Hey everyone,
I'm an 18-year-old guy, and I've been thinking a lot lately about the way our society and economic systems are structured, and I can't help but feel like we're being scammed. Hear me out:

1. Education System: We're told to spend years in school, accumulating massive debt, with no guarantee of a job that pays enough to cover that debt. Is the education system setting us up for success or for financial enslavement?
2. Job Market: Many people work long hours in jobs they don't like, with little to no job security, just to make ends meet. Meanwhile, the wealth gap keeps growing, and it seems like the system is designed to benefit a select few.
3. Housing Market: The dream of owning a home is becoming increasingly unattainable for many, with sky-high prices and interest rates. Are we being set up to be lifetime renters, funneling our hard-earned money into someone else's pocket?
4. Healthcare System: In many countries, healthcare is a massive financial burden. People go bankrupt over medical bills, and it seems like the system prioritizes profit over people's well-being.
5. Government and Taxes: We're taxed heavily, yet essential services like infrastructure, education, and healthcare are often underfunded. Are our taxes being used effectively, or are they lining the pockets of the wealthy and powerful?
6. Investment and Savings: Traditional investment vehicles often have high fees and low returns for the average person, while the wealthy have access to more lucrative opportunities. Are we being scammed out of our financial growth?

I know these are broad strokes, and there are many nuances to each issue, but it feels like the system is rigged against the average person. As someone who's just starting out in life, I don't want to be stuck in this system my entire life.
I'm reaching out to older folks here who have more life experience—what advice do you have for someone like me? How can I find an alternative path to avoid being trapped in this system? Looking forward to hearing your thoughts and experiences.

Besides the questions in the title I tired to elaborate a little and also each question(s) has two, a. and b. sections. Section a. is meant for sort of a broad understanding. Section b. is my personal, specific case example (active claim, CA ~10 months).
I'm sure who you'll see will depend on state law, your injury, among other things. Regardless of who you see, more importantly: How do we (the injured worker) know if who we've been assigned to is doing their job correctly or just having an off day, since we know it's not required to have good bedside manner, what are they required by definition AND law? That said:

1a. Despite case by case variations; who are personnel that everyone will see no matter what? What should you expect from them, and is there more they can do...but only if you know how to ask? I'm imagining a knowledgeable answer would be a long list of all the possible outcomes within the maximum allowed in WC, but probably more helpful is to address the most common. A small list may only include a companies HR, Claims adjustor, and an Occupational Health doctor for example. Then continuing the list after those essential people is there typically a usual process where if once your case goes for a certain amount of time or ______ happens, you could expect to meet these ______ job title? I'm hoping to help other people at least have an idea of what to expect out of said people.

1b. TLDR: Here's one of the biggest examples of not knowing who to talk to and whether that information is correct. I have not been given crucial test results from 3 months ago. Original test (Neuropathy) doc said to get my results from my doctor, who sends me to therapist, who sends me back to doctor, my adjustor says doctor, doctor sends me to "Specialist", turns out not specialist, who sends me back to my doctor...ummmm....WTF do I do at my next doctors visits in a few days??

1b (cont.) It has come to my attention that I'm completely unaware of exactly what a large majority of the people I've been assigned to see do. In fact, in what capacity do I "have to see them"? Can I request a swap, or how do I make a complaint? I have been MORE than patient, and I've given the benefit of the doubt for so long that I can no longer accept being passed along. I'm already back where I started, for the 3rd time. Uh...so, besides just wanting information for myself, I'd think the test results should help me heal. I've been denied more treatments (Appeal's denied too) where I'd think that those test results could play a crucial role. Where once I thought there has there been a miscommunication, now feels like I'm in an echo chamber, or worse. This is quite alarming as it also shines light into the fact that I am also unaware of how "my doctor" can best help me, if at all. "My doctor", the one I'm required to see at Occupational Health, (I'm told I not allowed to see my family doctor) doesn't seem to do anything other than fill out the "Return to work form". Is that correct? How would I know?? They seem to just write whatever I tell them. Similarly the same goes for what treatments I've gotten. Best I can tell, there is no indication they have reviewed any of the information from other doctors and therapists. It's now going on 3 months where I haven't been given test results.

Unfortunately it's not just my doctor who I'm not getting information from. "Generic Adjustor" Enters the chat. or maybe not, because to top off the confusion, I can't get ahold of my adjustor who so far been the one steering me into the .... direction. Unfortunately I believe I'm waking up too late. I've called multiple times a day for a week straight while leaving messages and follow up emails noting that I've called. They do respond to email, which usually consists of one line stating something like "call anytime, I'll be in the office all week".. Funny thing is I'm not sure what exactly they are even supposed to do or bare minimum required to do. Even when I get ahold of them, I'm questioning if I can even trust them. I'm not saying "it's conspiracy". However due to the most recent info I've gotten, I do think the run around could be very deliberate play. How do I know if they're simply bad at their job or leaving me in the dark. It sure feels like it's purposeful. This all came to a head when after reviewing our last few emails, I see a pattern where they only respond to some of the questions, and even have given verifiably incorrect, contradictory information. How do I check these facts? Should I talk to a supervisor? Is there a system to check and balance these things? Who do I talk to? It all came to a head when I opened mail to find: Request of QME with the reason being "Objection to Primary Treating Physician's determination regarding temporary disability, permanent disability, or the need for future medical care." Aggravating but I'm sure they followed the (rules I was unaware of) book. It's questions like this that have me really, really upset: What is even meant by "Objection to Primary Treating Physician's determination"? 1. Quick sidebar - is that decision made by the "my doctor" that I described earlier - or the "Provider"? > Meaning, those two terms have been used interchangeably, and I fear that, and why I used quotes for "my doctor" earlier, I'm wondering if this other name (who happens to be another doctor at the Occupational Health office) a person I have never met let alone seen is the one calling the shots. Either way I'm pretty worried. 2. Here is another example which shows only a part of the circle of "who do I talk to". Here is a quote from my adjustor 10 days after the letter had been officiated, but before I got it states "you have not seen a specialist, attended a QME, or have a clear treatment plan defined by your primary treating physician.". Am I wrong to have read that to believe I'd still be seeing a specialist? Doesn't it read that the information the specialist decides would be what determines the next step? Isn't it safe to say that by month 10 I'd have a treatment plan --of course unless your not privy to your own test results?
Ending note: There is so many more examples I could give which to me paint a picture of neglect. From what I can tell, I either already signed my rights away or it's just not worth the fight. I don't even want to fight, or believed there would be a reason for a disagreement due to my injury but since that bubble of disillusionment has popped, how can I reproach getting the best medical treatment. I was lead to believe that after seeing a specialist I would have the option to get a second opinion before the QME. I haven't even seen the first specialist (I was sent to an office with a specialist in it, but the person I saw was just a family practitioner).and since both my doctor and my adjutor are not helping ---Who the fuck do I talk to?

Prologue

Hello and welcome to my post. I will subdivide this into two large parts. One will cover my thoughts, feelings, my hopes and dreams...While the other will tell you the specifics of how I pass the time, what topics interest me, what passions do I posses. I believe that at the end of this leap into my inner world, you dear reader, will have all the necessary information to judge whether we are compatible or not.

Part I
I am writing this in the hopes of finding something that I lack. Lately I have had this feeling, this tinge of melancholy within the dephts of my being, this yearning to find a kindred spirit, another Soul, much like mine, to form a bond with. Perhaps Loneliness is the right word for what is bothering me, but to use it seems to carry with it a connotation of ungratefulness. Ungratefulness for the people that I do have in my life, although none of them, of course, have the connection to me that I seek here.

I have found it increasingly necessary to seek in this Life a sort of purity of thought. What I mean is, I have began to undestand what ideas and concepts are ultimately compatible with my inner most Self, ergo what guidelines I have to follow to feel the most whole. Naturally I have likewise realised what I cannot add to my Self and what I will henceforth reject with all the power that I posses.

With this new context in mind, I now follow on the path of self improvement. I will now begin to mold my Self into my perfected idea of how the Self should be. This is certainly a significant undertaking, one that will not be easy to follow through on but one that I ultimately have to do. To me such context is essential. It is akin to a Guiding Star shining in the night. I will follow this Star for without it I am lost in the vast Darkness.

Looking back at my life, it was suboptimal, especially if one compares the way it molded me to how I will now mold myself. I suppose I must look on with a hint of regret at all that time which one might consider to be lost. Still... I try to stave off such decisively negative interpretations, after all, I have ultimately came to these conclusions. That means that somewhere along the line I had to have picked up on enough of such ideas for them to become so cemented in my consciousness. Well, either that or I was always like this, but in that case I can at least thank my life up to this point for not being able to supress such manifestations of my inner most Self.

To add to the topic of my life, I must admit that not all the battles have yet been won, not all the Demons vanquished, not every Mountain climbed. I want you to keep such things in mind when deciding whether or not to approach me. Many will shy away, I undestand that much, but the pursuit of true Companionship is just another such battle. Having said all that I do believe that being able to overcome hurdles together carries with it a certain appeal. That is to say, what's the fun in joining once the Game is already over?

I don't shy away from such challenges, perhaps to a fault. Certain troubles that I faced in the past carry with them a long shadow over my current health and well being. Still, I intend to change little in this regard other than the proficiency with which I will clash the current of my Will against the cliffs of Life.
Part II
In this part of my post I will tell you about my interests and hobbies, I will try to be thorough, commonality in this regard is rather important to build a relationship
History. I have had an interest in history for almost a decade now, it started back in school and developed from there. Well, now that I think about it one could argue that it started even earlier in my life as I liked watching the odd historic documentary or film aired on television but it wasn't regular back then, I never actively sought it out. I am mostly interested in European history in the period between the 18th-20th century but I sometimes branch out to other time periods and other parts of the world. I watch various channels related to history and read articles and sometimes books. I have recently got a few books on the German revolution of 1848/1849 and a historical magazine on the Thirty Years' War. Besides that I try to visit museums sometimes.
Literature. Especially old novels. I like to immerse myself in the Worlds of these books, I tend to read them while listening to thematically fitting music and take my time with them. One time you are following a troubled Youth in his quest for spiritual understanding of the world, another you see the aged and decrepit Doctor gambling his very Soul on the promises of abtaining satisfaction in earthy pleasures, then again your olfaction notices the most pleasant scent known to man even as the one eminating it has the appearance of a revolting Frog. These and many other stories open up to you once you decide to set foot into the literary World.
Languages. I know three, with one being a bit rusty. I am currently working intently on strengthening it. I believe that if I continue to apply myself in this regard then I should be able to finally conquer it. What language am I working on? Well, if you were to stack all the major works in it they would be as tall as a house... It is fun to go through different works in multiple languages, the same goes for film, games and such.
Games. I recently played Cyberpunk 2077. Well as recently as I played any major story centric game. Now that the dust has settled and the bugs mostly removed...It's not that bad. The main questline at least. Besides that I tried Fallout 76 (Very average, I'm dissapointed with what they made the "RPG" system) and I might give Deus Ex Manking Divided another spin (since it's somewhat similar to Cyberpunk when it comes to its aesthetics). Dark Souls is one of my favorite series, I still haven't beaten Elden Ring though. When it came out I wasn't in the right mindset to invest a hundred hours into it, with all those bosses and difficult locations. I think I'll only consider playing it if I am streaming it to someone. I am generally interested in either streaming games or having the person I am talking to stream them to me. To be specific I mean streaming to a single person while being on call. Besides that I'm a big fan of Paradox strategy games, especially Europa Universalis IV and Heats of Iron IV, I tend to only play single player since I find multiplayer with many people to be rather stressful but on the other hand I have nothing against a co-op game. I'm not the best player though, despite the ammount of hours I have in them. Another great game I would mention would be Dragon's Dogma. A very underrated RPG. I recently beat it again and it was an atmospheric and interesting experience. It is one of those games that feel like they have an endless ammount of depth and constant new secrets to discover.
Anime and Manga. In recent times my interest in them has waned but I still watch the occasional series here and there. Like Cyberpunk Edgerunners (Which I found to be rather mediocre) and the very good first season from the new arc of Bleach. Some of my favourite series include: Fullmetal Alchemist Brotherhood, Death Note, Fate;Zero, Psycho Pass, Code Geass and Attack on Titan. I wouldn't mind if you were to introduce me to some new series, maybe based on the ones I mentioned. My favourite Manga is Berserk which I still follow, althought I am still not certain on the direction that the new author is taking. I suppose it really is a matter of contention whether a somewhat (or considerably warped) vision is better than an unfinished work. One could argue that a few novels remain unfinished and possess a macabre appeal to them as such.
Music. Classical music has a very special place in my heart. A few of my favourite pieces would be: Clair de Lune, Nocturne Op. 9 No.2, Devil's Trill Sonata, Danse Macabre, Valse Sentimentale, Symphony No. 7 in A Major, Op. 92: II. Alegreto (by Beethoven) and Suite from Swan Lake, Op. 20a: I. Scene. Moderato. There are more but these ones always invoke something in me when I listen to them. Besides Classical I also enjoy listening to Synthwave, old Western pop and J-pop, both modern and from the 20th century.
Esotericism. I am interested in things spiritual, mystical, magical and esoteric. I have read religios texts, magical grimoires, introductions to various schools of thought. It is interesting to me.
Epilogue
Hopefully I was able to cast the spotlight upon my inner World in a clear and unequivocal manner. I feel the need to add to the aforementioned that I am rather introverted, which means that I tend to dislike large social gatherings. I managed to condition myself to be able to endure the presense of large groups of people but it isn't something that I would seek out in most cases. Besides that I am neurodivergent and suffer from certain issues with mental health. I have to take medication to keep myself under control. They work well enough but certain days are harder than others. I respect the struggle that others have with mental health but in the context of a relationship I have my limits, no one with BDP for instance. I am also not looking for anything casual. I understand than one cannot demand depth and meaning from a conversation with an absolute stranger, that is akin to trying to build a sand castle right before the waves strike but I ask at least that you enter with a mindset that this might become something of significance. I also do want to say that I am completely Monogamous. My preference? The sickly, pale, intellectual who watches rain droplets slide down the window in Autumn. Lastly, if I enjoy the company of a person I tend to not want to let them go.
Thank you for taking the time to read my post and have a good day. I ask that you send a DM instead of a chat and that you give the English translation of my title as your own.
Goodbye...Or perhaps untill we meet again

Ministers apologise and return £7,000 in benefits to woman, 93, with dementia
Government ministers have formally apologised and repaid £7,000 to a 93-year-old woman whom they held responsible for running up benefits overpayment debts even though they were told she had dementia and was unable to manage her affairs.
The case, which the minister for disability, Mims Davies, admitted was “disturbing”, was brought to light by the Guardian as part of its investigation into carer's allowance overpayments.
The agreement to write off the debt of the 93-year-old, whom the Guardian has chosen not to name, comes as ministers have promised to try new ways of sharing information with carers to try to prevent them building up months and years of overpayments.
Read the full article on theguardian.com
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DWP confirmed that it is developing an ‘enhanced notification strategy’ to alert carer’s allowance claimants to possible overpayments
Notifications designed to encourage claimants to report changes in income and so reduce the risk of being overpaid.
As part of its policy paper, Fighting Fraud in the Welfare System: Going Further, that was published earlier this week, the Department says (at paragraph 78) -

'In carer’s allowance we are progressing an enhanced notification strategy as part of our existing commitment to improve customer engagement, building on our existing communications with customers. As part of this notification strategy we are considering all forms of targeted contact to find the most effective and efficient solution, such as exploring the use of targeted text messages or emails to alert claimants and encourage them to contact the Department when the DWP is made aware of a potential overpayment.'

The Department added -

'The new strategy will help claimants understand when they may have received an earnings-related overpayment or are at risk of doing so, and will encourage claimants to contact the DWP to meet their obligation to inform the Department of changes in their income and other relevant circumstances. This will reduce the risk of those customers being overpaid.'

Note: having expressed concern that the DWP had 'done nothing' to stop carers building up huge overpayments of benefit despite knowing what people are earning, Work and Pensions Committee Chair Stephen Timms called on the National Audit Office to investigate problems with the carer's allowance system and, in particular, its failure to prevent or rectify overpayments.
Stephen Timms has also written to Secretary for State for Work and Pensions Mel Stride highlighting concerns about the DWP's lack of progress with overpayments since the previous committee's report in 2019. Mr Timms' letter repeats the committee's recommendation that the DWP increase the rate of carer's allowance and goes on to call for the DWP to review both the amount and the cliff-edge nature of the earnings limit and for the removal of the 21-hour study rule.
For more information, see Policy paper: Fighting Fraud in the Welfare System: Going Further from gov.uk
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Carers UK has welcomed the DWP's plans, noting this is the 'minimum' they've been calling for to tackle carers' overpayments. However, Director of Policy and Public Affairs Emily Holzhausen also highlights that implementing the strategy is 'urgent', asks that the whole issue be moved out of being branded benefits fraud, and that carer's allowance be reviewed as it should be 'modernised to reflect the realities of caring'.
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DWP-commissioned research highlights how the carer’s allowance earnings threshold influences decisions about how many hours carers work
Report also makes clear that the Department was made aware three years ago that there was room to improve claimant understanding and possibly reduce mistakes leading to overpayments by improving its communications.
The research, Experiences of claiming and receiving carer’s allowance, explores how and why people claim carer's allowance; their caring roles; experiences of combining paid work and care; and how well claimants understand the rules associated with the benefit. While carried out in 2020/2021, the research has been published today against a backdrop of calls for the wholescale reform of carer's allowance as a result of evidence that claimants who have earned above the carer's allowance earnings limit have been left with large overpayments and, in some cases, prosecuted for fraud.
While the research found that many claimants in employment felt there was a practical limit to the hours they could work, with many saying it was only feasible to be working part-time due to their caring responsibilities, it also found that -

• the earnings threshold appeared to influence decisions about how many hours some people worked. Even though claimants often denied that the threshold influenced their choices, they acknowledged being mindful to stay below the threshold. One claimant felt he had to refuse shifts at work that would take him over the threshold;
• in another example, the earnings limit led a claimant to reduce her hours as her wages increased, and eventually she was working so few hours that her employer felt it was not worth employing her due to her limited availability; and
• some claimants in paid work felt they might work more hours if not for the earnings threshold, and even suggested tapering the carer’s allowance earnings rule to encourage claimants to work more.

Published on the same day that the Work and Pensions Select Committee said that there has been insufficient progress in addressing the problems with carer's allowance that it highlighted five years ago, the research makes clear that the Department has been aware of the issues for some time. For example, it highlights confusion relating to the complexity of the earnings calculation, including how deductions such as childcare expenses and pension contributions are taken account of, and whether wages can be averaged if you earn more in a particular week.
In addition, with the Chair of the Select Committee Stephen Timms having said recently that the DWP has done nothing to stop carers building up huge overpayments despite knowing what people are earning, and the Committee having called on the National Audit Office to investigate the problems with the system, the research found that -

• poor communication on the part of the DWP meant that not all of those that had been overpaid benefit were clear on the reason for the overpayment;
• some said that while they were initially notified or questioned about an overpayment there was then no follow-up from the Department; and
• when the overpayment was initially raised, several claimants felt that they were spoken to or treated by DWP as though they had intentionally committed fraud when the overpayment had been a misunderstanding.

As a result, the research says -

'... there is room to improve claimant understanding and possibly reduce mistakes leading to overpayments by improving communications around eligibility criteria. Since claimants did not engage with the detail of their benefit regularly, possibly only considering it once a year when they received their annual letter, more frequent communications may improve clarity of knowledge around carer’s allowance.'

Other key findings include that -

• most claimants cared for close relatives, with two in five caring for a child (39 per cent), a quarter caring for a spouse or partner (25 per cent), and one in five (22 per cent) caring for a parent;
• caring was a long-term and high-intensity commitment, with half of claimants (52 per cent) spending 65 or more hours caring per week and more than half (54 per cent) caring for between 5 and 20 years;
• only 16 per cent of carer's allowance claimants were currently in paid work, tending to work part- time in lower paid jobs that they were able to fit around their caring responsibilities, with most (81 per cent) working 20 hours or less a week;
• of those not currently in paid work, seven in ten (69 per cent) said this was due to their responsibilities as a carer, with other barriers including a lack of flexible working options, claimants’ own health and confidence issues; and
• there was a lag between starting caring and claiming carer's allowance, with seven in ten claimants (70 per cent) caring for 5+ years, but only 3 in 10 (34 per cent) having claimed carer's allowance for that length of time.

For more information, see Experiences of claiming and receiving carer’s allowance from gov.uk
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Almost 135,000 people currently have an outstanding carer's allowance debt, with more than £250 million owed in total, according to figures supplied by DWP Minister Paul Maynard
DWP Minister also confirms that women represent 68 per cent of those with an outstanding debt.
Responding to a written question in Parliament from Work and Pensions Committee Chair Stephen Timms, Mr Maynard said -

'As of 14 May 2024, the volume of people who have an outstanding carers allowance debt is 134,800 with a total value of £251 million. This figure represents the total stock and as such the total monetary amount may have been accrued over multiple years. Those who have an outstanding carers allowance debt may no longer be in receipt of the benefit.'

Mr Maynard added that -

'Women make up the majority of carer’s allowance claims, and this is reflected in the proportion of those with an outstanding carer’s allowance debt. As of 14 May 2024, there were 42,800 (32 per cent) males, 91,900 (68 per cent) females and 100 (less than 1 per cent) not identified, with an outstanding carer's allowance debt.'

The Minister also confirmed that, as of November 2023, there were more than 991,000 people in receipt of carer's allowance, consisting of around 271,000 (27 per cent) males and 720,000 (73 per cent) females.
Mr Maynard's written answer is available from parliament.uk
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Total value of benefit overpayments in 2023/2024 increased to almost £10 billion, representing 3.7 per cent of benefit expenditure for the year
New DWP figures also show that official error underpayments remained at around £1 billion, and that people could have claimed more than £3 billion more 'if they had provided accurate information about their circumstances'.
In Fraud and error in the benefit system: financial year 2023 to 2024 estimates, the DWP calculates how much money it overpaid or underpaid as a percentage of total benefit expenditure for the year (£266.2bn) - for benefits including universal credit, housing benefit, personal independence payment, employment and support allowance and pension credit - and how many claims were paid an incorrect amount.
Note: the statistics no longer include estimates of claimant error underpayments as these are now published separately, as confirmed in recent DWP guidance.
In relation to incorrect payment rates across all benefits for the financial year ending (FYE) 2024, the figures show that the total rate of benefit expenditure overpaid was 3.7 per cent (£9.7bn), compared with 3.6 per cent (£8.3bn) in 2022/2023. In addition, the total rate of benefit expenditure underpaid was 0.4 per cent (£1.1bn), compared with 0.5 per cent (£1.2bn) in FYE 2023.
Looking in more detail at the figures for individual benefits, the statistics include data showing that -

• for universal credit, expenditure increased to £51.9bn in 2024 with an overpayment rate of 12.4 per cent (£6.5bn) and underpayment rate of 0.3 per cent (£180m), compared to expenditure of £43.4 bn, overpayments at 12.7 per cent (£5.5bn) and underpayments at 0.6 per cent (£240m) in FYE 2023;
• for personal independence payment (PIP), the overpayment rate was at the lowest recorded level of 0.4 per cent (£90m), compared with 1.1 per cent (£200m) in FYE 2023. However, the underpayment rate went up to 0.4 per cent (£80m), from 0.3 per cent (£60m) the previous year;
• for pension credit, the overpayment rate was 9.7 per cent (£520m) in FYE 2024, compared with 6.8 per cent (£330m) in the previous year, with underpayments remaining unchanged at 0.3 per cent (£50m) for both years; and
• for housing benefit, almost £1bn (£980m) was overpaid in FYE 2024 (6.3 per cent of expenditure), compared with £860m (5.7 per cent) in 2023. Underpayments remained stable at 0.4 per cent of spending (£50m in FYE 2024 and £60m in FYE 2023).

In addition to the fraud and error statistics, the DWP has also issued Unfulfilled eligibility in the benefit system: Financial Year Ending (FYE) 2024, in line with its decision to remove claimant underpayments from its main fraud and error estimates. The new statistics set out the percentage of benefit expenditure that could have been paid to people with unfulfilled eligibility 'if they had provided the correct information', and show key findings that include -

• the unfulfilled eligibility rate for 2024 is 1.2 per cent of expenditure (£3.1bn), compared with 1.0 per cent (£2.3bn) in the previous year; and
• universal credit, PIP and disability living allowance (DLA) account for around three-quarters of the total value of unfulfilled eligibility (at £730m, £870m and £750m respectively in FYE 2024).

The DWP highlighted that -

'PIP has the second highest unfulfilled eligibility rate [4 per cent] of all benefits and fairly high expenditure [£21.6bn], so due to this combination, PIP accounts for around one-quarter of total unfulfilled eligibility in FYE 2024. DLA has the highest unfulfilled eligibility rate [11.1 per cent] but relatively low expenditure [£6.8m], so even though its rate is higher than PIP, it accounts for a similar amount of total unfulfilled eligibility in FYE 2024. Universal credit has a lower unfulfilled eligibility rate than DLA and PIP [1.4 per cent] but its high expenditure means that it also accounts for a similar amount of total unfulfilled eligibility in FYE 2024.'

For more information, see Fraud and error in the benefit system: financial year 2023 to 2024 estimates and Unfulfilled eligibility in the benefit system: financial year 2023 to 2024 estimates from gov.uk
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Work and Pensions Secretary Mel Stride has set out the DWP's plans to scale up its 'fight against fraudsters'
New measures include using machine learning to detect and prevent fraudulent claims, as well as introducing a new Bill to enable benefit fraud to be treated like tax fraud.
Issuing a written statement in the House of Commons on 13th May, Mr Stride said -

'In the continued fight against fraud, today the Government will publish a new paper setting out the progress we have made in tackling fraud and error in the welfare system - Fighting Fraud in the Welfare System: Going Further. The paper sets out the progress we have made in delivering the commitments in the Government's 2022 command paper Fighting Fraud in the Welfare System and it demonstrates where we are going further to protect taxpayers’ money from fraudsters.'

Highlighting that the Data Protection and Digital Information Bill, currently before Parliament, will enable the Department to work with third parties such as banks to identify claims that signal potential fraud and error, Mr Stride says that the new measures being introduced include -

• bringing forward a new Fraud Bill in the next parliament to treat benefit fraud like tax fraud, by providing for the ability to make arrests and conduct searches and seizures by warrant;
• exploring a new civil penalty to punish fraudsters, potentially broadening the scope of cases that can receive a penalty when the courts are not prosecuting, and increasing the value of the civil penalty;
• tripling the size of the Targeted Case Review programme to reach almost 6,000 staff with the aim of saving £6.6 billion by 2027/2028; and
• making changes to universal credit including new partly automated checks on self-employed income, new online prompts for claimants to re-declare their circumstances (such as if they have moved in with a partner), and increasing checks on capital when people claim the benefit to ensure they are eligible.

Note: the Department confirms that final decisions on accepting or stopping a claim will, however, continue to be made by a member of DWP staff.
For more information, see DWP updates Fraud Plan from gov.uk
In response to the above article the Disability News Service reported that the government's fraud policy paper ignores coroner’s concerns over review of disabled woman’s universal credit claim. Read the DNS article on disabilitynewsservice.com
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Less than half of legacy benefit claimants who were sent a migration notice between July 2022 and March 2024 have made a claim for universal credit, according to new figures from the DWP
However, new DWP statistics also show that 60 per cent of households that claimed universal credit have been awarded transitional protection.
In Completing the move to Universal Credit: statistics related to the move of households claiming Tax Credits and DWP benefits to Universal Credit: data to end of March 2024, the DWP sets out figures for the period since July 2022, noting that -

'In the period covered by this bulletin, the vast majority of migration notices have been sent to tax credit households whose likelihood of claiming universal credit and receiving transitional protection may be different from DWP legacy benefit claimants, the majority of whom had not yet been sent a migration notice in the period covered in this bulletin.'

The statistics include that -

• a total of 824,050 individuals (in 540,070 households) were sent migration notices up to March 2024 - up by around 300,000 and 200,000 respectively compared to the totals for December 2023;
• a total of 400,940 individuals (49 per cent of those sent migration notices), living in 275,980 households, have made a claim for universal credit;
• of households that have claimed universal credit, 166,860 (60 per cent) have been awarded transitional protection;
• a total of 238,990 individuals who were sent migration notices are still going through the managed migration process; and
• a total of 184,120 individuals who were sent migration notices have had their legacy benefit claims closed.

Move to Universal Credit statistics, July 2022 to March 2024 is available from gov.uk
Note: the DWP has also published Universal Credit statistics, 29 April 2013 to 11 April 2024­ which show that there were 6.7 million people on universal credit in April 2024 (300,000 more than the 6.4 million in January 2024) and that half of households on universal credit that received a payment in February 2024 included children.
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Department for Communities also confirms that claimants in receipt of other legacy benefits will be issued with migration notices 'in the coming months'
The Department for Communities (DfC) has confirmed that the 'Move to UC' rollout in Northern Ireland has expanded this week to include people receiving tax credits along with housing benefit.
Announcing the expansion of the process, Deputy Secretary of Work and Health at the DfC Paddy Rooney said -

'We continue to take a measured and carefully managed approach to migrating legacy benefit recipients to universal credit. We have already successfully completed issuing migration notices to tax credit only recipients and we will continue to take every step possible to ensure that everyone receives the help and support they need during this next phase of Move to UC.'

The Department also confirmed that once it has issued migration notices to all those receiving tax credits with housing benefit, the following groups will be contacted in this order -

• people claiming income support;
• people claiming housing benefit only, and those claiming child tax credit with income-related employment and support allowance (ESA); and
• people claiming income-based jobseeker's allowance.

In relation to the bringing forward of managed migration for ESA and ESA/housing benefit claimants in Great Britain, announced by the Prime Minister on 19 April 2024, the DfC says that it is working to assess the impact of this on the region. It also confirms that it will align with the DWP's aim to complete the migration of legacy benefit claimants to universal credit by March 2025.
For more information, see Tax credit with housing benefit recipients next to 'Move to UC' and Rollout of Universal Credit for Tax Credit and Legacy Benefit customers - screening from ni.gov.uk
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57,000 adverse universal credit sanction decisions were made in January 2024, according to new DWP statistics
DWP statistics also highlight that around 95 per cent of decisions are as a result of failure to attend or participate in a mandatory interview.
In Benefit sanctions statistics to February 2024, the DWP reports on both the rate and duration of sanctions for universal credit claimants who are in conditionality regimes where they be applied.
Key findings include that -

• in February 2024, 30.1 per cent of claimants were in conditionality regimes that were subject to sanctions and, of these, 6.52 per cent were sanctioned - down 0.64 percentage points from the previous quarter;
• over the last year, 94.9 per cent of adverse sanction decisions were for failure to attend or participate in a mandatory interview; and
• in February 2024, there were 20,000 completed sanctions in the 4 weeks to 13 weeks sanction duration band, 4,800 in the over 13 weeks to 26 weeks duration band, and 4,000 of over 26 weeks duration.

In addition, while the total number of claimants in conditionality regimes where sanctions can be applied has remained largely stable since May 2022 (currently at 1.95 million), the total number of adverse sanction decisions stood at 57,000 in January 2024, the highest since March 2022.
The DWP notes that -

'Comparisons with universal credit prior to February 2024 ... should not be made. This is because the data sources, methodology and rules of the benefits differ from those used for universal credit currently.'

However, it adds that, following the reinstated duration measures and rate methodology improvements, the data is now determined stable and fit for purpose and, as of May 2024, it is published under the 'Official Statistics' label as opposed to 'in development'.
For more information, see Benefit sanctions statistics to February 2024 from gov.uk
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DWP has admitted missing multiple opportunities to record the 'vulnerability' of a disabled woman whose death was later linked by a coroner to failings at the heart of its UC system
The Disability News Service reported on the case of Nazerine (known as Naz) Anderson, from Melton Mowbray, who died of an overdose in June last year, after receiving a UC review notice.
According to a prevention of future deaths (PFD) report sent to the department by coroner Fiona Butler, the DWP missed six opportunities to record Anderson’s “vulnerability” on its IT system while it was reviewing her universal credit claim, and had failed to act on the mental distress she showed in phone calls about her claim. It also repeatedly failed to act on requests to direct its telephone calls and letters to her daughter.
The DWP admits multiple universal credit failures before disabled woman’s death article is available on disabilitynewsservice.com
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Number of emergency food parcels distributed across the UK by the Trussell Trust has increased by 90 per cent over the past five years
Food charity reports that it distributed more than three million parcels last year, with more than a million of them going to children.
In Emergency food parcel distribution in the UK: April 2023 - March 2024, the Trust says that it distributed 3,121,404 food parcels, the most parcels that it has ever distributed in a financial year, representing a four per cent increase on last year's record-breaking numbers for 2022/2023 and a 94 per cent increase since 2018/2019.
The charity also highlights that the number of parcels provided to children has continued to rise, exceeding 1.1 million in 2023/2024, and that food bank support is provided disproportionately to children, compared to the proportion of children in the UK population. In addition, it notes that pension age households are increasingly likely to need to use a food bank, with food bank support for these households having more than quadrupled between 2018/2019 and 2023/2024 (an increase of 345 per cent), compared to an 81 per cent rise amongst households without someone of pension age.
Also sharing statistics on the reason for referral for an emergency food parcel - which include health, benefit issues, work hour changes, insecure housing, changes in personal circumstances, immigration status and domestic abuse, as well as income and debt levels - the Trussell Trust says -

'Across all households the most common reason for referral was due to issues with income and debt levels. The vital role of the social security system in driving these trends is clear from the fact that the majority (78 per cent) of people referred to food banks were reported to solely have income from the social security system, with a further 8 per cent having earned income as well as income from social security.'

Trussell Trust Chief Executive Emma Revie said -

'It’s 2024 and we’re facing historically high levels of food bank need. As a society, we cannot allow this to continue. We must not let food banks become the new norm ... A supportive social security system is the bedrock on which we end hunger for good. Building on this, we need much more effective employment and financial support for parents, carers and disabled people, and action to ensure everyone can have the security we all need to access opportunities and have hope for the future, through more secure and flexible jobs and investment in social housing. Food banks are not the answer. They will be there to support people as long as they are needed, but our political leaders must take bold action to build a future where everyone has enough money to afford the life’s essentials. The time to act is now.'

For more information, see End of Year Stats from trusselltrust.org
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Employment Minister Jo Churchill has provided a House of Lords Select Committee with an undertaking that the administrative earnings threshold (AET) in universal credit will not be increased again without a 'sound evidence base'
However, Minister's evidence to Lords Committee fails to address its dissatisfaction with DWP's explanation for not publishing robust evidence to support previous increases in the threshold.
Further to the Lords Secondary Legislation Scrutiny Committee's report on new regulations that implemented a further increase in the AET from 13 May 2024 - that criticised the ‘inexplicable’ lack of data evaluating previous increases in the threshold in September 2022 and January 2023 - the Committee held a one-off evidence session yesterday to question the Minister and DWP officials.
Introducing the session, Committee Chair Lord Hunt acknowledged that the DWP had agreed to share its informal findings supporting its AET policy. However Lord Hunt added that -

'... similar, no doubt to the material that the Social Security Advisory Committee saw but correctly declined, if information is not available to the House and the public, then we feel unable to consider it either.'

The Committee then questioned the Minister about the Department's failure to publish evidence providing an assessment of the impact of increasing the AET either before or after implementing the change.
In response, Ms Churchill highlighted that the Department did publish a randomised controlled trial evaluation in 2018 providing the highest level of evidence on the impacts of increased in-work conditionality that Ministers have had sight of. When challenged that this evidence is somewhat outdated and 'a bit threadbare' - as it has been relied on for three increases in the AET - Ms Churchill indicated that Ministers also had early sight of unpublished research (a Regression Discontinuity Design (RDD) study) that compares the experiences of claimants who are just below and just above the AET.
When pressed on the expected publication dates for this and further evidence, Mr Churchill said -

'I have asked for [the RDD study] to be available as soon as it can be, and the date I was given was spring 2024 ... I would like it out the door as soon as possible, so you have more data ... RDD is the next piece, the next building block and then, the longitudinal study will come through in 2025.'

Concluding the session with a final question, Lord Hunt, speaking on behalf of the whole Committee, said -

'... we're looking for an undertaking from you, not to further expand the cohort until the Department can publish robust evidence of its effects. Are you able to give us that undertaking?

Ms Churchill responded -

'So are you alluding to us holding 15 hours or with this latest laying at 18? Because I could certainly say to you, I think with all confidence that at 18, we want to understand the iterations and make sure that we've got a sound evidence base from there.'

NB - the increase in the AET in January 2023 was based, for individuals, on the equivalent of them working 15 hours per week at the National Living Wage, and this week's increase to the equivalent of them working 18 hours per week.
Despite welcoming the Minister's reply, Lord Hunt went on to say -

'... we accept your undertaking, except we are still as dissatisfied as we were because you haven't provided, in the view of the Committee, sufficient explanation yet. We are awaiting this robust evidence, which I think that we now expect in June 2024.'

The evidence session Regulations to increase the Administrative Earnings Threshold (Legislative scrutiny) is available from parliament.tv
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Work and Pensions Select Committee has called on the government to bring forward proposals to compensate women born in the 1950s who suffered as a result of the DWP's communication failures when their pension age was increased, and asks that it does so in the current parliamentary session
Committee chair highlights lengthy delay and urgency for affected women and calls on government to act on Parliamentary Ombudsman recommendations before summer recess.
Writing to Secretary of State for Work and Pensions Mel Stride, Committee Chair Stephen Timms requests government support for 'urgent action' following the Parliamentary Ombudsman's final report in March 2024 which recommended a remedy based on level 4 of its severity of injustice scale, putting awards at between £1,000 and £2,950.
Mr Timms says that the Committee does not seek to question the Ombudsman's proposal for compensation at level 4, but instead has focused on what a remedy may look like -

'The evidence we received indicated support for a rules-based system. This would be a system where payments would be adjusted within a range (based on the PHSO’s severity of injustice scale) to reflect the extent of change in the individual’s State Pension age and the notice of the change which the individual received. This would mean that the less notice you had of the change and the bigger the change in your SPA, the higher the payment you would receive. While not perfect, the advantages of such a system are that it would be: quick to administer; applying known data to a formula to determine the amount due; and relatively inexpensive (compared to a more bespoke system).'

The Committee's recommendation also includes some flexibility for individuals to make the case for further compensation in the event that they have experienced direct financial loss, for example where a woman whose divorce settlement was less than it would have been because it was based on the expectation that she would receive her state pension at 60.
Mr Timms also asks the government to consider -

'... the need for urgent action, given that the Ombudsman started to look at this issue in 2018 and that every 13 minutes a woman born in the 1950s dies ... Implementing a remedy will need parliamentary time, financial resources, and the data and technical systems only available to your department. It cannot happen without government support. We would ask you to bring forward proposals for a remedy by the summer recess.'

Mr Timms' letter to the Secretary of State for Work and Pensions is available from parliament.uk
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In California medical bills under $500 cannot affect your credit report, but the articles I've found on the matter are unclear on whether multiple bills totalling over $500 would meet this criteria. For example, if I receive a bill for $200 and another for $320, can $520 go on my credit report, or can none of it go on my credit report because none of the bills was over $500?

1330 Terran Front Fleet Time
On the Turinika homeworld, the first signs of unrest began to manifest like a wave, The broadcast of the most esteemed Tizikikoonazikiakakiatkata, Taratanti of the roost Kazatalak, openly performing the act of Kavsa had been met with shock. The last Taratanti who had voluntarily performed Kavsa had done so in protest of the treatment of the Kulorn caste, nearly two thousand years prior. It was an ancient rite, one that signified rejection of the greatest shame. Even more shocking than the act itself was the evidence that had followed it. Visuals of species, brought into the Conclave, not as migrant workers as had been believed, but as slaves, was met with an almost immediate attempt at censorship. This attempt failed spectacularly, mostly due to those who had been tasked to censor the information not only refusing to follow the command, but openly declaring that they had been ordered to do so. A situation that was already, as the humans would say, out of hand, spiraled completely out of control. Within only twenty minutes of the ending of Tizikikoonazikiakakiatkata’s broadcast entire cities entered a state of absolute anarchy. Two planetary capitals were stormed and taken by the furious civilian population, demanding the location of those who had been enslaved. The Turinika Armada, which even then was in the middle of a training session meant to prepare the fleet to withstand the Terran Front’s assault, began to cease operations. Within the hour, the entire armada would be recalled to the turnika homeworld. Those who did not take to the streets simply stopped whatever work they were doing and went to their homes to be around their brood. Images of Tizikikoonazikiakakiatkata with his stripped wings spread wide in front of the human fleet commander were on every news fed of the Conclave, as was the sound of his thunderous voice, and the wails of despair from a turinika female that couldn’t be seen. Close ups of the human fleet commander’s face were shown, with analysts remarking on the shock, horror, and sympathy. Since the outbreak of the Seventh Orion War, the female human known as Simmons had been reported to have made several threats towards the turinika, she had quickly become seen as a warmonger, ready to take revenge against the turinika for refusing to go to war and violate their principles of pacifism. Now the images of her lunging forward to stop the violation of Tizikikoonazikiakakiatkata’s plumage, the agonized expression of her face, and the true reason for her threats against the turinika were rapidly reversing her image. On far flung deep core mining stations and agricultural stations, on deep space stations dedicated to material processing, and in other areas hidden from the sight of the normal turinikan population, overseers and taskmasters felt their hearts run cold at the knowledge that very soon, their part to play in the willful enslavement of another species would be known to the wider Conclave. As the data package transmitted alongside the broadcast were fully decompressed and the scale of the Conclave’s government’s involvement was revealed, the entirety of the Conclave itself was teetering on the verge of absolute pandemonium. The image of a member of the kolra species, from the look of it barely a hatchling, quickly was becoming the face of the entire incident. The picture was absolutely damning, and the sight of the image had sent any who saw it instantly into contorting and painful displays of shame. The young kolra was sprawled on it’s stomach, looking to the one taking it’s picture with eyes that had no life in them. It’s shell covered it’s back, and despite the age of the kolra it was already dulled and scuffed. The foot pressing down on the shell was unmistakably familiar to those who saw it, the clawed feet of a turinika. Within the hour, billions of winged figures stood in streets, the normally soft spoken and passive species demanding action, demanding justice, on the hundred worlds of the Turinika Conclave. The bulk of the Taratanti caste, most of whom had been left in the dark of the truth of the situation, quickly went public with their own declaration of outrage, and the eyes of the entire species turned inwards to the mountainous homeworld of their species.
Hakuri Watanabe looked down at his helmet before putting it on his bed, the stylized SEVEN seeming to stare at him. He sat down in his chair and picked up a small cloth from his buffing kit. No one knocked on his door, in fact, mostly he and the rest of his squad were left alone before a major operation. They were just given their time, time to mentally prepare. Some of his squad would go over their mission briefing, some, like him, would spend their time doing something to relax themselves. Hakuri always found that taking care of his suit calmed him considerably. Granted he could simply turn it over to the squads armorers to be tended to and they would do as good of a job as he could, but he preferred it to be done by his own hand. The symbol of a triangle was on his form fitting shirt, the symbol of his special operations command unit. He was known as a Myrmidon, but the official title of his unit was Section Three. He knew this, his superiors knew this, and as far as Hakuri knew, most of the Terran Front was aware of his unit’s existence, but past that, they knew very little about what he actually did. As far as his mother knew, Hakuri was a pencil pusher onboard the TFS Berlin, the troop mothership that all of his letters were sent from. He thought about writing her, but then again, he only liked to do that when he returned from a mission, not when he was expecting to go to one. If he tried to write her when he was waiting, he would just get anxious, and homesick. That wouldn’t do when he was dropping into a combat zone. That wouldn’t do at all. Hakuri instead started to buff his helmet, waiting for the word to come down which meant they were prepared to jump. A glance at the clock made him pause in his circular rotations. The clock said 1330. Operation Naked Sun was about to begin.
Tika was on his side, Kzia standing at the end of the medical bed that had been adjusted for his turinikan physiology. He felt cold in more ways than one. For his people, clothing was more of a decoration than a necessity, but without his protective plumage he felt the cold stabbing him through to his hollow bones. His diplomatic access was already gone, his privilege access revoked. He heard the broadcast for a preparation to jump, but he wasn’t truly listening. There was no question in his mind he had made the right decision. There was no question at all. One of the humans, a nurse, came to his side and gently laid a heavy blanket over him. The human’s hand lingered on his trembling body for a few moments before it was removed, and Tika glanced in their direction. The female was one of the ones who had responded first to the call for medical service for him, had heard what had happened and why. Tika had gotten very used to being glared at on this ship. He was hated, and he knew it. He knew he had deserved it. He was a party to the vral’s enslavement of the humans, the chua, and far too many others. When he had come to Thermopylae station, he had not even given that fact a single thought. He was born into power, being of the Taratanti. He belonged to the most powerful species and government in the entire quadrant of the galaxy. His people, while mighty, did not seek to use it. To him, they had simply been above it all. When the vral had approached him with the offer to sell captured species at first TIka had wanted to reject it out of hand, but a few had told him to go through with the sale. Such was the nature of this galaxy, or so he had believed. The weak were at the whims of the strong, and one’s place in the galaxy was determined only by the power they could wield. The turinika were not nearly the first to have taken a species and used it for slave labor, and while Tika did not approve of the deal, he had not fought it either. As he looked back to the wall, he remembered what the humans had taught him these last days. When he had arrived in Thermopylae he had assumed he would find the chua species to have been at the very least regulated to a subservient role, if not outright enslaved. Finding them sharing power was a curiosity. He had expected to be treated with all the honor and dignity that his station demanded, that the power of his government demanded. Fleet Marshal Simmons had disabused him of that, and had left him humiliated and shamed. As he had laid in the dark as Simmons had declared the Seventh Orion War, covered in his own filth, feeling as if at any moment he was going to be killed he knew true fear and horrific uncertainty for the first time in his life. He had never faced these emotions, these sensations before. He had always been in power. He had stood with the full might of the Turinika Conclave behind him. He had never known anything other than the superior position. Now, as he lay in the hospital bed, staring at the wall, he was ashamed of how arrogant, how blind, and how short sighted he had been. After he had risen from his own filth, he had desperately tried to convince his leadership of the strength of the Terran Front, how it matched or eclipsed their own. The Conclave was not the unchallenged power in the quadrant anymore. The terrans, the human and chua, had somehow defied fate. They had not fallen to the vral after ninety years of near constant conflict, and now if Tika was right they had come out of it nightmarishly stronger than before. Tika had actually begged to be heard by his superiors, and he had never come close to that once in his life. The chua homeworld however, had fully broken him. If he had not been on the Antares, had not been humbled beforehand, he knew that he would have just clapped his hands together and said that it was delightful. As the transmission from the chua homeworld had come in, and the rescue effort had begun, he could only wallow in his own shame. He had profited directly from the chua’s suffering, the human’s suffering. Again he had tried, and failed, to convince his people, and again he had failed. Being on the Antares, for him, was torture. The lights were too dim, every human and chua looked at him with nothing more than loathing and contempt, his entire worldview had been shattered from the way he viewed the galaxy to his own place in it. Every time he closed his eyes he saw the shadow of Simmons standing over him, her voice cold with a lethal rage, hearing her voice echo in his mind, seeing the glint from flashes of light shining in her eyes. ‘We Know.’ echoed in his mind in his sleep, the voice of the terrifying Fleet Marshal transforming into the sound of a vengeful god demanding compliance and promising retribution. Then he had watched the humans and chua, who he knew were preparing to go to war with his people, celebrating the return of the shesvie. Once more he had expected them to be integrated into the Terran Front, but as soon as he learned Simmons offer to them, and what it had entailed, he had been called to his room to answer the latest message from his people. Once again, his people had doubled down, the knowledge of the enslavement of the humans had been suppressed, and once more Tika found himself, and his people, standing against a Terran Front that had every justification to declare war, to right the wrongs that had been done to them. All the while, he knew something else. He knew that, after everything he had seen, that his people would lose. The turinika had not been to war for nearly two thousand years. His people were not ready for what the Terran Front could do, and after seeing what they had done to the vral so far, he knew his people were not ready for what the Terran Front would do. He was afraid of the dark. Tika was absolutely terrified of it now, because now he knew the monsters were real. Simmons had shown him that, but the humans, the chua, they were not the monsters. He was. He had refused to be one any more. He had announced his intentions to his staff, who had squalled in rejection, all but three. Kzia was the first to step to his side, Kikumot and Tziki had stepped forward as well. Never, in his most nightmarish dreams, did he ever think that he would stand in front of Simmons and voluntarily have his plumage stripped from him, performing the act of Kasva. He never thought that his staff would have ever compiled and transmitted the data package they had sent. He had never thought that he would betray his people, if only to save them. Simmons had changed that, the humans had changed that. He knew the terror of the dark, he knew fear for his people’s safety, he understood the horror of war, and for the first time in his long life he could truly look back at every interaction he had had, with every species, that had asked for help in their struggle for survival against the vral and truly understand their fear and desperation. Now he lay, his plumage stripped from him, his station revoked, his status removed, surrounded by a people who despised him. He wouldn’t have it any other way now. He knew that they would listen now, if not to him, then to the civilian masses of the Conclave that would not stand for what they had done. He prayed to the Great Mother often now, shivering in the dim light, hoping that it would be enough. He had been wrong, and in his error he had sullied his own people. He had made them complicit. Even now, he did not know how they would ever be forgiven, because right now he wasn’t quite sure he could ever forgive himself. As he heard the broadcast calling out on the ship, announcing one minute to jump, he felt a hand on his side, and looked up to the human nurse. She was smiling at him. Not a smile born of malice, or anger, but a genuine smile. She patted his side lightly, then turned to walk out of the room. For not even the twentieth time since he had come onboard Thermopylae, he was mystified by these people.
The bridge of the Dhampir was thrumming with music and the vibrations of the reactor and Conrad leaned forward in his chair mount, his eyes almost feral as he looked at the empty space that was the mandeville point. He was positively chomping at the bit. Batz was positively roaring the lyrics to the song that was blaring over the ships speakers. Rev and Dev sat side by side in their mounts, throwing their hands up in time with the pounding bass beat of the sound. Towns was the only one besides Conrad that was quiet, both of them looking towards the mandeville point with complete impatience. Conrad felt like jumping from his skin. Fidget, well, fidgetted, holding his hands over his headset and listening as if he were trying to hear secret messages in the music. They were ready, their pulses were racing. The crew of the Dhampir was positively vibrating. Conrad looked to the shipboard clock, seeing 1330 displayed, and his head snapped to Fidget, waiting for the word. They were going to run, they were going to chase, they were going to hunt.
Vicky sat back, looking towards Jess and Kukat as they slept. Jess was in her chair, Kukat in her medical bed. Vicky glanced back at the block print on the paper and read it for the fifth time. She read the individual lines, one at a time, cursing their existence. After reading through the message printed she let her hand hang again. Kukat would be released from medical tomorrow, and both her and Jess still thought they would be boarding the Thumper to join the Vellacore once more. Jess had talked non-stop about her quarters on the Vellacore the past few days, how she just wanted to be back in her room. Kukat was equally excited. Only Vicky didn’t share their excitement. They didn’t know yet. They didn’t know about their battlefield promotions, they didn’t know about their reassignments, they didn’t know the days of them working together were functionally over. Vicky looked down at her hand holding the paper again, and felt like crumpling it. She had lost her crew. She had lost them not due to negligence, or time, she had lost them to fame. Kukat was to be promoted to ensign, and was to be the sensor officer on the destroyer Hadrian, Jess was getting the same promotion, her station on the cruiser Victorious. Vicky? She was the sparkling new commanding officer of a destroyer that was arriving at Thermopylae in two days, the Quarrel. She never wanted this. She had turned down promotion after promotion that would take her from the cockpit of the Thumper, away from Kukat, away from Jess. She wanted to serve in this war in her own way, as a pilot, with the two who had made her life so enjoyable. Now though, they were to be split up, and there was nothing she could do about it. These promotions hadn’t come from simple seniority, they had come from High Command, as had the orders. Tomorrow, when Kukat was released, they would be ushered into the hanger bay of the Barrowmore. They would all three be awarded the Star of Terra, then they would be reassigned. Tonight was the last night they would all be together. Vicky wanted to wake them up, she wanted to tell them, to give them a chance to process it. As she looked to Kukat and Jess she couldn’t bring herself to do it. She held up the letter again, reading the first few lines, then she felt the sting of tears in the corners of her eyes. She looked away, her heart panging with sadness, and stared at the wall. The clock read 1330.
Corporal Brandy was sitting on the small rack, with Janet Shippen sitting between his legs using his thighs as armrests. They were both dressed for the first time in the last few hours, both of them staring at the clock. This close to the reactors they could feel them beginning to spool up for the trip through hyperspace. When the news of the operation had come down they had elected to spend as much time together as possible, which Brandy had enjoyed to no end, and he had made sure Janet had as well. Brandy had even taken some time to reach out to his sister Victoria, a rarity for them both, as since they were children they were often barely able to speak to each other simply due to schedules. He had even told her about Janet, and although he hadn’t gotten a response from his sister yet he already knew what she would say. Janet nestled back against him, but he could feel her body was stiff. Neither of them knew what the next few months were going to hold. Their time together might be constricted, in fact, this might be the last few moments they were together for quite awhile. Brandy’s Ghouls were specialists, ship boarders. Chances are he was going to be extremely busy, as was she. He didn’t quite know how he felt about Janet, but he did know that beyond a shadow of a doubt he didn’t want to be away from her. Judging from how she was acting, she felt the same as him, conflicted about her relationship with him, but not wanting to be apart. He knew what he needed to tell her, that he had to get up, that he had to leave. The Ghouls were going to be assembled at 1345, ready to board. Her unit was going to be prepared at the same time, to begin taking on salvage. Her hands were like clamps on his legs, and from how tense she was, he wasn’t going to get up until she was good and ready. The clock on the wall switched to 1330. He stared at the clock, feeling like the clock was mocking him, when suddenly Janet leaned up and turned. Her hands took hold of his shoulders and she threw her body against his, her lips finding his own. Her arms wrapped around her frame and he tightened his grasp on her.
Simmons spread her hands over the panel in front of her, looking at the table. Seven points connected the recently reclaimed chua space to what was former Shesvie territory, and beyond that, the heart of the Vral Empire. Her lip curled in a wicked smile, On the digital display of the table the hyperspace lanes, and more importantly, the avenues of attack her fleet was preparing to take. She held out her hand, all five fingers splayed over the lanes, envisioning the war as it stood now. The war to come. Seven hyperspace lanes, seven systems, branching out into sixteen, branching out again to another twenty. The Antares herself was going to link up with the Barraki, and was set to simply plough through the next five systems to do so. Slowly she tightened her hand into a fist as she looked along the hyperspace lanes, seeing task forces lined up and ready to jump. Drones had already been sent through. The vral had forces along the border, but nothing that could withstand what was to come. Her fleet was ready. She was ready. The Seventh Orion War was at the end of it’s first month, and had taken back six systems. The first moves of Operation Naked Sun would double that and exceed it, then double it again. She had already given her speech, her task force commanders were ready. High Command had taken it’s time making this decision, and while she had railed against the delay that didn’t matter now. All along the front, individual task forces were joined into larger fleets, ready to jump into the next system and eliminate any vral defenses, but unlike now, they simply would not wait. Naked Sun was to be a lightning strike to cut off as much of the Vral Empire as possible, to deny them their own space, to imprison them on their own worlds. Task Forces were designed around three types of vessels combinations, Lighthammer Task Forces were comprised of corvettes and fast destroyers, the fastest vessels in the fleet, meant to take systems quickly, to devastate unprotected infrastructure, and to eliminate light resistance. Simply put, they were going to swarm into vral space, determine pockets of resistance, and move on. They were going to rip entire sections of vral space from them, calling in other task groups if needed. Thunder task groups were the primary capital fleets, meant to be sent into those pockets of resistance, and neutralizing them, joining with the Lighthammer groups if needed. The cruisers, carriers, battleships, they all belonged to these task forces. Her own task force was called the Nova task force, and it comprised only the Antares and it’s sizable fleet escort. Simmons glanced up at the clock, the time was 1329. She breathed in slowly, then unbidden the thought came to her head and she looked to the report from the two habitable planets that had been scanned by the drone cutters, the information having been relayed to her almost twenty minutes prior. She was not worried about the ground campaign, in fact a reserve fleet from Thermopylae would be the ones to escort the landing ships from planet to planet that her fleet left behind in it’s wake, isolated and defenseless from the wider Vral Empire. Fleet escorting was no longer her job, protecting ground invasions were no longer her job. Simmons was positively growling now, as her only job was to take her fleet and use it to rip the vral out of the stars. Still, the thought nagged at her. On both of the planets that her fleet was set to overrun, there were Vral ships in orbit. On the first, there was evidence that the Vral had been bombarding a small area of the surface, extremely similar in size to the hole that now existed on Zvitia, the planet that even now was being integrated into the Terran Front. In the second system it showed Vral ships in orbit, but whatever they were doing during the time they had taken the scans, whatever they were covering up, they didn’t seem to have gotten to it yet. On the radiological scan of the planet a massive bloom of electromagnetic energy painted a broad region of the planet blistering white. She had sent the images back to Earth, back to High Command, but no one seemed to know what was happening. The one thing that every analyst agreed on so far that was that whatever the blooms represented, it meant nothing good. She took another long look at the radiological scan, seeing the intensity of the radiation, and her lip curled in a snarl. She couldn’t think about that right now, but orders had already been given to notify her the moment that they had taken a planet that still bore the radiation signal. The vral were being damned fastidious about it though. She pulled her thoughts away from it, looking back to the hyperspace lanes. The slow grin entered her features again. She glanced at the clock. 1330. Her hand took hold of the receiver next to her station and she pressed the transmission stud, knowing that Hazard had already opened a channel to the wider fleet.
“Commence.”

But even typing this, it doesn’t feel real. I still have hope tonight that he can change. I feel so stupid.
I am 38F and he is 39M.
I am devastated. I would do anything and everything to be married forever, but it’s no longer an option and hasn’t been since the fourth month of our marriage. I was 8 weeks pregnant with his child and he assaulted me with a metal cup in the car while he was driving on the freeway because I wouldn’t stop saying why he was upsetting me. The fight continued when we got home and he had called the police, lied to them and had me arrested. Eight weeks pregnant. With bruises up and down my body. I got arrested. I spent the night in jail and had to listen to my baby’s heartbeat for the first time from a county jail exam table.
Somehow, through that, we stayed married. Abuse makes you do wild things. It changes your brain. Abusers purposely make you confused. Through counseling, I am coming out of the confusion now, though.
I could go on and on about the abuse I have suffered. I am here today because typing this makes it real that I am leaving. And I am here today because I need support in understanding that he is not going to change.
This morning things escalated by 8am. This is typical weekend behavior. I discovered that he has been smoking cigarettes in one of the vehicles that is in my name and that I pay for, and that I have asked him not to smoke in repeatedly. I do not smoke. I think it’s gross. And it has ruined the interior of this vehicle that is expensive. Not only that, but our child has asthma. Most likely because he IS a smoker. Anyway, I grabbed something out of the vehicle for his 6yo and I came back in and simply said “please don’t smoke in the truck anymore. Please don’t tell me that you haven’t been either.” This sent him into a spiral. He called me names and said that I am controlling. He started following me around the house screaming behind my head. He is nearly a foot taller than me and this is physically intimidating to me. So much so that my hands start to shake, my heart races and my thoughts become blurry when he does this. I knew at this point it was best for me to get our child and leave. So I was doing that. But this morning he would not let me leave the bedroom and was blocking me from leaving with our child with his body in the doorway. I told him I was going to call non-emergency if he didn’t move. And he would not. So I was trying to figure out how to call but my hands were shaking so bad and my brain was so jumbled I gave up and called my sister on speaker. I asked her to call the police. As soon as he saw her name on my phone he moved and let me leave. He yelled at me and our child out the door and to the neighborhood “see - I’m so scary - I’m letting you leave”. I got our child in the backseat and drove down the street to park and get them dressed. They were only in a pull up. I saw the officer coming down the road and flagged him down. I told him what happened and he went and talked with him. I left with our child and went to my sisters. Eventually we came home and he has been upstairs ever since. This is also typical. He will have an outburst. And then go upstairs and not speak to me for a week. And then one morning he’ll just wake up and decide that it’s time to be normal again. And generally comes to me and says “have you calmed down”. Which, as you can imagine, perpetuates the situation further. And drags it on. He does not understand accountability.
We have been married 3.5 years, together for 5 total. We have one child together (2yo) and he has two other children (6yo and 14yo).
We moved in together after 9 months of dating. That is when the abuse started. The first time he was physically abusive, he broke through our bedroom door. Broke. The entire door - down. Somehow, I decided to continue.
From the start, I’ve known it was never going to last. He is unstable. He has a long and dark history of mental illness (both himself and his immediate maternal and paternal family). In addition to struggling with substance abuse his entire life. His childhood is tragic and full of heartache. It shaped the man he is today, and not for the better.
He is in the trades industry and has a GED. I am a director level professional and have a college degree. His father was in prison for the last half of his childhood and eventually took his life when he was released. My father is a retired architect, Vietnam vet. We grew up completely different. Both of our parents divorced. He then suffered verbal and emotional abuse from his step father. I suffered verbal, emotional, and physical abuse from my mother.
I believe my mother is a narcissist and undiagnosed. And I believe my husband has narcissistic tendencies and/or is one. But I am not a medical professional. I am going on what I’ve experienced with both of them.
When we first met, he was 34 and I was 33. He was unemployed and really not doing well. Drinking in access. A lot. Everyday. But I did not know. I was doing very well. I had spent my 20s creating a fulfilling and financially successful career. He spent his 20s job hopping and, quite honestly, messing around. But we had fun together. But having fun together is not real life.
Here is where the manipulation began. He was upfront about his upbringing and past. And was genuinely making steps towards a better life. He is a born again Christian. And as an educated person, I believe he has grabbed on to what is actually important in the Bible. However, he is unable to abide by what a husband biblically should be. He does not love, protect or provide for me or our child. We joined a church, I became involved and made friends, and we went there as a family for multiple years. Until one night he showed up drunk, and I never went back.
I am the breadwinner. I pay for ev. ry. thing. He keeps his entire paycheck and will not give me money to pay bills. He will also not physically pay the bills. I manage and pay all bills. But not because I don’t want him to. I have begged, cried, and tried a million different systems (both digital and analog) to make him involved. And he flat out refuses. He abused our shared checking by taking money out to “pay bills” from his personal checking account and then did not pay those bills and spent the money. So I would then have to pay multiple months and late fees to catch up. Many. Many. Times.
In addition to not contributing financially, he does not contribute to the household upkeep or yard maintenance. Literally nothing. If I want the yard kept, I do it, or I pay someone to do it. If something on a vehicle goes out, I make the appointment and consult with the technician. But again, not because I want to, but because he will not participate. Or if he does, it’s half assed and more work for me. He does not grocery shop or cook. He has never cooked one meal for me. I think he’s maybe gotten a bowl of ice cream for me a couple times? He does not clean. He has cleaned the bathroom in our home two times. We have lived here 4 years. We live in separate bedrooms because he won’t pickup after himself. His room is squalor. Clothes on every square inch. Fast food wrappers. No sheet on mattress. I have cleaned it for him many times in hopes that we could make a drastic change and start sleepin next to each other again. But he refuses. I know this sounds insane that I have stayed married. It sounds insane to me.
He verbally, emotionally, physically, spiritually, sexually and financially abuses me. Maybe not all at once, everyday. But one of them most likely daily now. Or a couple. It’s been a very long time since there has been a long stretch of stability or peace.
However, I am changing all of that this year. I have hired an attorney and am climbing through the paperwork right now.
On Christmas morning last year, before we hosted family that day, he threw a (heavy) laundry basket full of dirty clothes at me as I was going down the stairs because I asked him for help with something. And after the first one hit me, I sat down and covered my head so I wouldn’t fall, and he threw another one at me. I don’t know how I masked my raw emotions through the rest of the day with family over. I ate not one bite. I pushed my food around my plate and tried to make my face contort into normal emotions for the day.
But I stayed. Again.
Mother’s Day morning this year. Just one week ago - I spent it locked in my bedroom with our child paying the divorce attorney retainer fee on the laptop as he screamed at me what a piece of shit mother and wife I am. I honestly don’t even know what I did or remember why it escalated. Most likely because it was a holiday - and not about him.
I am exhausted. I have lost close to 30lbs since January. People are beginning to notice.
I wanted a family more than anything. I adore my child. I spend my days and nights dreaming up ways to enrich their life. I wanted family vacations and world travel. I wanted to host, big, extended family holiday gatherings. I wanted my little baby to know what it felt like to have a mom and dad at home together every night. But not at this cost. The very worst part of my parenting is staying married. I am a bad parent every day that I stay here.
I wish I could file the petition and fast forward a year. I know I’ll be okay. It’s ripping off the bandaid that hurts.

Hello Fellow Apes,
In my recent posts, there were discussions regarding how Clover Assistant will compete with Epic EHEMR in the future, and someone asked about how CA can make EMR better. To understand this thesis, we're going to start by looking at the two offering in a table. It's going to be a long one.

Clover Assistant	Epic
Clover Assistant is a clinical support tool designed by Clover Health, a health insurance company. It aims to help physicians make more informed decisions by providing them with actionable insights at the point of care. The tool integrates data from various sources to present a comprehensive view of a patient's health, aiming to improve outcomes and streamline care delivery. At the moment, CA has the capacity to integrate with Epic. CA is primarily focuses on enhancing clinical decision-making by providing insights and recommendations based on data analysis. It is designed to complement existing EHR. However, in the future I think CA will break away from this, and we will go into more detail when we look at the history of Epic.	Epic Systems Corporation provides one of the most widely used electronic health record (EHR) systems in the United States and globally. Epic EHR is a comprehensive platform that covers various aspects of healthcare management, including patient records, scheduling, billing, and clinical workflows. Epic is a full-fledged EHR system that manages all aspects of patient care and hospital administration. It includes modules for clinical workflows, patient scheduling, billing, and etc. CA isn't at this level yet.
CA is designed to integrate with various EHR systems, providing a layer of intelligence on top of existing workflows. Its goal is to enhance the data already present in the EHRs with additional insights. It does so by aggregating data from multiple sources, including claims data, lab results, and patient-reported information. It uses this data to offer real-time recommendations and insights to physicians. Additionally, it offers insights in a concise, actionable format to help physicians quickly make informed decisions. We don't know what the cost of CA implementation will be, but I know 100% it will be cheaper than Epic, and in the future it will have the same features as Epic.	Epic is known for its interoperability through the use of standards like HL7 and FHIR, allowing it to connect with other systems and share data across different healthcare providers and organizations. It collects and stores a wide range of clinical and administrative data. While it offers decision support tools, its primary function is data management and workflow facilitation. However, there are a lot of manual work involved for those who use this because it is an older system. While functional, Epic is often criticized for its complexity and steep learning curve. However, it is also praised for its extensive customization options, allowing organizations to tailor the system to their specific needs. The biggest problem with Epic is it is known for its high implementation costs and resource-intensive deployment process. However, it advertises itself as a comprehensive solution that can manage all aspects of healthcare operations.

With the comparison between Epic and Clover Assistant clarified, let's delve into the history of Epic Systems Corporation. Founded in 1979 by Judith R. Faulkner, Epic started as a small company focused on developing database management systems for healthcare. Initially, it faced several challenges, but these obstacles helped shape its pivotal role in the healthcare industry.
Epic's first product was Chronicles, a clinical database management system designed to handle patient records and clinical data. This foundational product set the stage for the more comprehensive EHR systems Epic would later develop. Notably, Epic adopted a client-server architecture early on, which was advanced for its time. This technology allowed multiple users to access and update patient records simultaneously, significantly improving efficiency and collaboration in healthcare settings.
In its early years, Epic primarily catered to small to mid-sized healthcare organizations, including hospitals and clinics. The potential to streamline operations and improve patient care through better data management attracted these early adopters. Epic's readiness to customize its software to meet the specific needs of each client helped build strong relationships and loyalty among its early customers.
One significant challenge Epic faced was integrating its systems with the existing healthcare infrastructure. Many healthcare providers operated disparate systems that did not easily communicate with each other. Epic addressed this by evolving into one of the leading providers of EHR systems, gradually expanding into almost every healthcare system. As Epic's client base grew, the company had to ensure its systems could scale to handle larger volumes of data and more complex operations.
From the outset, Epic focused on designing systems that were user-friendly and tailored to the workflows of healthcare professionals. This emphasis on usability set it apart from competitors. The company also invested heavily in developing standards for data exchange and interoperability, which later became crucial as the healthcare industry moved towards more integrated and connected systems.
Epic's success stories from early clients built a strong reputation in the healthcare industry, helping to attract new customers. The company formed partnerships with academic medical centers, which drove innovation and provided a platform for testing and refining new features. Epic continuously reinvested in research and development, ensuring its products remained at the cutting edge of technology and met the evolving needs of healthcare providers. The robust customer support system, including extensive training programs for users, was vital for successful implementations and fostering long-term customer relationships.
Epic played a significant role in setting standards for electronic health records and healthcare IT. Its systems helped drive the adoption of standardized practices across the industry. Early implementations of Epic's systems demonstrated significant improvements in operational efficiency, reducing administrative burdens and allowing healthcare providers to focus more on patient care.
Moving forward, the healthcare industry recognizes that the new frontier is based on a strong foundation of social determinants of health and preventative medicine. With that said, it is evident that Epic has built a comprehensive platform that covers various aspects of healthcare management. Starting as merely an EHR company, Epic has added numerous features, setting a precedent that newer entrants like Clover Assistant are following. Clover Assistant, an AI clinical support tool, aims to modernize EHR usage by helping physicians process data with speed and accuracy not possible by a normal human. In the future, just like Epic, Clover Assistant is expected to add more features. The key differentiators moving forward will likely be cost, compliance with evolving standards like CMS-HCC V28, and adaptability to policy changes.
Currently, the estimated cost for implementing Epic is:

• Large Health Systems and Hospitals: Total costs (including initial and ongoing) for large implementations can range from $100 million to $1 billion, depending on the size and complexity of the organization.
• Mid-sized Hospitals: Mid-sized hospitals might spend between $30 million and $50 million.
• Small Hospitals and Private Practices: Smaller hospitals and private practices typically spend significantly less. Through programs like Epic's Community Connect, the costs can be reduced, making it feasible for smaller entities to adopt Epic’s EHR system. Costs for smaller practices might range from $1 million to $5 million. Who the fuck has this kind of money as a private practice?

Andrew mentioned that Clover Assistant (CA) plans to adopt a Software as a Service (SaaS) revenue model, charging on a per member per month basis. This pricing strategy aims to provide a steady, recurring income and is designed to be affordable and scalable, particularly for small businesses. For example, the hypothetical cost could be around $5 per patient per month (I'm pulling these numbers out of my ass because I don't have Clov's data). This pricing structure makes it feasible for private practices to adopt the system and have a positive experience with it. The goal is to replicate the success of systems like Epic by providing a cost-effective and manageable solution for healthcare providers. The person who will be leading this charge will be none other than Peter Kuipers.
Peter Kuipers is a seasoned financial executive with over 25 years of experience in technology leadership. He has held senior financial roles in various prominent companies, including Omnicell, Quantcast Corporation, The Weather Company, Yahoo!, Altera Corporation, General Electric, and Akzo Nobel. Before joining Clov, Peter served as the Executive Vice President and Chief Financial Officer (CFO) at Omnicell, a healthcare technology company focused on medication and supply management solutions. He joined Omnicell in August 2015 and played a crucial role in the company's financial and strategic development. During his tenure at Omnicell, Kuipers contributed significantly to the company's growth, helping to increase its revenue from $485 million to $1.3 billion. His responsibilities extended beyond the traditional CFO role, as he also oversaw global supply chain and manufacturing, information technology, international business, corporate development, and mergers and acquisitions. His efforts were pivotal in transforming Omnicell into a leader in cloud-based platforms and SaaS/Tech-Enabled Services for the healthcare industry. He also oversaw various strategic initiatives, including international business expansion and mergers and acquisitions, contributing to Omnicell's global reach and market leadership.
I became aware of Peter Kuipers and Omnicell because Upsetweekend's company, along with many others, shifted from using Pyxis Oncology to Omnicell. Initially, Pyxis Oncology offered superior tools and services. However, during Peter's tenure at Omnicell, not only did the company offer more cost-effective solutions, but it also began to provide superior services. Securing Peter as a CFO for Clover was quite a coup, and it's impressive that they managed to attract such a seasoned executive to a smaller, less established company. Given his extensive experience and track record, Peter is well-equipped to strategically price and market Clover Assistant (CA). His expertise will likely be pivotal in attracting early adopters and expanding the company's operations. Just look at Omincell's stock price during his tenure.
https://www.tradingview.com/symbols/NASDAQ-OMCL/
At their core, both Clover Assistant (CA) and Epic are tools designed for electronic health record (EHR) management. They facilitate the presentation of data to physicians, enabling them to devise accurate treatment plans. However, there are notable differences between the two systems, primarily driven by their technological foundations and target functionalities.
Clover Assistant: This is a relatively new tool that integrates artificial intelligence (AI) to process EHR data, aiming to simplify and enhance the efficiency of physicians' work. The use of AI allows Clover Assistant to offer advanced data analysis, potentially providing more insightful recommendations and support for clinical decisions.
Epic: As an older and more established EHR system, Epic has a broad user base and is deeply integrated into many healthcare institutions' workflows. While it is built on an older technological framework, it is robust and extensively supports various healthcare operations from patient records management to billing.
The analogy of video game development is apt for comparing these systems. Imagine Epic as a game built on an earlier version of the Unreal Engine, while Clover Assistant is akin to a game developed on Unreal Engine 5. The newer engine (or in this case, the newer AI-driven platform of Clover Assistant) offers enhanced capabilities, such as better processing power and more advanced features, which may not be as optimized in the older system used by Epic.
As Clover Assistant gains traction and proves its efficacy and cost-efficiency, it could start to compete more directly with Epic, especially if it continues to attract positive feedback from early adopters. This competition could push both platforms to continuously innovate and improve, potentially leading to better EHR management tools available to healthcare providers.
In summary, while both tools serve the fundamental purpose of managing health records and aiding treatment planning, their underlying technologies and approaches to handling data greatly influence their capabilities and potential impact on the healthcare industry.
*Update* I forgot to delete the title, but there will not be a part 2. I'm tired ^_^

Thanks in advance to everyone who spends their time reading through my post. I believe my situation is unique and can't find straight answers after hours of research.
Turned 65 in October 2023. Went to apply for Medicare (both Part A and Part B) the first week of January 2024 (during the initial enrollment period). Had a phone interview with the SSA office in March 2024. Medicare finally approved in mid-April 2024 EXCEPT the SSA messed it up and only approved Part B. Visited the SSA again to understand what happened - they said a mistake happened and that my Part A will become available very soon. Part A finally became available in mid- May 2024. But my Medicare card now says the following:
Part A - effective date 10/01/2023 (they used my birth month when in reality I didn't receive part A until May of 2024)
Part B - effective date 02/01/2024 (again, this is misleading as I didn't receive part B until April of 2024)
I recently worked with a local broker to enroll in Part c. I explained what happened and he said it was not an issue to have me enrolled in their plan. I now have Part c and only intend to hold it for 6 months. I am planning to switch to Original Medicare plus Part G + Part D in the fall. My questions are following:

1. The SSA is asking me to pay the Part B premium for the months in which I did NOT have access to medicare. The bill covers February through June when medicare wasn't approved until mid-April. Is this normal??
   
2. Does the trial period right under the guaranteed issue right apply for me when I try to switch to Original Medicare in December 2024? The rule says it only applies if I enrolled in Part C as a 65 year old who first became eligible for Medicare. This sounds like they are referring folks who enrolled in Part C during the initial enrollment period. I obviously couldn't enroll in Part C as early as I wanted because of the SSA messing up my case.
   
3. If the answer to my question #2 is NO, do I have to worry about any premium increase based on the medical underwriting when I try to join Part G in the fall? I am currently healthy with no underlying conditions or medications.
   
4. Do I have to pay the late enrollment penalty for Part D starting next year? The rule says I have to if I went without the drug coverage for 63 days or longer in a row post the initial enrollment period. Even if I wanted to apply for a separate Part D within that 63 day window, I wouldn't have been able to do so because the SSA didn't approve my Part B until mid-April.
   
5. Now that I look into things further, I am realizing that the broker signed me up for Part C during what's called the special enrollment period. He didn't explain anything to me but there is no other way that He was able to get me signed up for Part C outside the initial enrollment period or the annual open enrollment period. No idea what he gave as the reason to the insurance company for me enrolling during the SEP. Is this going to cause any issue down the road as far as switching to Medigap concerns?
   
6. I am planning to stick to Part C for about 6 months starting June 1st. Will the insurance comany allow me to use the dental and vision related benefits up to the annual limit during this period? I am wondering if they typically prorate the annual limit based on the number of months that the beneficiary is enrolled in their plan (when they are enrolled for less than a year).
   

Thanks so much to everyone who can share their perspective/insights on any of the questions.

This is for us normies who don’t want to sift through a hundred youtube videos just to figure out basic information that should be readily available. This guide is designed for people who are new to modding.
This LLO follows Brxsie’s model. For more detailed info on categorization refer to their reddit post.
You can leave out any mod on this list that you don’t want except for USSEP.
Key:
*= my personal notes explaining what a mod does or why I added it
e.g. = extra examples of popular mods that should be placed in that category
Blurb
(skip this section if you want the quick version of this post)
Hi everyone; I’m not a modder nor a PC player, but I was desperate to figure out how to safely load my game with reasonable lore-friendly updates. Every LLO guide I’ve found so far has either been outdated, contradictory to other sources, does not specify which mods fall under what category, is way too vague, or way too specific. The mods I’ve listed here should be easily searchable on the recently updated Xbox creations menu so that any Xbox player can easily copy this list. Originally, I was just recording my LLO for my own personal use, but I figured this could help people who don’t have the time to put in as much research as I have.
If you are brand new to modding, vanilla+ means that you want to stay faithful to the original game as much as possible while upgrading the look of your Skyrim world and making a few convenient tweaks. The least “true to the original game” mod on this list is convenient horses. In my experience so far, this LLO plays just as smoothly as vanilla Skyrim.
Unless I wrote a note next to the mod stating otherwise, all of these mods are independent of one another, except for: divine atmosphere, divine atmosphere snowflake edit, and realistic snowflakes. If you like the ugly fractal snowflakes in divine atmosphere then don’t bother with the other two mods, but if not, you need the vanilla snowflake edit and the snowflake texture mod to go together. Therefore, you can leave out any mod on this list that you don’t want except for USSEP), and the game will function normally.
To customize settings of mods while in-game, go to magic -> powers. “Equip” the mod you want to change and press RB once out of the menu. This is relevant to divine atmospheres, divine interiors, flute finder, convenient horses, and some dialogue mods.
Most mods on this list can be downloaded or deleted safely while playing a pre-existing save file. Deleting mods become problematic when you have already added and interacted with a custom item to the game and then delete the mod that supported the item. When testing new mods, I suggest only adding a few at a time so that you know what to delete if you encounter any issues.
If you are reading this on a laptop or PC, you can press command/control F to search for keywords of the mods you want to install to find where they belong in the LLO.
Personally, my favorite mods that I’ve added to the game are the dialogue mods and the texture mods. They make Skyrim feel like a real world with real people living in it and I would highly suggest using some or all of them. I’d also love to hear everyone’s suggestions on proposed edits to this load order. Please let me know if you are aware of any conflicting mods or bugs, or if I have made any mistakes in my layperson's explanation of techy stuff. Unsure if this is relevant information, but I’m located in the USA.
Extra notes:
What the heck is a leveled list? A leveled list is a change in the code that makes changes to certain values. Such as changing how much gold a character has or how powerful an enemy is.
And what exactly is an area edit? An area edit is any mod that adds or significantly changes a location in the game. This includes adding extra trees, adding extra smelters, or adding custom player homes that do not exist in vanilla, among other things.
Why are there all of these categories and why is it so complicated? LLO sorts mods so that the game can load the most important files first. When LLO is not followed, the game will inevitably crash. Categories allow us to sort mods into the LLO based on how they interact with the game's code. People sometimes disagree on what order to put the categories in, but all LLO templates use the same basic categories.
I do not use immersive citizens AI because multiple people have reported bugs. Other people have no issues with it, but I prefer to stay on the safe side.
Remember to lower your in-game brightness, especially when you are using divine interiors and divine atmospheres. If the brightness is all the way up, things will start to glow. You will have to use torches in locations with zero light, such as corners in caves. This adds a realistic feel to the game. If you give a torch to your follower, they will automatically use it in in low-light conditions. I switch between default/glimmegrim/vivid depending on where I am and how colorful I want things to be. The game may look darker overall as you can see in the screenshots, but this is more true to how lighting works in the real world.
Skyrim 101 tip: When you ditch items to reduce your carry weight, store them somewhere (such as a dead body or a chest) instead of dropping them on the ground. If you drop items all over your game it will eventually lag.
When creating a new character, keep in mind that once you start playing, you might change the lighting and make the colors more saturated. For example: I accidentally gave myself yellow hair instead of natural blonde because I forgot about lighting and atmosphere changes. This is another reason to install the vanity mirror mod, which allows you to change your character mid-game.
Storage space: all of the mods I have listed here take up approximately 4.36GB.
I suggest keeping a note of your LLO on your phone so that you can easily categorize mods you want to add the future.
Sometimes LLO will not save, so I recommend double-checking that everything landed in the right spot or backing up your LLO to bethesda before exiting the LLO menu.
Sometimes you need to restart your game to enable a newly installed mod.
How to delete a complex mod without causing problems: disable the mod, hard reset (hold power button for 10 secs or unplug the console), uninstall the mod, hard reset.
I’ve noticed a bug where I cannot tell my follower (Lydia) to do anything in “command mode”. I don’t know what’s causing this- it seems like a dialogue issue but I rarely use the command mode feature anyway so it’s small enough for me to ignore for now. Let me know if you find out what's causing this!
*Blurb over\*
Master Files

• Unofficial skyrim special edition patch (USSEP) *almost every source says that this must be installed. It fixes core bugs in the game that developers have not bothered to update themselves

Foundations: Lots of game changes (e.g. cheat room, encounters overhaul, etc.)

• Convenient horses *allows you to summon your horse from anywhere, store items on your horse, give followers horses, etc.

Dialogue Overhauls

• Guard dialogue overhaul
• Follower commentary overhaul
• Misc dialogue edits and more
• Relationship dialogue overhaul

Fonts/UI (excluding map mods)

• Font replacer - eadui

Alterations to vanilla quests
Any craftable item

• Vanity Mirror *this is to fix the makeup bug where your lips are off center when you create your character. I have not tested this yet, but apparently if you open up the customization menu with the vanity mirror then the makeup will work again. Cheat room also works for the makeup issue, but I didn’t want so many extra cheats in my game just to fix this one ridiculous bug
• Get no more dead followers *functionally turns off friendly fire for followers

Game mechanic changes: races, perks, vampires, adoptions, etc.

• Flute finder - a skyrim gps tracker for npcs *this is because I always lost my followers in vanilla and it was super annoying
• Multiple Marriages *haven’t tested this yet so cannot vouch for its effectiveness
• Auto unequip ammo *unequips arrows when you uneauip your bow so that you’re not always walking around with a sheath on your back

Level Progression (e.g. Clever leveling)
Perk overhauls/changes
Magic additions and modifications

• Master of Destruction (xb1) *adds new high level spells that target specific characters instead of killing everyone in the area
• Mining spell *I hate carrying a stupid pickaxe everywhere, so this spell mines for you. I haven't tested this mod yet though

Leveled list changes (e.g. rebalanced leveled lists)

• Better gold *adds slightly more gold when looting specific high level enemies
• Master trader 1x *this replenishes merchant gold each time you speak to them

NPC Leveled list (e.g. organized bandits in skyrim)
Any audio

• Chapter II - Jeremy Soule inspired music *Jeremy Soule composed the original game soundtrack. This adds a few hours of similar sounding music that blend in with the game

Weather and Atmosphere (put weather up ^ in LLO if the mod is just a weather mod and not an atmosphere mod)

• Divine Atmosphere: Aetherius *my favorite setting is vivid or grim
• Divine Atmosphere: Aetherius vanilla snowflakes option
• Ultra realistic snow flakes (custom snowflake texture) *if searching for this mod, search for “snow flakes” instead of “snowflakes”

Grass
Grass Fixes
Skin/skeleton physics and appearance changes

• pristine vanilla movement
• XP32 maximum skeleton special edition plus *changes some physics for smoother movement

Animation mods

• 360 walk and run *at first I put this in the gameplay mechanics category, but it did not work there. In the animation category it works as intended

Meshes and Textures
*The mods I’ve listed in this section should cover almost every visual in the game. Nothing is too drastic of a style change and fits right in to the game’s vibe.

• Wear multiple rings *this mod is more useful for stacking enchantments rather than pure aesthetics. Not necessary if you want a more vanilla game
• Divine texture pack - architecture
• Dark ages: fantasy dungeons
• Dark ages: dragon Textures
• Divine creatures texture pack
• Omen armors weapons and clothing *I highly recommend this one!
• Fluffy snow
• Dark ages - landscapes
• Divine skins and bodies for men *misleading name: this is actually unisex. Make sure this goes above^ divine people otherwise you might experience an occasional face glitch. This must be used along with divine people in order to work correctly
• Granite mountains *another mod I highly recommend
• Dark Ages: Trees of the north
• Divine SMIM *Static mesh improvement mod. SMIM mods redesign lots of small items in the game
• Lucidaps’ high poly project v5.x *This corrects blocky items to make things look more realistic. It cooperates with the SMIM to create beautifully textured and realistic item designs, such as the ridiculously good looking head of cabbage

Non-combat NPC AI
Immersion (e.g. immersive patrols, landlord etc.) - can be tricky to categorize
Anything that changes a character’s/npc face or hair (e.g natural eyes)

• Divine people of skyrim: celestial *For more vanilla/gritty looking people, try the dark ages texture pack. Both divine people and dark ages people mods must be paired with its corresponding skins mod, otherwise the textures will get cut off at the neck due to mismatching colors

Interior lighting changes

• Divine interiors shadows and light *my favorite setting is glimmer or default if the game looks too oversaturated because of the lighting. I highly recommend this mod, it makes the game feel much richer

Interior decorating changes
Lightweight multiple area edits

• Unique bridges of skyrim
• Divine forests
• Get more smelters *haven’t tested this extensively but I don’t foresee any issues since it doesn’t interfere with anything big

Single area edits like player homes
Multiple area edits (e.g. divine cities)
*I do not recommend divine cities or divine villages because it can be buggy. One time Lydia got permanently stuck in a modded tavern and I had to backtrack through an hour of progress to get her back out
Adding individual unique objects

• Auto Harvest Ring *because I like alchemy but hate picking flowers. Equipping this ring automatically harvests ingredients in range. Just remember to ditch the cabbages to reduce your carry weight

Combat changes, combat AI (e.g. realistic damage, wildcat)

• Dark ages: immersive dragon ai
• Better stealth ai for followers *followers will not start fighting automatically while you are trying to be sneaky

Unique follower mods (e.g. Sofia)
Mods that add new quests (mods that alter vanilla quests do not go here)

• More to say 9.0.2 *this dialogue mod is here because it adds new quests. The other dialogue mods I’ve added are less consequential and simply add a little immersion. I’m unsure if this conflicts with the other dialogue mods

Map mods

• A quality world map - vivid with stone roads *map mods use up VRAM and many people recommend against using them. I’m not a tech person, so forgive me if this isn’t accurate, but VRAM is similar to regular RAM. This means you can reset VRAM if you hard restart your console. If you are playing with tons of heavyweight mods all the time then maybe you should skip map mods, however in this LLO I have not noticed any FPS changes at all and personally, it’s worth it to me to hard restart the console every once in a while so that I can keep this mod. Source for the tech info (posted Oct. 2023) - https://www.xboxforums.com/threads/ram-and-vram.24007/
• Pastel map markers *Can you tell I like organizing? Color coding the map makes it more readable and gives locations a touch more personality

Mods that specify bottom LO

disclaimecw: this has to do with US health insurance and all that entails
I have a high-deductible plan, which means it covers 0% of my medical costs up to my deductible, then 90% of the remainder up to my out-of-pocket max, which all resets yearly. Some doctors and clinics will bill insurance first, then bill you for whatever isn’t covered, but many will charge you upfront for what they estimate it will be, and then (supposedly) refund you if it turns out they overcharged you.
Well, i have some conditions that basically mean I’ve hit my out-of-pocket max for the last few years and expect to continue to do so for the foreseeable future, so each year i save up the full amount for the next year by December and start January with a fully prefunded category (yes, this did involve some finagling when I first set it up). So this year, I hit May and find I’m now underfunded on my medical deductible category— obviously something somewhere is wrong.
Turned out, I hit my deductible in late January (reminder, this means we’re now in the 90% covered zone instead of the 0% covered zone). However, there were several appointments that charged me 100% upfront but then were covered at 90% by the time insurance processed them a month later, to the tune of around $400 😱. I’m sure you’ll all be shocked to hear that i had not yet been refunded any of that overpayment a few months later.
BUT! Because i had all of the transactions in YNAB and categorized, i was able to identify the precise dates of the appointments, know exactly what i had paid, grab the corresponding insurance documentation, and request and receive refunds of all of it (from two different practices) in less than a week! By far the most straightforward experience with health insurance shenanigans I’ve ever had (once had a single billing / insurance issue that literally took 4+months).
Anyway, if this had happened pre-YNAB I likely would not have even noticed, and if i had it’s even odds that I’d have managed to sort through insurance documentation, calendar events, and credit card statements enough to track down exactly what happened when.
🏆!

Swoop has shared the following message on her YouTube page's community tab:
"Finally Opening Up" (link)

TW: DV, illness, MH Tldr: Recent physical as\ault and medical trauma*
Hey friends. This is the most difficult thing I’ve ever shared, but dealing with this privately for so long, while trying to put on a “brave” face has been destroying me, and fear of oversharing has left me feeling painfully disconnected from all of you, the community whom I cherish so deeply. But everything has come to a head recently, when I was violently physically assaulted, battered, and threatened by a person who has abused me in the past.
Most of you know that I am a survivor of r*pe and ab*se as a child and adult, being slowly on the journey of trying to process both publicly and privately. I’m imperfect in this journey, but trying. In addition, for most of my life, I have been living with chronic illness, spinal injuries, and chronic pain from trauma as well as fibromyalgia. And for the past 2+ years I have been living in a nightmare.
I have been living with widespread partial and total limb numbness, tingling, and electric shocks in both my arms, hands, legs, and feet, as well as deep spasms. At times it’s excruciating and would intensify without warning. It has left me with extended periods where I can’t feel parts of my body at all, while other times my body is on fire. A team of doctors had put on the “MS Protocol” meaning, my doctor, who has Multiple Sclerosis, has been evaluating me for MS. At this time I have not been officially diagnosed, while being told they cannot rule it out, and to expect a long process.
In addition, after endless MRIs and painful procedures, my doctor found white spots within my spine. I was told they have only seen this once before, where what appeared to be lesions were tumors, and they have me regularly testing for cancer, indefinitely. I do not have answers yet. This has caused a depression and level of anxiety that has felt too much to handle, so I’ve buried it deep and kept it private, even from many close to me.
On top of this, I was recently physically battered by a person who has abused me previously. I was trying to escape being cornered in a room when I was attacked from behind and tried to defend myself but it wasn’t enough. As a result, I am struggling with an immense amount of physical trauma, and mentally I’m just a shell of myself. I’m so embarrassed that after telling so many “it’s not your fault” - I still can’t tell myself.
I am neurodivergent, and get stuck in “brain loops” where I spiral into self harm and feelings of uncontrollable dread and worthlessness. I’ve tried my best to combat the loops by throwing myself in my work, even when I could hardly feel my own hands, and am left feeling massive guilt if my work feels incomplete, sloppy, out of touch or disconnected. I tried taking on projects that became too triggering, and had to walk away, riddled with shame that I might be letting anyone down for not covering a story. Everything about what I’m going through has shifted my perception of stories and how I cover them, trying to introduce more perspectives (you may or may not have noticed) and I hope to continue to develop and find more eloquent and inclusive ways to do so. Petty has always been my coping mechanism to mask my pain, but now I wish to focus more on perspective.
I have sat down countless times to film a video about my trauma, and may try to post one, the way I used to with our community. I have been keeping things private out of fear that people would think I’m “trauma dumping” or asking for sympathy. I’ve realized: that is an irrational fear and trauma response, because, like so many other survivors, I have been conditioned to feel guilty for sharing, or like I’m just looking for attention. If that’s how someone interprets me, that’s ok. But holding this has only made the darkness deeper. I no longer want to be an example of suffering in silence, in hopes someone else might feel seen.
I am also working to take some time away to find healing. I have a number of previous videos already in production from a while ago, and contractual obligations I can’t cancel, so I’ll likely have someone upload them for me, so that I can try to breathe for once, and you’re not without the content you generously spend your time with. I don’t know how much time I will or won’t take, but it’s a start. Thank you for your openness to hearing my story. I’m broken, but still here.
I feel like I’ve been fighting for my life, and this is not a battle I want to lose.
Love you all, Swoop

This thread is for all SPM related discussions, may it be results, universities, courses etc. The intention is to help school leavers talk about the SPM in one central spot on the subreddit.
For both public school and private SPM candidates, you can check your results online at myresultspm.moe.gov.my or retrieve via SMS by sending SPM < space> IC number Examination number (Angka giliran) to 15888. Example: SPM 000527031234 WY189A123
Mental health resources

• If you are feeling intense emotional distress and need someone to talk to, please call (a) the Befrienders Suicide Hotline at +603-79568145, (b) Talian Kasih at 15999 any time 24/7, or (c) the Buddy Bear Childline at 1800-18-BEAR (2327) if you’re under 18
• More mental health resources

Links to relevant post-SPM posts

• Why aren't there many SPM graduates enrolling in government politeknik or TVET?
• A Discussion on Should You Take a Degree
• Almost done with STPM and here's my experience if anyone is interested in it
• I feel completely hopeless after secondary school
• It's been almost 2 years since I got straight As for SPM
• More posts

For young Nyets who are interested in TVET (Pendidikan Teknikal Dan Latihan Vokasional):

• Apply to TVET courses (Pendidikan dan Latihan Teknikal dan Vokasional) offered by 7 different ministries and over 15,000 spots through https://mohon.tvet.gov.my/
• Skills For Life programme by Youth and Sports Ministry that offers basic skills training to local youth through short-term courses. Registration link
• Apply to SKM (Sijil Kemahiran Malaysia) courses. Check out Group SKM on Facebook for opportunities
• Program Latihan Kompetensi Kemahiran Belia - sponsored fully by CIDB (Construction Industry Development Board) in 6 campuses; Kedah, KL, Johor, Terengganu, Sabah and Sarawak

Education Fair Dates

• TheStar Education Fair in Penang, KL and Putrajaya
• StudyMalaysia Education Fair in Sabah and Sarawak - (22-23 June and 29-30 June)
• SureWorks Education and Further Studies Fair in KL and Johor
• Jelajah Jom Masuk U

Free courses to explore new/existing interest:

• National Training Week (NTW) 2024 from 24 – 30 June, when up to 150,000 free training courses covering essential life skills, future readiness, creativity, financial literacy, and sustainable development
• e-Latih - free e-Learning platform for Malaysians with over 1800+ courses
• Free digital tech training by MDEC
• 42KL - Learn to code for free (F2F classes)
• FreeCodeCamp - Learn to code for free
• EdX (choose free audit track)
• Coursera

Volunteering/internship after SPM:

• Kechara Soup Kitchen [Link]
• SPCA Selangor Link
• MNS (Persatuan Pencinta Alam Malaysia) [Link]
• WWF Malaysia Link
• MyKasih Link
• Free Tree Society Link
• AIESEC Link

General Scholarship info links

• Telegram channel for a list of scholarships, constantly updated
• Telegram channel for any questions regarding UPU, matriculation, STPM,asasi
• Afterschool.my
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• FB Group: Biasiswa Dalam dan Luar Negara (for undergraduates, Masters/Postgrad and PhD)

Fully Sponsored Overseas Scholarships

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The moderation team will be removing any SPM-related posts - please share your advice threads, rants, and memes on , on the Daily Discussion Thread, or in this post.

I was NEVER going to post here, but obviously I'm "judas" with tits. I was never going to engage with the drama anymore that is fucking "TRISH" Jesus fuck. I thought I had found my people!! You see(and by all means ,I'm not looking for a pity party) my life is fucking hard! My child is fighting for his life, we are medical refugees to try alt meds for my son, I have basically no family left(they don't approve of anything I do, all Westboro level Baptist cult) I live in remotely, I'm 24/7 unpaid caregiver (fighting for paid caregiver) and literally have nobody. I was vulnerable and thought I had made life long friends. The other mods, I viewed them as sisters but they stabbed me in the back, I stood up for them, I genuinely let myself care about them and boom!! Trish lied and lied and lied on me ,behind my back then played the victim. She is always the poor victim, guess what , I'm a fucking victim too. You get poor older ladies to cashapp you 1000s of dollars and gifts and clothes and make up and my veteran(combat vet usmc) family can't even pay our power bill most months trying to keep my son alive, you know "snoop Dogg oil" isn't cheap and cash only, so get piss ass mad I posted here, get worried ill share your screenshots and secrets, or walk the fuck away and leave me alone. You showed your true manipulation tactics today and I won't be apart. These "evil" reddit ppl have shown more intellectual kindness and honesty than you and I've only spoken to them TODAY. No, I won't ever regret walking away from that shit show and Trish, you are a bold face fucking liar and you know why. Lies after lives and then cover it with lies. So, eat that. Also, I bet you smell like rotten gouda. 😏 Sorry, was invited to rant here and needed to get that off my chest. I know they will all read it, but unlike you motherfuckers, I don't lie, and I don't back stab. I will however stick around here for a bit I think and test the reddit world waters.. can't be hurt worse than I was. Thanks reddit ppl for allowing me to vent, I was a complete idiot to ever get entangled in that shitshow.

I’m trying to determine if an orthopedic office is billing me correctly. My daughter broke her wrist out of state. We went to the ED and she was x rayed and sedated for realignment and casting. Discharged with instructions to follow up with an orthopedist local to us.
A week later we went to a local orthopedic clinic. They did X-rays through her cast, told us it looked good, and wanted to see her back in 3 weeks for more x-rays.
We received the claims for that first visit and the charges were over $2500. The clinic submitted CPT 25600, no modifiers. As I understand it, this code covers both the initial fracture treatment (“surgery”) and post operative care. A doctor who is only providing follow up/post operative care should submit the code with the modifier -55 which is billed at 20% or the full code cost. I spoke to the clinic but they gave me an explanation that didn’t make sense (basically said her ED provider wasn’t part of their clinic so they bill the full code). Insurance company can’t/won’t do anything because the ER billed her care as general emergency codes and not specific treatment codes, so there’s no evidence on their end we have been double-billed (this is also going toward our deductible so the insurance doesn’t have any real skin in the game). I submitted a formal request to review the billing code to the clinic through their online portal, but haven’t gotten a response yet.
So my question is two-fold: 1. Am I right in thinking the CPT code was billed incorrectly and we were overcharged? 2. What are my options to escalate/get a third party review if the clinic refuses to change the codes?

hello, i'm turning 14 this summer and starting to stress immensely about my future and getting a job and attempting to stay somewhere at-least somewhat comfortable once i'm an adult, and having two jobs seems to be what i may do, but i'm curious about what that's like.
a few questions i have are: what are your hours/how does your day go? how do you handle taxes with the two jobs? are most jobs okay with you having a second or is it rather difficult to find somewhere okay with it? how do you handle if one of your jobs wants overtime? if you're sort of young with 2 jobs, is it possible to maybe buy a small house (1-2 bedrooms) soon w/ how much you're earning?
a few ideas i've had for my jobs are medical billing/coding, just managing medical records, being a front office representative/medical receptionist, then also doing amazon flex, waitressing, and usps. my options are after either very minimal research or my mother's encouragement, i'm planning to do my research on those jobs this summer. i'm curious if these jobs are flexible and good when working two jobs. additionally, i'd love to start a band but that'd be pretty hard so unless somehow its successful it couldn't take much of my time as an adult and i understand.
also, if this is important, my parents do want me out of the house at 18, and i'm in arizona. so yeah, if anybody can answer my questions i would greatly appreciate it! sorry if i don't make much sense or if i'm in the wrong place, i'm a bit tired and confused with reddit. again, thank you.

I work in a medical scrub store, so I have to wear scrubs; long bottoms and socks and shoes. They are very strict with the dress code. For a few weeks now the AC has not been turning on at all. The temperature only fluctuates with the temperature outside. Even if the thermostat is set to 68 in the morning, it slowly climbs up to 75 by 3pm (when I usually clock in) and it is very difficult to work and breathe for me. By the end of the shift around 7-8 it gets as high as 78. I’ve asked my manager a few times to have someone come fix it, but she says the company gets billed whenever they call someone to look at it and she’d rather wait for when the AC company comes to do their routinely checks—or wait for the regional manager or owner to worry about it when one of them come down in mid June (which I have no idea how likely it will be that they will actually come to this location by then).
I understand it costs the company money to do things like that, but it is directly affecting my asthma, and making it hard to work in here for my coworkers as well. Even the customers have started making comments on the heat in here. We have a small fan we can sit in front of behind the counter, but it still leaves me huffing and puffing (even after taking my rescue inhaler) if I have to help a customer or do something across the store. I now get light headed and feel like I’m going to pass out at work quite often, and there is no sense of relief since it is also just as hot outside.
However, I don’t want to create contention between my manager and I, since I have already brought it up to her quite a few times already, and she seems pretty adamant with her decision. But it’s really miserable at work and I don’t want to have an actual asthma attack or pass out. Another issue is, I am really sensitive to my albuterol (my rescue inhaler, I take QVAR twice daily and a singulair (montelukast) pill before bed), so my heart starts racing and I get incredibly shaky after taking it. My asthma diagnosis is also pretty new and is not very well managed right now, I’m still trying to figure out how to effectively treat it. In the end, either way, I am physically uncomfortable and there isn’t much I can do at this point—at least I don’t think. Thoughts?

A year and a half ago, I was in a car accident, I was 17 at the time and the passenger in the car. me and the driver were rear-ended on Main Street of our hometown. at the time there were no clear injuries so we decided not to go to the hospital, we went to work that day but the next day we were both feeling it and didn't feel good. so we decided to go to the ER and there I was diagnosed with whiplash and muscle strains. now obviously, I'm 17, I don't know anything about insurance or car accidents or claims so I left it be. my friend who was in the car accident didn't tell me a lot about the process he was going through so I have no clue as to what needed to happen. I was never spoken to by an adjuster or anybody from anyone's insurance and so I just thought that was the end of it. I had falsely assumed they would take care of my medical bill the way that they were taking care of my friends, My friend had a case and claim numbers and representative or lawyer, whatever it was, I was just glad I didn't have to go through that too. he told me about the settlement and what was going on I was like that's amazing, after how that went you definitely deserve the settlement this is been taking up so much of your life and you've been in immense pain. so my friend got all taken care of and I was still receiving medical bills, just before he had settled I told him I was receiving medical bills for this visit he said he would bring it up with his lawyer and he tried to at least once but nothing ever happened. I have called the hospital that we went to dozens of times to talk to them about this bill and tell them it wasn't my fault this should not be coming towards me and they would always say oh okay we’ll put down a note. apparently the note was never enough so one day I cracked down and I called them and I got insurance information and I got the police report I contacted both insurances, the hospital again both of the billing numbers and God knows what else. at the beginning of this year I thought it was solved because that's when I got in contact with everyone and they said will talk to the hospital we'll figure it out, soon after I received a packet from one of the insurances saying this is what we will cover, what they were willing to cover was $160 out of an almost $1,000 charge, but I had stopped receiving bills so I was like okay maybe this is taken care of because I'm barely 19,Reading the packet was a nightmare and I couldn't tell if they were saying you have to pay for the rest of this or if they were saying the hospital has to settle for $160 so I left it be. about a week ago I received another bill saying insurance has covered 160 now you have to pay for the rest. so of course I'm upset I'm distressed I barely work 25 hours a week on a good week. There's been a lot more going on with it than what is in here but I have no clue what to do, I called my father to get him involved because he's made it clear that he's willing to fight for me and help me through this but they are not receiving him any better than they received me, if anything it feels worse because he is taking the aggressive route and making it clear he has no problem with starting a lawsuit but we still have received no communication at all. this entire thing has been a terrible headache extremely distressing and upsetting. every time I get a bill not only is the amount of money overwhelming for someone who has basically nothing but the car accident itself was already really bad and every time I receive a bill the car accident is brought to the Forefront of my mind and I can just see us getting hit the car moving across the road the airbags hitting my head and getting hurt. I don't know what to do so if you have any advice please leave it in the comments. thank you.

This is a rather unique situation. Im in the middle of a chapter 13. Converted to a 13 in march. My confirmation will be in July.
In 2019 I left my DOD civilian job. Due to a technicality, I could not terminate my coverage with my insurance. Someone somewhere in HR needed to send a form to the insurance provider letting them know to terminate my coverage. So the insurance carrier kept paying bills even after years of telling them not to pay. They knew what was going on. It was out of their hands. Out of mine. Trust me it's a cluster***k.
Fast forward to 2023, they finally terminate my coverage. They have guaranteed me they will not come after me for the overpayments based on the fact that I did everything I could to tell them not to pay the bills. I even told my medical providers not to bill them. To bill my current insurance. The insurance even sent me a letter I am not liable for the overpayments. That's great!
So now they're going after the providers to pay them back. im being copied on the letters to my medical providers demanding payment. So now that has me concerned, because providers can also turn around and ask me to pay them back.
So assuming the medical providers want me to pay them, can the debts be added to my case? I know the debt did not exist pre-filing, but the service dates are all before the filing date.
TLDR: Can medical overpayments from service dates before filing bankruptcy be added to my chapter 13 case since the debt did not technically exist when I filed?