Today's Extended Update

I should mention that I FINALLY received the long delayed letter from SSI, confirming the conclusion of Sam's medical reevaluation. (You can go back and look at previous posts if you want to see what I'm talking about. I'm too burned out to go back and link to them.)

What's surprising to me, aside from having to wait five months to get a copy of this letter, is how completely uninformative it is. Other than some fairly standard SSI boilerplate language, it tells me almost nothing.

Near the end of the months-long struggle to find out Sam's status in this excruciatingly long process, I had finally managed to talk to his caseworker at (the other) DDS (she being the one who let me know that the reevaluation had been completed months prior - apparently by her). She's the one that said I should have received this letter directly from SSI months earlier and that I needed to call them for a copy.

But one of the things she also said was that she reclassified Sam. As I understand it (and I don't understand it very well), SSI has (at least) three general tiers, for some reason called "diaries". These tiers are based on the severity of one's disability and their prognosis. These tiers dictate, among other things, the frequency of these medical reevaluations.

Not that you need to know (but I'm going to tell you anyway), the three tiers are: Medical Improvement Expected (MIE), Medical Improvement Possible (MIP), and Medial Improvement Not Expected (MINE). 

MIE looks to be for so-called short term disabilities; issues that might be resolved through surgery and the like, where there is an expected recovery in the not too distant future (though at least a year away, since, again as I understand it, you have to be disabled for at least a year before you can qualify for any assistance). MIE cases have the most frequent medical reevaluations - at least once a year.

MIP is similar but longer term. This includes, among other things, certain types of mental illnesses and, for some reason which she bothered to tell me, it also includes Irritable Bowel Syndrome. Under an MIP classification, medical reevaluations generally happen about every three years.

And then there's MINE. This covers, among other things, autism. Medical reevaluations under this classification happen about every seven years.

All of these tiers can have reevaluations more frequently, but that, apparently, is the general outline.

When Sam was originally approved for assistance, he was classified under "Medial Improvement Expected". This was long before I had any awareness of the various tiers. But even back then, I knew enough to question how they could expect any improvement. Unfortunately, I could never get an answer beyond a terse, "We don't make those decisions in this office." End of discussion.

Now, even though you won't find it anywhere in this letter, according to Ms. Other DDS, she has reclassified Sam under the MINE tier - which is both a little bit heartbreaking and, for better or worse, pretty accurate. But the thing is, I wouldn't even know about it had I not talked with her.

Anyway, I realize this is way more than you need to know but, rest assured, I probably have most of it wrong and have therefore wasted not only my time, but yours, as well.

Oh, and P.S... If you're ever unfortunate enough to have to deal with these things, don't confuse medical reevaluations with re-determinations. That's a whole different thing. Sam and I have already been through that - three times, so far. 

I won't bore you with those details - at least, not yet. We've all had enough for one day.