CLAIM...or The Impossible Hurdle of State Disability

written on August 6, 2014

I had to spend a couple of hours at the disability office today (well, more like 90 minutes in total).  Turns out my disability claim still hasn’t been approved (or processed for that matter).  I check my account online multiple times every day and it’s been saying “Pending Processing” for three weeks now.  Finally I decided to take the time to go in person and find out what’s happening.

Now, let’s give you some backstory (especially if you haven’t read my earlier posts about filing the claim and debating whether or not I should go back to work)... 

I went to the ER with renal failure on Sunday May 18.  I was in the hospital for 4 days, so I returned home on Thursday May 22.  I decided to not go back to work on Friday the 23rd.  Then on Tuesday the 27th, my daughter was sick and I could not go back to work – I had to stay at home to take care of her.  Wednesday May 28th I went back to work and worked through that Friday (May 30).  Unfortunately it was a production week for us, so I had to work 12 hour days on Thursday and Friday.  Friday night I worked until about 12:30 am and I felt horrible.  All day I felt like I was getting the flu – by the time I got home I was done for. 

On Saturday my blood pressure was high, I felt like I had the flu and there was a headache coming on.  We went back to the ER where the doctors and nurses discovered my white blood cell count was exceptionally low (normal is around 12, I think – mine was just under 4).  And I had some kind of nasty virus.  So two more days in the ER with antibiotics being pumped in through an IV and a shot of nupogen to replace my white blood cells and on Monday I went home.

I knew then that going back to work would be a total crap shoot.  In the ensuing two months, my biggest issue with returning to work has been energy levels.  On days I dialyze, I tend to be very lethargic and fatigued.  This is finally starting to get better for me, but on days when I have a bad migraine, I’m right back to the fatigue and lethargy.  I decided the first week of June to just stay on disability until the fall, when we hoped I would have a kidney transplant.  So I filled out the claim form on June 3, online, then went and told my doctor to do the same. 

Two weeks later I get a form in the mail from California’s EDD (Employee Development Department)  - it was my doctor’s form.  Apparently he had never filled out his form online.  So I went over to his office and dropped off the form and he said he had filled out the online form three times but had never received confirmation that it was sent.  I asked him to just fill out the paper form and mail it – he said he would do it that day.  I left, thinking okay, in a few weeks I’ll start getting some money from the state (my doctor assured me that End-Stage Renal Disease is a slam-dunk for medical disability claims).

Two weeks later and the website still says my claim is pending the physician form.  I ask my doctor, he says he filled it out and mailed it the day I gave it to him.  Another week goes by, still nothing.  So I decided to go to the disability office in person (the phone line for the EDD is always over-loaded and they just hang up on you whenever you call).  I wait a little over 2 hours to get to the staff person and they tell me that they’ve still never received the claim form from my physician.  I call my doctor’s office and ask when they mailed the form – they admit that they did it two days prior to me calling (I called on a Thursday and they said it was mailed on Tuesday of that week).

Now it’s been 5 weeks since I submitted my initial claim.  A week later the website changed to say that they’ve received his form and now it’s “pending processing.” 

Now three weeks later and it’s still pending processing.  So I went in again this morning to figure out if they’re missing something, if my doctor forgot to fill something out, or if there’s something I can do to speed up the process (keep in mind, the EDD has not sent me any notice of anything wrong – they’ve not tried to contact me in any way).  The wait was only about 45 minutes this morning, thankfully.  When I got up to the window, the woman helping me said they still hadn’t received the doctor’s form.  Not what I wanted to hear.

Then she looked somewhere else in her computer and apologized – they did have the form.  Whew!  Then she said “oh my god” and shook her head.  She looked at me – “he didn’t sign the form.”

Well all sorts of expletives floated through my head at that point.  I stood there in shock for a couple of seconds – the f-word was really at the fore-front of most of the responses coming to mind.  I think I mumbled something like “oh wow” or something else generic and vague like that.

She was kind enough to print out the form and she said if I could get him to sign it, I could return the form to her and that would help expedite things.

I took the form, walked back to my car, drove to his office and asked his receptionist if he could please sign the form for me and I would wait for it.  Of course she said no, I couldn’t wait.  He might not be able to get to it until later today.  At this point, I was very upset.  It’s been eight weeks since I submitted my claim, and the delay this entire time has been because of my doctor.  I calmly explained to the receptionist that my doctor’s repeated mistakes in dealing with my disability claim has put my wife and I in a financial hardship position because we’ve been expecting money to come in from the state to help us live.  She looked through the form, noticed that I was only asking for his signature, and said she would see what she could do.

I sat down, waited about 15 minutes, and she handed it to me and thanked me for being patient.  I managed to get the form over to the disability office before I had to come in to dialysis (whew again!).  Now it’s up to the state to determine whether or not they’ll approve the claim.

I think this is the last straw with my doctor though.  I’ve been having issues with his prescribing and diagnosing lately (that has come up in several of my prior posts).  I don’t feel like he’s taking my symptoms seriously.  I don’t feel like he’s taking the time to really try to take care of me.  I feel like I’ve become a challenge patient for him – someone who doesn’t accept the status quo.  But his inability to file my disability claim paperwork in a timely fashion, and his oversight in not signing the form (his office also didn’t keep a copy of it on file – why would you not keep a copy of a government form on file?) has really pushed me over the edge.  I have lost most of my ability to trust him because of all of this.  And goodness knows, if you can’t trust the person who’s supposed to be in charge of your health, what should you do? 

Find someone else, I think.  And I better do it fast – the transplant surgery will be here before I know it.  I’ll need to make sure that whoever is doing my follow-up care has my best interests in mind.  But it’s also a pain, because changing doctors means I also have to change dialysis centers – on the plus side, I might be able to find one closer to home (the one I’m currently in is about 7 miles from home.  I know of one that’s less than two miles from our house).

We’ll see how all of this plays out.  The biggest concern for me right now is getting that claim approved, so maybe I can go back to getting some money to supplement our rapidly shrinking savings account.