Your state may be different, but I just downloaded a form from the Secretary of State filled out my part and took it to the cardiologist with me and they filled out their part. Then I mailed it in to the address provided. The first one I applied for was temporary since I couldn't comprehend how long I would be needing it. I just received a new one that is permanent that I had my neurologist sign for. I think it's the nature of POTS to not be consistent. I get some days where my heart rate doesn't ever get over 90. Then there's the rest of the days where it will go from 125 to 89, to 111, or 148 etc. My blood pressure is very inconsistent as well. I wouldn't worry about it. I have a family member who is disabled with MS. He is allowed to work 20 hours a week on disability and some weeks he can and other weeks there's no way. I was a little nervous at first too, but I figured the worst that could happen is that they don't give it to me. But they did, and I'm very grateful! Now if I could just be well enough to drive so I could use the darn thing