What are you waiting for, register to join now (it's free): CLICK HERE

Author Topic: my heart is breaking! help!  (Read 35792 times)

Offline breezy03

  • Posting Member
  • Posts: 19
  • PC Status: Applicant
my heart is breaking! help!
« on: January 22, 2014, 02:10:18 PM »
So I have anxiety and depression. Both of which are controlled. The Peace Corps right now is giving me a hard time because of the anxiety medicine that I'm on that is "as needed". I've done a mental health eval, pharmacy records, a personal statement, and an addendum personal statement. Now, I've gotten a note that states they cannot give me pre-medical clearance because of my as needed drug. I have responded that I want to appeal their decision. Anyone know what the appeal process is like or what I should expect? And good ways to argue? They're basing my "instability" on my pharmacy records even though my mental health evaluation says I am completely stable. Help please! I feel like my dreams are shattering right in front of me. Here's what they said specifically:


"We have reviewed your Health History Form and other medical information you provided.  We regret to inform you that we are unable at this time to medically clear you for Peace Corps service.

The Peace Corps has medical status eligibility requirements that every applicant must meet.  Every applicant must, with reasonable accommodation, have the physical and mental capacity required of a Volunteer to perform the essential functions of the Peace Corps Volunteer assignment for which he or she is otherwise eligible, and be able to complete a tour of service (ordinarily 27 months) without unreasonable disruption due to health problems.

The Peace Corps is responsible for providing necessary and appropriate health care to all Peace Corps Volunteers and, in certain countries, the Peace Corps may be unable to provide necessary and appropriate health care for particular conditions.   Furthermore, in evaluating an applicant’s medical and mental health status, we look at whether serving as a Peace Corps Volunteer in a particular country would give rise to a significant risk of substantial harm to others.

The Peace Corps does not have blanket rules excluding applicants with particular conditions and your medical condition has been assessed individually by staff in the Office of Medical Services. Based on that individualized assessment, we have concluded that you do not satisfy the medical status eligibility requirements for Peace Corps service because you are unlikely to be able to complete 27 months of service without unreasonable disruption due to health problems. Your pharmacy records show a continued, regular use of a ****, which indicates that moderate to severe symptoms are still present and not fully managed/stable on the Citalopram alone, as *** is to be used “as needed” for symptoms that are unmanageable. You also indicate a need for continued access to “as needed” **** due to ongoing symptoms, which are likely to be exacerbated by Peace Corps service. Overall, this determination was made as the result of an inadequate period of stability with regards to a lack of symptoms and a continued need for medication management for anxiety via an “as needed” medication, which cannot be supported by Peace Corps at this time and indicates ongoing, unmanaged symptoms.

Please note that medical clearance decisions are not permanent and that you may later satisfy the Peace Corps’ medical status eligibility requirements if your medical condition changes.

You may appeal this decision to the Peace Corps’ Pre-Service Review Board by sending a message requesting an appeal through your Medical Applicant Portal.  Please let us know within 60 days whether you are requesting an appeal.  Upon receiving your request, an “appeal task” will be posted on your portal.  At that time, you will have the opportunity to upload any new or additional information about your medical condition you would like considered in connection with your appeal.  If you do not intend to submit any further documentation, please upload a statement to that effect.  Please be aware that, even if your appeal is successful with respect to the medical condition referred to above, you may have other medical conditions that we have not yet fully evaluated and that might prevent us from providing you with medical clearance for Peace Corps service.

The Peace Corps deeply appreciates your commitment to service.  If you are interested in other service options, you may wish to visit www.serve.gov.  This website is a comprehensive clearing house of volunteer opportunities to serve across the country and the world.  Serve.gov is managed by the Corporation for National and Community Service."

CMambu

  • Guest
Re: my heart is breaking! help!
« Reply #1 on: January 22, 2014, 09:23:31 PM »
Yes, I also had to go through the appeal process and I am currently finishing my 3rd year in Botswana. I remember the call very well when they told me they were going to reject me. It truly was heartbreaking.

The appeal process is not very complicated. I found the name of the person responsible for evaluating my case and called her to discuss the decision -- I had been hospitalized for asthma in the 80s but have been healthy pretty much ever since. Then I had to write a letter saying I wanted to appeal the decision (there is probably some formal template that I had to use). I also went to a new Dr. -- a specialist -- and got a second opinion stating that I was fit for service. He even wrote a memo to PC saying that they could equip me with whatever I needed.

PC is seriously stressful, especially at first. They are just trying to cover themselves because if you do not already have anxiety and depression issues, chances are you will at some point in your service. What they need to know is that you have the tools/training/whatever you need to be able to manage your condition through the adjustment process. If you can convince them that you do, you will be fine.

Good luck.

Offline the boss

  • Leading Member
  • Posts: 28
  • PC Status: RPCV
Re: my heart is breaking! help!
« Reply #2 on: January 22, 2014, 09:23:59 PM »
Breezy...   I did not have to appeal, but I have heard of others who did successfully.  Sorry I don't have more information for you than that, but I do know that appeals have been made with good results. 

Peace Corps service can be very stressful.  We had someone in our group medically separate due to depression.  I only mention this to say that Peace Corps medical does have reason to be careful with this issue.

Best of luck... let us know what happens with your appeal. 

Offline schm90659

  • Posting Member
  • Posts: 1
  • PC Status: Applicant
Re: my heart is breaking! help!
« Reply #3 on: January 22, 2014, 09:25:14 PM »
Based on what I read, it seems as though you are probably on medications for depression and anxiety. Apparently your records have demonstrated that you have continuously been on the anti-anxiety medication, which is "use as needed", for an extended period. You also seem to have indicated that you will need to continue to use said medication. They are arguing that your anxiety has not been treated because you still require a type of sedative to manage your anxiety, at least enough so that you have filled the prescription repeatedly for an extended time. I believe what they would need from you is for you to come off of that medication for a certain period, to be sure that you were not dependent on that type of drug while in another country where it is possible that you may not have easy access to it.

Ultimately, they are being extremely cautious so as not to send someone who may not be fit for service at the time of their medical clearance.

If you suffer from anxiety, I suggest considering some sort of meditation or yoga. I really like Gil Fronsdal and Jack Kornfield's talks. Here is a Fronsdal talk on anxiety. http://castroller.com/podcasts/Zencast/2195582

Good luck. Hope you feel better soon. I am sure that if you stick to it, you will be able to serve.

Offline PeaceCorps1

  • Forum Champion
  • Posts: 75
  • "Don't try to fine tune someone else's view"-Bush
  • PC Status: RPCV
Re: my heart is breaking! help!
« Reply #4 on: January 22, 2014, 09:49:24 PM »
I would tell anyone who had not already declared insignificant things to medical to not do so (small things that you take over the counter meds for). Otherwise, it becomes a giant task trying to tell them that the "nightly cod liver oil is just to make easier bowel movement" (example)...

"If it were not for the reporters, I'd tell you the truth"', President Chester A. Arthur

Offline Marion

  • Administrator
  • Forum Champion
  • Posts: 70
  • Botswana (2011-2013)
  • PC Status: RPCV
Re: my heart is breaking! help!
« Reply #5 on: January 22, 2014, 10:03:38 PM »
If that quote is true, that at some point "we will all go through depression"-- what mechanisms does PC have to mitigate this? Regular get togethers in country?
The Peace Corps gives a lot of support and advice on ways to deal with stress, unwanted attention, depression, etc.  This occurs pretty much throughout your service: during Pre-service training, In-service training, and Mid-service training. They stress finding "healthy outlets" to deal with stress rather than falling into depression, drinking too much, or any of other negative outlets.  The Peace Corps doesn't facilitate or have anything to do with Volunteers getting together (other than scheduled meetings), but that is certainly one "healthy outlet" that they don't discourage.

The Peace Corps also has something called PSDN (Peer Support and Diversity Network).  These are volunteers specially trained to help other Volunteers deal with problems, including emotional ones (up to a point).  Members of PSDN will be in touch with you on a regular basis just to chat and see how you are doing.
Marion
RPCV, Botswana (2011-2013)

Offline Rodericktribe@yahoo.com

  • Posting Member
  • Posts: 1
  • PC Status: RPCV
Re: my heart is breaking! help!
« Reply #6 on: January 23, 2014, 07:37:53 AM »
I have successfully appealed a medical decision: it was a long ordeal requiring second opinions and a lot of self advocacy, including a letter from a lawyer threatening to sue for violations of the ADA and filing a civil rights complaint. I would love to talk with you more about this and share some ideas. Is it possible for you to email me at roderick.tribe@yahoo.com or to reach me on Facebook. My name is Melissa Blaine Roderick.

Offline breezy03

  • Posting Member
  • Posts: 19
  • PC Status: Applicant
Re: my heart is breaking! help!
« Reply #7 on: January 23, 2014, 09:33:54 AM »
I have as needed medicine but I do not take it all the time. I have filled it five times in 12 months. They are going off of my prescription records and have decided that I take it more often than I do without asking me how often I take it. I'm wondering if asking them for maybe a three month deferment in which I will not refill it (or take it which I haven't been doing anyway) and then have another mental health evaluation. I just need some ideas really on how I can prove that I AM mentally stable and do NOT need the as needed medicine in my appeal. I'm really worried. This is my dream and I am mentally stable and I do realize how stressful and depressing and anxious serving can be and I am ready for it.

Offline shawn

  • Forum Champion
  • Posts: 85
    • Pack.It.Up Adventures
  • PC Status: RPCV
Re: my heart is breaking! help!
« Reply #8 on: January 23, 2014, 12:55:45 PM »
I think this is one of those cases where you should appeal, get the portal task, and get in touch with whoever is in charge of monitoring this or reviewing it (if you're not sure, your recruiter or placement officer [if you've gotten one] would be a great place to start). I would ask them straight up what would need to happen in order for the appeal to be successful.

I do think you're right; i think they want to make sure you don't already need medication to maintain your sanity. If you think (or if the confirm) that you we're not cleared because of their thoughts on the frequency of your as needed meds, then I would think a memo from your prescribing doctor and/or a specialist stating the full case of you're condition and the current use of your medication should be sufficient.

If you get stone-walled and no-one from PC will be straight with you about what has to happen, PLEASE send me a message or email and I'll see if I can't use one of my PCV-buddy-turned-recruiter to get an in.

$.02
PCVL - Rwanda 2010-2013
NPCA Serving Volunteer Advisory Council

Offline Mary

  • Posting Member
  • Posts: 3
  • PC Status: RPCV
Re: my heart is breaking! help!
« Reply #9 on: January 23, 2014, 03:27:48 PM »
This is a tough situation.  PC is protecting themselves from accepting someone who is at risk for not being able to complete their 27 months of service.....which is understandable.  As has already been stated, PC service is stressful....at best.  Someone in my group had inadvertently not listed an anxiety medication she was taking.  When she arrived in country and mentioned that she was taking it....she was on the next plane home, no questions asked!  Also....and I know every country will be different.......you can't really expect to have any type of psychological therapy/counseling available to you in country......maybe one or two or three sessions....but if you end up needing more than that, you would likely be medically separated.  You are your best advocate!  As someone has already mentioned, you should find out what needs to happen in order to have a successful appeal.  That might mean waiting a certain amount of time and trying again when you know you are completely armed with what you need to show them! Just think of this as another one of the PC hoops you need to jump through!  And FYI....I was on an anti-depressant before and during my 3 years of PC service.  It is do-able!  I wish you the best of luck!  Feel free to write me at elmocat123@gmail if you'd like to chat more.  (I'm also a Family Nurse-Prctitoner)        Mary

Offline breezy03

  • Posting Member
  • Posts: 19
  • PC Status: Applicant
Re: my heart is breaking! help!
« Reply #10 on: January 23, 2014, 04:52:35 PM »
That's what confusing me the most because I'm 21-years-old and I haven't been to/needed therapy since I was 12. It's been a long time and I don't expect to have it while I'm in the Peace Corps. I've come up with others ways to deal with stress/anxiety (like meditation and journaling). The only medicine I really need is my anti-depressent. I just need to know what they want me to do since they're making such a big deal out of the as needed that I don't take but is prescribed to me.

I haven't heard back from them yet and I still don't have an appeal task open on my portal. I'm crossing my fingers it will come soon. Thanks for all of the great and insightful comments!

Andrea Schindler

  • Guest
Re: my heart is breaking! help!
« Reply #11 on: January 24, 2014, 02:05:17 AM »
Hi Breezy,

Way back when (1985), I was initially rejected for medical reasons.  I had a neurological disorder and needed to take medication every day.  My neurologist totally went to bat for me, and he suggested that the Peace Corps match up my illness with a country that would work for me.  That is exactly what they did.  You need your doctor on board with you and ready to do battle.  Now I'm in the State Department, and it's the same procedure.  I have other health issues now, but with my doctor supporting me and me being very proactive, I got posted abroad again. Don't give up!  Tell them that "1 in 4 Americans have some form of mental illness; are you going to keep all potential Peace Corps volunteers out of the field?".  It's a good quote that gets people's attention. Best of luck from one who has been there and, 30 years later, is still there!

Offline breezy03

  • Posting Member
  • Posts: 19
  • PC Status: Applicant
Re: my heart is breaking! help!
« Reply #12 on: January 24, 2014, 12:25:59 PM »
Thank you!

It's been a few days and still no word on my appeal process or portal task. I'm anxious and a little scared. I was supposed to leave in June to somewhere in Africa....I guess that won't be happening. I left a message on the pre-service nurse line as well. Haven't heard back.

I hate the waiting game.

Edit: I emailed my recruiter. I hope he can help me but I doubt it. I was never given a placement officer so I can't contact anyone in placement.

A. C.

  • Guest
Re: my heart is breaking! help!
« Reply #13 on: January 24, 2014, 07:26:35 PM »
Recruiters have no access whatsoever to your medical files, and nothing to do with the medical process. They will tell you to do the same thing you are doing - contact the Medical office.

Offline koji

  • Forum Hero
  • Posts: 113
    • Transitions in the East
  • PC Status: RPCV
Re: my heart is breaking! help!
« Reply #14 on: January 25, 2014, 01:47:45 AM »
A thing to note, they do say you can re-apply at a later date. I know they wanted to see a longer space of time for me after my mental health issues and I waited until I was 27 to serve- and getting medical clearance took me about half a year, my application process was significantly longer than that of the others in my group. So, if things don't work out this time, and it is something that your heart is really set on, you can definitely work towards it in the future as well.