What is your approach to disability?

[goldsummer]

FMLA, Short term, Long Term... When a patient comes in to discuss anyone of these, do you have a specific approach or "flow" as far as whether you will approve or not, follow ups, specialist involvement, etc? Inexperienced and looking to learn from the experienced.

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[deleted87716]

FMLA, depends. If I'm familiar with the circumstances, I'll usually fill those out whether the patient is there for an appointment or not (it's usually better if they are, however). I'll usually charge a form fee if they aren't in the office.

Disability forms always require an appointment, with no guarantee that I'll complete the forms to their satisfaction.

 

[B1GM0N3Y86]

FMLA and Short Term forms: Fill out at apt. Exceptions made at times to fill out outside of apt tho.

When it comes to long term disability forms, 1 of 3 things occur:
1. If they follow with a specialist who manages the condition in question that is causing the disability, I defer to the specialist in filling it out since they are the treating physician.
2. If it's straight forward condition, I'll fill it out.
3. Anything else in question, I refer to occupational medicine for functional capacity exam.

 

[goldsummer]

FMLA and Short Term forms: Fill out at apt. Exceptions made at times to fill out outside of apt tho.

When it comes to long term disability forms, 1 of 3 things occur:
1. If they follow with a specialist who manages the condition in question that is causing the disability, I defer to the specialist in filling it out since they are the treating physician.
2. If it's straight forward condition, I'll fill it out.
3. Anything else in question, I refer to occupational medicine for functional capacity exam.

Thats a good approach. After the functional capacity exam, does it then become more of a straight forward case? Or does occupational medicine handle everything from there?



Disability makes me a bit nervous as I had One previous attending who would always say if you want to avoid getting sued, dont fill out disability paperwork. I'm not sure if that just pertains to long term, or if short term is included in that (or if that attending might have just had a bad experience)

 

[B1GM0N3Y86]

Thats a good approach. After the functional capacity exam, does it then become more of a straight forward case? Or does occupational medicine handle everything from there?



Disability makes me a bit nervous as I had One previous attending who would always say if you want to avoid getting sued, dont fill out disability paperwork. I'm not sure if that just pertains to long term, or if short term is included in that (or if that attending might have just had a bad experience

From my experience the FCE have all of the abilities listed on it that a disability forms needs to be filled out. It also has info in regards to the patient's effort during exam and if the abilities appear accurate. I also would advise my patients to take the LTD form with them to the FCE so the examiner would know exactly what was needed for me to fill it out.

About 9 in 10 people requesting these questionable LTD forms to be filled out stopped asking after I gave them the prior options listed if the disability wasn't straight forward to me.

 

[Sardonix]

If it's something like wanting permission to keep their cat in an apartment or applying for general assistance (like a couple hundred bucks a month) I have a very low threshold to sign. If anything it becomes a bargaining chip to get them into my clinic and address their other health issues where I know they likely would not have showed.

If it's long term disability that has big money or lifestyle implications, I'm gonna want support and proof from other specialties, PT, OT etc.