Jane's illness had led to her being unable to work for a year, and even though the State of California had provided her short-term disability benefits, insurer MetLife refused to cover her longer-term disability.
Luché-Thayer then secured documentation demonstrating how MetLife made bad faith practices and discriminated against Jane Furer. This discrimination is based on Jane’s suffering from a chronic and complicated case of Lyme disease. According to Luché-Thayer, MetLife and other insurance companies routinely deny benefits to persons living with chronic Lyme despite the Affordable Care Act’s (ACA) formal recognition of chronic Lyme disease in 2012.
Not only does the ACA recognize chronic Lyme, the federal Job Accommodation Network (JAN) also recognizes chronic Lyme and assists those who suffer from this illness to receive disability benefits. JAN is a service provided by the Department of Labor to support the Americans with Disabilities Act.
MetLife’s denial of Jane's benefits was based on the outdated science found in the 2006 Infectious Diseases Society of America’s Lyme disease guidelines –these outdated guidelines do not meet the Institute of Medicine’s (IOM) internationally accepted 2011 standards for guidelines and they do not recognize chronic Lyme disease. MetLife’s practice of discrimination is demonstrated by their refusal to adopt Lyme treatment guidelines that do meet the IOM 2011 standards –these updated guidelines recognize chronic Lyme and the many debilitations and disability it may cause.
Luché-Thayer also found that MetLife fraudulently misrepresented their legal responsibility for Jane’s coverage –as well as that of Jane’s employer– in correspondence to a senior official with the state of Pennsylvania’s Insurance Department. Luché-Thayer brought this to the attention of Comcast/ NBCUniversal.
Shawn Leavitt, the Senior Vice President of Global Benefits for Comcast and NBCUniversal, personally engaged to try and address the situation. Leavitt expressed concern and has since facilitated collaboration between Global RBCC and key medical staff at Comcast and NBCUniversal resulting in the dissemination of updated science on Lyme disease.
Most recently, an interactive quiz on Lyme disease – developed by Dr. Holly Ahern, professor of microbiology and member of Global RBCC – was used as an educational tool for Comcast employees. When Jane heard about the quiz, she said, "I am glad to know my situation might help other Comcast and NBCUniversal employees."
In June 2017, Luché-Thayer organized an international team of scientists, medical professionals, human rights experts and patient advocates to testify before the United Nations Special Rapporteur responsible for health and human rights. The human rights violations validated included the obstruction to treatment options and coverage for the many confirmed serious complications and disability caused by Lyme disease.
In the meanwhile, NBCLA producer Jane Furer remains uncompensated for her extended period of disability that left her unable to work. With support from NBCUniversal, she is working less than full time under the protection of the Americans with Disabilities Act and while still under significant therapy, including intravenous treatment taken at her desk.
Much of this treatment is not covered because most health insurers use the outdated 2006 IDSA guidelines to determine treatment coverage as opposed to the protocols that have met the 2011 IOM standards. Jane asks, "How can I possibly afford to pay for policies that do not cover my Lyme disease expenses … particularly when I have children to care for and I used up all available financial resources because MetLife refused to provide my disability coverage?"
Luché-Thayer believes such practices of discrimination could be quickly overturned when employers realize just how much it is costing them in loss of skilled labor, productivity and absenteeism. For example, according to the CDC, Lyme disease is found in 48 states. Based on the CDC’s conservative estimate of annual Lyme disease infection, their 2017 article on persistent infection and their 2006 study on the cost of Lyme disease, Lyme disease may already be costing Comcast/NBCUniversal over four million dollars per year for new infections.
Says Luché-Thayer, “This calculation of four million does not include the estimated 36 percent of those infected who will develop long-term illness that is often not covered by insurance. This illness causes significant financial stress for employers, employees and their families.” For example, based on CDC infection estimates, between 2011 and 2017, more than 3200 new Lyme patients and 1000 new chronically ill Lyme patients needed medical, or medical and disability coverage from their Comcast/NBCUniversal employee benefits packages.
Lyme patients – including many who go undiagnosed due to the low accuracy of the standard tests– may have compromised function and neurological symptoms that impair driving, vision, climbing, technical proficiency, and judgement. These impairments are considered serious enough that federal authorities such as the Federal Aviation Administration ground infected pilots until they are six months clear of Lyme symptoms.
Luché-Thayer asks, “Why would any major employer allow for their employee benefits to not properly cover the treatments and disabilities caused by the fastest growing vector borne disease in the nation?”
To contact the main author Jenna Luché-Thayer, visit her LinkedIn profile. This article is published here with her permission.
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