If a doctor refused to write a recommendation with DX, that is not good. Most doctors who are confident of their DX would do anything to help that patient to survive. His reasons seemed rather shoddy. All my care specialist, gladly wrote what ever I needed to have, to qualify for help. You doctor hesitated, and that would indeed cause me concern. Medical reviews are quite necessary, when trying to cover missed days of work, insurance and SSD. Accept only those docs. willing to help you in all ways for the betterment of your life. It sounded stange to me, and I bet I would run for the hills to find another doctor. Hard as that is, you need all the help you can get to further your case, and get the help you need. I sure hope it all works out for you. I believe in absolute cooperation between doc. and patient. ginnie