Facing the Snake Pit
Lisa Kantor fights insurance companies who deny treatment coverage for eating disorders
Published in 2019 Southern California Super Lawyers magazine on January 30, 2019
Lisa Kantor fell into representing people with eating disorders mostly by accident.
In 2006, the employee benefits and appellate attorney began representing a UC Santa Barbara student who returned home from her first semester suffering from an eating disorder. Treatment proved challenging: Her psychiatrist wanted to medicate her; group therapy sessions were often empty; and the insurance provider declined to cover treatment. To pay for it all, her parents had to mortgage their home.
In trying to get the insurance reimbursement for the family, Kantor lost the case. “And I don’t like losing,” she says.
She quickly filed an appeal with the 9th Circuit.
“The first question I got from the panel was ‘How is she doing?’” Kantor says. Decades later, she still sounds surprised by the moment. A judge wondering about a client’s health? Even better: In an unpublished decision, that three-judge panel found for Kantor’s client, and chided the insurance company for its denial of coverage.
The more Kantor researched, the more she realized how much attorneys were needed in the eating-disorder area.
“Insurance companies were running roughshod because people were so ill and didn’t have the ability to fight back,” she says.
That’s why, 20 years ago, Kantor and her husband, Glenn, founded Kantor & Kantor, where they focus on insurance and disability claims. Kantor describes the shift in her practice as a win-win. The underrepresented got a strong advocate and she found the work fulfilling.
Since then, she’s not only watched the field develop, she’s contributed to those developments. Mental health parity laws have provided important guideposts, and judicial decisions in Kantor’s cases have been helpful in enforcing those laws. Two cases she was involved with stand out: Harlick v. Blue Shield of California and Rea v. Blue Shield of California. “They were the first cases to interpret the California Mental Health Parity Act and what the scope of it was,” Kantor says.
But Kantor still finds a stigma attached to eating disorders.
“We still face the issue of: ‘Why don’t you just eat? Isn’t this a privileged white woman’s disease?’ … I still get pleadings from defense lawyers who describe treatment facilities as spas.”
Many people, she adds, think it’s a choice and not a true disease, whereas Kantor, and the medical community, have found the opposite. She says disorders are in large part a coping mechanism for some larger issue—often, she’s found, patients have suffered sexual or physical abuse. “The disorder is telling the patient, ‘Don’t listen to anybody else; listen to me.’” Patients, she says, wind up thinking: “The eating disorder says it will protect me and nobody else can.”
Merely seeking treatment is frightening enough. “Imagine if you were afraid of snakes,” Kantor says, “and something was protecting you from snakes, and the rest of the world was telling you to walk into a snake pit.” The first time one client was taken home—within a half hour of leaving medical supervision—she tried to strangle herself with the car seat belt.
“Eating disorders are akin to cancer,” Kantor says. “They go into remission and flare up again. And just like cancer, you can’t predict who will relapse and who won’t.”
Meanwhile, she says, “insurance companies have this attitude that they don’t have to bring [an eating disorder] patient to full recovery. They can get them 85 percent or 90 percent of the way there.” Kantor sighs. “Imagine if we said that for people with cancer.”
In Her Own Words
It’s interesting how life works. On this parallel track [at the time of my first eating-disorder case], my niece came to live with us and it turned out she had an eating disorder. She was living with us and working with us and struggling. I didn’t know that much at the time; I’ve learned on the job how to help her. It became personal along the way.
The end of the story is ironic and beautiful. She fell in love with one of my lawyers and they got married. She had twins and then another baby. She’s in full recovery and happy. –Lisa Kantor