Disability paperwork and companies like Binder and Binder

[PinchandBurn]

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I'm sure you guys have heard of companies like Binder and Binder (disability attorneys).

If patients send you paperwork from these type of people, how do you go about it? My personal opinion is that unless something is fractured or there is a loss of a limb, etc disability is unwarranted. I'm sure others feel different.

For some minor disc bulges or facet arthropthy somewhere.....

The issue is, if a company like the above requests your information adn then asks you the patient's functional capacity, how many hours can be worked, etc....how do you guys go about doing this? Literally there are like 20 pages to fill out!!

Do you guys send people like this for a functional capacity? Do you send them to PMR folks (which I know some of you guys are), Occ Med docs? Some people may hv legit issues I agree, but some are just Medicaid people that are trying to milk the system. I do not want to contribute! However, if a lawyer sends it to me, am I bound to having to fill this paperwork out?

 

[Gauss]

usually this is for social security disability which is it's own process with independent contracted evaluations. SSI will subpoena records and pay you for copies. Binder is a factory of clerks, not even lawyers. So you're under no legal obligation to fill out any of their crap. SSI will not recognize pain as a disability either

 

[PinchandBurn]

usually this is for social security disability which is it's own process with independent contracted evaluations. SSI will subpoena records and pay you for copies. Binder is a factory of clerks, not even lawyers. So you're under no legal obligation to fill out any of their crap. SSI will not recognize pain as a disability either

Oh really? I thought Binder/Binder is a law firm. I checked out there website.

So if these guys send me papers to fill out, I cna just tell my RN to call them and tell them that I do not want to fill them out or that I do not do thsi sort of thing? There's no legal obligation?

It's one thing if they want my notes, they can have the pt sign a release.

It's literally 20pgs to fill out. I almost feel as though if a patinet gives me a book like this, I shoudl have them come in and tk 15min to fill it out and bill a level 3 f/u. However ,my issue is that I do not think I'm the right person to place them on weight restrictions and figure out wht they can and can not do. How many hours they can work/stand/sit for....The question is who is the right person ...generally speaking.....(PMR vs Occ Med vs funciton capacity by PT, but i hear insurance companies dont pay for this).

 

[pmrmd]

Binder will ask for a narrative. For free. "If there is a charge, let us know and we will bill the patient." Riiight. These charts may be quite extensive and there is no f'n way I am going to type any kind of report for disability. Tell your patients you have no idea how long they can squat or kneel or carry as you do not evaluate them in that kind of setting. Refer for FCE and that's that.

 

[Aether2000]

Most of the attorney forms would have the physician commit fraud in completing them. Trying to determine cardiac risk is outside the realm of our specialty. Completing statements such as "How many hours can the patient stand at work" are simply speculation- we have absolutely no idea, and once you make up a number you are committing fraud if this document is used in court to support their claims. We fill out zero disability paperwork, and will happily forward all the OBJECTIVE evidence we have in our charts to whomever the patient so desires....

 

[SSdoc33]

the patient is paying a lawyer for all of this disability nonsense. If they want their forms filled out, or a separate narrative, then charge a fee. this fee will eventually be picked up by the patient. if you feel bad about charging the patient some money, thats one thing. but realize that the lawyer, the insurance company, eseentially everybody else won't. don't be the sucker.

just because you receive paperwork from a "lawyer" doesn't mean you have to fill it out. it also doesnt mean you have to answer the questions they want. a FCE (when it is covered -- most of the times it is not) may help give you some idea of the patient's capabilities, but usually it doesnt help much.

also, i wouldnt bring them back for a level 3 visit. a level 3 visit takes me 5 minutes -- maybe. filling out all that crap they way they want it filled out takes a lot longer than that

 

[Dr. Ice]

this is an interesting topic. So what do you guys do if your patient asks you to fill out temporary disability paperwork, which could keep them out of work for 6 months? I have the same issues with work comp. The paperwork is generally the same. How do we determine how long these people can sit, stand, walk, do modified duty, lift, push, pull, etc? How do you all address these questions? Patients also have occ med docs who refer to us for expert opinion, but are otherwise essentially useless.

Also, if the patient asks you to fill out the disability paperwork, how do you get around it? as technically we are the ones treating them for their injury. We cant exactly punt it to their PCP without pissing off a valued referral source.

 

[PinchandBurn]

this is an interesting topic. So what do you guys do if your patient asks you to fill out temporary disability paperwork, which could keep them out of work for 6 months? I have the same issues with work comp. The paperwork is generally the same. How do we determine how long these people can sit, stand, walk, do modified duty, lift, push, pull, etc? How do you all address these questions? Patients also have occ med docs who refer to us for expert opinion, but are otherwise essentially useless.

Also, if the patient asks you to fill out the disability paperwork, how do you get around it? as technically we are the ones treating them for their injury. We cant exactly punt it to their PCP without pissing off a valued referral source.

Yes.....Dr. Ice's q's are what mine essentially are. I tried punting to a PCP once, it blew up in my face. Basically he stated 'you are the one treating him, you fill it out'. This was back when i started.

Technically he is write. But taking someone out of work for a fee weeks is vastly different from forever. Regardless, how are people going about putting restrictions????

 

[Jitter Bug]

Work within your scope of practice. If you routinely treat injured workers then you should be able to do workability. Since I only do spine and EMG's now, I will only address spine restrictions (lifting, twisting, bending kneeling etc). If the patient also has for example a right ankle fracture s/p ORIF they would get a separate work note from whichever doctor is treating their ankle. Occ med folks in general are comprehensive MSK/spine so they don't mind writing a wholistic workability. If you are a PM&R generalist you shouldn't mind either. If you specialize in spine only you may not want to write general workabilities anymore that address stuff like hand grasp/pinch.

NOW, let's talk about those lawyer request for the 20 page disability papers. SSDI has their own process with their own doctors and they do not need letters from you. They can ask for your records for their own purposes. The lawyers are asking you to create paperwork that they can spoon feed to the SSDI evaluators. I don't know if this is effective or not, maybe if docs on this forum have been SSDI evaluators they can chime in.

All lawyer requests require 2 things in my opinion: #1 it's work you normally do, and #2 you get prepaid. So since I don't do disability evaluations, I fax it back and write across it that I don't do disability evaluations. ( Because I don't normally schedule a 60 minute visit to do a complete H&P and an expanded history that includes ADL's and IADL's).

 

[PinchandBurn]

Work within your scope of practice. If you routinely treat injured workers then you should be able to do workability. Since I only do spine and EMG's now, I will only address spine restrictions (lifting, twisting, bending kneeling etc). If the patient also has for example a right ankle fracture s/p ORIF they would get a separate work note from whichever doctor is treating their ankle. Occ med folks in general are comprehensive MSK/spine so they don't mind writing a wholistic workability. If you are a PM&R generalist you shouldn't mind either. If you specialize in spine only you may not want to write general workabilities anymore that address stuff like hand grasp/pinch.

NOW, let's talk about those lawyer request for the 20 page disability papers. SSDI has their own process with their own doctors and they do not need letters from you. They can ask for your records for their own purposes. The lawyers are asking you to create paperwork that they can spoon feed to the SSDI evaluators. I don't know if this is effective or not, maybe if docs on this forum have been SSDI evaluators they can chime in.

All lawyer requests require 2 things in my opinion: #1 it's work you normally do, and #2 you get prepaid. So since I don't do disability evaluations, I fax it back and write across it that I don't do disability evaluations. ( Because I don't normally schedule a 60 minute visit to do a complete H&P and an expanded history that includes ADL's and IADL's).

Jitter-

Thanks for teh response. Perhaps I should have posted this on the Private Forum.

But the question is, like you I pretty much do spine work. Sure I can saw 'no twisting, bending, etc". But isnt that subjective? HOw can I say teh restriction should be 25lbs vs 50lbs? How can I say the guy should work 4 vs 6 vs 8 hours a day requiring sitting in 30min intervals?

 

[Jitter Bug]

Well for things like lifting, bending, twisting, sitting and standing it comes with practice and experience. I ran a lot of cases by my more experienced physician partners in the beginning, and you can also discuss if you have ties with the PT's or OT's who do FCE's or work a lot with injured workers.

There are no rules. It's all part of the art of medicine. But the literature supports having people do as much as they can while injured will speed up the recover process in the long run.

 

[Jcm800]

dont fill them out. tell them you will give them records, thats it. and send them how much and collect for the records ahead of time. its nonsense. i have never filled out any of those papers ever.

Oh really? I thought Binder/Binder is a law firm. I checked out there website.

So if these guys send me papers to fill out, I cna just tell my RN to call them and tell them that I do not want to fill them out or that I do not do thsi sort of thing? There's no legal obligation?

It's one thing if they want my notes, they can have the pt sign a release.

It's literally 20pgs to fill out. I almost feel as though if a patinet gives me a book like this, I shoudl have them come in and tk 15min to fill it out and bill a level 3 f/u. However ,my issue is that I do not think I'm the right person to place them on weight restrictions and figure out wht they can and can not do. How many hours they can work/stand/sit for....The question is who is the right person ...generally speaking.....(PMR vs Occ Med vs funciton capacity by PT, but i hear insurance companies dont pay for this).

 

[Mister Mxyzptlk]

You have to provide the records free of charge for an SSDI case. That's federal law and Binder & Binder encloses a memo about that with every request.

You don't have to do anything else. You don't have to fill out any forms, write a summary or whatever. That is at your discretion.

 

[ampaphb]

Sometimes refusing to fill them out can cause more headaches than it's worth. If its a one page form, I fill them out if it's a patient of long standing. However, if they ask for specific restrictions, I warn the patient that I am going to be non-specific, and ask if that is ok with them. It almost always is, but this way,m they are on notice.

20 pages? We charge a a per page fee to fill those sorts of forms out. For $500? of course, we will be happy to take care of your paperwork.

 

[ghost dog]

Sometimes refusing to fill them out can cause more headaches than it's worth. If its a one page form, I fill them out if it's a patient of long standing. However, if they ask for specific restrictions, I warn the patient that I am going to be non-specific, and ask if that is ok with them. It almost always is, but this way,m they are on notice.

20 pages? We charge a a per page fee to fill those sorts of forms out. For $500? of course, we will be happy to take care of your paperwork.

With a request for an evaluation of this nature, I will typically do the following:

1.I Inform the third party that they are requesting an expert opinion in regards to this issue, and as such my fee for this is $ ( whatever your fee is for such a lengthy evaluation).

2. As the patient is an individual known to myself, and been treated my myself for a period of time, this is not an independent medical evaluation. As such, this assessment will be inherently biased. This should be taken into consideration when reviewing my assessment.

This usually takes care of the request. 😎

 

[mille125]

Sometimes refusing to fill them out can cause more headaches than it's worth. If its a one page form, I fill them out if it's a patient of long standing. However, if they ask for specific restrictions, I warn the patient that I am going to be non-specific, and ask if that is ok with them. It almost always is, but this way,m they are on notice.

20 pages? We charge a a per page fee to fill those sorts of forms out. For $500? of course, we will be happy to take care of your paperwork.

We do fill out short term disability/FMLA forms. I refuse to fill out long term disability forms. I gladly send records. I gladly refer for an FCE.

 

[PMR 4 MSK]

Anything over one page requires an office visit.

The questions asks "How long can the patient stand at one time?" I ask the patient and he says"10 minutes". I write down "The patients says 10 minutes."

 

[specepic]

Anything over one page requires an office visit.

The questions asks "How long can the patient stand at one time?" I ask the patient and he says"10 minutes". I write down "The patients says 10 minutes."

I agree, doing these at a dedicated OV is probably best. The things that keep me from having dinner with my family is all that little crap that builds up on my desk. These are a royal pain in the a** at the end of the day as part of a pile of paperwork but surprisingly easy at a face to face OV.

My office has really low paperwork fees and they don't want to raise them. This has been my counterstrategy and it works great. Also writing "get an FCE" in certain sections, or "please see my notes" is a fun passive aggressive, albiet totally appropriate approach.

FMLA forms are also fun 🙂.

 

[Tenesma]

Binder & Binder has never paid for any forms that I billed them for --- then they started adding a note that "they will charge the patient", and still didn't pay the invoices... so for the last 5 years, if Binder (or any other law firm) wants a narrative/20 pages etc filled out, we advise patient that they will have to pay cash or credit (don't accept checks cause they typically bounce) upfront before we mail anything beyond copy of medical records...