Doctors Letters And Common Mistakes
Medical records are a critical component of a disability claim. While including a doctors letter may also support a claim, a letter that is not specific enough or gives the wrong impression of an applicants disability could result in a claim denial. The best way to avoid these common mistakes is to consult our disability lawyers at Disability Attorneys of Arizona. Our legal team has a well-deserved reputation for being dedicated advocates of the disabled. We understand the complex medical and legal issues involved in disability claims and have a proven history of helping our clients obtain the benefits they deserve.
How Do I Submit My Medical Certificate To Centrelink
Create and submit Medical Certificate formSelect Centrelink Forms from the main menu in HPOS.Select Medical Certificate option from the page displayed.The Medical Certificate Instructions screen will be displayed.Read the instructions and select Continue.Enter the Patient Details.Select Save and continue.
Evidence From Your Treating Doctor
The Social Security Administration is required to give your treating doctors opinion more weight in the decision to award or deny you disability benefits. The SSA knows that your treating doctor will have a better and more informative opinion about your condition than a medical consultant since he or she has been consistently giving you medical attention for your disability. Administrative law judges are also required to give your doctors opinion more weight during an appeals hearing.
Out of all the medical documentation you provide, the SSA is required to give more weight or consideration towards your treating physicians opinion and reports. The SSA makes the assumption that your treating physician will have a more informative opinion about your impairment than a medical consultant from the DDS. This is due to the fact that your physician has been treating your condition for a length of time while a medical consultant has one chance to review your condition.
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Judge Agrees With Unum Disability Denial
Unum was found to have acted reasonably in upholding its decision to terminate Franks benefits as his own treating physicians agreed with Unum that he was capable of performing his occupation even though Franks had been told several times by Dr. OConnor that he was not capable of working in his previous occupation.
This is why it is extremely important to obtain good supportive medical opinions and documentation from your medical providers. It does not matter how many times they tell you verbally in their office that you cannot work or whether they agree with you that you are unable to return to your job, everything must be documented or it will not be considered. If your physician is not supportive or refuses to fill out paper work that supports your disability it is pertinent to your claim to find a physician that will be willing to do so. Mr. Franks surrendered his rights to long-term disability benefits because he failed to obtain a supportive doctor. Dont let this happen to you.
The law firm of Dell & Schaefer was not involved in the above-mentioned case, but we run into very similar situations on a daily basis. We cannot stress enough the importance of good doctor support. If you need assistance with your claim please feel free to contact us.
When you receive a letter from your insurance company, it will contain language similar to the following:
Whether You Meet A Disability Listing
The SSA outlines a number of conditions that, if all the criteria are met, are eligible for automatic approval. These conditions are known as “listings.” If your doctor thinks that your condition qualifies for automatic approval under a listing, the doctor should complete a listing form that explains his or her opinion and provide the appropriate medical documentation. Here is an example.
The claimant was diagnosed with skin cancer, specifically sarcoma. Sarcoma of the skin is eligible for automatic approval for benefits under the disability listing for cancers if the cancer has spread to, or beyond, the regional lymph nodes. A biopsy revealed that the claimant’s cancer had spread. To prove she met the listing requirements for sarcoma of the skin, the claimant provided the following information from her doctor.
- The pathology report that initially diagnosed the claimant with sarcoma of the skin.
- A surgical and pathology report that established that the sarcoma cells had spread to her lymph nodes.
Visit our section on disability listings for more information.
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Can Centrelink Reject A Medical Certificate
The most common reason for applying for an exemption is temporary incapacity due to a medical condition. Why didnt Centrelink accept my medical certificate? There are a range of circumstances where Centrelink may not grant an exemption from the activity test, even if you give them a medical certificate.
Understand Where Your Doctor Is Coming From And Then Ask For Help In A Way That Will Support Your Claim
By David A. Morton III, M.D.
If you believe you might qualify for Social Security disability benefits, you need your doctor to support your claim for disability. You’ll need your doctor to send your medical records to Social Security as well as a statement about any limitations you have that prevent you from doing work tasks. What do you need to do to make sure Social Security gets the documentation it needs to decide your case?
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Poor Medical Support Can Be Disastrous For Your Disability Insurance Claim
On or about July 20, 2009, Franks filed an application for disability benefits due to severe back problems and degenerative disc disease. He was employed as a CNC Operator with job duties requiring him to stand most of the day, bend frequently and lift between 10 and 25 lbs frequently 20-50 lbs occasionally and never more than 50 lbs.
His treating physician, Dr. Kotecha performed spinal surgery on him in July of 2009, put him off work for several months and referred him to a physiatrist, Dr. OConnor. He treated with Dr. OConnor in November of 2009 and informed him he had recently been in a car accident and was experiencing pain which was a setback to his recovery. He received injections for several months. Dr. OConnor filled out a form sent to him by Unum that Franks could return to work by October 2010 even though he had told Franks that he could never return to his previous occupation as it required heavy lifting and frequent twisting and turning.
Unum had his records reviewed by a medical expert who concurred with Franks own treating physicians restrictions and limitations claiming that Franks was able to perform the duties of his own occupation which supports a lifting restriction of 25 lbs frequently and 50 lbs occasionally.
What To Do If A Doctor Refuses To Fill Out Your Disability Forms
After you have identified your doctors reason for refusing your forms, you will have a better idea about how to solve the problem. A few of your options include:
- Ask for a narrative report. One way to get the information you need for your long term disability forms is through a narrative report. While you are with your doctor, ask them to dictate a narrative report. Together, you can address the questions listed on the form.
- Take a Functional Capacity Evaluation test. If your doctor refuses to fill out your disability forms, you can take a Functional Capacity Evaluation test. An FCE test lasts around four hours and assesses your abilities and range of motion. The results shed light on a persons physical restrictions, and therefore can indicate whether they are fit to work. Beware of FCE providers that work mainly for disability insurance companies, because they will often use versions of this test that will not help you.
- Find a new doctor. You can also opt for finding a new doctor. While perhaps inconvenient, your long term disability insurance benefits may be on the line. Finding a doctor who will provide the medical information insurance adjusters need can help you with your benefits in the long run.
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N Environmental Sensitivities And Nut Allergies
An emerging issue in many workplaces involves accommodating the needs of employees with environmental sensitivities and serious allergies, for example to nuts. The Commission has previously stated that these may be considered disabilities. For example, if a person with asthma, environmental sensitivity or allergies found themselves disadvantaged in the workplace as a result, that person could be considered a person with a disability under the Code. Employers may therefore have a duty to accommodate these kinds of needs.
This may include limiting, where possible, opportunities for workplace exposure to common substances that trigger asthma or allergies. For example, an employer may institute a scent-sensitive or scent-free workplace policy or designate the workplace as a peanut-free zone. Depending on the workplace and the particular situation of the persons in question, there may be other appropriate accommodations. An accommodation will be appropriate to the extent that it respects the dignity of a person with a disability, takes into account individual needs, and promotes integration and inclusion of persons with disabilities. The Canadian Human Rights Commission has recently posted materials on environmental sensitivities on their website at www.chrc-ccdp.ca.
Healthcare Providers’ Frequently Asked Questions
Get answers to questions about your patients’ and their caregivers’ Temporary Disability and Family Leave Insurance claims.
- Temporary Disability Insurance
Can I charge a fee for completing my patientâs Temporary Disability paperwork?
No. The N.J.S.A. 12:18-1.6 prohibits charging a fee to complete Temporary Disability forms.
Is it safe and secure to file my patientâs medical information online?
Yes. Precautions are taken to keep the information that you provide in the online application private and secure. The online application uses a secure connection and the data submitted is encrypted.
If my patient has a planned/scheduled surgery date can I fill out their paperwork ahead of time?
No. A disability claim cannot be filed until the period of disability actually begins.
I gave my patientâs estimated recovery date on the original application. Why didnât my patient receive benefits until the date I provided?
In order to certify the patient is under continuous medical care, and because the outcome of a patients condition can change at any moment, we require the physician to routinely certify medical information for the duration of the claim. We typically issue benefits for the onset of the disability period, and request an updated medical statement to extend the benefits further.
Do I need to have seen my patient on the first day of their disability period?
What is an approved medical practitioner under the Temporary Disability Benefits Law?
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Dear Doctors Please Complete My Disability Paperwork
Last week, I learned why some of my doctors wont fill out my disability paperwork and I was surprised. It wasnt the time it took. Their decisions seemed to be based on principle. The nurse practitioner at my headache clinic said, Patients who work do better with treatment, so we encourage our patients to work and therefore dont fill out disability paperwork. Later that day, I watched the Migraine World Summit 2016 where a doctor said something close to, You can be in pain anywhere so you should be at work which will make you more happy and successful.
I feel I must challenge these notions. I agree that patients should work for as long as they can, but there are people who need to miss work during pain or illness flare-ups, switch to part-time jobs, change careers, and even stop working altogether because of their health issues. These changes are simplified when doctors complete paperwork.
My pain is better when I exercise participate in very limited social activities and do self-care activities like cooking, food shopping, cleaning, laundry, paying bills, and visiting doctors when I am at a level 6 or lower and with rest breaks in between. My migraine symptoms cause me to do these regular activities at a slow pace and they take up all of my energy, leaving nothing for a job.
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Four Ways To Start Fresh
TRY SWITCHING DOCTOR
Some doctors simply wont support disability applications under any circumstances. If youve tried everything you can, and your doctor still does not understand how severe your condition is, sometimes a new doctor is the best solution. Heres some tips for: How to Find a Doctor to Help With Disability Documentation
TRY BEING HAPPY
If your doc doesnt believe you are disabled or thinks you should go back to work, you are very fortunate that they told you the truth. Its much better to find out sooner than later. Some of our readers report that they did not find out what their doctor really thought until they had been applying for disability for three years, and then read quotes in the judges denial letter. You may find it helpful to read Dandelions story: Dandelions Doctor Doesnt Support Her
TRY A NURSE PRACTITIONER
Some of our readers report that Nurse Practitioners can be more willing to help with paperwork then MDs. You can also look for a Physicians Assistant. A few important things you need to know: If you first applied before March 2017, you should first read the acceptable medical source rules.
WHATEVER HAPPENS: TRY NOT TO TAKE IT TOO PERSONALLY
Some doctors simply do not support any patients to apply for disability. They have their own personal or political reasons that may have nothing to do with you or how sick you are.
LEARN MORE
Art on this page by Robin Mead and Elizabeth DAngelo.
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Who Is Responsible For Getting A Doctor To Complete Disability Forms
Social Security Ruling 17-4p is titled Responsibility for Developing Written Evidence.
The Rulings purpose is to clarify the SSAs responsibilities and those of disability claimants and their attorneys to develop evidence in disability and blindness claims under the Social Security Act.
It states:
Although we take a role in developing the evidentiary record in disability claims, claimants and their appointed representatives have the primary responsibility under the Act to provide evidence in support of their disability or blindness claims.
Relying on the SSA to develop the evidentiary record and get the medical opinion source statements is risky. Take control of your case by working with your doctors to get the reports you need.
What Should You Not Tell A Disability Doctor
The last thing you want to do during a Disability medical exam is exaggerate your condition. Dont say you have pain everywhere or try and make your condition look worse than it really is. The doctor and staff will observe you arriving at the office, entering the exam room, and getting on and off the table.
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Note: If Your Patient Has A Terminal Illness
For the purposes of CPP, a terminal medical condition is a disease state that cannot be cured or adequately treated and is reasonably expected to result in death within six months. If your patient has a terminal illness, please complete a Terminal Illness Medical Attestation. Terminal illness applications receive priority handling.
Why Won’t My Doctor Help Me
There are many reasons why doctors won’t help claimants by filling out RFC forms. Here are some examples of common reasons doctors won’t help their patient with disability forms.
Unclear expectations. Frequently doctors don’t understand exactly what is expected of them. They may think the forms you need to have filled out will be lengthy and complicated.
Because disability claims often end up at the hearing level, some doctors may worry that they will be called to testify on your behalf or otherwise caught up in lengthy litigation.
Some doctors are concerned that their reputations could be adversely affected if Social Security disagrees with their opinion.
Personal opinions. Not everyone agrees with the federal disability program. This means that some doctors may not help you because they do not want to “support” what they perceive as an entitlement program. In these cases, the physician may feel reluctant to label you as “disabled,” knowing that it may result in an approval of benefits.
Medical opinions about your disability. Sometimes doctors will not complete RFCs because they don’t think the claimant is disabled. In these cases, sometimes a physician will complete the form but state that the individual has no limitations in his or her ability to work.
Lack of time.Other doctors are simply busy and think that filling out forms for you will take up too much time.
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Is The Label Of Disabled Really In Their Patients Best Interest
The psychiatrist may be working to reduce a patients counterproductive feelings such as dependence, isolation, apathy, and inadequacy. In some cases, a doctor will find that encouraging productivity and possibly returning to work is in the best interest of the patient, rather than reinforcing the notion of incapacity.
Your doctor may be concerned that your daily structure, independence, and sense of purpose may suffer and that social skills and sense of identity maintained through employment and being around others in the workplace may be weakened.
Therefore, giving signed statements to the SSA or the insurance company that their patient is psychiatrically disabledis at odds with their responsibilities to the patient. Designating a person as disabled would be against their purpose of treatment to improve mental health and functioning.
Applying For Social Security Disability Is Notoriously Challenging Experts Explain How The Physician’s Documentation And Informed Opinion Can Ease The Process
Meyer Silver, Esquire , Lawrence J. Weinstein, Esquire and Steven Mandel, MD
The Social Security Disability process is complex, unlike any other type of disability application process that a physician may have helped a patient through. Social Security Disability is usually a last resource for people. Affected patients are often individuals who do not have workers’ compensation or private long-term disability policies. Without SSD benefits, they may lose the ability to keep their residences, fill prescriptions, and/or buy enough food to sustain themselves and their families.
This article will explore how neurologists can ensure that their patients do not face such grim scenarios. The physician’s role in this area can be critical, and absent a history of treating disabled patients applying for disability benefits, it is unlikely that most physicians will be sufficiently familiar with the unique requirements of the Federal system to effectively assist their patients to be found disabled. We will emphasize what physicians can do to show the Social Security Administration , including the Administrative Law Judges who are often the final decision makers, what is needed to determine in their patient’s cases in order to find someone disabled. At first glance, a doctor may think some of these suggestions are excessive or tedious, but a close reading will show how necessary the suggestions are.
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Diseases & Diagnosis
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