Hey there! Just reaching out to see if anyone else has experienced something similar and would be willing to share the process/outcome. I've been working with my PCP for the past year to address possible reasons for my most obstructive symptoms (mainly extreme fatigue and joint issues). We did a few blood panels, and there wasn't any indication of malnutrition, other mental health issues, hormone issues, thyroid issues, etc. Additionally, my inflammation markers were within normal range, negative ANA, but a high RF (26). My doctor thought it would be a good next step for me to visit a rheumatologist, and submitted a referral, which was denied by the clinic. They said that they would need additional information, as it was not enough. So, we confirmed an elevated RF again, and my doctor told me to chart and photograph my symptoms over the course of 1.5 months. Last week, we were able to submit images of mouth ulcers, rashes on hands, joint irritation/swelling, and of my hands as they normally appear. Everything was time stamped for reference, and a basic charting of the main symptoms was provided to show what appears to be a "flare-up" period of around 16 days. I met with my doctor to review everything, and they were confident about resubmitting a referral with the information the clinic had requested. Well, today I received a second rejection letter that essentially boils down to "you have negative ANA and standard-range CRP, so we can't schedule you." Am I mistaken for thinking that symptoms are considered in addition to labs for a referral like this? There was long-term documentation of these issues, as well as our experimenting with lifestyle changes, and of course the images we submitted. I apologize for the length of this query, but I just wanted to know if someone has encountered something like this, and if there are any steps/resolutions I should consider. Thank you to anyone reading this, and I hope that this post finds you in good spirits and health.