A Singular Woman - Janny Scott [146]
In late April, a representative of the insurance company, CIGNA, notified Ann that the company had begun evaluating her disability claim. (According to CIGNA, the disability policy was underwritten by Life Insurance Company of North America, a subsidiary of CIGNA.) In the meantime, the representative suggested that Ann find out if she was eligible for benefits under the Social Security system. Ann had already been told by Social Security Administration officials in Honolulu that she was not eligible: She had not earned enough credits in the previous ten years to be eligible for Social Security disability income, and she was ineligible for benefits under the Supplemental Security Income program for disabled people with limited resources because she owned an asset worth more than $2,000, an Individual Retirement Account. In response to the letter from CIGNA, Ann sent back copies of letters from the Social Security Administration and a half-dozen other documents that CIGNA had requested, along with a four-page letter that included a detailed chronology of her illness. “During the three months before joining DAI, the only doctor I consulted was Dr. Barbara Shortle, a New York gynecologist,” Ann wrote in the letter. “Dr. Shortle gave me a routine annual examination in May 1994, including pap smear and pelvic exam. She sent me to a laboratory for a mammogram and pelvic ultrasound. On the advice of the radiologist of the laboratory, I also had a breast ultrasound. None of these tests indicated that I had cancer. The pelvic examination indicated that I had an enlarged uterus, but this is a condition which I had had for about five years previously.”
Ann’s letter did not mention the one procedure, the dilation and curettage, she had omitted to have.
By late June, CIGNA had made no decision on Ann’s disability claim. The company was waiting to hear from Shortle, a representative told Ann. Ann faxed a letter to Shortle, whom she had not seen since her appointment thirteen months earlier. She explained that she was being treated for ovarian cancer in Hawaii and that her disability claim had been held up for months while CIGNA investigated whether her cancer was a preexisting condition. She said she had given Shortle’s name to CIGNA, which, in turn, had faxed Shortle a request for information. Two weeks later, CIGNA sent another letter to Ann, addressed this time to “Mr.” Dunham. Among other things, the letter said, “If we do not receive either the requested information or some communication from you within 30 days from the date of this letter, we will assume you are no longer claiming benefits under your Long Term Disability Plan.”
In one of several drafts of a response to CIGNA, Ann coolly leveled a pointed objection.
Since I have sent you a mountain of forms and a lengthy letter dealing with my illness, which is ovarian cancer, I am surprised that you are not aware that I am a woman. I realize that it is unusual for a woman to have a man’s first name, but I have signed my correspondence to you with my middle name of Ann. Also we have spoken by phone within the last month. Combined with the fact that my claim has been pending for five months, I am forced to wonder whether it is receiving proper attention.
In mid-August, CIGNA denied Ann’s claim on the basis of her visit to the New York gynecologist two and a half months before she started work in Jakarta. Shortle’s office notes had indicated that she had formed a working hypothesis of uterine cancer, though Ann said Shortle never discussed that hypothesis with her. When I spoke with Shortle, she said it was quite possible that she had not told Ann of her suspicions. “Whenever you do a D and C on any woman who has bleeding on and off, you’re always doing it to rule out uterine cancer,” she said. But, she said, the procedure can be therapeutic