its an absurd process, infuriating, discouraging, and impossible, but that is its intention. you must remember that the system's intention is to shake you off, hence the automatic denials. but dont let it get you down. you might want to go for the doctors letter approach. when my husband and i were going through this, we had his doctor fill out a written statement of his condition. the papers were issued either by his lawyer or by the ss admin. and they outlined and specified the severity of his illness and the immediate need for medical care. his lawyer then sent these papers and a letter expressing the urgent need for a quick resolution to the judge that was supposed to hear the case. the judge, after considering my husbands condition, made an 'on record' decision to approve him. that was in august, and he has since recieved his medicaid card and other benefits. this was no easy process, and i dont mean to make it sound as such. he first applied in 2003, and suffered through three years of unmanaged chronic pain and total bankruptcy before we got to where we are now, but really, the doctors letter was a golden asset that really pushed the process along. you must remain proactive in this persuit. there is no answer to why this system is so anti effective, at least no answer to it in words. it needs change, but you worry about that after you get your other issues in order. i will close this statement by saying that once we feel that we are in a better position of control over our own lives, we can make the decision to help others who are now where we once were. dont be discouraged by the denials. they are merely technical. and get your doctor to work with you. best of luck to you. keep us informed.