Disability diagnosis during residency

[worriedguy]

Hello guys, Im a PGY3 in a surgical subspeciality and recently received a diagnosis of cerebral palsy. I never had any problems with surgery and dexterity and I operate sit down, so that its not an issue in my area.
I always had a slightly different gait, on toes, but nothing dramatic or that looked disabled, but after I saw a video of my gait I looked for an ortho, and then a neuro, and it came out as that. After some months of PT the limp is undectable, but I worry about the repercussions of this diagnosis even if its not progressive. Of course I havent told anyone in my residency nor plan to, but what if they discover somehow? There are not many neuro PTs around, specially in a smaller metro such as the one I want to practice after, and if someone else knows that I think I can be used against me such as blackmail, liability, malpractice, or just badmouthing by other doctors.
What do you think I can do?
Thanks in advance

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[anonperson]

Hello guys, Im a PGY3 in a surgical subspeciality and recently received a diagnosis of cerebral palsy. I never had any problems with surgery and dexterity and I operate sit down, so that its not an issue in my area.
I always had a slightly different gait, on toes, but nothing dramatic or that looked disabled, but after I saw a video of my gait I looked for an ortho, and then a neuro, and it came out as that. After some months of PT the limp is undectable, but I worry about the repercussions of this diagnosis even if its not progressive. Of course I havent told anyone in my residency nor plan to, but what if they discover somehow? There are not many neuro PTs around, specially in a smaller metro such as the one I want to practice after, and if someone else knows that I think I can be used against me such as blackmail, liability, malpractice, or just badmouthing by other doctors.
What do you think I can do?
Thanks in advance

Do you have disability insurance?

 

[smq123]

Hello guys, Im a PGY3 in a surgical subspeciality and recently received a diagnosis of cerebral palsy. I never had any problems with surgery and dexterity and I operate sit down, so that its not an issue in my area.
I always had a slightly different gait, on toes, but nothing dramatic or that looked disabled, but after I saw a video of my gait I looked for an ortho, and then a neuro, and it came out as that. After some months of PT the limp is undectable, but I worry about the repercussions of this diagnosis even if its not progressive. Of course I havent told anyone in my residency nor plan to, but what if they discover somehow? There are not many neuro PTs around, specially in a smaller metro such as the one I want to practice after, and if someone else knows that I think I can be used against me such as blackmail, liability, malpractice, or just badmouthing by other doctors.
What do you think I can do?
Thanks in advance

If your co-residents or PD found out without your consent, I would encourage you to sue your healthcare providers for a serious HIPAA violation.

 

[Apollyon]

Isn't something already evident in that you operate sitting down? The way you word it, it sounds to me (a non surgeon) like this is an accommodation already being made.

Oh, wait, maybe everyone operates sitting down in your specialty.

 

[NotAProgDirector]

If you can do your job with or without reasonable accommodations, no one will ever care. And CP is not felt to usually be progressive - it's unlikely this will get any worse. If you don't need accommodations, then you are under no obligation to disclose it to anyone at work.

The biggest problem you're likely to have is getting disability insurance once you graduate. If you get insurance through your employer, it's basically automatic and you'll need to do nothing. If you apply for your own policy (which is in general recommended), then you'll need to disclose it. I don't know whether they will care or not.

 

[worriedguy]

I have no disability insurance, but I think that a CP diagnosis can be seen as red flag for that, no?
I dont have any accomodations, most surgeries in my subspeciality are done sitting down, I sit for every single procedure and nobody ever told anything, as Im taller than my coresidents.
Also, have you ever seen any doctor with very mild CP?

 

[anonperson]

I have no disability insurance, but I think that a CP diagnosis can be seen as red flag for that, no?
I dont have any accomodations, most surgeries in my subspeciality are done sitting down, I sit for every single procedure and nobody ever told anything, as Im taller than my coresidents.
Also, have you ever seen any doctor with very mild CP?

CP diagnosis will probably cause issues with a policy but you will have to look into this with an insurance broker.

I would look into this sooner rather than later to be honest.

For any residents reading this, get your disability insurance ASAP and before you embark down the road of getting any specific diagnosis.

 

[michaelrack]

Hello guys, Im a PGY3 in a surgical subspeciality and recently received a diagnosis of cerebral palsy. I never had any problems with surgery and dexterity and I operate sit down, so that its not an issue in my area.
There are not many neuro PTs around, specially in a smaller metro such as the one I want to practice after, and if someone else knows that I think I can be used against me such as blackmail, liability, malpractice, or just badmouthing by other doctors.

OP, the title of your thread is "disability diagnosis..."
Right now it is not clear that you are actually disabled (not requiring accomodations etc), but your diagnosis can be perceived as a disability by many. The ADA does have provisions for those who are discriminated against for a PERCEPTION of being disabled.

I do agree with what everyone is saying about disability insurance

 

[worriedguy]

Sure, I dont feel disabled at all and seeing a small brain lesion on MRI was a real shock for me. Every CP patient I have seen was quite visibly disabled, and the diagnosis has a strong negative connotation.
It would be better if I just had carried on and not investigated anything

 

[LucidSplash]

Same as others, the issue will be disability insurance. I have a small policy I ported after graduating from residency, which has no exclusions. But I was diagnosed with an autoimmune nephropathy chief year. The disability insurance through my subsequent employer was no problem. But the individual own-occupation policy I just secured while I am working as a 1099 excludes anything that involves the kidneys, either as a primary OR secondary issue, even though I have no sign of active disease and renal function stable for 5 years. It also took me using a broker to secure this, as other places just automatically said they had nothing to offer. Suboptimal, but it is what it is.

 

[TelemarketingEnigma]

Sure, I dont feel disabled at all and seeing a small brain lesion on MRI was a real shock for me. Every CP patient I have seen was quite visibly disabled, and the diagnosis has a strong negative connotation.
It would be better if I just had carried on and not investigated anything

i don't have much to offer regarding impacts on training/insurance, but since it seems like this diagnosis is weighing on you - would you find it helpful to see examples of very independent and successful individuals with cerebral palsy to help you get a better sense of the true spectrum of the condition? I suspect you've met a lot more people with milder forms than you know, and are just not directly exposed to the full range of presentations much in your professional/personal life. Yes, many people with cerebral palsy are profoundly disabled, but presentations vary widely and many people who have milder forms probably go undiagnosed (like you did until now).

if you think some inspo might help, you could look up people like paralympian Nick Mayhugh

 

[worriedguy]

Sure it would, thank you! Everybody I saw before was way worse off, including doctors, so that its hard to relate

 

[HemeOncHopeful19]

http://docs.crumplifeinsurance.com/documents/guardianUWfieldimpairmentguide.pdf

Per this document that I have bookmarked you might not be screwed for life or disability insurance but I think I would definitely find out if you can get a guaranteed standard issue policy through your residency.

 

[NotAProgDirector]

I know you're worried - hence the user name. But honestly there isn't much to worry about now. You're already in residency. You're performing well. You don't need any accommodations, or if you do they are minor and no one cares. This type of problem does not progress - any "deficits" you have are unlikely to change. The disability insurance is a minor blip, and may not be an issue at all. Your anxiety over this is a bigger issue than the problem itself.

 

[worriedguy]

I agree, you are right. I really hated the diagnosis and its dark aura, started noticing the clonus, saw old videos with a bit of leg circumduction...
Luckily it went away, people just dont care or didnt notice, and my hands are normal

 

[clausewitz2]

Same as others, the issue will be disability insurance. I have a small policy I ported after graduating from residency, which has no exclusions. But I was diagnosed with an autoimmune nephropathy chief year. The disability insurance through my subsequent employer was no problem. But the individual own-occupation policy I just secured while I am working as a 1099 excludes anything that involves the kidneys, either as a primary OR secondary issue, even though I have no sign of active disease and renal function stable for 5 years. It also took me using a broker to secure this, as other places just automatically said they had nothing to offer. Suboptimal, but it is what it is.

Strongly second exhausting any mandatory issue disability insurance policies you can get in residency before you apply for anything on your own. Speaking from personal experience, every insurance application will ask if you've been declined for disability insurance in the past 5 years and if the answer is yes, it will often be an automatic no or you will pay something outrageous.

 

[j4pac]

First of all, DO NOT PANIC. This should not have any impact at all on your training/credentialing, etc. If it does, I'd sue. Not just for yourself but for the betterment of everyone, and society on a whole. Society has a big deal with discrimination, but discrimination on grounds of disability is definitely among the most common (and it is likely the MOST common when you look at per capita numbers). We cannot give medical advice on this forum, but there is a specialty designed to care for and educate patients about neurological disease, and I so happen to be a part of that specialty.

 

[j4pac]

Strongly second exhausting any mandatory issue disability insurance policies you can get in residency before you apply for anything on your own. Speaking from personal experience, every insurance application will ask if you've been declined for disability insurance in the past 5 years and if the answer is yes, it will often be an automatic no or you will pay something outrageous.

Without getting into medical advice...because that's tricky, even anonymously. First, this is not a neurodegenerative process that we are talking about here. But in general, I agree with maxing out the available health/disability insurance available. Not because I'm worried, but because...why not? The OP would have to claim the diagnosis when applying for future health/disability insurance in the future if he/she has been diagnosed, otherwise that would be fraud.

 

[worriedguy]

Sure, its better to play safe...
And its really amazing to see how rehabilitation services are awesome and can change ones life