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James Martin's Lyme Disease Horror Story
How Lyme Disease and Exploitation of ERISA Laws Can Destroy A Life

The only prognosis worse than "poor" (my current prognosis) is "fatal."
Granted Social Security Disability during July, 1999.

Their Life Destroying Actions Are Legal!

The ERISA provisions for employee health benefit plans sucks. There is no way we can scrape together enough $$$ to file in Federal Court, much less find an attorney to take the case.

There is ample evidence to show that MRG and First Health are guilty of employment discrimination, violation of the ADA, violation of fiduciary duties, and arbitrary and capricious administration of an employee health benefit plan that should accrue to the benefit of the plan members.

However, ERISA states that recovery is limited to paying what they should have paid in the first place.

No pain, suffering, wrongful death, etc. penalties. Attorney cost recovery is at the discretion of the judge, and limited to "litigation time"; it excludes discovery, administration, and research time. Unless you can find a "ticked-off" Pro Bono attorney, your "rights" under ERISA are useless.

We've written to our Senators and Congressional Representatives, asking for support of the Lyme Disease Initiative Act of 1998 ( H.R. 3795 in the House and S. 2034 in the Senate ) , and various other ERISA modifications.

As currently written, single-employer, self-funded plans have no incentive to do the right thing. Instead, if they can stall you long enough, maybe even to the point of giving up on "exhausting all administrative remedies" or dying, the corporate bottom line is improved because they didn't pay health benefit costs legally due.

(For those that would like to see ERISA changed so that this kind of perversion of intent stops, write your Congressional Representative, and ask them to support H.R. 2960, 'Responsibility in Managed Care Act of 1997' ). It removes the current provision that exempts ERISA employee health benefit plans from State control, litigation, and protection.

To write to your Senators and Congressional Representatives, try Citizen Direct . They've been real responsive using this tool.