Legal Issues? For a Possible Project forIndividuals and Families Impacted by Cancer

[mekasan]

Hello everyone,

I need help from the group in order to develop a cancer specific legal project. I am currently a law student, about to graduate, that works at Legal Services Inc, where we provide free legal assistance to clients who meet our financial eligibility guidelines. I want to continue help those need but unable to afford legal assistance when I graduate.

Because I am a law student, I CANNOT offer any legal advice in any way. (Because I am a law student, I am trained to make sure all disclaimers are presented in conspicuous font - i.e. the bold and underlined text)

What I would like to do after I graduate is create a project that provides legal assistance to individuals and families fighting cancer. I need you to help me identify the legal issues that impacted you so I can understand what type of assitance is most needed. I personally know where I felt I needed legal advice:

Of course I can imagine several other legal issues directly or indirectly related to cancer:

1. Employment Discrimination - not being hired, or fired
2. Estate Planning
3. Access to healthcare for those without coverage - pre-existing conditions impact
4. Bankruptcy
5. Family Law Issues - anything related to relationships, marriage, divorce, child support, alimony, cohabitation, same-sex couples, etc...
6. Consumer Fraud... (I personally got ripped off by my wig lady who promised me it would be one price b/c Komen would pick up half and then
sent me a bill for double after I had owned the wig for a month)
7. Life Insurance
8. Public benefits claims - SSI, SSDI, Medicaid, etc
9. Making sure my insurance was covering everything it was suppose to and
not acting in bad faith. (Again something I dealt with)

I know this question is personal and often difficult to discuss with a stranger, but I do not need specific details and it does not have to be your issue. I simple need to get an idea of what types of issues concern us the most as a group.

Of course you can send me a private message if you like.

If you have any questions, I will be glad to tell you more about what I would like to do.

Thank you for your help,
Shannon

[Lani]

you should look up Gina's post regarding how her filing for Medicare disability impacted her health insurance, disability issues, etc

As I recall, being a small business owner she could not get/keep health insurance, once she got Medicare disability her insurance company wanted to be paid back and once she earned more than Medicare said she should (out of financial hardship with her own company, Medicare came after her to repay as well.

Issues you may not have listed include--how to keep insurance for those who are self employed and small business owners ie, if they can't work or close the business they lose their insurance and are insurable, disability issues (both Medicare, state and private) and insurance companies who just decide to drop individuals or small groups when one member gets cancer (a friend got dropped by his health insurance company when he developed prostate cancer when they claimed he had lied about a history of preexisting problems HE DID NOT HAVE AND WHICH HIS MEDICAL RECORDS SHOWED HE DID NOT HAVE)

I have read articles in the Wall St. Journal wherein drug companies who are making lots of money on drugs developed under the Orphan Drug Law are paying the premiums of patients through a charity they surrupticiously fund as the premiums cost a lot less than the profit the drug company makes on the patient who depends on these drugs for life for their lifetime.

I would hope that you could find funding from Genentech to provide legal services for those whose insurance companies are trying to drop them as Genentech supplies the drugs for free for those without insurance, but makes a lot of money on those with insurance.

You might like to network with Cynthia who lives in Washington DC and is an attorney who was interested in lobbying and other activities to help breast cancer patients.

Hope this gives you some ideas. I think each state should pass a law making it illegal for insurance companies to drop patients with cancer (other than simple nonmelanoma skin cancers) and illegal for them to charge them any increase in premium other than the general rate of inflation/with perhaps the government making up the rest or providing them with a tax benefit.

[mekasan]

Hi Lani,
That's interesting that you mention Gina. I actually met her in DC last year when I went to the NBCC patient advocacy conference. She was in the area and Michele (from here) called up.

We did discuss some of her issue and it upset me to hear about what she went through. I know that many of us get pushed around when we are the most vulnerable and that is why I want to do this.

From the first month of my diagnosis through the present, I spent and spend hours on the phone with all levels of my insurance company's decision-makers trying to remedy thier "confusion" with the policy coverage. It is tiring. I am young and considered myself "energetic" even when in treatment (no one else will agree). I can imagine that many people may not be as energetic (for a number of reason i.e. kids to tend to, age, longer treatment, more side effect, etc) and that would make it hard to just sit on the phone for hours fixing this side of cancer.

It is should not be the job of the person in treatment to resolve adminstrative issues from their bed. I want that job. Let those in treatment rest and get better, not waste precious moments of energy making calls!

Thanks for the help

[mekasan]

Oh, by the way.. I also met Cynthia in DC the same weekend I met GIna. How funny you mentioned them both.

I am also taking an insurance law and policy course so that I can learn where to begin understanding just how insurance companies get way with all their horrific acts.

It is so disturbing.

Thanks for the suggestion about funding for Genetech. That great.

Once I get a list together, I will have to narrow it to some specific areas that I think I can manage and then go grant hunting. This should be interesting.

Thanks
Shannon

[Sheila]

Shannon

I don't believe you were on the board yet when I took on my hospital in Chicago for overcharging on Herceptin....with the help of many on this board...i was able to gather info on what people are paying or being charged for Herceptin all over the country....I even went to a different clinic and oncologist for 1 treatment to prove my point....the insurance company (BCBS of IL) would not argue the charges, the hospital would not budge, so I filed a complaint with the IL Attorney General....the hospital reduced their price for everyone on Herceptin and even retoactive reimbursement to the insurance companies....they are still charging way more than other hospitals, so I think its time to tune them up again with another complaint. BTY, the chemo nurses and my Oncologist were behind be on taking the hospital to the cleaners so to speak for making a profit at breast cancer patients expense.

I also had the experience of receiving long term disability from the company I worked for for 11 years...I paid while I was working for this benefit....once I qualified, they insisted I apply for SSD to help defray their costs. I did and was granted Social Security Disability without any questions....after that, the disability insurance decided I was no longer "disabled" and stopped payment of long term disability payments. I still recieve disability through Social Security, but lost about 2000.00 a month in income from this. After that, my employer terminated me because I wasn't released to go back to work.....nothing like adding to the stress for cancer patients. By the way, my employer was the largest construction company in the world with over 10000 permanent employees....I guess I was truly a number in the pool!

[mekasan]

Thanks Sheila,
I was absent from the boards for a few months and I did miss your fight with the hosp. Wow, you really helped so many people in your community! Congratulations on making a substantial change. You are amazing!

Thanks for the feedback.

Shannon