Mandatory Special Necessities Benefit Request Forms

[sapphire]

Hi everybody, I hope you are all having the best day possible.

 

I would appreciate hearing from anyone who has experience with my situation and can advise me  IF  I must take the action the ODSP is telling me is "MANDATORY" now.

I live in Durham Region and travel frequently to Toronto for medical visits. I have had to do this since I became disabled-5 yrs ago.

Three years ago I was informed I no longer needed to submit gas receipts, record kilometers driven to & from doctors, or parking costs I paid to be reimbursed.

My caseworker at that time was with the OW dept. She told me as of then that she was going to ADD the maximum allowed for "medical travel" which was $70.00 monthly, even though my expenses were always around $78.00 monthly, back when gas was between .65 / .69 cents a litre.

This carried over with my ODSP file (my start date approx. December 2004) and I never questioned if it would be "clawed back" as my medical condition as not changed and I didn't think they would just stop it-without informing me first/ as to WHY the stop.

 

Now they tell me it is "MANDATORY" that each and every doctor I see on a regular basis, MUST FILL OUT THESE FORMS" I received today.

ODSP told me I must also "show proof" of each app't I had in January IF I want them to reimburse my costs for travelling.

I asked her if my regular/GP can fill these forms out on behalf of the specialists I see so I wouldn't need to make appt's with them (save waiting time) seeing as it was my GP (of 23 years I must add) who refered me in the first place-seeing as they send reports to my family GP... and I was told "NO, every doctor must fill them out personally."  As well it states on these lengthy " Mandatory Special Necessities Benifit Request "  forms that "I" nor anyone else may fill them out and to do so will result in the forms being "incomplete and will need to be redone by the doctor."

 

These forms are titled " Mandatory Special Necessities Benifit Request " and they are THREE pages long-for each doctor.

I have a good doctor, who always helps me with OW and ODSP special diet forms... however, no doctors these days have time to sit and read over 3 pages of questions, nor will they work that long for $25.00 ( they call it OHIP fee code K054 ).

 

On December 05, 2005 my doctor filled out diet forms for me, only to have ODSP make me return to my doctor with the same forms because apparently he didn't write down HOW LONG the special diet is needed for...needless to say he expressed his frustration with the ODSP forms and new rules and they don't make clear on their forms......so he filled in the blank date as "PERMANENTLY." If a doctor says I need certain foods regarding my medical situation, and he wrote "permantly

A year ago my doctor told me the government is aiming to get rid of OW and they also are making it harder to get any "special" benefits for those on ODSP. I shrugged it off at the time but NOW I CLEARLY SEE- he knows what the government is doing.

Shame on the gov't for causing undue harm/stress on those that are already fighting with medical problems as it is. When I had my heart attack I was told to avoid STRESS at all costs, and when I am under doctors care (for PTSD, Anxiety Attacks,Depression,Mood Disorder,etc) than who are they to constantly bring stressful situations to me-knowing full well my situation.

If I could handle/afford it, and (my nerves/mental state)  I would get a lawyer and fight them for literally jeopardizing my health.

When I asked "Mrs.Smith" why they didn't inform me that there was a deadline to meet before the benefit would end, rather than just cutting it off she replied "it's now Mandatory, it's not a priveledge they have to give you."

I asked her to stop calling me "Ma'am" as it was rude, seeing as she asked for me by name when she called and her reply was " your being rude" immediately she hung-up in my ear.  How should I deal with this...?  What would you do?

Warmly,

Sapphire 

 

 

 

 

 

"Happiness is a choice you have
the ability and free will to make."

[Patricia Duck]

Hi Sapphire

I know someone on ODSP that is getting $300plus a month for taxi expenses to his Specialist.

Whom he see's once a week!This amount is added on to his check.

Maybe the Drs letters are required as people are taking advantage  of this that I didn't know was a vailable till recently!

Pat

[SIOBHAN]

Hi

 

I am on ODSP and every month I fill in this MONTHLY MEDICAL TRANSPORTATION FOR it is like a log - I put where the app't was what date and they sign it I also enclose any parking receipts and they send me a cheque - by the way you can do this retroactive to 3 yrs people - I had a great worker who told me about it 3 yrs ago - I called any Dr/dentist etc I had been to they just put in writing the dates I had been I filled in forms for each month and got a cheque for over $1890

 

I only had to have the MD fill a long form in 1 time - each month when I send ion the trip sheet as I call it they send another for the following month..........just got a cheque for 4138 for last month they pay .18 cents per KM

[Pat Cavanaugh]

> Hi everybody,
Sapphire I received those sheets also but I never really looked at
them.It was one of them I accidently took to specialist for special
Diet. The New RULES are you have to give that exact same form cannot be
faxed, photo copy
or even white out or they will be refused. I knew this when dr told me to
fax it so sent regular mail. I received it back and took it to odsp office
personnally(sp) where it was rejected as he filled out lactose intolerant
on pg3 as opposed to bottom pg2; page 3 is for breastfeeding moms &
infants. As well he never specified timeline although for metabolic
disorders he put ED's and a bowel disorder that would last FOREVER. I
asked why such a run around. She said they have to follow Liberal Rules.
Back to msn forms, even though my wife and I go to same clinic with
different drs at same time and day we both have to fill out the sheets
although they wont give us each the money. Maybe with the media attention
ow/odsp is getting things will change,
although less hassle will likely be a tradeoff for money. I emailed
Pupatello suggesting there will be a lot of pissed off Doctors with having
to refill sheets several times, in my email to mcguinty I added that the
20.00 each time they fill out the sheet might take away some of their
anger. I imagine in reality drs will be paid one time until form lives up
to their standard.
Pat

[peeebbbles]

Hi there. Sorry for what you are going through. I would contact your
local m.p.p. immediately and let him/her know exactly the story and how
you were treated. I would also go over the workers head and ask to
speak to the director, or further still, do it in writing and keep the
copy.
Hope this helps.
Donna

[Dancing Sky]

Recently I had to go to a dental surgeon that was not on my approved list (I had the forms filled out previously for regular dentist and medical specialist).  I submitted the appointment card like I do for the approved Dr.s, hoping I could get it covered because it was an emergency appt.  I was told no.  They used to pay retroactively, but don't anymore.  The rule was changed.  My worker told me to appeal it but at the time I didn't have the energy.  If you want to get mileage, the person/agency you are seeing must be on your approved list 'before' you go.

 

I don't have regular appointments, so just submit the appointment cards at the end of the month for the 18 cents/km.  Usually ODSP issues a separate check but I guess sometimes they add it onto your regular check. 

I have never been told there is a limit to how much one can claim.

 

Sky

 

[Rosie]

What is this "approved list" for dentists? I have never had to do that. I just started going to a dentist here in Oct. and handed them my dental card with no problem. It was an emergency appointment, and a month later, I had a couple teeth pulled without needing prior approval. I also just had a checkup and partial cleaning without needing prior approval.

 

Regarding transportation, I had to get a form filled out quite a while ago, it was part of the old special diet form and on it, my doctor put down I have to see her once a month, so my transportation allowance for that is on my cheque each month. If I needed to go somewhere else that month, I could submit to get reimbursed, but I just make all my appts for the end of the month and do it when I'm in the city anyway, as I can't afford to pay out ahead of time like that, given that taxi fare is $25 each way.

 

Rosie

 

 

----- Original Message -----

From: Dancing Sky

To: odspfi...@googlegroups.com

Sent: Tuesday, February 07, 2006 3:37 PM

Subject: Reply: Re: Mandatory Special Necessities Benefit Request Forms

[sapphire]

Hello again,

How are you all doing today? Great I hope.
I need to apologize for yesterdays LONG WINDED, and FRUSTRATED lengthy
post. Looking back at it now I realize "wow,what was I thinking?"
Obviously I wasn't thinking about how much I was venting. (aka:
rambling on & on) and In the future I will definately try harder to
post, and/or ask questions in a more "brief details" format. Please
forgive me.
As for the replies I rec'd, I really appreciate them. I'm feeling
positive about the generous support you all showed me.
There's no better medicine for those of us living with disabilities
than the support you can receive from a group of folks that share
similar problems, in my humble opinion.
I haven't figured out the (least stressful) best way to deal with this
problem YET.
ODSP is replacing many benefits & forms these days...but sadly, they
aren't informing those affected by their changes until AFTER it causes
us undue hardship/grief ( caution: cause & effect conspiracy ).

ODSP seems to have a never ending list of excuses, OOOPS I meant to say
"REASONS" for why we don't qualify,or receive: special diet costs,
transportation costs, dental needs, community start up, and the list
goes on.
Or maybe I'm just being paranoid & suspicious for nothing.... U
Think???
Can you imagine how many of us would benefit greatly IF they were to
offer/assist us with the "special" help we need.
Now THAT is wishful thinking... well I must go for now.
Stay strong & keep smiling everybody!
Sapphire

[Dancing Sky]

Rosie:

 

I mean that the dentist had to be on the approved list for travel expenses.  I have to travel over an hour to see my dentist so am compensated for travel expenses.

 

Yes, I just use my dental card to pay for the actual dental work.

 

Sky

 

On 2/8/06, Rosie <msr...@cogeco.ca> wrote:

What is this "approved list" for dentists? I have never had to do that. I just started going to a dentist here in Oct. and handed them my dental card with no problem. It was an emergency appointment, and a month later, I had a couple teeth pulled without needing prior approval. I also just had a checkup and partial cleaning without needing prior approval.

 

Rosie

 

 

[Boo]

Make arrangements with the cab company to charge your trips and arrange
with ODSP to write the cheque to them. That way you are not out of
pocket. I prepaid a $55 trip and it took ODSP a year to reimburse me.
ODSP arranges with dentists and denturists for cut rates. They will
tell you who, if you ask. With mileage rates, many of us wait 12-13
weeks for reimbursement. If one has had to see the doctor or clinics a
number of times in the interim, we just run out of money to go and
don't get the tests or treatments we need.

[vintag...@gmail.com]

Hi All
Even tho I've been a member here for awhile now, I don't think I've
really posted anything before, but this dental topic got to me...so
just have to add my own 2 Bits Worth! LOL

I've been on ODSP since 2002 when I had a breakdown followed about 3
weeks later by a stroke (TIA). My right side was affected and took me
a few months to get relatively back to some kind of so-called normal.
A few months after the stroke, I noticed some of my teeth on the upper
right side seemed loose. They began to fall out. Just fall out!! No
pain, no bleeding, no hole in the gums, just literally plop out of my
mouth. Told my doctor about it, and he said I should see a dentist
(logical right?) but when I mentioned it to my worker at the time, I
was told I had to fill out forms to get "approval" to have basic dental
work done. When I asked if there was a list or anything of dentists
that ODSP expects us to go to, I was told (shockingly no less!!) that
of course not! That was up to me to phone around and find one that
would take me on. Then came the next bombshell answer - I asked
Ok...if the rest of the teeth have to come out, where do I go about
dentures. Ohhhhh ODSP doesn't cover that!!! (I was told, completely
with almost a smurk) When I asked how was I supposed to eat then, she
suggested baby foods would work, but of course that isn't covered under
my existing "special diet" of fruits & veggies & low cholesterol/fat
foods so therefore I would probably loose the "special diet" - the
entire "generous" $57.00 I get a month! In the meantime, I would have
no teeth to eat with, no way of replacing the teeth AND it was
questionable if ODSP would cover to have all the rest of my teeth
removed in the first place as that was kind of pushing the "basic
dental care" definitition! I asked about maybe going into hospital to
have them out... well that could be looked into, but doubted it would
be covered.
This whole rigamorole started almost 3 years ago now. I STILL haven't
been to a dentist (haven't gotten any approvals yet and now I have
another worker), and now only have 3 teeth left on the right side and
those are split now where one half fell out and the other half must be
stuck in there rotting away. All of the front bottom teeth are now
very loose and I can no longer bite into anything at all with them (not
even toast), and the upper teeth also split and the back halves of my
"eye" teeth remain (looking horribly brownish and obviously rotting
too) with my two upper front teeth so far intact, but pulling away from
the gums as they are caps. So who knows how much longer they will
last!
I now get headaches every few days, and face aches every so often, as
I'm sure there must be some poison or something going thru my system
with all this rotting and falling out going on. I've called a few
times to ask if I've any approval yet to go ahead and find a dentist
that MIGHT do this for me under the "Basic Dental Care" we so
generously get from ODSP....only to be told..."still looking into it
for you"
I checked on the net recently and discovered a site (thru a link on
www.WebMd.com ) that from the description it gave, I have developed
periodontal disease and should be having antibiotic treatments to try
save whats left of my gums and before the jaw bones deteriorate.
Then there is also a slightly related issue of blood thinners!! My
doctor prescribes me 325mg of coated aspirin daily as he said that is
what ODSP will cover. Anyone else I know taking coated aspirin, takes
the 81mg daily, which my doctor said ODSP does NOT cover. One dentist
office I DID speak to suggested (almost panic strickenly) that I would
have to go off them for several days to a week, before any oral surgery
could be done as they could not be held liable since I was taking such
a high dosage, "higher than normal" was her words.
At this point, I don't know really who I should be chasing after on
this...my GP for some kind of referral or seeing if this could be done
in hospital under OHIP; my ODSP worker to please bust a gut and get me
some approvals here girl; or a dentist to sit up and beg for some
help!! And then maybe stand on the street corner, cup in hand, asking
for donations to get dentures!! LOLOL I'm sure if I gave people a real
purdy smile they might kindly donate some spare change!

But ooops, forgot, I guess I'd have to declare that as income wouldn't
I???

Any suggestions/ideas GREATLY appreciated.
TIA
~ VintageBabe

[Rosie]

Just find a dentist that will take the ODSP dental card, present the card at
your appointments, and they will do the rest.

Rosie

[immortal...@yahoo.com]

A while ago (a year or two) ODSP switched from filling out travel logs
to bringing in the Mandatory Special Necessities Benefit request. I
found it extremely easy and had no problems with ODSP about it. The
pages are divided into sections and only one section applies to medical
transportation. I filled out my name and stuff and my doctor filled out
the rest (no. of visits, etc), then signed it at the end. I was told
that for any doctor/specialist I am referred to by my family physician,
my family physician can just fill out the form for them. So, there were
trips to her office, there were trips to other doctors' offices, all
filled out on the same form by the same doctor.

You seem to have an ogre of a worker. I don't know why she is being so
difficult with you. My advice is just get your doctor to fill it out
for everyone, estimate the number of monthly visits, put anything in
the notes (parking is $5, for example), and hand it in. If they give
you more problems or deny you, request an internal review.

[SARAH BOURQUE]

My God Rosie, your story is truely terrible! I dont have any idea where you
are, but Im in Belleville and my dentist is Dr. Lee on Albert Street and he
takes ODSP to an extent. Im not entirely sure how far, but if youre
anywhere near here, its worth a shot, right?
Good luck, and I hope I was a little help

[LEO Bisson]

Hello Rosie

If you happen to be in sudbury region go see

Doctor Hebert or Hibert  on the corner of Lasalle and Atlee.

He is good dentist and will do all paper work for what you need.

SARAH BOURQUE <sara...@sympatico.ca> wrote:

---

Find your next car at Yahoo! Canada Autos

[Rosie]

Hi Sarah, I don't need a dentist, I have one. I was responding to someone who is having problems.

 

Rosie

 

 

----- Original Message -----

From: LEO Bisson

To: odspfi...@googlegroups.com

Sent: Saturday, February 11, 2006 9:26 AM

Subject: Reply: Re: Mandatory Special Necessities Benefit Request Forms

Hello Rosie

If you happen to be in sudbury region go see

Doctor Hebert or Hibert  on the corner of Lasalle and Atlee.

He is good dentist and will do all paper work for what you need.

SARAH BOURQUE <sara...@sympatico.ca> wrote:

My God Rosie, your story is truely terrible! I dont have any idea where you

are, but Im in Bel leville and my dentist is Dr. Lee on Albert Street and he

takes ODSP to an extent. Im not entirely sure how far, but if youre
anywhere near here, its worth a shot, right?
Good luck, and I hope I was a little help


>From: "Rosie"
>Reply-To: odspfi...@googlegroups.com
>To:
>Subject: Reply: Re: Mandatory Special Necessities Benefit Request Forms
>Date: Thu, 9 Feb 2006 17:47:41 -0500
>
>
>Just find a dentist that will take the ODSP dental card, present the card
>at
>your appointments, and they will do the rest.
>
>Rosie
>
>
>----- Original Message -----
>From:
>To: "ODSP Fireside"
>Sent: Thursday, February 09, 2006 12:08 PM
>Subject: Reply: Mandatory Special Necessities Benefit Request Forms
>
>
> >

> > Hi All< BR>> > Even tho I've been a member here for awhile now, I don't think I've

> > really posted anything before, but this dental topic got to me...so
> > just have to add my own 2 Bits Worth! LOL
> >
> > I've been on ODSP since 2002 when I had a breakdown followed about 3
> > weeks later by a stroke (TIA). My right side was affected and took me
> > a few months to get relatively back to some kind of so-called normal.
> > A few months after the stroke, I noticed some of my teeth on the upper
> > right side seemed loose. They began to fall out. Just fall out!! No
> > pain, no bleeding, no hole in the gums, just literally plop out of my
> > mouth. Told my doctor about it, and he said I should see a dentist
> > (logical right?) but when I mentioned it to my worker at the time, I
> > was told I had to fill out forms to get "approval" to have basic dental
> > work done. When I asked if there was a list or anything of dentists
> > that ODSP expects us to go to, I was told (shockingly no less!!) that
> > of course not! That was up to me to phone around and find one that
> > would take me on. Then came the next bombshell answer - I asked
> > Ok...if the rest of the teeth have to come out, where do I go about
> > dentures. Ohhhhh ODSP doesn't cover that!!! (I was told, completely
> > with almost a smurk) When I asked how was I supposed to eat then, she
> > suggested baby foods would work, but of course that isn't covered under
> > my existing "special diet" of fruits & veggies & low cholesterol/fat
> > foods so therefore I would probably loose the "special diet" - the
> > entire "generous" $57.00 I get a month! In the meantime, I would have
> > no teeth to eat with, no way of replacing the teeth AND it was

> > questionable if ODSP would c over to have all the rest of my teeth

> > removed in the first place as that was kind of pushing the "basic
> > dental care" definitition! I asked about maybe going into hospital to
> > have them out... well that could be looked into, but doubted it would
> > be covered.
> > This whole rigamorole started almost 3 years ago now. I STILL haven't
> > been to a dentist (haven't gotten any approvals yet and now I have
> > another worker), and now only have 3 teeth left on the right side and
> > those are split now where one half fell out and the other half must be
> > stuck in there rotting away. All of the front bottom teeth are now
> > very loose and I can no longer bite into anything at all with them (not
> > even toast), and the upper teeth also split and the back halves of my
> > "eye" teeth remain (looking horribly brownish and obviously rotting

> > too) with my tw o upper front teeth so far intact, but pulling away from

> > the gums as they are caps. So who knows how much longer they will
> > last!
> > I now get headaches every few days, and face aches every so often, as
> > I'm sure there must be some poison or something going thru my system
> > with all this rotting and falling out going on. I've called a few
> > times to ask if I've any approval yet to go ahead and find a dentist
> > that MIGHT do this for me under the "Basic Dental Care" we so
> > generously get from ODSP....only to be told..."still looking into it
> > for you"
> > I checked on the net recently and discovered a site (thru a link on
> > www.WebMd.com ) that from the description it gave, I have developed
> > periodontal disease and should be having antibiotic treatments to try
> > save whats left of my gums and before the jaw bones deteriorate.

> > Then there is also a slightly related issue of blood thinners!! My

> > doctor prescribes me 325mg of coated aspirin daily as he said that is
> > what ODSP will cover. Anyone else I know taking coated aspirin, takes
> > the 81mg daily, which my doctor said ODSP does NOT cover. One dentist
> > office I DID speak to suggested (almost panic strickenly) that I would
> > have to go off them for several days to a week, before any oral surgery
> > could be done as they could not be held liable since I was taking such
> > a high dosage, "higher than normal" was her words.
> > At this point, I don't know really who I should be chasing after on
> > this...my GP for some kind of referral or seeing if this could be done
> > in hospital under OHIP; my ODSP worker to please bust a gut and get me
> > some approvals here girl; or a dentist to sit up and beg for some

> > help!! An d then maybe stand on the street corner, cup in hand, asking

> > for donations to get dentures!! LOLOL I'm sure if I gave people a real
> > purdy smile they might kindly donate some spare change!
> >
> > But ooops, forgot, I guess I'd have to declare that as income wouldn't
> > I???
> >
> > Any suggestions/ideas GREATLY appreciated.
> > TIA
> > ~ VintageBabe
> >
> >

[Boo]

Something I've learned about ODSP is they "lose" mail. ALWAYS make 3
photocopies of everything you send to them, and even REGISTER it. That
way there can be no denial of receipt. At the bottom of the page, on
the left hand side below your signature, always write cc file This
lets them know that you have a copy of this letter. You want to date
your letter, including your case number and your phone number. Another
thing, try to keep it brief, they are busy. Lengthy complaining does
nothing, just state what you need, then ask them to please advise. In
the meantime, take a copy and mail to your politician. They will call
you, usually within a few days. You will be sent a brief form asking
you to sign a release of information, otherwise they can learn nothing
from ODSP.
Hope this helps. In the mean time, take your dental card, get to a
dentist and get those teeth pulled. Your medical card will cover the
antibiotics he may prescribe. They don't cover all but he may know
which are covered.

[vintag...@gmail.com]

Thanks everyone for your suggestions. I've tried to phone around to
some of the dentists in town, but it's like no one wants to take on a
"welfare case" so to say. I must admit, I have not contacted all the
local dentists, it just got so discouraging I just gave up on it at the
time. Around here they don't accept you just taking your dental card
in and go from there - I"ve no idea why. There seems to be this
constant vicious circle of contact your worker/contact your
dentist/contact your doctor, that as I say it gets quite discouraging
and humiliating after awhile. I even spoke to a local foundation that
was suggested I contact re dentures, and was told they will accept
"applications" only once a year and I would have to include all my
income and expense receipts, copies of income tax, ODSP statements,
bank statements, etc. and then it would take about another 6 months to
be notified IF I would be accepted to have dentures paid for. I even
contacted a dental college it was also suggested I contact, only to be
told I would have to go thru my own local ODSP as I didn't live in
their (college's) area.
Anyway, I do have to see my doctor sometime this week, so I'll check
with him again to see if he's got any more ideas too.
Thanks again for the suggestions.
~ Vintage