Should this woman lose her sick pay benefits for attending her birthday party at Chippendales?

[Better Believe It]

Woman loses benefits over Facebook photos
Canadian, who was on sick leave, shown having fun at Chippendales, on trip
Associated Press
November 23, 2009

BROMONT, Quebec - Photos on Facebook have cost a Canadian woman her long-term sick leave benefits.

Nathalie Blanchard has been on leave from her job at IBM in Bromont, Quebec, for the last year.

The Canadian Broadcasting Corp. reported she was diagnosed with major depression and was receiving monthly sick-leave benefits.

But when a Manulife insurance agent discovered pictures of Blanchard having a good time, the payments dried up.

Blanchard said she was told by Manulife that the photos of her at a Chippendales bar show, at her birthday party and on vacation were evidence that she is no longer depressed.

Blanchard told the CBC that on her doctor's advice, she had been trying to have fun.

http://www.msnbc.msn.com/id/34089972/ns/world_news-weird_news/?GT1=43001

[SteppingRazor]

1. Meh. I understand having a little fun at your birthday, but...

once you're hitting Chippendale's and going on vacations, it might be time to think about going back to work.

[ixion]

2. heh... so in order to maintain her benefits, she should stay at home and get really depressed

yeah, that makes sense. :eyes:

Why do we tolerate this non-sense from insurance companies? Shouldn't that be what reform is about?

[MUAD_DIB]

45. This is a cautionary tale about how not to give the

insurance agencies any rope in which to hang you with.

[Bitwit1234]

50. When I worked for the State of Maryland

there was a woman on sick leave who had permission to take a cruise. The doctor told our personnel department it was for her health. And it was approved she continued to get sick leave. And it was borrowed at that.

[tammywammy]

3. We're only hearing her side of the story

I would doubt the facebook photos were the only reason to deny her benefits.

[Hassin Bin Sober]

16. Yes, The reason is profit for the insurance company.

Or do you have some other evidence you would like to share?

[tammywammy]

42. I don't discount that they could have very substantial evidence to deny it

Nor do I presume just because she said it was because of only Facebook photos that that's the full story either.

[polly7]

27. Here is a little more on the topic

http://www.digitaljournal.com/article/282528

According to CBC News the photographs in question were of Ms Blanchard at her birthday party, taking a beach holiday, and watching a performance in a bar by Chippendales, the male dancing group.
Ms Blanchard, who is from Eastern Townships in Southeastern Quebec, says that she took the beach holiday and enjoyed the evenings out with her friends on the advice of her doctor. Furthermore she maintains that she actually notified Manulife that she would be taking the holiday.

Now, having been forced to sell her home because she was unable to meet the mortgage payments, her mortgage insurance provider was informed too of the photos on Facebook, allegedly by either Manulife or IBM, and with her credit record adversely affected, Ms Blanchard is seeking redress in the Quebec Superior Court, where she has filed a claim for wrongful dismissal. In addition damages from Manulife are being sought.

Severely depressed people are always advised to get out in the sun and try to participate in things that will make them feel better. Doctors have nothing to gain by misleading insurance companies about a pt's progress or non-progress. Judging someone's condition by smiling facebook pictures makes as much sense as it would for a diabetic, or any other disease not apparent by appearance. Manulife told her the pics were 'evidence'. She's lost a lot, I hope the Quebec Superior Court decides it fairly.

[Lance_Boyle]

31. Just how long should this person be paid to take vacations and go to strip clubs?

It has been well over a year. The photos are a good reason for a medical review of her condition.

[polly7]

33. Just how many strip clubs or vacations did she go on?

I can only gather one of each from what I've read.

Do you belive diabetics should be encouraged to follow doctor's orders? Why not the same for depression? I'm sure her doctor would have no regrets telling her to get out and hearing she'd actually gone to a strip club or a sun vacation. Possibly SAD made her depression worse, as it does for many people. A sun trip makes sense. A birthday party - why the heck not?? A stripper ........ depression cured? I doubt it. Probably back to the same suffering the next day. I know people whose lives have been ruined by severe depression yet still can occasionally smile and have a good time. It's a day to day thing ........ you do what you can to feel better. Sometimes it helps, sometimes it's just going through the motions and you're right back at the bottom of the well the next morning.

[Lance_Boyle]

34. Unknown - there's only evidence available of one each.

The bottom line remains that this person has been on long term disability for well over a year, and evidence has emerged that calls into question whether her condition now is the same as it was when her benefits began. A review is appropriate. Or do we assume this person should just be paid to vacation and leer at nekkid men forever?

[polly7]

37. I presume they have done reviews all along.

Someone stated they did them every three months. She saw some nekkid men one time. Big deal. Manulife using smiling pictures as evidence of anything other than she got out of the house ........ like her doctor ordered ......... is lame. They'd better have other 'evidence', because according to the article I've posted, the pics were sent on to her mortgage company allegedly by either Manulife or IBM, and then they cancelled her insurance. She lost her home. Her doctor dx'd her dep. as severe. It's not unusual for anyone with severe depression to be unable to function normally day to day for years.

[FarCenter]

36. I had an employee once who insisted that he needed a private office with a window for his SAD

Nice try!!!!

[polly7]

38. What???

I don't know anything about your employee. SAD affects more people here, especially those already with dx'd depression. I said ...... possibly?? I haven't read her medical report, neither have you.

[dugaresa]

48. how does one get out of a severe depression if you don't try to have fun?

am i missing something?

sitting in her bathrobe, entombed in her home wouldn't have done her any good.

[lightningandsnow]

4. I have a couple of anxiety disorders and am on two psychiatric medications....

and I'm planning a pretty rockin' birthday party.

Oh, I forgot. If you can have any kind of fun, you're not mentally ill. :sarcasm:

[FarCenter]

5. Her birthday and the Chippendales show were two different occasions

"Blanchard said she was told by Manulife that the photos of her at a Chippendales bar show, at her birthday party and on vacation were evidence that she is no longer depressed."

Plus, her vacation pictures are probably even more telling.

Now that she has lightened up, she can go back to work.

[Barack_America]

7. If it hadn't been for this international public humiliation. nt

[tammywammy]

8. She didn't have to do the interview with the CBC. n/t

[Better Believe It]

9. So watching nearly naked good looking men dance around can cure depression?

Or is a clear sign that one no longer has depression?

Combine that with smiling at a birthday party and one is without a doubt cured!

:)

[Barack_America]

6. How can you prove someone is "happy"?

Surely it requires more than a smile.

Regardless, I would imagine she is likely depressed again, if she ever wasn't. That would be a pretty normal reaction to having a story like this told about you around the world.

[demosincebirth]

10. Its not up to the insurance...its up to her doctor!

[debbierlus]

14. That is exactly right. Even on DU, we will argue for the rights of the insurance company to trump

A doctor's decision.

This is brilliant.

I am sure many people who are isolated with depression and mental illness will think twice about even reaching out through a computer to have a little bit of social networking.

Perhaps, she should have posted shots of her bad days when she hadn't bathed and looked hung over from psych meds.

[FarCenter]

19. Doctors are not impartial -- they are motivated to prolong treatment and collect fees

Sort of like a credit card company.

[polly7]

28. This woman is in Canada.

Her treating doctor gains nothing by dragging out her illness. Manulife has nothing to do with the health-care she's provided.

[FarCenter]

35. Manulife appears to be the insurance company paying the long term disability for IBM

Actually, IBM is probably self insured, and they retain Manulife to adminster the long term disability benefit. As part of that, Manulife will investigate beneficiaries in order to determine whether they are truely disabled or not. So Manulife definitely has an interest in whether she is fraudlently claiming benefits.

A neighbor worked for a while as a private investigator. Disability fraud cases were not infrequent, although cheating spouses were the bread and butter.

[polly7]

39. Of course they have an interest.

So does this woman who presumably paid into those benefits.

[FarCenter]

47. She would have used the "flex" dollars in the benefits plan to pay for LTD

http://www-03.ibm.com/employment/ca/en/pay.html

[FarCenter]

40. The Canadian doctor collects fees from the health plan

The fee per visit appears to be negotiated according to the plan (like Medicare), but if the doctor isn't seeing patients, the doctor doesn't get paid. So it is in the doctor's interest to maintain a full appointment book of patients.

http://pn.psychiatryonline.org/content/43/9/4.1.full

Canada's Health System Draws Mixed Reviews From Psychiatrists
<SNIP>

Suppose you awakened one morning and discovered that you could care for your psychiatric patients in whatever manner you deemed best—even by providing lengthy psychoanalysis—and that you would be reimbursed for your efforts by simply submitting a bill. No managedcare exclusions or precertification hassles.

You might think that you had died and gone to heaven, but what's more likely is that you simply relocated to Canada where such seemingly luxurious perks of the government-run universal health insurance program are routine.

The name of the program is “medicare,” although it differs dramatically from the U.S. program with the same name (see A Tale of Two Medicares).

The Canadian health system covers all citizens and works well in some areas in which the U.S. system has problems.

“I hear stories of patients being turned away from hospitals in the United States or being afraid to go to the emergency room because they can't afford the care,” Padraic Carr, M.D., an associate clinical professor of psychiatry at the University of Alberta, said in an interview. “In Canada that really doesn't happen. When people come to the emergency room, or for an appointment, or to be assessed, no one is refused treatment because of inability to pay.”

“Even if psychiatric patients start off rich in their lives, many drift down to a low socioeconomic level because of their illness,” Dhanapal Natarajan, M.D., a Saskatchewan psychiatrist who also practiced in Great Britain, reported. “So for them, a universal health care system is extremely important. Even after they are discharged from the hospital, they are looked after.”

“Another thing I like about the Canadian system,” Carr said,“ is that the doctor decides what treatment is appropriate, and it does not have to be approved by any insurance company or third party.”

<SNIP>

[polly7]

43. Of course they want to keep their practises busy.

I know many of them, they're usually TOO busy and it's really not a question of fraudulently prolonging treatment or reporting inaccurately ........... they usually have more pts. than they can handle.

[polly7]

44. Exactly!!! n/t.

[dana_b]

11. people need to change the privacy settings on their

social network sites! It seems like the insurance companies are doing this more and more to spy on us all.

[Lucian]

12. This is why I have my privacy settings set to "friends only" on facebook.

Then shit like this won't happen.

[Lance_Boyle]

17. it will if your friends share your pics/details

Locking down facebook and other social-networking memberships can be nontrivial.

[Kaleva]

13. not enough info to make a decision.

[Lance_Boyle]

15. not sick pay - long term disability

And IMO, the photos are at least enough to justify a medical review. This woman has been on long term disability for over a year. The photos constitute evidence that she is not so incapacitated she can't leave the house or function. There may be a good case to be made that she's defrauded the insurer.

[debbierlus]

20. Oh please. People who suffer from chronic mental illness have some good days

As a psychiatric nurse for over 10 years, I have witnessed patients experience ups and downs. I have seen patients come in out patient in a good place and then a week later they are admitted to the hospital.

I know one woman who gave a birthday party, brough in the pics to show us, and then threw herself in front of a train a month later.

She was on long term disability, we should have probably called her insurer and let them know about the smiling pics with balloons. She even baked the cake.

I am GLAD that she had some reprieve from her depression, and I hope that even if she can't go back to work EVER, she finds moments of happiness and joy in her life without the threat to her benefits.

[Lance_Boyle]

22. and people who know how to game the system will do so

She may or may not be gaming the system - like I said, the pics at least justify a medical review. If she can function for weeks at a time on vacation at the beach, she's going to have a tough time explaining why she can't work.

[Better Believe It]

23. Looking for gaming? Check out the insurance industry. They are experts at it.

[Lance_Boyle]

24. no argument there

but that fact doesn't make it right for their customers to game the system, either.

And as I said upthread, this NOT health insurance - this is long term disability, which is more related to an unemployment benefit, providing a percentage of salary during an extended period of incapacitation. If this person is going weeks at a time enjoying herself at beach resorts, the argument for incapacity needs to be reviewed.

[polly7]

41. One vacation from what I understand. Weeks at a time? I didn't read how long the

vacation was, but how many days should it have been limited to?

[polly7]

30. So true, thank you.

I mentioned on another thread, the last suicide we were called to the man's sister was overcome with undeserved guilt because her brother had been laughing and enjoying a get-together just a week earlier. Severely, clinically depressed individuals survive day to day. If one or two of those days consists of laughter ............ good for them. Her doctor has nothing to gain by not reporting on her illness accurately.

[arbusto_baboso]

18. Mrs. Arbusto is a chronic depressive and her shrink PRESCRIBES vacations.

A direct quote from him: "I wish the meds I prescribe could do as much good as a 10-day vacation."

The problem is, eventually, she has to go back to work and deal with her depression again.

I see nothing wrong with what this Canadian woman did.

[kixat2550]

21. Hell no

[TexasObserver]

25. No, because inability to work from Depression doesn't mean inability to emote at all.

There's a popular notion that only the person who is cloistered away, uncommunicative with the world, sleeping all day is depressed. Certainly, that person is deeply depressed, but it does not always have the same symptoms in every person. Many persons who are depressed need their work to help keep them together. Many persons who are depressed cannot handle working at all.

The folly is thinking one event and the photos from it negate the baneful effects of depression on a worker.

[Tierra_y_Libertad]

26. The Insurance Company accountants would much rather she sit at home and eye razorblades.

Which they would find a possible cure for their liability to pay up.

[Fearless]

29. I should think she'd be required to try to have fun... what being depressed and all.

:banghead:

[La Lioness Priyanka]

if the womans doctor prescribed going out and going on vaca

then she shouldnt be penalized for it

[ieoeja]

32. "Depression" is not a synonym for "sad".

In this layman's words, it's essentially an inability to cope on an ongoing basis. My ex-wife can dig deep, get herself together and function quite well for days at a time. But then the bottom falls out, and she spends weeks in which she can barely rouse herself out of her bed.

And if anything truly challenging happens during her "up" moment, that bottom falls out almost immediately. She just might get herself home. Or she might call me to come pick her up because she can't figure out how to get home from wherever she is. Or more likely some stranger will take her home or borrow her cell to call someone to come pick her up because she can't figure out to do even that. She can go from normal, happy go-lucky-party-gal to that state in minutes.

And she sure as fuck can't hold down a job if any minor crisis is going to throw her into near a near catatonic state.

[Jack Rabbit]

46. I, too, have major depression

I have strong feelings about this. It is a classic case of corporate bean counters playing doctor, something they have no business doing.

May Manulife suffer the same fate I wish on US health insurance companies.

[polly7]

49. Yep.

I hope the truth comes out in front of the Quebec court. Until then, I won't assume this woman is lying or scamming for benefits she paid into and that should continue until her doctor says otherwise. She also lost her home because of this.

ETA: I'm sorry you're suffering with it and hope your condition improves soon.

[Duer 157099]

51. Plus, what if alcohol were involved somehow?

I have no doubt that many depressed people use alcohol to temporarily relieve symptoms, and people on vacations and at Chippendales also typically drink, so perhaps she had a few which allowed her to smile for awhile?

Does that mean she's "gaming the system" or is capable of work?

This mentality is so disgusting, that if people can do "X" then they can do "Y" -- as determined by insurance companies who, naturally, profit by their decisions.

Just disgusting.

[Jack_DeLeon]

52. I dont think someone should get paid to not work just because they are "depressed."

Shit I've been depressed too from time to time, but I didnt expect anyone to pay more to sit at home because of it.

[polly7]

53. A lot of severely (as she was diagnosed) depressed people struggle

just to keep on living every day. Sometimes it takes years to get the right combo of meds and therapy. I've had some tell me they're angry when they wake up in the morning, wishing they'd died during the night. I really have seen people live this way for years. It's a horrible, debilitating illness and I wish it were understood better. This woman is lucky she has friends that seem to understand and are trying to help her. Also, an understanding doctor. imo.

[Gwendolyn]

54. Not really for us to judge as we don't know the other side of the story. BUT:

It's a great lesson for the rest of us. If you don't want your info or pics made public, don't put personal stuff out there on the web. Read the privacy policies of the groups you frequent. FACEBOOK says they will divulge your info to third parties if fraud is suspected.

When you go on long term leave, staying on it is your new job. I had three of my emps go on long term leave for depression/mental exhaustion when it was clear the company wanted them out. If people think that HR, the department heads, upper management in general, "forgets" or doesn't care, you're mistaken. They very much do, and the longer the emp is out, the more they care.

The way to behave is keep your life low-key, modify your behavior, keep only the people you truly trust in your inner sanctum. Document and save everything. If it means entertaining the girls at home with the curtains drawn and the booze smuggled into the house in gym bags, so be it. Appear outside occasionally in unwashed hair and ashen complexion. Staying on disability is a full-time job.

This girl was basically a dumbass to put her info out there, then blew the bank on a vacation when she didn't have any savings to cover her mortgage. Maybe this evidence of irrational behavior will work for her in court.

[polly7]

55. And you know the trip wasn't a gift from friends? n/t.

I'm not saying it was for sure, but it's possible. Regardless, the facts will all come out in the Court case. If she was unfairly treated, I hope she gets back what she lost. I agree, it is a good lesson to anyone posting things on the internet, no matter which way it turns out.