...And It Only Took Them Eleven Months!

Some long running drama finally reached an end yesterday.

First, a little background for those not following my trials and tribulations:
On June 1, 2006 I applied for Disability through the Railroad Retirement Board (hereafter "RRB"), since I worked for Amtrak I was not eligible for Social Security Disability, or ANY SSI programs for that matter.

In March of 2007 my Disability was finally granted (after many RRB-scheduled doctor appointments, psychologists, and tons of paperwork), but instead of my original application for a Disability Onset Date of June 1, 2005 (which was 1 year previous to my filing, that's as far back as I could claim although I have been unable to work since January of 2003).

This gave me a monthly Annuity starting in December 2006 (since there is a 5 month "waiting period" from the Onset Date), and I wouldn't receive Medicare coverage for 30 months, yes THIRTY, due to the Federal Government's own seperate "waiting period" for benefits.
So no Medicare coverage until December 2008.
With my chronic medical problems (Crohn's Disease, kidney stones, frequent hospitalizations, yada yada yada) I could not afford (quite literally) to get so sick as to require hospitalization until December 2008!!

I immediately asked for a reconsideration of the Onset Date, and was promptly denied. The RRB felt confident that I haven't been sick since 1996 and was somehow able to (but refusing to?) work since January 2003!

I then officially applied for an Appeal of the decision.
And then I waited....and waited....and in the time between my application for Appeal and the actual scheduling of an Appeal Hearing I could have had a baby (if I were female, of course).
Yes, it took the RRB 9 months just to schedule a Hearing!

Finally, I had my "date in court" on March 18, 2008. I presented my evidence (which was plentiful - 13 years' worth by this point) and pleaded my case for granting my Disability Onset Date to be moved back one year (the furthest I would be eligible for, so why fight for more?) to June 1, 2005. This would give me not only an additional year's worth of back-Annuity (almost $15,000) but more importantly, it would activate my Medicare coverage effective December 2007! (meaning NOW)

This was most important because in the 2+ years that I have been unable to afford to see any doctors for any of my ongoing conditions (Gastroenterologist, Urologist, Nephrologist, Neurologist, and General Doctors for everything else), my conditions have gotten increasingly worse, which means any need for a hospital would be impossible to afford.

I was promised a decision by the Hearing's Officer "within 45 days" (from March 18 meant by May 2, 2008).

As expected, May 2, 2008 came and went and I never heard a word. (I say "as expected" because that's the way my luck works - against me)

So I called 2 weeks past the May 2 deadline and was told that the Hearing's Officer was "sick for a few days in April", so it would be "another two to three weeks" before a decision could be made. How "a few days" delays a decision by "2 to 3 weeks" is beyond me, but this is a display of typical delay tactics.

Now, in the meantime, my worst fears became reality when I was stricken with Cluster Headaches (CH's) daily since January 28, 2008 and on the night of May 14 I had to be taken to the local hospital's ER. Some pain drugs and a CT Scan of my head later revealed that at least there was no tumor causing my CH's but my left eye is going out-of-focus and was most likely the culprit for the severe physical pains. I was advised to go to Wills Eye Clinic in downtown Philadelphia (for superior low-cost eye examinations). The ER bill alone (plus the CT Scan came to almost $10,000 - of which I don't have, of course).

The Wills Eye Clinic was a one-time $70 fee (a 33% discount for those of us without medical coverage and living below the poverty line). So, with a Urinary Tract Infection (hereafter "UTI"), my father & I rode the local train into town and I walked the 4 1/2 blocks to Wills Eye Clinic and had my eyes examined. My left eye was going bad and for the first time in my life I required glasses. So another $100 for glasses. One problem solved (although it costs more than I could ever hope to pay back).

Then the UTI got worse, giving me nausea, blood, lightheadedness, and on the morning of May 25 I again had to be taken to the ER due to severe pain in the right kidney and the lack of urine production. In November of 2005 I had the same symptoms and once the urine stopped passing I wound up in ICU for 5 days. My kidneys stopped in 2005 and I very nearly bit the big one! This was turning out to be a repeat, but while I had Insurance back in 2005, I am still waiting to hear from the RRB about my Appeal (I called the RRB for an update again and the message I left on the Hearing Officer's voicemail went completely unanswered) so I still have none, and this could be VERY bad and VERY expensive, but I had no choice left to me. It turns out I had (and still have) 2 very large (15mm) kidney stones - one in each kidney! I wound up being admitted for 4 days.

Since the hospital could do nothing to help the process, they let me out (also, the bills that were being racked up could never be paid in full - and they knew this so they kicked me out). Of course, a few days later I wound up back in the hospital for 5 more days, this time with an infection. While there the doc inserted 2 stents into my ureters (one to each kindey). Again, after 5 days they kicked me out.

This past Tuesday I went back in to have the right kidney stone smashed up in a Lithotripsy procedure. It's normally an outpatient procedure, but of course I was admitted overnight for "observation". The stone was demolished as expected, and now I'm just waiting for the pieces to pass out of me. I still have the stents (and probably will for a few months), and will soon have to go back and have the left stone taken care of.

Now, we finally get to the update; When I came home from this procedure on Wednesday, a letter from the RRB was waiting in my mailbox.
This was it. I was finally going to have an answer.
[Though I always expected it to be a denial - this way I didn't get my hopes up to be fatally crushed by the inevitable bad news]

The Hearing's Officer found in the course of the hearing and evidence provided that I have indeed been permanently disabled since January 2003, and this was proof enough that my Disability Onset Date should be moved from June 1, 2006 to the requested June 1, 2005!
I won!!!
After a year of fighting, I finally fucking WON!
The paperwork for the Medicare is "being processed" by the RRB on my behalf and so also should be year's worth of back-Annuity owed (December 2006 to December 2007).
Hopefully the Medicare information will come quickly and since the new Onset Date makes the Medicare effective December 2007, these recent hospital bills (that have to add up to at least $100,000) should be covered by whatever Medicare normally covers.
[This will all have to be worked out once I receive the information]

So, 40 days after the initial promised May 2 decision date, they grant me my Appeal.

Now I can start seeing all of my doctors again, find out what my physical state really is, and try to agressively fix all my ills (or at the very least, control them) and try to get some sense of a "normal life" back.

Things are starting to look up as opposed to one bad thing after another hitting me time and time again. Now, I have the means to actively fight back.

RobMac