusing to be the ones to say I was “disabled” for the past month. Even with all this documentation, and my approval of an accommodation to work from home full time, they are doing everything they can to not pay me for the entire month of August. I came back to work this week, and my company's HR team is extremely unhelpful and continue to place blame on our third-party benefits supplier, insisting they have no say in whether or not I get paid for my time out. I find this hard to believe as they are the ones with a policy in place stating that my physician “must disable” me to be eligible to receive payments.
Has anyone ever ran into a situation like this one? Does anyone in HR believe that my HR department is trying to minimize their responsibility in assisting me in this position? I fell so behind on bills because of (1) the claim manager's inability to have her cases covered for nearly 3 weeks (2) my doctors avoiding saying that they took me out of work due to my illness. Does this sound like a good case for an attorney to take on?