Re: Pt request Disability form.

[Guest guest]

Do you think she is disabled? I have filled out disability paperwork for my patients. I would get her old records to see if maybe her previous doctor had refused. I am always suspicious when a brand new patient asks for stuff like that. Kathy Saradarian, MDNJ From: [mailto: ] On Behalf Of Wen LiangSent: Monday, July 09, 2012 6:20 PMTo: Subject: Pt request Disability form. Hi group, I saw a new patient once last month. Tomorrow she is coming for 2nd time, supposed to f/up on Depression, smoking cessation, etc. Today, she have her lawyer fax me her disability form Social Security. She is in her mid 50s, had 2 fractures on hip, osteoporosis, ETOH Over use...Would you fill out this type of disability form? I don't normally do this. But at the same time, I don't know where else she could go to. Wen

[Guest guest]

Wen,I agree with Kathy's questions. Why does she think she is disabled? And do you agree with that assessment? Is it for State Disability or Social Security Disability (which is basically total disability and not partial or temporary disability)? http://www.socialsecurity.gov/dibplan/dqualify4.htmIf it is for California State Disability, this is only for partial or temporary disability, and physicians are asked to specify whether the patient is disabled or not, and for how long (I think up to 1 year). If it is for Social Security Disability, the decision to grant or deny the claim is not up to you, it is determined by Social Security's own physicians/consultants. You are just asked to give them information to help them decide:http://www.socialsecurity.gov/hlp/radr/10/ent001-app-process.htmI'd also make sure you know who is paying for your time to do the evaluation. Insurance? Patient? Nobody? If you don't feel comfortable doing it, then don't. There's always the local medical society who could give names of local physicians, if you don't have anyone to recommend. SetoSouth Pasadena, CA

Do you think she is disabled? I have filled out disability paperwork for my patients. I would get her old records to see if maybe her previous doctor had refused. I am always suspicious when a brand new patient asks for stuff like that. Kathy Saradarian, MDNJ From: [mailto: ] On Behalf

Of Wen LiangSent: Monday, July 09, 2012 6:20 PMTo: Subject: Pt request Disability form. Hi group, I saw a new patient once last month. Tomorrow she is coming for 2nd time, supposed to f/up on Depression, smoking cessation, etc. Today, she have her lawyer fax me her disability form Social Security. She is in her mid 50s, had 2 fractures on hip, osteoporosis, ETOH Over use...Would you fill out this type of disability form? I don't normally do this. But at the same time, I don't know where else she could go to. Wen

[Guest guest]

Wen, For Social Security disability, they send a big form to complete, but the

small print at the end of the cover letter says you can choose to just send a

copy of the patient's records. This is what I do when I don't know the patient

well or don't know whether I think they are completely and permanently disabled.

SS then sends them to one of their own doctors for further eval. If it is a

patient that I know well and I truly believe they are disabled and I want to

help as much as I can to help them get the benefits, then I might fill out the

form if I don't think that is expressed directly enough in my notes.---Sharlene

>

> Hi group,

> I saw a new patient once last month. Tomorrow she is coming for 2nd time,

> supposed to f/up on Depression, smoking cessation, etc. Today, she have her

> lawyer fax me her disability form Social Security. She is in her mid 50s,

> had 2 fractures on hip, osteoporosis, ETOH Over use...

> Would you fill out this type of disability form? I don't normally do this.

> But at the same time, I don't know where else she could go to.

> Wen

>

[Guest guest]

Thank you all for the input. To be honest, I don't think it is fair for me to fill out a disability form for her. It looks like permanent Social Security. When I saw her the first time, it was a followed up after hospitalization. That was after she had a seizure after ETOH withdraw and other stuff overuse. She only come to see me because another patient recommended her to me.

 She did mention her disability application is ongoing. My impression was it had been taken care of by somebody else. Just because I saw her once or twice, shouldn't make me feel obligated to be the physician to fill it out. I will try to talk to her and her husband tomorrow, to see if they can call our county medical association. 

 Her attorney form did call and ask if I charge for that. I just don't feel I know her that well to fill out something permanent.  Crazy world. Wen

 

Wen, For Social Security disability, they send a big form to complete, but the small print at the end of the cover letter says you can choose to just send a copy of the patient's records. This is what I do when I don't know the patient well or don't know whether I think they are completely and permanently disabled. SS then sends them to one of their own doctors for further eval. If it is a patient that I know well and I truly believe they are disabled and I want to help as much as I can to help them get the benefits, then I might fill out the form if I don't think that is expressed directly enough in my notes.---Sharlene

>

> Hi group,

> I saw a new patient once last month. Tomorrow she is coming for 2nd time,

> supposed to f/up on Depression, smoking cessation, etc. Today, she have her

> lawyer fax me her disability form Social Security. She is in her mid 50s,

> had 2 fractures on hip, osteoporosis, ETOH Over use...

> Would you fill out this type of disability form? I don't normally do this.

> But at the same time, I don't know where else she could go to.

> Wen

>

[Guest guest]

upon advisement of the lawyer, she is impaired from alcohol and the

complications of being without it, therefore the rest of the world should

sustain her activities of daily living and the complications thereof...

(cynicism won today... i couldnt help it..

im glad youre standing ground)

g

> > >

> > > Hi group,

> > > I saw a new patient once last month. Tomorrow she is coming for 2nd time,

> > > supposed to f/up on Depression, smoking cessation, etc. Today, she have

> > her

> > > lawyer fax me her disability form Social Security. She is in her mid 50s,

> > > had 2 fractures on hip, osteoporosis, ETOH Over use...

> > > Would you fill out this type of disability form? I don't normally do

> > this.

> > > But at the same time, I don't know where else she could go to.

> > > Wen

> > >

> >

> >

> >

>

[Guest guest]

g and others, I saw the pt today. She and her husband understood that I didn't know her long enough to fill out a permanent disability form. She has seen a state disability doctor once and plans to follow up there.

 She appears to be a nice person, depressed and lots of other issues though. I wish she had worked with a caring physician closely 30 or 20 years ago. Now I can only try to help a little bit at a time. It is going to take time, if she is willing to work on her issues.

 Her attorney firm requests her record, including previous hospital note, specialist consultation notes, test results. I have no problem to send them my notes ( pt has signed release). But could I release third party notes? Am I allowed to do so? Would I violate HIPPA? I am confused regarding 3rd party info.

 Thank you all. Wen  

 

upon advisement of the lawyer, she is impaired from alcohol and the complications of being without it, therefore the rest of the world should sustain her activities of daily living and the complications thereof...

(cynicism won today... i couldnt help it..

im glad youre standing ground)

g

> > >

> > > Hi group,

> > > I saw a new patient once last month. Tomorrow she is coming for 2nd time,

> > > supposed to f/up on Depression, smoking cessation, etc. Today, she have

> > her

> > > lawyer fax me her disability form Social Security. She is in her mid 50s,

> > > had 2 fractures on hip, osteoporosis, ETOH Over use...

> > > Would you fill out this type of disability form? I don't normally do

> > this.

> > > But at the same time, I don't know where else she could go to.

> > > Wen

> > >

> >

> >

> >

>

[Guest guest]

She signed a release. It is legal for you to send anything she has provided for you. Kathy Saradarian, MD From: [mailto: ] On Behalf Of Wen LiangSent: Wednesday, July 11, 2012 1:38 AMTo: Subject: Re: Re: Pt request Disability form. g and others, I saw the pt today. She and her husband understood that I didn't know her long enough to fill out a permanent disability form. She has seen a state disability doctor once and plans to follow up there. She appears to be a nice person, depressed and lots of other issues though. I wish she had worked with a caring physician closely 30 or 20 years ago. Now I can only try to help a little bit at a time. It is going to take time, if she is willing to work on her issues. Her attorney firm requests her record, including previous hospital note, specialist consultation notes, test results. I have no problem to send them my notes ( pt has signed release). But could I release third party notes? Am I allowed to do so? Would I violate HIPPA? I am confused regarding 3rd party info. Thank you all. Wen upon advisement of the lawyer, she is impaired from alcohol and the complications of being without it, therefore the rest of the world should sustain her activities of daily living and the complications thereof...(cynicism won today... i couldnt help it.. im glad youre standing ground)g> > >> > > Hi group,> > > I saw a new patient once last month. Tomorrow she is coming for 2nd time,> > > supposed to f/up on Depression, smoking cessation, etc. Today, she have> > her> > > lawyer fax me her disability form Social Security. She is in her mid 50s,> > > had 2 fractures on hip, osteoporosis, ETOH Over use...> > > Would you fill out this type of disability form? I don't normally do> > this.> > > But at the same time, I don't know where else she could go to.> > > Wen> > >> >> > > >>

[Guest guest]

my office doesnt send out third party notes like medical records from the last /

previous doc.

to circumvent that issue, i just mention what i read in my note ... in that way

they/ i have a record of what happened. the attorney can request that from the

hospital

grace

> > > > >

> > > > > Hi group,

> > > > > I saw a new patient once last month. Tomorrow she is coming for 2nd

> > time,

> > > > > supposed to f/up on Depression, smoking cessation, etc. Today, she

> > have

> > > > her

> > > > > lawyer fax me her disability form Social Security. She is in her mid

> > 50s,

> > > > > had 2 fractures on hip, osteoporosis, ETOH Over use...

> > > > > Would you fill out this type of disability form? I don't normally do

> > > > this.

> > > > > But at the same time, I don't know where else she could go to.

> > > > > Wen

> > > > >

> > > >

> > > >

> > > >

> > >

> >

> >

> >

>

[Guest guest]

It is legal but a burden .If Wen  can log in and go get hospital notes it is still not her job to  do that for the 10.00  fee This stuff is nuts without  interoperability If something  has gotten into my emr- I scanned in and attach a consultant note, fine .BUt prior docs and hospital records  should be gotten from those folks..

I do agree with others that we do not   determine disability I  try to docuemtnt well and just send the notes.It is possible but a rare case  that I have such an opinion  that I send in a letter and that is usually to SUPPORT the disability.

There are two sides to things  Docs are often at fault for not documenting what would help a  patietn get  o r not  get disabilty; the notes if done well  stand then on their own. I did some of this work I also have a disabled family member  We see but do not  write that we had to assist them to exam table that they had pain behavior in the office  that they came in  in a wheelchair, cannot arise from chair etcetc WRITE THAT DOWN

 And we forget that a person who looks  good can be dealing with damaged nerves and  needs to sleep alot and would like to work but can find no employer  flexible enough to allow  such people to be productive. The system is not perfect and imperfect in alot of ways but in this one we get to be docs we do not  determine disabiltiy.

When I write any letter or form I do it with the patietn present Partly that is because my stoopid life is run by stoopid money- working for free is not paying the bills but more importantly here is that the patietn and I write together that they  " can't lift anything " - I hand them a pen or a book I say see if you can lift that  see we just have to be clear I know this is emotional but lets  just tell SS  exaclty.etc

Then I have joined with patietn Occasionally I disagree with patietns about what they can do but it is usually minor and the patietn  can be persuaded to see  how I see their ability to functionI bet you can tell I get a lot of this stuff and I teach it alot to residents   so they do not,early in their  careeer feel  it to be antagonizing a /war, about what to do. IT is actually a satisfying part of teh job

I liked Wen's comment- too bad she the patient had not  found someone caring earlier:)Jean

 

She signed a release.  It is legal for you to send anything she has provided for you. 

Kathy Saradarian, MD 

From: [mailto: ] On Behalf Of Wen Liang

Sent: Wednesday, July 11, 2012 1:38 AMTo: Subject: Re: Re: Pt request Disability form.

   g and others, 

I saw the pt today. She and her husband understood that I didn't know her long enough to fill out a permanent disability form. She has seen a state disability doctor once and plans to follow up there.

 She appears to be a nice person, depressed and lots of other issues though. I wish she had worked with a caring physician closely 30 or 20 years ago. Now I can only try to help a little bit at a time. It is going to take time, if she is willing to work on her issues.

 Her attorney firm requests her record, including previous hospital note, specialist consultation notes, test results. I have no problem to send them my notes ( pt has signed release). But could I release third party notes? Am I allowed to do so? Would I violate HIPPA? I am confused regarding 3rd party info.

 Thank you all. Wen 

 

  upon advisement of the lawyer, she is impaired from alcohol and the complications of being without it, therefore the rest of the world should sustain her activities of daily living and the complications thereof...

(cynicism won today... i couldnt help it.. im glad youre standing ground)g> > >> > > Hi group,> > > I saw a new patient once last month. Tomorrow she is coming for 2nd time,> > > supposed to f/up on Depression, smoking cessation, etc. Today, she have

> > her> > > lawyer fax me her disability form Social Security. She is in her mid 50s,> > > had 2 fractures on hip, osteoporosis, ETOH Over use...> > > Would you fill out this type of disability form? I don't normally do

> > this.> > > But at the same time, I don't know where else she could go to.> > > Wen> > >> >> > > >>

 

--      MD          ph    fax

[Guest guest]

I used to know how much a PDR and other books weighed so I could see if patient could lift it....a little harder now since we don't use books, but yes, document everything.  Good points Jean.

Wen, good job trying to help appropriately and as you can.Sharon

Sharon McCoy MDRenaissance Family Medicine10 McClintock Court; Irvine, CA  92617PH: (949)387-5504   Fax: (949)281-2197  Toll free phone/fax: 

www.SharonMD.com

 

It is legal but a burden .If Wen  can log in and go get hospital notes it is still not her job to  do that for the 10.00  fee This stuff is nuts without  interoperability If something  has gotten into my emr- I scanned in and attach a consultant note, fine .BUt prior docs and hospital records  should be gotten from those folks..

I do agree with others that we do not   determine disability I  try to docuemtnt well and just send the notes.It is possible but a rare case  that I have such an opinion  that I send in a letter and that is usually to SUPPORT the disability.

There are two sides to things  Docs are often at fault for not documenting what would help a  patietn get  o r not  get disabilty; the notes if done well  stand then on their own. I did some of this work I also have a disabled family member  We see but do not  write that we had to assist them to exam table that they had pain behavior in the office  that they came in  in a wheelchair, cannot arise from chair etcetc WRITE THAT DOWN

 And we forget that a person who looks  good can be dealing with damaged nerves and  needs to sleep alot and would like to work but can find no employer  flexible enough to allow  such people to be productive. The system is not perfect and imperfect in alot of ways but in this one we get to be docs we do not  determine disabiltiy.

When I write any letter or form I do it with the patietn present Partly that is because my stoopid life is run by stoopid money- working for free is not paying the bills but more importantly here is that the patietn and I write together that they  " can't lift anything " - I hand them a pen or a book I say see if you can lift that  see we just have to be clear I know this is emotional but lets  just tell SS  exaclty.etc

Then I have joined with patietn Occasionally I disagree with patietns about what they can do but it is usually minor and the patietn  can be persuaded to see  how I see their ability to functionI bet you can tell I get a lot of this stuff and I teach it alot to residents   so they do not,early in their  careeer feel  it to be antagonizing a /war, about what to do. IT is actually a satisfying part of teh job

I liked Wen's comment- too bad she the patient had not  found someone caring earlier:)Jean

 

She signed a release.  It is legal for you to send anything she has provided for you. 

Kathy Saradarian, MD 

From: [mailto: ] On Behalf Of Wen Liang

Sent: Wednesday, July 11, 2012 1:38 AMTo: Subject: Re: Re: Pt request Disability form.

   g and others, 

I saw the pt today. She and her husband understood that I didn't know her long enough to fill out a permanent disability form. She has seen a state disability doctor once and plans to follow up there.

 She appears to be a nice person, depressed and lots of other issues though. I wish she had worked with a caring physician closely 30 or 20 years ago. Now I can only try to help a little bit at a time. It is going to take time, if she is willing to work on her issues.

 Her attorney firm requests her record, including previous hospital note, specialist consultation notes, test results. I have no problem to send them my notes ( pt has signed release). But could I release third party notes? Am I allowed to do so? Would I violate HIPPA? I am confused regarding 3rd party info.

 Thank you all. Wen 

 

  upon advisement of the lawyer, she is impaired from alcohol and the complications of being without it, therefore the rest of the world should sustain her activities of daily living and the complications thereof...

(cynicism won today... i couldnt help it.. im glad youre standing ground)g> > >> > > Hi group,> > > I saw a new patient once last month. Tomorrow she is coming for 2nd time,> > > supposed to f/up on Depression, smoking cessation, etc. Today, she have

> > her> > > lawyer fax me her disability form Social Security. She is in her mid 50s,> > > had 2 fractures on hip, osteoporosis, ETOH Over use...> > > Would you fill out this type of disability form? I don't normally do

> > this.> > > But at the same time, I don't know where else she could go to.> > > Wen> > >> >> > > >>

 

--      MD          ph    fax

[Guest guest]

and then there are those that wear the dark huge sunglasses in your exam room

and wants stadol rx for their migraine headache and as soon as you deny them

that, they huff and puff and almost blow your 500 sq ft ofc down, take their

sunglasses off and drive off in their top down convertible parked in your one

and only handicap parking spot...

cynic today, woe is me

grace

(wen, hats off to you)

(and you too jean)

> >> > > >

> >> > > > Hi group,

> >> > > > I saw a new patient once last month. Tomorrow she is coming for 2nd

> >> time,

> >> > > > supposed to f/up on Depression, smoking cessation, etc. Today, she

> >> have

> >> > > her

> >> > > > lawyer fax me her disability form Social Security. She is in her

> >> mid 50s,

> >> > > > had 2 fractures on hip, osteoporosis, ETOH Over use...

> >> > > > Would you fill out this type of disability form? I don't normally do

> >> > > this.

> >> > > > But at the same time, I don't know where else she could go to.

> >> > > > Wen

> >> > > >

> >> > >

> >> > >

> >> > >

> >> >****

> >>

> >> ** **

> >>

> >> ****

> >>

> >>

> >

> >

> > --

> >

> >

> >

> > MD

> >

> >

> > ph fax

> >

> >

> >

> >

>

[Guest guest]

Oh, on the medical records from third parties issue, I was taught (by my malpractice insurer; can't remember if it was in Washington or California now and don't know if still relevant) that I was only to release records that I generated and not those from specialists, etc. that had been conveyed to me.  In practice, this is rarely done, but I have seen some practices strictly adhere to this.

SharonSharon McCoy MDRenaissance Family Medicine

10 McClintock Court; Irvine, CA  92617PH: (949)387-5504   Fax: (949)281-2197  Toll free phone/fax:  www.SharonMD.com

 

and then there are those that wear the dark huge sunglasses in your exam room and wants stadol rx for their migraine headache and as soon as you deny them that, they huff and puff and almost blow your 500 sq ft ofc down, take their sunglasses off and drive off in their top down convertible parked in your one and only handicap parking spot...

cynic today, woe is me

grace

(wen, hats off to you)

(and you too jean)

> >> > > >

> >> > > > Hi group,

> >> > > > I saw a new patient once last month. Tomorrow she is coming for 2nd

> >> time,

> >> > > > supposed to f/up on Depression, smoking cessation, etc. Today, she

> >> have

> >> > > her

> >> > > > lawyer fax me her disability form Social Security. She is in her

> >> mid 50s,

> >> > > > had 2 fractures on hip, osteoporosis, ETOH Over use...

> >> > > > Would you fill out this type of disability form? I don't normally do

> >> > > this.

> >> > > > But at the same time, I don't know where else she could go to.

> >> > > > Wen

> >> > > >

> >> > >

> >> > >

> >> > >

> >> >****

> >>

> >> ** **

> >>

> >> ****

> >>

> >>

> >

> >

> > --

> >

> >

> >

> > MD

> >

> >

> > ph fax

> >

> >

> >

> >

>

[Guest guest]

Thank you all for the feedback and comments. For the specialist consultation note, I called and asked the neurologist's office, since he is the one seeing her for seizure. He doesn't want me to release his note to attorney office. But it is okay for pt to have a copy.

 So I am going to fax my notes only. The attorney office can get the 3rd party notes. They all response quickly at low or no cost for the attorney firm.  Wen

 

Oh, on the medical records from third parties issue, I was taught (by my malpractice insurer; can't remember if it was in Washington or California now and don't know if still relevant) that I was only to release records that I generated and not those from specialists, etc. that had been conveyed to me.  In practice, this is rarely done, but I have seen some practices strictly adhere to this.

SharonSharon McCoy MD

Renaissance Family Medicine

10 McClintock Court; Irvine, CA  92617PH: (949)387-5504   Fax: (949)281-2197  Toll free phone/fax: 

www.SharonMD.com

 

and then there are those that wear the dark huge sunglasses in your exam room and wants stadol rx for their migraine headache and as soon as you deny them that, they huff and puff and almost blow your 500 sq ft ofc down, take their sunglasses off and drive off in their top down convertible parked in your one and only handicap parking spot...

cynic today, woe is me

grace

(wen, hats off to you)

(and you too jean)

> >> > > >

> >> > > > Hi group,

> >> > > > I saw a new patient once last month. Tomorrow she is coming for 2nd

> >> time,

> >> > > > supposed to f/up on Depression, smoking cessation, etc. Today, she

> >> have

> >> > > her

> >> > > > lawyer fax me her disability form Social Security. She is in her

> >> mid 50s,

> >> > > > had 2 fractures on hip, osteoporosis, ETOH Over use...

> >> > > > Would you fill out this type of disability form? I don't normally do

> >> > > this.

> >> > > > But at the same time, I don't know where else she could go to.

> >> > > > Wen

> >> > > >

> >> > >

> >> > >

> >> > >

> >> >****

> >>

> >> ** **

> >>

> >> ****

> >>

> >>

> >

> >

> > --

> >

> >

> >

> > MD

> >

> >

> > ph fax

> >

> >

> >

> >

>