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Tag Archives: bureaucracy

And Now For Something Completely Different … – Part III

19 Sunday Nov 2017

Posted by ts4jc in About Me, General Transsexual issues, Living Female

≈ 2 Comments

Tags

65th birthday, appeal process, April deadline, bureaucracy, dentures, Derma-Lase, Dr, Dr. Carolyn Wolf-Gould, Dr. Sherman Leis, extensions, female swimsuit, full plate, Gender Reassignment Surgery, genital hair removal, GRS, health insurance, income tax preparation, Medicaid, Medicare, mouth infection, New York State, New York State of Health, NYU Plastic Surgery, oral surgery, Rachel Bluebond-Langner, Ramapo College, soft diet, tax clients, tax season, tooth problems, Transgender, victory, winning appeal

The Battles and the Progress Continues

The early winter months of 2017 brought the usual New York area snow and the onset of tax season.  Snow also postponed my first appointment with Joy Vanderberg for hair removal on March 14.  We were able to reschedule it for two days later.  Spring was just around the corner and snow days would soon be over.

My first visit with Joy also brought an excellent report.  She told me that I had much less genital hair than the other trans patients she had worked on.  She also told me that I had very little gray hair in that area.  I couldn’t have asked for better news.

Even so, she wanted to wait until my second visit before she gave me a time frame for how long it would take to clear me of my genital hair (excluding those sparse gray hairs that laser won’t touch).  And that delay, due to no fault on Joy’s part, led to another battle.

My second session with Joy was on March 27.  Based on my body’s reaction to the first session, she estimated that I could be cleared in 6 months, which would take me to sometime in August.  By this time, the wait list for Dr. Leis took us into September at the earliest.  Carole Sherman in Dr. Leis’s office tried for a date in September but it fell through.  So the earliest date we could come up with was October 5.  That wasn’t ideal for me as the recovery period would include and go past the due date for returns on extension.  But I accepted the date and would just have to make it work with my clients.  (I did, by the skin of my teeth.)

The scheduling wouldn’t prove to be that simple.  As we were in the process of finalizing the surgery date, Dr. Leis’s office was contacted.  Until this time, New York State was allowing Medicaid payments to be ported outside of the state for GRS because there were no qualified surgeons in New York State doing this surgery who also accepted Medicaid.  That situation had now changed.  Dr. Leis was told that he had received his last approval from New York Medicaid for a New York patient’s surgery.

Had I not had the bureaucratic gremlins’ snafu delayed approval for my consult; had not the troll delayed the start of my hair removal by at least three weeks; we would have put through a request for my surgery well in advance of the change in status between Dr. Leis and New York State.  Instead, we had just missed the cutoff.

Carole told me that she would submit a request for my surgery (and a pre-surgery visit with Dr. Leis on September 13) anyway, knowing it would be denied.  Then it would be up to me to appeal while she would work with my caseworker to see if an exception in my case could be pushed through.  As soon as the denial was received by me, I was told that I needed to respond immediately.

There was one big problem.  The denial came through promptly (amazing how the insurance carrier can move fast with denials but not approvals), right at my busiest time of tax season: the first two weeks of April.  And this was already shaping up as my worst tax season in my entire 29 years as a professional tax preparer.  New York had put through a requirement for taxpayers to include their driver’s license info on their tax returns (including an obscure document number that could be in different places depending upon when the license was issued, and was nearly invisible to the naked eye for the older licenses).  Despite me telling my clients this info in my year end tax letter, not one New York client brought me this information.  I had to put about a half dozen last minute New York clients on extension just for this reason alone.  In addition, I had a number of clients in California who work for a major Internet company who had a variety of unusual tax situations that added a lot of extra hours to my prep time.  I was also doing my best to maintain my commitment to a mentoring program for freshmen at a local high school.

And I had to spend time straightening up as best I could because my building management company had picked April 13 as the date for their new pest control company to inspect the apartments.  This was another thing that couldn’t have come at a worst time.  My life gets pretty basic at this time of year.  Dishes and garbage (mainly recycling and items to shred) pile up.  As many meals as possible are either sandwiches, pre-packaged meals or take out.

The bottom line is this: my clients come first, and especially at this time of year.  If I think that a client wastes my time by habitually coming in late without good reason, I have been known to fire a client.  But for the most part I love my clients, especially ones who have been with me for years.  So when one of my dearest octogenarian (and snowbird) clients calls me in early April to tell me that she broke her shoulder and was going to have surgery and didn’t know when she could see me, how could I get mad at her or deny her to meet with me for the first time on the morning of the day that taxes were due?

The main academic building at Ramapo College

I worked nearly non-stop on April 18th to complete returns or file extensions.  Usually I file 10-12 extensions per year.  This year I filed 26.  There were 18 returns that I didn’t even start to work on until the due date.  Usually I work like crazy about three to five days before the due date so that by the due date, I only have one or two stragglers to finish.  I couldn’t get close to that this year.  I filed the last extension (my octogenarian snowbird) with 41 minutes to spare.  I had something to eat and watched an episode of Bonanza online to decompress.  And then I got a few hours of sleep before waking up in time to be part of a transgender panel to speak to a class at Ramapo College.

Even then, I had some tax duties to complete: specifically my payroll client and Canadian client who have returns due at the end of the month.  But somewhere during the end of April, I could finally start to work on the appeal.

Ah, but if it was only that simple.  Three appeal processes were offered.  So the first thing I needed was guidance on which one I should use.  I ruled out one, but what of the other two?  While waiting for the guidance, using my vast prior experience with bureaucratic language, I deciphered that it seemed best if my surgeon’s office filed the one appeal (which they did), while I went to work on the other process.

In my so-called spare time, I also had to deal with a problem caused by either the previous building manager for my co-op apartment building or the attorney they used.  When my name was changed, it took me two years to get the name changed on my stock certificate for ownership in the co-op that entitles me to live in my apartment.  When that was finally accomplished, I was told that they would contact my local town so I would not lose the school tax credit to which I was entitled.  Someone dropped that ball and as of January, I was paying more in monthly maintenance because the tax credit was gone.  To my local town, it looked like I had recently bought my apartment and had to apply all over again.  (As of the date of this writing, I have gotten my 2017 credit, but not my 2016 credit, which I soon have to follow up on.)

The other problem I had to deal with was more painful.  I was starting to have problems with my teeth.  Years ago, I had a post and crown put in.  That fell out, and other teeth were starting to break.  I’ll mention more about this in a future post, but this was one more major item to deal with.  I was getting a full plate and then some.  And there was a deadline on filing the appeal.

It also needs to be mentioned that I wasn’t just denied my surgery with Dr. Leis.  They did assign me to another surgeon: Dr. Rachel Bluebond-Langner at New York Langone Health/NYU Plastic Surgery Associates.  So it behooved me to check out what her procedures would be.  But I could get precious little over the phone and even though I have a good friend who was scheduled to have breast augmentation with her in early May and offered to find out information for me, I was running out of time for my appeal.  Besides, I was able to find out the most important piece of information.  This surgeon’s waiting list was already so long, with the earliest I could schedule a consult, the earliest I could have the surgery would be late spring or early summer of 2018.  It was bad enough that this was just one more delay after so many delays.  I would turn 65 before then.  (In fact, I was barely getting in under the wire with that important date with Dr. Leis.)  This would mean starting all over with new insurance, assuming that Dr. Bluebond-Langner and NYU accepted Medicare for GRS (not many places do).  This was a major game changer.  And I had other concerns as well, especially since I had so many unanswered questions.

So I gave high priority to my appeal, making sure that my two clients were taken care of by their respective deadlines (they were).  Except for the three part harmony, I detailed all the delays caused by my insurance carrier’s representatives in a way that rivaled Alice’s Restaurant.  I noted that I had already established a relationship with Dr. Leis and was in the process of finalizing a surgery date when NY State’s edict came down.  I noted ways in which the surgery process in NY was inferior service to what Dr. Leis offered, at least for me.

On April 29, I mailed out the appeal and sent copies via e-mail to Carole Sherman, my insurance carrier caseworker and Dr. Carolyn Wolf-Gould.  It was Dr. Carolyn who proved to be key to the way the process worked out.  And at some point as tax season was winding up, she encouraged me with the information that another patient in a similar situation and with Dr. Leis as surgeon had appealed and won.  She also suggested I get legal assistance, but I had already started working on my appeal at that point.  I trusted in my ability to deal with bureaucrats and didn’t need another delay to make contact and go over my case with the people she recommended (5 hours away from me up in Rochester).

On May 4, my insurance carrier signed for receipt of my appeal and I received the card in the mail indicating that on May 8.  I let my caseworker, Carole Sherman and Dr. Carolyn know so that they could take any further action on my behalf.

And on May 16, I was told by Carole: WE WON!!!!!!!  We had authorization for the surgery on October 5 and the pre-surgery visit on September 13.

In response to sharing this news, I received the following from Dr. Carolyn on May 17:

I spoke to the chief medical officer yesterday about your case. He agreed to look into your troubles. I have been having a lot of trouble wth [this particular insurance carrier] lately, and got lawyers from Legal Aid involved behind the scenes. I believe this is why your case was appealed. I asked him to look specifically at yours and one other yesterday and both went through this morning.

So much for my writing skills.  Well, I will at least take credit for choosing the right doctor!  It helps to know people in positions of influence in situations like this.  And this is why I always searched for people who were knowledgeable about transgender issues when it came to anything related, medical or counseling.  I appreciate those who pioneered and had to, in a sense, train the people who took care of them. Dr. Carolyn and Dr. Leis didn’t learn how to treat transgender patients in medical school (and there is still too little training in that area).  It took a determined transgender patient in both cases to get them started on the path they now embrace.

In a later note, Dr. Carolyn was gracious enough to share some of the credit with me:

You are very welcome, Lois. It’s people like you who make my job such a joy. I’m very pleased that both these cases went through today and also encouraged that [this particular insurance carrier] has now updated their policies.

This wouldn’t have happened if you hadn’t made a stink. You have changed things for the patients who will come after you.  This makes my job easier in the future. If not for your hard work on your appeal, this huge change in the system wouldn’t have happened. If you hadn’t filed all the paperwork, there would have been nothing to review and nothing for me to point at during my phone call yesterday.

It takes a team.

I am blessed and honored to have done my modest part of that team.

But perhaps there is some sort of conservation of insurance problems, just like there is conservation of mass and energy.  As of this writing, I have one relatively minor insurance situation unresolved, reimbursement for my travel and lodging related to the gender surgery, at least issues regarding my gender surgery.  But new issues cropped up regarding my teeth and my turning 65.

I will not spend a lot of time on these issues, as they are not directly related to my blog.  But they have complicated my life at a time when I need to recover from my GRS and need no complications.

Basically what happened is that I went to the dentist about my teeth at the end of April.  He didn’t like what he saw on my x-rays and had a more detailed scan done.  From that, he submitted a plan of extensive root canals and crowns.  Some dentist sitting behind a desk decided his plan was not warranted, because the teeth and gums were not in good enough condition.  So we went the opposite direction: pull all the teeth and put in dentures.  The dental desk jockey turned that down as well because six teeth could be saved.  They did cover the extractions of most of the teeth, but not the dentures and not the extractions of six teeth.  Despite dental coverage, it cost me $4500 dollars, most of which I have charged, but that eventually has to be paid off.

Then there was the matter of the timing of the extractions.  I am in the process of switching from Medicaid to Medicare plus a Medicare supplemental plan.  Oral surgery is part of my Medicaid coverage, but the oral surgeons in my area are only available a few days a month when they take Medicaid.  Therefore, they tend to be booked well in advance.

This created a second problem: when did I switch from Medicaid to Medicare?  I assumed it would be on my 65th birthday, in mid-November.  Wrong!  Medicare started on the first day of November for me.  So Medicaid would end on the last day of October, right?  That’s what I was told by the Department of Social Services in my county, New York State of Health (the Obamacare marketplace in New York through which I had been applying for health insurance coverage) and my insurance carrier.

They were all wrong.  While I was in Pennsylvania recovering from my GRS, I received a notice that my Medicaid coverage will be terminating on the last day of November.  Had I received the correct information; had I known that before I left for Bala Cynwyd, I could have made different arrangements with my dentist and the oral surgeon.  I could have either postponed the surgery until November, or had the back teeth pulled in October and the front ones pulled in November and started with the dentures after the rest of the teeth were pulled.  The latter way would have been the preferred way as it allows the gums to heal better.

Instead, I came home from GRS recuperation on October 19, two weeks after my GRS surgery, and on October 20 I had all my teeth pulled.  By the 27th, I couldn’t wear my dentures, the pain was so great.  A terrible post-operative infection devastated my gums, leaving large areas of exposed bone.  I had to take a week’s worth of a strong antibiotic plus do a 50% hydrogen peroxide rinse to combat the problem.  While the gums are growing back over the bones, I still have significant areas of exposed bone.  I will be without teeth until at least December 6 and on a soft food diet for all this time.

Oh well, at least my current diet might help me get in shape for my first swimsuit season without any fear of a bulge.  Still, while there is no definitive proof possible, my recovery from both surgeries was compromised because of the ignorance of bureaucrats.

My people are destroyed for lack of knowledge: – Hosea 4:6a

God bless,

Lois

My Obamacare nightmare finally resolved and other news on Lois

26 Monday May 2014

Posted by ts4jc in About Me, General Christian issues, General Transsexual issues, Just for Fun, The Bible on transsexualism, Uncategorized

≈ 1 Comment

Tags

bureaucracy, Burlington County College, Christopher Reeve, church doctrine, Church membership, college reunion, Cornell, counseling, customer service, Human Sexuality, Medicaid, New York State, Obamacare, Obamacare nightmare, Patient Protection and Affordable Care Act, proof of income, verification of income

The aftermath of tax season is pretty much over.  And my Obamacare adventure has finally come to an end.  While it has taken me longer to post than I anticipated, I wanted both of those to be completed before I wrote my next post.

My last post took you up to April 15 when I left you hanging as to my Obamacare progress.  I can happily attest that it has worked out in the end, but I believe that was due to the Lord watching over me.  I still had more absurdity to deal with before things were resolved.

Easter weekend followed close on the heels of the end of tax season.  There was still no response to the verification of my income (my 2013 income tax return) that I had posted on February 11.  So I called early the following week to find out the progress on my application.

Years ago, a career counselor taught me a phone technique that I probably should use all the time when dealing with customer service reps.  Probably due to a combination of my overly optimistic view of people and the fact that the technique doesn’t work when calling the IRS (about 90% of my customer service calls), I have gotten out of the habit.  But the technique is a good one.

The technique is that immediately when the phone is answered by an actual person, you make sure you have their name.  Then you explain that it is your practice to immediately ask for their supervisor’s name.  The reason you do this is that in the event the person to whom you are speaking is unable to resolve your problem, they are on notice that you will be asking to speak to their supervisor at that point, but it is nothing personal against them.

So this is what I did when I called NY State to find out the progress on my Obamacare application.  Here is where the story gets absurd again.

The first person I spoke to told me that my verification had been rejected once again.  New York’s first error was that they had sent no notice to me about this latest rejection: not by e-mail, not posted on my account, not mailed to me by snail mail.

The bigger problem was how in the wide, wide world of sports (for you fans of Blazing Saddles) could they reject my 2013 income tax return when they would have used the information from my 2012 income tax return had I merely checked the box that my income had not changed?

When I asked the customer service rep this, she began to respond in that droning voice that occurs when someone is reading from some sort of script or set of guidelines that he or she clearly does not understand.  She tells me that as a self-employed person, I need to submit three months of income and expenses.

My reply was that I have a seasonal business, and depending upon which three months are chosen, it could look like I earn as much as four or five times my annual income or as little as 10% of my annual income.  Furthermore, I explained that I provided far more than 3 months’ worth of income and expenses.  I provided a full 12 months.

She responded that this was not part of her job to make these decisions.  Those were the magic words that caused me to ask to speak to her supervisor.  She had no problem with that, and I was put on hold for a few minutes.

The supervisor came on the phone and I begin to go into the technique again.  He gently cut me off, telling me that the first person I spoke to had explained the situation to him and we would be able to resolve it.  He apologized for the lack of notice being sent to me, and said there was no explanation for it.  When I chimed in that foul ups were a common occurrence with bureaucracies and explained some of my experience working for or dealing with government bureaucracies, he replied that this was his first job with the government.  Previously, he had always worked in the private sector.  I could almost see him shaking his head in disbelief as he acknowledged the mistake-prone nature of government bureaucracies.  I smiled.  I knew I had an ally.

Then we turned to my more immediate problem: what would New York State accept as proof.  He told me that he knew this would not make any sense, but he assured me that he had run into this problem before and that what he was recommending had worked.  He recommended that I just submit my Schedule C from my 2013 income tax return.  Yes, he knew that it was part of the tax return that they rejected.

I am all for doing what works rather than reinventing the wheel, even if it doesn’t make sense.  So I thanked him and told him I would be uploading my Schedule C within 30 minutes (it was actually 5 minutes, but I like to leave margin for error).  I asked if he could fast track my application under the circumstances.  He said that he could not, but he knew how to flag it so that someone else could.  And by the end of the week, my application was finally approved.  I am eligible for Medicaid.

That eventually led to me changing doctors.  It is a separate story.  The only connection to Obamacare is that my previous doctor sold his practice because of Obamacare.  But the circus that resulted was due to his staff not explaining to me that he was still practicing medicine with the new practice.  They had made it seem like he retired.

I had my first appointment with my new doctor on Friday.  She is wonderful.  All of her staff is wonderful.  She even read some of this blog before we met!  But with all the details of a first appointment, I forgot to ask for permission to use her name and link to her fabulous You Tube video.  I hope to get that permission soon.  People need to know of the good work she does.

The only downside is that she is much further away from me than my previous doctor.  She is 6¼ times further away by time and 7½ times further away by distance.  Fortunately on the drive to my new doctor, I am traveling mostly over upstate roads that generally are not congested instead of heavily traveled roads and roads with many traffic lights in the NYC metro area.  And the increased travel will be mitigated somewhat by the fact that because I am in excellent health (hopefully to be confirmed by the tests that will be done), she will only be seeing me once per year rather than four times per year.  While I would love to see her more often, all that extra gas for four visits would have undone much of the savings Medicaid would be providing.

Now to move on to other exciting things in my life.  First on the list is my 40th Cornell reunion.  It is the first time I have attended my college reunion, but a woman needs to know how to make an entrance, right?  I am looking forward to seeing classmates again and actually meeting some for the first time.  At a college as large as Cornell, you have to be very outgoing to meet all of your classmates.  For example, Christopher Reeve lived one dorm away from me freshman year (the student union was in between our dorms).  Undoubtedly I saw him at one time or another (getting mail, eating in the cafeteria, etc.) but back then he would have been some unknown tall, skinny kid that I didn’t know and who wasn’t famous.

It will be fun seeing if people can figure out who I was and their reactions when they find out.  I am not expecting any problems, and if there are any negative people, other classmates should rally around me.  I have an interesting planned schedule of events to attend.  In addition to those that are class-related, I will be attending a meeting for transgender and gender queer alums, one for people who were involved in athletics as a Cornell student, and one for Christian alums.

The most interesting will be the last event, Sunday morning breakfast.  In the fall of my senior year, I was tapped for a senior men’s honorary society.  That spring, the society changed 81 years of tradition (the first of similar societies throughout the Ivy League) and began to select women.  In retrospect, I was the first female in the society!

I am also in the process of becoming a member of my church, the church that I started attending the day after I starting living full-time as Lois.  The pastoral leadership and some other key members of the church know about my past.  For the rest, they know me as Lois and that is perfectly fine.  Right now, I am reading about the doctrines of the denomination.  I presume there will be a follow-up discussion when I have finished my reading.

Recently, a professor at a small college in central NJ (Burlington County College), sent a request to one of my support groups, looking for a speaker to make a presentation to one of her classes.  The professor was interested in the information about me that I shared with her, so I will be speaking to her class on Human Sexuality in the middle of June.  It will also give me the opportunity to visit with some dear people who are both friends and clients, and have been very supportive of me.

Last but not least, a possibility is developing where I may be a resource for a family with a transgendered member.  It may be that my involvement will be personal (my preference, because I can do a better job that way).  Otherwise, it will be the use of selected posts from my blog.

Speaking at the college and helping in personal situations are two areas that I have been praying about and seeking God’s guidance for future ministry.  “Yes, Virginia,” a person can be both Christian and Transsexual.  I am living proof.

Let your light so shine before men, that they may see your good works, and glorify your Father which is in heaven. – Matthew 5:16

God bless,

Lois

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My Ongoing Obamacare Nightmare

04 Sunday May 2014

Posted by ts4jc in About Me

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ACA, application, bureaucracy, bureaucrat, Federal Government, government, Health Insurance Exchange, income tax return, incompetence, Internal Revenue Service, IRS, Medicaid, net income, New York State, nightmare, Obamacare, Obamacare nightmare, Patient Protection and Affordable Care Act, privacy issues, proof of income, self-employed, self-employment income, Social Security Administration, Tax return (United States), United States, verification of income

Back in November, one of my clients asked for help with his Obamacare application.  Like me, he is both a New York resident and has self-employment income.  It would be a good learning experience for me, as I would be putting in my own application soon.  I found the New York health exchange easy to use, living up to the early reviews that it was far superior to the severely flawed Federal website.  It was very responsive each time we clicked on a link and soon we had a completed application except for the choice of plan.

A few weeks later in early December, I confidently ventured onto the same site for my own application.  Once again, entering personal data was quick and easy.  Then it came time to answer the income question: did I expect my 2014 income to be the same as in 2012?  And here was where the nightmare began.

When my client reached this question, he answered “yes”.  Apparently this government agency has access to your 2012 income tax return, but hey, no privacy concern there, right?  Anyway, that answer bypassed a number of additional steps and questions, as I was to find out.

My answer to this question was “no”.  While I did have a net loss of clients in 2013 (some related to my transition and some not) and some associated loss of income, the major reason for a decrease in income was that I had a project in 2011 for which I was able to charge about twenty times my usual average fee.  Three-quarters of my fee had been paid in 2012.  It is highly unlikely that this type of work will come my way again.

To be expected, I was taken to pages on the site to provide my estimated 2014 income.  Unexpectedly, this was where things started to fall apart.

First of all, it did not want to take my income as a self-employed individual.  I found I was only able to enter it if I said that I was an employee of my own company.  A further complication came because it was insisting that I provide data for my last three months of income and expenses.  As a tax preparer, providing my income and expenses for September-November would have vastly understated my net income.  There seemed to be no understanding that some people have seasonal businesses.

But the biggest problem of all was that the site kept timing out on me and returning me to an earlier screen.  I type rapidly and had all the information at my fingertips.  There was no significant delay in my data entry that should have caused this error.

Admitting defeat, I reluctantly called their help line number.  Soon, I was speaking to a capable agent who was more than willing to enter the information that I gave her.  In minutes, I felt vindicated.  She was getting the same time out problems.  Soon, we reached a point (about our fourth or fifth try), where she said that we would try it one more time and if it didn’t work she was going to call tech support.

For some reason, this time it worked.  It was like the Dilbert cartoon where the pointy-haired boss is telling Dilbert that he keeps clicking on a link and it doesn’t work.  Just as Dilbert starts to quote the line that insanity is doing the same thing over and over and expecting a different result, the boss clicks again and it works.

So now all the income and expense data is entered.  At this point, she tells me that we cannot proceed any further as they want verification of the financial information I just provided.  Thinking quickly, I ask her what will be acceptable as verification.  I know this might be a problem as my business income comes in the form of about 80 checks a year from almost the same number of individuals.  None of them are required to issue me a 1099.  And there is little reason for me to incur the cost of a separate business bank account, so I don’t have one.

She replies that this is outside of her area, but that in about 7-10 business days, I should receive an e-mail providing this information.  Unfortunately, I received no such e-mail and that time frame took me to December 23, the original deadline by which you had to have completed your application to be covered by January 1 (which they magnanimously extended one day).  There was no way I was getting through on the phone then.

So I called back between Christmas and New Year’s Day.  This time, I got an all too familiar government bureaucrat bozo.  When I asked what I could use as verification of my income and expenses, he replied to my amazement, “We don’t tell you what to send.”

Keep in mind that I worked for HUD for three years, a local housing authority for four years, and then was a stock broker for over twenty years which meant that my activities ultimately came under regulation by the Securities and Exchange Commission of the Federal Government (and I had to know those regulations to pass my licensing exam).  And for the past twenty-five years, I have dealt with the IRS, the NY State Department of Taxation and Finance, and New York’s counterparts in a few other states in my work as a paid tax preparer.  Finally, as part of my transition, I needed to know Social Security Administration and NY Department of Motor Vehicles verification requirements.  Never has there been a time when there were not clear regulations on what could be used as verification of statements made on an application.

Even so, I had no basis on which to argue with this agent.  So I am trying to figure out what I can use as verification.  Making a spreadsheet of my income and expenses would have been easy.  But I dismissed it as self-serving.  Anyone could type numbers and descriptions into Excel without a shred of truth in it.

What followed was Kafkaesque with a touch of Seinfeld plot line.  The results were as poor as could be expected under such circumstances.

There was only one way that came to mind as to how I could verify my income in 2013 as being less than in 2012: bank statements.  My bank statements for each year would show that the deposits in 2013 were less than in 2012 (by the differential I had stated in my application).  I was able to download monthly bank statements online from my bank account in a format that was acceptable for uploading to my Obamacare application.

However, there were three problems with this method.  The first was the amount of documents I would need to send.  My bank’s website did not provide a filter so I could retrieve only the deposits.  So I had to upload the entire bank statement.  Twenty-four months’ worth of bank statements at three pages each would mean a lot of pages for some bureaucrat to review.

The second problem was directly related to my transition.  Knowing who I might be dealing with, I wanted to make it as foolproof as possible.  The name on the account in 2012 did not match the name in 2013.  I could not count on the reviewer noting that the account number did not change.  So I uploaded a cover letter with an explanation and also uploaded my name change documents.  Now some reviewer has an awful lot of information about me.  I could just see him or her calling over another reviewer: “Get a load of this person’s application!”

Finally, there is the fact that deposits show income but not expenses.  And while 99% of my deposits are business-related, many of the expenses are for personal items.  I explained that the expenses are independent of income and are basically the same from year to year.  Since the expenses are approximately the same in 2013 as in 2012 (which information they already had), the deposit differential is essentially the same as my decrease in net income.

I was able to upload all this in the first week of January.  And then I waited, and waited and waited some more for the great State of New York to reply.

Knowing I would be getting much busier over the next two and a half months, I called back at the end of January.  I figured that four weeks was enough time to expect my information to have been reviewed.  This time, the person on the other end of the phone was very competent in her job.

She noted the large number of documents that I had uploaded and said it would take a few minutes before they would all be available.  While we waited, I was able to ask her a few questions about Medicaid and how it worked.  Finally, she told me that she was able to see on her screen that they were in the process of reviewing my documents, which means they should be finished soon.

And soon they were: the documentation I supplied was not considered sufficient proof of my self-employment income.  When I received a hard copy of this notice, it came with a document that set forth all the acceptable means of verifying any statement you might make on your application: the very information I was unable to receive a month earlier.  They wanted more hard proof, not just my statement that expenses were unchanged.

So I did something that I hadn’t done for at least 30 years (since becoming self-employed made my tax return more complicated), if ever.  I was preparing my own tax return at the beginning of February instead of working on my clients’ returns.  And as soon as I learned that my e-filed return had been accepted by the IRS, on February 11, I submitted my entire, five page, 2013 Federal Income Tax return as my most up to date proof of my income and expenses.  And I sent a copy of the proof that my e-filed return had been accepted).

I went back to the waiting game.  Around March 18, I called.  It was another trip to Bozoland.  First, he told me that they hadn’t even started reviewing my latest submission.  Okay, there’s nothing he could do about that.  But then he made the most ridiculous statement.  I mentioned the irony that I would have qualified for Medicaid using the income on my 2012 return.  (I was told this by the competent agent on my previous call.)  His response?  He actually told me that you don’t apply for Medicaid through the website that I was calling about!  Since the client I had helped months earlier had his Medicaid benefit card by now, I knew this was patently absurd.

By the time April 15 came and went, I still had not heard anything.  As it turned out, my health care nightmare was only beginning.

Praise God that for those of us who are in Christ, we are only sojourners here and we have a better country to look forward to.

And he shewed me a pure river of water of life, clear as crystal, proceeding out of the throne of God and of the Lamb. In the midst of the street of it, and on either side of the river, was there the tree of life, which bare twelve manner of fruits, and yielded her fruit every month: and the leaves of the tree were for the healing of the nations. – Revelation 22:1-2

God bless,

Lois

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