Thrivent disability claim denial, My first experience Part 2, Incompetence?, Delay & Deny tactics?, Staff not trained to understand contract?, Unable to perform regular occupation not unable to work
Part 2 – Frustration begins
In Part 2 I will describe events leading up to surgery, filling out claim forms and the beginning of frustration as Thrivent does not adhere to the contract using “unable to work” in place of the contract stipulation of unable to perform regular occupation.
Thrivent’s inconsistency in complying with the contract and obfuscating facts will become a trend which will continue on in later dealings with them.
There is a clear pattern of incompetency on their part. The question is: Is it intentional. I.E. part of a insurance industry pattern of Delay and Deny?
I had my own IT consulting firm for years.
This was not a desk job.
An integral part of my duties, aside from transporting myself to the customer site, was walking around the office area and in recent years warehouses. Three of my last customers had extensive warehouse spaces and I had traversed them much.
As stated in Part 1, my right knee had gone out running. I was having great difficulty walking and the intense pain was affecting my ability to perform and sleep.
Dr. Frank Aluisio was my Orthopedic Surgeon.
From my November 15, 2001 visit:
The diagnosis confirmed my experience.
This confirms that on June 18, 2001, I had severe osteoarthritis with functional loss and pain.
On November 19, 2001, Dr. Aluisio filled out a Statement of Disability.
This form was sent to Thrivent along with a claim form.
Compare this statement with the diagnosis above and then the language of the contract.
This was my first warning that Thrivent may not be dealing fairly with me.
One of the first questions is why did Dr. Aluisio use “unable to work” instead of applying the contract language and his diagnosis?
Unable to work is a Social Security definition and perhaps it could have been an honest mistake.
It was not.
This was ultimately driven by Thrivent.
Here is the first proof that Thrivent was driven by incompetency and/or an agenda.
A letter from Thrivent dated December 7, 2001:
Notice that the correct language from the contract, unable to work at your regular occupation, is quoted.
At the bottom they state: “Dr. Aluisio has verified total disability beginning December 17, 2001, the date of your surgery.”
THAT IS NOT WHAT DR. ALUISIO WROTE!!
He put 12/17/01 beside of unable to work, which is not the contract dictate.
He also wrote “functional loss” in his diagnosis of my June 18, 2001 condition.
It was clear then as it is now, that Thrivent should have helped me for a least a few months past the 3 month elimination period.
A later review of this letter has given me new insights into why they were trying to restrict my disability to 3 months. This applies to the residual disability clause above. I did not realize then that minimally I should have been entitled to this due to the impact on my profession.
Also from the letter:
Note they are stating I should pay attention to the contract. This theme plays out the rest of my experience with Thrivent. I am paying attention to the contract. They should do the same.
Also, this is the first notification of their Dispute Resolution Program. More on this later.
More on Thrivent’s disregard for the contract and my well being in Part 3. More pain and more frustration.
