What is the name of your state (only U.S. law)? California
I have a seizure disorder and have been taking (extended release) Lamictal for more than ten years. During this time I have had the same neurologist. I am eligible for MediCal. I was hired by a school district as a paraeducator, working with extremely autistic children. The hourly pay was excellent. By error, I signed up for the Medical Coverage Plan, without knowing that it would make my MediCal obsolete until I met the $5,000 deductible. I chose this version of the health plan because nothing was deducted from my monthly salary. (No judgement here please, I did not know it would immediately become my primary insurance even in this political climate, I just figured if MediCal didn't cover something, insurance would I know this is entirely my error - I did not clarify with district benefits coordinator that my MediCal would become obsolete. I signed up upon hire in August.
After my new health plan took effect in December, I learned that my Lamictal XR (Extended Release) would cost $560 monthly, until the $5,000 deductible was met. I spent several days speaking with the Benefits Coordinator for my district and the insurance company and was told that I couldn't opt out of the program until September 2017. I could not afford my $560 medication nor the several appts and blood tests needed to taper off Lamictal and start an affordable medication. My neurologist's billing coordinator was able to find a program which would make Lacmictal affordable, but not the Extended Release version. Due to side effects with this version (nausea, vertigo) I was nervous, but figured that I would be able to tolerate this version through September. After all, I had a great job.
The affordable version prescription was written as "Take three pills (600 mg) two times daily." I only took three pills (600 mg) of the XR version once in the evening. I called my neurologists office to clarify and understood that 600 Mg twice daily was the prescribed amount for the regular version. Because I was paying $60 a day for my XR version, I decided to switch to the regular version the Thursday before my winter break. Lamictal in both versions can cause dizziness. On the XR version this may happen about twice a year, always between 11:30 and 12:30 during the day. I disclosed this side effect to my district upon hire.
The first day (Thursday) that I took my morning 600 mg dose at 10:00 I experienced a dizzy spell that required I lie on the floor in the classroom for about 35 minutes. (I work in a Mod/Severe classroom, with a quiet area btw, lying down wasn't really an issue). I got over my dizzy spell, finished my day and took the evening dose of 600 mg at 10:00 pm, as prescribed. I was awake all night. I couldn't miss the last day before winter break so I went to work the next day. Tired, but very successful working with my students. I took the same dose that friday 600 mg, 12 hour wait, 600 mg. Again I was up all night - 48 hours no sleep.
By about 6:00 am, I was having intense crying spells that lasted two to three minutes. I called the emergency number for my neuro (supposed to get call back within 30 minutes) No response call, I called repeatedly at least three more times. By about 10:00 I was getting nervous and felt enough to visit the local emergency room. There, I was treated as someone having a psychotic break. Before even being seen, I asked whether I would be charged for this ER visit, alternating between crying and not, and of course they needed to see me.
I have a $1,000+ bill for this ER visit. They were trying for a full chem 7 blood workup, I stopped them after getting a med level one. Hospital staff evaluated my behavior and wanted me to stay for a 72 hour hold. Because I wouldn't be able to afford that bill I left. I finally heard from my neuro office (other doctor, not mine) after I got home and he told me to skip doses, let amount level, etc. I was on Christmas break, and could just stay home and deal with it. I finally heard from my neuro perhaps the following Monday and she further explained how to maintain safe level.
In order to go back on the better version of Lamictal, I also gave up that paraeducator position maybe second week into break. I believe I also have a case against the district HR superintendent for wrongful termination (another long story, but he called me to "release me" from position and I agreed, as I had been led to believe that I would be able to substitute in same position until another permanent one opened, which I could interview for etc etc...) I am going to begin a long term sub placement beginning next week, lower level position, about $10 less an hour. Again, decision to leave position was naive - med level of different version was now appropriate and although there is slight insomnia and more chance for dizziness, I can tolerate it through September. I had stated by phone and not email that I was going to go through break and make my final decision, which would have entailed letting position go in writing, by my own decision.
Given that my HR guy knew about the $560 med price starting December 1, and his calling me to "release" me is wrong in a sense, but not illegal. I think my Neurologists inappropriate prescription is responsible for the decision - the double dose left me overwhelmed and scared. But given that my Winter break is three weeks long, I would not have given it up, and just stayed in the high deductible health plan for ten months. Since December, my HR guy was going along with my verbal statement of subbing, my position reopening. He called mid break: "Gillian, I am going to release you from that position" and never once (in several emails, in person meeting and one more phone call) saying point blank that my position would be gone if I chose to leave it. This may be separate "case" in a sense, but ultimately, discussions about my position with HR was due to taking twice the regular ammt of my Lamictal prescribed by my Neuro, and the decision to agree was mine.
I would like to sue my Neuro for the $1,000 ER visit and second lost wages. In my Paraeducator position the gross pay is $2,990 a month. I have been told I will be getting a long term Instructional Aide sub position starting February 6, with same district, gross pay is $1,950 a month which through end of semester. This is a $6,000 loss in take home pay, at least through this semester. I don't know if her mistake should pay my lost wages until I get another paraeducator position with the district, picking back up in August, beginning of 17/18 school year, and doubt is legally. But I do know, and staff and administration would agree, that I was in no threat in losing position due to job performance. I would not have contacted HR about giving up position because the bad version of med is tolerable.
I know I am due any lost paraeducator wages by the district, but think my neuro is responsible to pay that. It's frustrating that what HR guy did isn't Illegal, just morally wrong and due to his statement - "I am going to release you from your position" my idiotic decision to say yes. The reason he told me this is because one of the students was wheelchair bound and needed nursing care as well, and there was a Paraeducator onsite who is, and the position needed to go to her. There is not another paraeducator position available, but I am willing to stay with district until one does open. But I do believe that my Neuro is responsible for the approx 6k loss in take home pay plus ER visit.
I suffer from partial complex seizures, no convuslions
I disclosed dizzy spell side effect of med overall upon hire
I signed up for district med plan unaware that it made MediCal unusable
My neuro of writing wrong prescription caused a toxic level which required ER Visit
Lamictal regular was written 600 2x daily, Lamictal XR, which I've taken since about 2015, is 600 mg before bedtime
I think my neurologist is responsible to ER visit and lost wages due to leaving well paying job, and should pay 1k monthly until I get paraeducator job back.
So sorry this is so long and convoluted, my cases tend to be.
Gillian
(Please feel free to ask me to shorten this, it just has a lot of elements and I really don't want to spend an hour with an attorney before reaching an "I think this is what your neurologist is liable for and here's why...")
I have a seizure disorder and have been taking (extended release) Lamictal for more than ten years. During this time I have had the same neurologist. I am eligible for MediCal. I was hired by a school district as a paraeducator, working with extremely autistic children. The hourly pay was excellent. By error, I signed up for the Medical Coverage Plan, without knowing that it would make my MediCal obsolete until I met the $5,000 deductible. I chose this version of the health plan because nothing was deducted from my monthly salary. (No judgement here please, I did not know it would immediately become my primary insurance even in this political climate, I just figured if MediCal didn't cover something, insurance would I know this is entirely my error - I did not clarify with district benefits coordinator that my MediCal would become obsolete. I signed up upon hire in August.
After my new health plan took effect in December, I learned that my Lamictal XR (Extended Release) would cost $560 monthly, until the $5,000 deductible was met. I spent several days speaking with the Benefits Coordinator for my district and the insurance company and was told that I couldn't opt out of the program until September 2017. I could not afford my $560 medication nor the several appts and blood tests needed to taper off Lamictal and start an affordable medication. My neurologist's billing coordinator was able to find a program which would make Lacmictal affordable, but not the Extended Release version. Due to side effects with this version (nausea, vertigo) I was nervous, but figured that I would be able to tolerate this version through September. After all, I had a great job.
The affordable version prescription was written as "Take three pills (600 mg) two times daily." I only took three pills (600 mg) of the XR version once in the evening. I called my neurologists office to clarify and understood that 600 Mg twice daily was the prescribed amount for the regular version. Because I was paying $60 a day for my XR version, I decided to switch to the regular version the Thursday before my winter break. Lamictal in both versions can cause dizziness. On the XR version this may happen about twice a year, always between 11:30 and 12:30 during the day. I disclosed this side effect to my district upon hire.
The first day (Thursday) that I took my morning 600 mg dose at 10:00 I experienced a dizzy spell that required I lie on the floor in the classroom for about 35 minutes. (I work in a Mod/Severe classroom, with a quiet area btw, lying down wasn't really an issue). I got over my dizzy spell, finished my day and took the evening dose of 600 mg at 10:00 pm, as prescribed. I was awake all night. I couldn't miss the last day before winter break so I went to work the next day. Tired, but very successful working with my students. I took the same dose that friday 600 mg, 12 hour wait, 600 mg. Again I was up all night - 48 hours no sleep.
By about 6:00 am, I was having intense crying spells that lasted two to three minutes. I called the emergency number for my neuro (supposed to get call back within 30 minutes) No response call, I called repeatedly at least three more times. By about 10:00 I was getting nervous and felt enough to visit the local emergency room. There, I was treated as someone having a psychotic break. Before even being seen, I asked whether I would be charged for this ER visit, alternating between crying and not, and of course they needed to see me.
I have a $1,000+ bill for this ER visit. They were trying for a full chem 7 blood workup, I stopped them after getting a med level one. Hospital staff evaluated my behavior and wanted me to stay for a 72 hour hold. Because I wouldn't be able to afford that bill I left. I finally heard from my neuro office (other doctor, not mine) after I got home and he told me to skip doses, let amount level, etc. I was on Christmas break, and could just stay home and deal with it. I finally heard from my neuro perhaps the following Monday and she further explained how to maintain safe level.
In order to go back on the better version of Lamictal, I also gave up that paraeducator position maybe second week into break. I believe I also have a case against the district HR superintendent for wrongful termination (another long story, but he called me to "release me" from position and I agreed, as I had been led to believe that I would be able to substitute in same position until another permanent one opened, which I could interview for etc etc...) I am going to begin a long term sub placement beginning next week, lower level position, about $10 less an hour. Again, decision to leave position was naive - med level of different version was now appropriate and although there is slight insomnia and more chance for dizziness, I can tolerate it through September. I had stated by phone and not email that I was going to go through break and make my final decision, which would have entailed letting position go in writing, by my own decision.
Given that my HR guy knew about the $560 med price starting December 1, and his calling me to "release" me is wrong in a sense, but not illegal. I think my Neurologists inappropriate prescription is responsible for the decision - the double dose left me overwhelmed and scared. But given that my Winter break is three weeks long, I would not have given it up, and just stayed in the high deductible health plan for ten months. Since December, my HR guy was going along with my verbal statement of subbing, my position reopening. He called mid break: "Gillian, I am going to release you from that position" and never once (in several emails, in person meeting and one more phone call) saying point blank that my position would be gone if I chose to leave it. This may be separate "case" in a sense, but ultimately, discussions about my position with HR was due to taking twice the regular ammt of my Lamictal prescribed by my Neuro, and the decision to agree was mine.
I would like to sue my Neuro for the $1,000 ER visit and second lost wages. In my Paraeducator position the gross pay is $2,990 a month. I have been told I will be getting a long term Instructional Aide sub position starting February 6, with same district, gross pay is $1,950 a month which through end of semester. This is a $6,000 loss in take home pay, at least through this semester. I don't know if her mistake should pay my lost wages until I get another paraeducator position with the district, picking back up in August, beginning of 17/18 school year, and doubt is legally. But I do know, and staff and administration would agree, that I was in no threat in losing position due to job performance. I would not have contacted HR about giving up position because the bad version of med is tolerable.
I know I am due any lost paraeducator wages by the district, but think my neuro is responsible to pay that. It's frustrating that what HR guy did isn't Illegal, just morally wrong and due to his statement - "I am going to release you from your position" my idiotic decision to say yes. The reason he told me this is because one of the students was wheelchair bound and needed nursing care as well, and there was a Paraeducator onsite who is, and the position needed to go to her. There is not another paraeducator position available, but I am willing to stay with district until one does open. But I do believe that my Neuro is responsible for the approx 6k loss in take home pay plus ER visit.
I suffer from partial complex seizures, no convuslions
I disclosed dizzy spell side effect of med overall upon hire
I signed up for district med plan unaware that it made MediCal unusable
My neuro of writing wrong prescription caused a toxic level which required ER Visit
Lamictal regular was written 600 2x daily, Lamictal XR, which I've taken since about 2015, is 600 mg before bedtime
I think my neurologist is responsible to ER visit and lost wages due to leaving well paying job, and should pay 1k monthly until I get paraeducator job back.
So sorry this is so long and convoluted, my cases tend to be.
Gillian
(Please feel free to ask me to shorten this, it just has a lot of elements and I really don't want to spend an hour with an attorney before reaching an "I think this is what your neurologist is liable for and here's why...")
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