Friday, July 1, 2016

SGI: First Prize for A Well Delivered Insurance Fraud! (Part 3)

       After my character and motivations as a person were put to question, I was scheduled at Saskatoon City Hospital for a forty hour a week, three month long tertiary treatment program. Coincidentally the entire floor of the hospital was reserved and private for the two largest insurers in Saskatchewan. It was mandatory for me to attend one hour weekly psychological sessions. Group sessions with a social worker and group discussions were also mandatory while under observation.
      There were stringent rules to attending this "specialized" program: Clients in a program may be asked to justify any statement and/or action. I was instructed that any attempt to speak with or possibly influence any other person in the facility would be met with expulsion from the program. Any negativity was prohibited. Choosing not to participate, questioning practitioners, hostility, profanity, or raising of voices would result in expulsion. I was put under duress to sign consent forms, of which I was not allowed to have a copy of. I had to sign to guarantee that all of my efforts in physical exercises were going to be 100%, and that I would adhere to requests by all practitioners. It was made extensively clear to me that this was the top facility in Saskatchewan, in one of the largest hospitals in the province, that could immediately draw upon many medical experts if needed. It was politely explained that expulsion from their program would result in the termination of all insurer benefits. I was to have complete faith in the system without question. These people were the educated experts, I was just a guy that believed he was seriously injured....
       Of course the first order of business was to take a look at those ribs! LOL, no! Just joking. The largest priority was to sit me down with a psychologist to determine what my attitude problem was. The psychologist realized quickly that I was not exhibiting the behavioral symptoms he was told to expect. He also recognized and was interested that I had an understanding of psychology. I explained as nicely as I could that I was trying to participate although the entire process made no logical sense. I assured him that I firmly believed I had a serious rib related injury and was there for medical help/intervention. I openly admitted that I needed help, and asked for it. I had nothing to hide. A concern was raised that because SGI and Saskatchewan insurance was under review and scrutiny at that time I may try to negatively influence the process due to my perceived animosity towards the insurer. It was getting tough to tell who was more paranoid! I reminded the psychologist that I was there for a rib injury. I assured him that any past or present disagreement with SGI was of no concern nor issue while I was attending medical treatment and trying to return to my life. I also explained that I was not active nor interested in politics at that time.
      I began the FIT For Active Living Program under severe scrutiny and question, and was put under moderate duress to remain silent for their extent of my program. I was to smile and work through my pain. My own interpretation of being moderately injured and having very high pain tolerances weren't seriously regarded. Heart monitors were initially used to monitor my heart rate during exercises, but they stopped usage when seeing unsafe heart rates for particular exercises. I was unable to bike nor run at a safe heart rate, but I was allowed to walk and stretch. This didn't seem to be a serious concern to anyone...a man previously athletic and very physically agile unable to perform basic physical functions.
       I was very notably being "educated" about how to work through pain and become accustomed to it. Many group activities were about breathing exercises and relaxation therapy. I was strictly instructed to work through the pain despite my background of martial arts/sports and years of experience with pain and residual pain. In one of the physical exercises I went down on one knee and couldn't remain standing. A practitioner was there immediately....but not to help. I was told I was there to work through the pain and I was reminded I'd signed a consent form to give maximal effort. The only acceptable time to succumb to pain was if it reached an 8 or 9 on a pain scale of 10, with 10 being death. If anyone reported 8 or 9 it was required to immediately go to the emergency room downstairs (I'd already been turned down for acute care, and it'd been five months with no medical testing). This was the unrelenting undertone of the program, despite any opinion I had of my body. The opinion was that I needed to work on my endurance and pain tolerance.....
       I was kept quite busy having my attitude questioned regarding anything I did or said. Things I claimed abilities to I was asked to prove, like woodworking. If I went to the washroom and took a minute too long, somebody came looking for me. My input and behavior was monitored in several social activities by a social worker to ascertain if I was being positive and a positive contribution. The weekly psychologist interviews constantly probed for a positive attitude and a person that was blindly being spoon fed a complete line of shit. As I was there to work through my perceived pain, the only important issue seemed to be that I was positive about it. My own concerns were muted, as I was supposed to have faith in the process.
     After two months of the fiasco that was deemed a rehabilitation program, I was congratulated and told a gradual return to work could occur. By this time I was accustomed to the idea that my pain was considered superficial and that I was being a good boy by being positive and returning to work. The vast increases of pain started immediately but  it was explained how normal that was and that it would get easier. Over a period of three weeks I began to get severe headaches and my pain levels remained unacceptably high. I raised a concern about pushing around carts that weigh 300-450 lbs as it wasn't feeling too good on my ribs. I was questioned regarding my opinion of the weight of the carts! The carts were weighed on site to confirm I was correct. Without any consideration regarding how insulting the notion was....it was scheduled for a member of my "treatment team" to follow me around at work to see what I was doing wrong!
      You can imagine the shock and confusion when a practitioner noticed my shirt moving peculiar during a movement. She asked me to reproduce the movement without my shirt, which I did. The young lady was shocked to realize my ribs were moving and asked if it was uncomfortable. I positively responded with a polite yes.....it was difficult not to laugh.
        A specialist was called in within a day, and he didn't look happy at our meeting. He explained he was going to perform a very discomforting procedure to verify a diagnosis. He verified his diagnosis, and explained that several of my ribs were not attached at the sternum. He explained the rarity of the diagnosis and said that a surgical consult would be scheduled to examine if the ribs could be reattached. I thanked him very much, even though I was in some discomfort. He seemed disturbed, while I took his diagnosis as "good" news. Somebody had verified I was actually injured, and it was the first medical test of any kind since the night of the MVA. By this time I believed that there would never be any serious acknowledgement of the injury....it had been seven months, much of it under duress and personal attack while having my injury symptoms downplayed.
       I had misunderstood the seriousness of the revelation, and within a minute of the diagnosis I was asked to step into a private side room. My second return to work program was canceled, and the vast majority of my "treatment program" was immediately canceled as well. The young lady simply said how very sorry everyone was, and that an immediate meeting had been requested with my insurance adjuster. I took the news very poor and asked to be excused for the day. After having the on site psychologist assess whether or not I was potentially a risk to anyone, I was "permitted" to leave the facility. Several of my treatment team were in tears as well, and were also clearly disturbed.
       Upon my return the next day, I was greeted and offered an explanation by the "Rehabilitation Coordinator" for the FIT For Active Living Program. She explained that in no way should I have been involved in a return to work program nor any exercise/strengthening programs with my ribs unattached. She snidely explained that their program would in no way be accepting any responsibility for the severe misunderstanding as there was pertinent medical information they did not have. She clearly indicated that Saskatchewan Government Insurance and my General Practitioner completely failed to share with the hospital a vital medical note from five months ago that clearly indicated I had a moderate to serious rib or rib related injury. It was sadly explained that I was in a crucial stage of healing and I'd just underwent everything I wasn't supposed to be doing. I was vastly agitated at the lack of professionalism and cheap pointing of fingers to alleviate blame to other people. The lady refused to engage in any conversation after offering the explanation, other than saying I was still expected to show up, walk around, and attend social activities and psychologist interviews.
        Despite verification that at least two major ribs were moving freely, the FIT program stated they "were curious" as to my abilities with my condition. They requested I perform the physical testing to rate a person for what their overall capabilities were to return to work. I was perplexed and asked why they would take me off work and exercise and then test me for return to work capabilities. Everyone was in agreement that the results would never be used to actually return me to work, as they had indeed confirmed I could not work with the seriousness of the rib detachment. They insisted it was simply curiosity. It was the only time I was allowed to quit at times of severe discomfort, and I did what I could at the time without incurring severe amounts of pain.
       I was discharged from the intense tertiary program in the same condition or far worse than when I entered, and to this day am unaware of what part of my injury is from the accident.....and what is a result of the treatment program. The surgical consultation went very poor for me and I again was not treated well. Again my input and opinion of my body was mute and considered useless, allowing a return to the ignorance that an injury was even present. It was decided there was no surgical option and I could work. Everything that had been learned was thrown out again.
      It took me years to understand how and why I was returned to work again so soon. The third failed return to work program was the final effort my Employer would participate in. I was by this time severely physically agitated and emotionally exhausted. The very test results that the FIT For Active Living program stated would never be used were the key papers referenced to determine my supposed physical abilities. The exercises in which I had to be stopped (or stopped myself due to pain) were not noted, giving a falsified better impression of my physical abilities. I still didn't understand how my proven diagnosis could be ignored and how I could possibly be returned to work so very injured, but that was the end of any intervention or help.
      It was 2006, five years after the injury and preparing for a simple appeal to a committee regarding chiropractic treatment, that I noticed the document. After the initial diagnosis at the FIT program in 2000 and before any discharge reports or information about my diagnosis were issued to any person or organization...a communication was sent from my injury adjuster to a privately hired "practitioner of the evening". The hired whore was a licensed practitioner that stated he had never heard of the diagnosis. He simply wrote a note back to the injury adjuster that the diagnosis should not effect me. Clearly evident from viewing insurer communications is an insurer (in this case a former police officer) manipulating and determining my treatment coverage, while always ignoring my input.
       A great example of insurance fraud is indeed involving me but not by me. All I ever wanted was medical treatment, my human rights, and my civil rights. I found having no rights effected my treatment options and recovery. I also received no benefits to continue life with a permanent physical impairment, my extended family helped me for years.
         Saskatchewan Government Insurance sometimes defrauds and discriminates against people for being injured in an accident, and bullies them. The implemented system and lack of checks for it allow insurers to save millions regarding benefit payouts for treatments, etc. My reasons for coming forward are not monetary. I'm simply returning to scrutinize the insurance industry that is still ripping people off and disregarding Civil Liberties. The acknowledgement of Fundamental Freedoms for injured people is often vital to their treatment and recovery. Perhaps Canadian insurers will be better educated when I am done pointing out several examples of legal loopholes that allow discrimination, criminal negligence, fraud, libel, and slander.
         Everybody drives or works, or drives to work, or knows someone that works or drives. Then this can happen to someone you love. I share because my own experience was obtuse enough to actually serve useful in pointing out improvements for others. If I didn't care I'd say and do nothing. From a proud patriotic Canadian, Happy Canada Day! Long live Canada's Civil Liberties!








  

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