Handicap Placards

[Louisville04]

How do you the attendings here handle forms for handicap placards? I work at a VA so usually tell them to ask their PCP. I know you can't do this is private practice for fear of losing future referrals from the PCP.

What is your criteria for filling them out?

72 y.o. man with moderate OA in his knee that he receives viscosupplementation. Ambulates without any assistive devices. Not overweight. Yes or No?

42 y.o. man with a history of a knee arthroscopy five years ago (unsure of reason). Has chronic knee pain. Receives viscosupplementation. States knee hurts with prolonged ambulation. Slightly overweight. No assistive devices but wears a brace. Yes or No?

55 y.o. man with chronic low back with history of laminectomy and spinal injections. He is on chronic opioids with a BMI of 32. Back pain aggravated with ambulation. Would also like a scooter. Has a cane and a walker with a seat. Yes or No.

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[lobelsteve]

3 no for me there.

 

[DOctorJay]

Agree with Steve. Easiest way to do this is sit pt down and read the requirements on the form to them. People rarely qualify.

 

[RUOkie]

I tell people that I will only fill out the paperwork honestly. I don't decide if they qualify. The state does. But in those three, the documentation would not support the use of a disabled person's placard.

 

[Louisville04]

Agree with Steve. Easiest way to do this is sit pt down and read the requirements on the form to them. People rarely qualify.

I disagree with this. Here are the requirements for my state to qualify for a permanent handicap placard. Most patients state #7 as the reason for wanting a handicap placard.

PERMANENT PERMIT: This is to certify that the applicant named above is legally blind or is a disabled person with a permanent disability (ties) that limits or impairs
his/her ability to walk 200 feet without stopping to rest. Specify below (2-8) either legally blind or the specific disability (ties).
DISABILITY TYPE AS DISPLAYED IN FRVIS:
2. Inability to walk without the use of or assistance from a brace, cane, crutch, prosthetic device, or other assistive device, or without assistance of another person. If the
assistive device significantly restores the person's ability to walk to the extent that the person can walk without severe limitation, the person is not eligible for the
exemption parking permit.
3. The need to permanently use a wheelchair.
4. Restriction by lung disease to the extent that the person's forced (respiratory) expiratory volume for 1 second, when measured by spirometry, is less than one liter or
the person's arterial oxygen is less than 60 mm/hg on room air at rest.
5. Use of portable oxygen.
6. Restriction by cardiac condition to the extent that the person's functional limitations are classified in severity as Class III or Class IV according to standards set by the
American Heart Association.
7. Severe limitation in a person's ability to walk due to an arthritic, neurological, or orthopedic condition.
8. Legally Blind (This is the only disability an Optometrist can certify.)

 

[DOctorJay]

Ahhh, my state requirements were much more clear and not open to interpretation. Sorry my response wasn't more helpful.

 

[j4pac]

Just curious...is there pushback from the state to grant permits, other than their very rigid requirements? And if there is...why?

 

[Jitter Bug]

Simple, if any of them have been instructed by me to start a walking program to aid in their mobility, strength, chronic pain etc than no handicap sticker. They can use to long walk through the parking lot as their daily walking exercise. If they need more time to get from the car to the store/dentist/neighbors house then they should leave 15 minutes early. Helps also build the idea of getting exercise automatically through daily activities instead of only in a scheduled time totally outside of real life.