Disability

[GoodVibes1313]

For those of you working in family practice/primary care (or any specialty dealing with disability), what is your criteria for giving someone disability? Because I work in one of the poorest communities, I get requests regularly for disability. Reasons range from leg cramps and controlled/uncontrolled diabetes to low back pain (very commom) and severe CHF. I'm curious as to your approach on the cases that are not so clear cut such as pain, which is difficult to gsuge because it is so subjective. At the same time, I wonder if a 30yo should be on disability for back pain.

I am curious because I was browsing through the Internet and found an older article on NPR regarding disability: http://apps.npr.org/unfit-for-work/. What do you think? 

[rev ronin]

I don't certify disability myself.  If they want disability, they can go through a specialist, such as a physiatrist, who certifies them as disabled.  They can submit to Social Security, and I will happily make my notes available to them or any other arbiter.

Disability is a necessary evil: necessary because some people cannot work, but evil in two different ways--those who fraudulently obtain it, and those who are forced onto it and thus forced to give up any hope of usefully contributing to society.  Even being a Wal-Mart greeter gives a person something useful to do.  The saddest thing I've seen medically is when young, gung-ho employees get injured, and then the system fails to get them back to work in a timely manner, and I watch them slowly die, visit by visit, month by month, as all their raison d'etre is stripped from them, one humiliating IME at a time. Their eyes dim; the fire that burned... no longer does.  They become husks, stuck in the system for years with no hope for cure, no hope for return to work.

I wouldn't wish disability on anyone.  It's just sometimes less bad than the alternative.

[Marinejiujitsu]

Only give it to chronic low back pain. What ever you do, don't approve it for downs syndrome or cerebral palsy, these 2 groups are known to take advantage.

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[Hemmingway]

17 hours ago, GoodVibes1313 said:

For those of you working in family practice/primary care (or any specialty dealing with disability), what is your criteria for giving someone disability? Because I work in one of the poorest communities, I get requests regularly for disability. Reasons range from leg cramps and controlled/uncontrolled diabetes to low back pain (very commom) and severe CHF. I'm curious as to your approach on the cases that are not so clear cut such as pain, which is difficult to gsuge because it is so subjective. At the same time, I wonder if a 30yo should be on disability for back pain.

I am curious because I was browsing through the Internet and found an older article on NPR regarding disability: http://apps.npr.org/unfit-for-work/. What do you think? 

My criteria was it should be decided by a specialist. The disability system is full of corruption and anyone willing to engage a lawyer and be a big enough pain for long enough can get disability. I don't need the headache. I have refused handicapped stickers for people who were lazy. I have laughed at people who wanted me to certify their pets as comfort animals so they could either skip paying a pet deposit or move, with their pet, into a place that didn't allow animals. I'm just not willing to participate in the circus.

[ventana]

If pushed I will fill out the paperwork HONESTLY

 

ie - I believe that Mr smith would benefit from getting a job and becoming a productive member of society.......

 

on true disability - clear and straightforward I will document - but these are rare

 

I did turn down out of state Handicapped plates to a guy that wanted them for his parents hot rod in FL - this patient was spastic CP and WC bound so he was truly disabled, but this was just a tax dodge issue and I declined (it have been litteraly decades since he had gone to florida and he so much as told me it was just for them to save the tax bill)..