The first appeal I remember as a survival document was not eloquent. It was the moment I finally admitted what the financial pressure was doing to me.
May 15, 2018
I had gone from a stage 2 breast cancer diagnosis to learning that the cancer was stage 4. The medical crisis was already consuming my calendar, my body and my ability to work. The financial crisis was running beside it.
On May 15, 2018, I wrote a letter because I had reached the point where I was talking to my doctors about something I still have trouble believing I considered: stopping treatment because I could not see a path to financial survival.
The cancer was not the only thing threatening the treatment. The cost of staying alive had become part of the medical decision.
That letter was not a clever appeal strategy. It was a truthful record of where I was. And sometimes that is where an appeal has to begin.
What happened next
The letter did not make the bills disappear. Some financial help eventually came, and more bills followed. There were more denials, more paperwork and more decisions made by people looking at numbers on a page that could not possibly explain the whole life behind them.
But the letter created a record. It said, in writing, that the financial burden was affecting whether I believed I could continue treatment. That mattered.
What I learned about appeals
State the consequence
Do not only describe the bill. Explain what the decision is doing to your ability to obtain care, remain housed, work, or function.
Use dates
Dates turn a story into a record. They help show what happened, when it happened, and what changed.
Write what is hard to say out loud
A letter can carry the sentence you cannot get through on the phone.
Keep the original
Your appeal is evidence of what the system knew at the time it made the next decision.
I did not know in 2018 that I would someday build an entire publication around paperwork, denials and survival. I only knew I needed someone on the other side of that letter to understand that the numbers had become life-and-death numbers.