Uptick in patient disability claims

[dddunit]

Hey guys. Since the pandemic and would say specifically in the last 2 years I've seen an increase in patients wanting to claim disability. Most are legit i.e. ankle fractures and wounds, but there has been an increase in patient claims with things like plantar fasciitis and neuromas that are asking for more than 1 or 2 months off work (not modified duties but completely off work). I've also encountered a mild non-op lesser toe fracture where the patient wanted more than 2 months off work. When the line is drawn with patients they often get upset. Of course each patient and situation is different but I'm thinking in these cases there is often more going on with the patient than their foot/ankle. I often get the sense that they don't want to go back to work.

What are you guys seeing and what are some things that have been successful for guys in dealing with this?

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[DYK343]

I had SO many disability requests in my last job. Every other patient wanted disability.
Now that I have moved to a new job - none. 100% less. Its been great. I actually offered disability to a patient last friday because they actually needed it.

Just gotta be able to say no. I always said something along the lines of "I cant. The injury is not serious enough for disability. I understand that you hurt but if I get investigated I will lose my license". Easiest way I found to end it.

 

[Boba Foot]

I’ll entertain short term disability/time off work for a visit or two while the biomechanical root of the issue is being addressed. Or if I have to do surgery, I’ll entertain it through surgery, recovery and PT. If it goes beyond that, I’ll refer to pain management and they can deal with it. “I’m just a foot doctor” is an easy out when they hand you disability forms every visit for months.

 

[heybrother]

I had a patient ditch their disability claim recently because Home Depot offered them so much money. It kind of made me smile. We had amputation history but his main issue was claudication that wouldn't resolve.

 

[PMG03470]

I had a patient last year with a completely healed hallux amp. No issues with stability or anything that would make you think he needs disability from my assessment. I had taken over for another doc who just kept writing him letters monthly to be out of work until his full disability came through. In the previous docs notes he had advised the patient to do PT because he was claiming he had instability (he didn’t). I saw him 2 months after that referral was made. My first question was “how did PT go” and he stated he refused to go because he was afraid of getting COVID. I said “everyone is still required to wear masks, did you get the vaccine?”. He said he refuses to wear a mask and he refuses to get the vaccine. So I just looked at him and said I don’t feel comfortable giving you a note to be out of work or helping you get full disability because I do not think you need it and you aren’t even going to PT to work on your “instability” you claim you have. He walked out cursing and I never saw him again.

We really should start being firm with these people instead of giving them whatever they want. We are part of the problem if we hand out disability like candy

 

[deleted1138023]

I had a patient last year with a completely healed hallux amp. No issues with stability or anything that would make you think he needs disability from my assessment. I had taken over for another doc who just kept writing him letters monthly to be out of work until his full disability came through. In the previous docs notes he had advised the patient to do PT because he was claiming he had instability (he didn’t). I saw him 2 months after that referral was made. My first question was “how did PT go” and he stated he refused to go because he was afraid of getting COVID. I said “everyone is still required to wear masks, did you get the vaccine?”. He said he refuses to wear a mask and he refuses to get the vaccine. So I just looked at him and said I don’t feel comfortable giving you a note to be out of work or helping you get full disability because I do not think you need it and you aren’t even going to PT to work on your “instability” you claim you have. He walked out cursing and I never saw him again.

We really should start being firm with these people instead of giving them whatever they want. We are part of the problem if we hand out disability like candy

But then you get one star on your Google reviews…

 

[Pronation]

But then you get one star on your Google reviews…

Oh hell naw. I’ll give out permanent disability for a 5 star review

 

[Boba Foot]

Oh hell naw. I’ll give out permanent disability for a 5 star review

I’ll deny all disability paperwork if my long term disability insurance provider will give me a discount on my own plan.

 

[PMG03470]

But then you get one star on your Google reviews…

This guy was not intelligent enough to be able to leave a google review

 

[heybrother]

This guy was not intelligent enough to be able to leave a google review

A patient was arrested and institionalized after a visit to my clinic and they still managed to get onto the internet and write a bad review.

 

[DYK343]

Guys, guys, guys...

"Look, so I'm only the foot doctor. You'd need to visit with your primary care, a pain doc, or somebody like that who can do a full disability evaluation to work on that. You can always have my office send your foot and ankle notes to support the claim... but I'm just the podiatrist."

Pain and PCP say the same thing with a podiatry referral.
Nobody wants to deal with it

 

[DYK343]

But then you get one star on your Google reviews…

This is a real issue and unfair.
My only negative reviews at my last job were due to unqualified nail care or disability or something that wasn't legal/covered.
In some cases we either break the law or get a negative review.
Its an unfair system.

The happy patients ironically never write a positive review (unless you gently remind them). I think Feli said he had a system something along the lines of if they write 5 stars from an in office review system then they get another message requesting they write the same review on yelp or google. Brilliant and I should start doing the same.

 

[Pronation]

This is a real issue and unfair.
My only negative reviews at my last job were due to unqualified nail care or disability or something that wasn't legal/covered.
In some cases we either break the law or get a negative review.
Its an unfair system.

The happy patients ironically never write a positive review (unless you gently remind them). I think Feli said he had a system something along the lines of if they write 5 stars from an in office review system then they get another message requesting they write the same review on yelp or google. Brilliant and I should start doing the same.

Check out rater8, the reviews go directly to google

 

[NatCh]

I've had a few people pointing towards a long-term disability claim in the past couple of years. I just tell them that I don't do those evaluations, and that their insurance company can arrange to have an Independent Medical Examiner (IME) do it. I believe IMEs get trained and paid specifically for that type of work.

 

[Boba Foot]

Check out rater8, the reviews go directly to google

What do you pay for this?