If you read my post on Monday, when I was in tears and in pain all at the same time, you might recall that the absence management company used by my employer denied my most recent absence on the grounds that I am only “allowed” to have one episode per month, according to how they read the form that my doctor filled out multiple times.

Now, I know some doctors are more idiot than useful, but I assure you mine is not. For him (or my neurologist/physiatrist for that matter), I would gladly hand over one of my O- organs should he ever need a kidney or a live liver donor or a lung (I have two). So it irritates me beyond belief that the absence management company sends out a four page form but always bases the determination on one question.

It’s just hard. I work with a lot of people, and few people know how hard it is to have a body that works great one day and completely fails the next. And most of the people who work in the warehouse and have accommodations (because most people who have a permanent and chronic condition don’t want to work in the warehouse) have them for a temporary amount of time due to surgery, injury or pregnancy.

And any time a disabled person asks for an accommodation (like adjustments to a work station or permission to have a tasking canine at their side), there will be other people who take advantage if the system. Everyone’s body is very different, so two people could have the very same condition and still need unique accommodations. And I think some people lose sight of the fact that a reasonable accommodation for a person who needs it makes the situation possible and that it is not necessarily designed to make the situation easier.

When I tell you my leg feels like it’s facing the wrong direction and just drags along like a dead tree stump, believe me. And when I’m standing there afraid my leg may not continue to hold me up, believe me. And when I have to fight with absence management companies and agree to policies that allow me to take unpaid leave in accordance with the conditions approved by the absence management company, because my employer will penalize me if I continue working and meet less than 100% of their expectation… all of that causes me stress.

And I have a neurological condition that prevents my brain from telling my lower body to relax. Do you know what happens then? My discomfort gets worse. It is a big decision for me to tap out of work and use my intermittent leave. I’m losing my job in a little more than six weeks. I have no paid time off because I use it all for doctors appointments.

And to receive an email before I even get home that implies I’ve abused my leave is infuriating. My boss told me to stop stressing so much, that we’ll figure it out. His boss encouraged me to redo the forms again because she doesn’t want my employer to have any reason to question my productivity or attendance. She also doesn’t want me to risk losing my meager severance.

The claims examiner never sent me a new form. I imagine he or she posted it to my file in the app. Because while all warnings and denials come to my personal email, good news and important documents seem to appear in the app with no acknowledgement.

But being me, I kept a blank from last time. I sent that to my primary care physician’s office with a note that I could fill it out over the weekend and drop it off on Monday. Because I don’t want them to have extra work. My doctor’s assistant said that would be good.

And it turns out– I saved a previous form that I modified on Kami. I changed the dates and fixed the offending question and submitted it electronically to the doctor’s office a few minutes ago. I’m emotionally drained and the whole experience has me drained.

Five Tips if you are dealing with medical paperwork & paper pushers

1. Keep extra blank copies. When you receive a document, try to get an electronic copy and a print copy. Obviously, if you have an electronic copy, you can print one. Print a blank copy and set it aside for your medical provider. Before you interact with an electronic copy, duplicate it. That way if you make a mistake or someone loses something you don’t need anyone’s help to get another copy.
2. Warn the provider. Call the office or use your electronic patient portal. I had my first intermittent leave form filled out by my neurologist, but had to pay a $25 fee and it took two weeks. The second time (and the third time and now the fourth time) I asked my primary care physician. I know from past experience, he fills it out with me and doesn’t report it to the office so I don’t get charged the fee. Ask if the provider would prefer you book an appointment so he/she can evaluate you, if you can email, mail or hand deliver a copy.
3. Do as much as you can yourself. At this point, I discuss a lot of these things in the patient portal via “ask a non-urgent medical question” to my doctor, which I know is read by his assistant. I literally start with “This message is for X. I apologize for another paperwork request, but my employer is giving me trouble again.” I send a form I filled out (except for the doctor’s name, date and signature of course) AND a copy of the blank form with the notation “in case my responses are not accurate, hopefully I did not misspeak”). On paper forms, I use post-it notes to direct the doctor to the actual medical stuff.
4. Record the answers. Part of the reason I can fill out most of these forms is because I keep and file the forms. So I use the doctor’s previous answers and update as needed. That way you sound like your doctor, because you are using your doctor’s language.
5. Keep copies. I always ask that they leave me a copy at the front desk so I can pick it up. I always point out to them this is not to check up on my physician, but to make sure no paperwork gets lost in the system. I have experienced several instances where the absense management company mislaid a fax, then changed my examiner, who never received a second fax which meant I was mired in paperwork for a month trying to get one of my short-term disability payments. If they give me a copy, I scan it and upload it to them directly, either my email or whatever the primary interface is. And if they lose it, I can email the scans again and not have to bother my doctor’s office.

Following up with the dietician

The dietician called me consistent. I did not lose any weight. I did not gain any weight. But my orthostatic hypotension has all but disappeared. But to maintain that, I need to consume three to four times the amount of salt I have been eating. And monitor my water intake. She perused my macro balance and my diet from the last month and really did call me consistent. So I guess the next step is to deal with my weight.

Speaking of weight, the nachos I had for dinner didn’t help.

• Cool Ranch Doritoes
• two slices organic American cheese
• Sam’s Fresh Pineapple Salsa
• Spicy Cuban Black Beans
• Avocado Crema
• Nutritional Yeast

600 calories. 20 grams protein.

Maybe tomorrow I’ll tell you how/why I missed the event at the Parkland Community Library. Maybe tomorrow will be smoother.