T
Too2Sweet
Guest
FACTS: Thank you in advance for even taking the time to read through my problem. Any help you can render will be so greatly appreciated.
. 1990 - Joined Class Action Suit San Antonio, Tx. attorney
. 1991 - Case passed to Houston, Tx. attorney for Global Class Action Suit
. 1992 - Global Suit filed in Northern District of Alabama District Court.
. 1994: Victory for Plaintiffs - Case Won and revised settlement program approved by courts and escrow established.
. 1992 - To Date: I Remain a current claimant with settlement pending.
. SEPT. 1998 - Claims Officer sends "Notification of Status Letter" to Houston attorney 3 defincies noted (i.e., request for re-examination, unacceptable proof of ruture, and notice of deduction of benefits due to "Dow Corning Implant", etc.). Notice that my claim will not be reviewed again until additional medical documentation is sent.
. SEPT. 1998 - Houston attorney does not contact me regarding this correspondence. After 60 days my rights to be re-examination at the claims office expense was waived due to lack of response from myself or my attorney.
. DEC. 1999 - Houston attorney has another physician review my medical documentation and send a letter to claims office giving dianoses and disability criteria "B" and able to perform vocation and self care. I never saw or spoke to this doctor.
. MARCH 2000 - Original Plastic Surgeon, who performed all 4 operations to remove and reconstruct breasts) clearly answers the question of the "Rupture Claim" by reviewing his own records of first surgery in which he states "An incision was made through the capsule (breast cavitity)and some whitish-yellow floud came out". In re-review of the surgical records he states "I can state that in all probability it was ruptured based upon the above facts". Should this definincy be deemed acceptable it will double my claim settlement,but is still be denied as not enough proof.
. JULY 2000 - Houston attorney's office sends letter to claims officer stating that there is/was no proof of a Dow Implant being placed in my body (legal assistant did not know how this mistake was made)and therefore my benefits should not be reduced by 50%. This defincincy was finally corrected in the claims file in Oct. 2000. Although the letter was received by the claims officer in July the record was not corrected until October 6th after I repeatedly called requesting a response. This record correction was considered to be the answer to my first "Request for Assistance Form", dated May 19,2000, by the claims office. I was told it "we have up to 90 days from 10/06/00 to respond to your request to have your claim re-reviewed so you'll just have to wait for that phone call". 2nd request recieved in the claims office October 6, 2000.
. DEC. 2000 - Claims Office calls to state that my case has been re-reviewed and although I have been re-examined and documentation was provided that it was not written clearly enough to determine just how and why I could no longer work and that there is still a question as to how I could take care of my own self care without assitance.
I have been under the care of both an Internal Medicine physician as well as a Rhematology Specialist (since July 25, 1998)for Fibromyalgia, Sleep Disturbance, Carpal Tunnel, Irritable bowel, Depression and Chronic Pain Management.
QUESTIONS:
1. Should I report the attorney to the Texas Bar Association for malpractice and violation of my right to timely counsel as was paid for?
2. If I should file a complaint which attorney do I report?
3. If I hired another attorney to represent me in the resolution of the pending claim would this increase my possibilities of successful closure of the claim at the highest level of compensation allowed?
4. Last but not least should I even continue to attempt to respond to the claims officer's ongoing requests for answers that I believe have already been resolved repeatedly or should I just settle the case at the much reduced amount just for the sake of ending this Never Ending Nightmare?
. 1990 - Joined Class Action Suit San Antonio, Tx. attorney
. 1991 - Case passed to Houston, Tx. attorney for Global Class Action Suit
. 1992 - Global Suit filed in Northern District of Alabama District Court.
. 1994: Victory for Plaintiffs - Case Won and revised settlement program approved by courts and escrow established.
. 1992 - To Date: I Remain a current claimant with settlement pending.
. SEPT. 1998 - Claims Officer sends "Notification of Status Letter" to Houston attorney 3 defincies noted (i.e., request for re-examination, unacceptable proof of ruture, and notice of deduction of benefits due to "Dow Corning Implant", etc.). Notice that my claim will not be reviewed again until additional medical documentation is sent.
. SEPT. 1998 - Houston attorney does not contact me regarding this correspondence. After 60 days my rights to be re-examination at the claims office expense was waived due to lack of response from myself or my attorney.
. DEC. 1999 - Houston attorney has another physician review my medical documentation and send a letter to claims office giving dianoses and disability criteria "B" and able to perform vocation and self care. I never saw or spoke to this doctor.
. MARCH 2000 - Original Plastic Surgeon, who performed all 4 operations to remove and reconstruct breasts) clearly answers the question of the "Rupture Claim" by reviewing his own records of first surgery in which he states "An incision was made through the capsule (breast cavitity)and some whitish-yellow floud came out". In re-review of the surgical records he states "I can state that in all probability it was ruptured based upon the above facts". Should this definincy be deemed acceptable it will double my claim settlement,but is still be denied as not enough proof.
. JULY 2000 - Houston attorney's office sends letter to claims officer stating that there is/was no proof of a Dow Implant being placed in my body (legal assistant did not know how this mistake was made)and therefore my benefits should not be reduced by 50%. This defincincy was finally corrected in the claims file in Oct. 2000. Although the letter was received by the claims officer in July the record was not corrected until October 6th after I repeatedly called requesting a response. This record correction was considered to be the answer to my first "Request for Assistance Form", dated May 19,2000, by the claims office. I was told it "we have up to 90 days from 10/06/00 to respond to your request to have your claim re-reviewed so you'll just have to wait for that phone call". 2nd request recieved in the claims office October 6, 2000.
. DEC. 2000 - Claims Office calls to state that my case has been re-reviewed and although I have been re-examined and documentation was provided that it was not written clearly enough to determine just how and why I could no longer work and that there is still a question as to how I could take care of my own self care without assitance.
I have been under the care of both an Internal Medicine physician as well as a Rhematology Specialist (since July 25, 1998)for Fibromyalgia, Sleep Disturbance, Carpal Tunnel, Irritable bowel, Depression and Chronic Pain Management.
QUESTIONS:
1. Should I report the attorney to the Texas Bar Association for malpractice and violation of my right to timely counsel as was paid for?
2. If I should file a complaint which attorney do I report?
3. If I hired another attorney to represent me in the resolution of the pending claim would this increase my possibilities of successful closure of the claim at the highest level of compensation allowed?
4. Last but not least should I even continue to attempt to respond to the claims officer's ongoing requests for answers that I believe have already been resolved repeatedly or should I just settle the case at the much reduced amount just for the sake of ending this Never Ending Nightmare?