Doctors Aren’t Asked About Their Patients
Disability
determinations are made by a department of the various states. Once the
determination is made the federal government makes a decision based on the
determination. Sound familiar? Of course. We have discussed the desecration of
the rights of the disabled on two previous occasions. Actually the oblique
indirect method of determining disability disregards the recommendations of the
patient’s doctor and leaves the ultimate decision in the hands of panels of
anonymous people (some of whom are supposed to be doctors) who never sees the
patient.
Despite the fact
that all evidence pointed to the facts as described above, I really couldn’t
bring myself to believe them until I received a letter from Governor Kean who
himself was recently disabled by a back problem.
The letter stated
that “The Division of Disability Determinations operates under the provisions
of Social security Law, which when compared to other insurance and disability
programs, are very strict. Under both
Title II and Title XVI Programs, medical evidence forms the backbone for the
determination of disability. The existence of a disability condition must be
supported by a medical report containing the medical history, symptoms and
laboratory findings. The law is explicit in that it states that disability
decisions cannot be made on the basis of clinical judgments relating to the
applicant’s diagnosis, prognosis or remaining capacity to work. A physician
provides medical evidence upon which impairment can be evaluated. The impact on
the impairment of an individual’s ability to work and the decision as to
whether the impairment constitutes a disability is an administrative, not a
medical decision. The physician is neither asked nor expected to make a
decision as to whether his or her patient is disabled.”
So we are correct
after all. The law of the land has contrived to conspire to deprive people of
their right to be judged impartially by people who examine them, and have the
determination in the hands of hidden, anonymous indifferent, predatory types
who live in the trough provided by public funds. And all of this is prescribed
by law.
John A. Svahn, the
commissioner of Social Security writes to confirm the above. “Disability
determinations are made by designated state agencies. A physician in the agency
participates in every determination of the severity and duration of a
disability applicant’s impairment. This method of independently determining
disability can result in a determination that a person is not disabled within
the meaning of the law, even though a treating or examining physician concludes
otherwise. In line with this, treating and examining physicians are not asked
to give conclusions about their patients’ disabilities. These (the patients’ )
physicians are asked to furnish medical history , examinations results and
supporting laboratory information that would help define the nature of their
patient’s impairments. This medical evidence is even evaluated and an
independent determination is made by personnel who are trained in the law and regulations
concerning Social Security disability eligibility.
Both letters
emphasize that a physician is on the determination panel, but both letters fail
to emphasize that no one on the determination panel ever sets eyes on the patient,
has an opportunity to visibly inspect the disability, or touch the patient. The
procedure is as desiccated as a carcass in the hot sun of the desert, as barren
of feeling as ice, and the ultimate contradiction of the injunction to love thy
neighbor. Somehow those who perform evil deeds always clothe them in some sort
of legitimacy. In this case your congress has included a physician in the panel
that perpetrates the final solution; as if indeed the presence of this salaried
flunky with a medical degree lends probity and decency to a bankrupt procedure
that does no honor to this country.
Trying to find the
file of a patient caught up in this labyrinth is like trying to catch up to a
person riding two horses ahead of you on a merry-go-round. The file is always
in someone else’s office, or an appeals court waiting for a trial to be
scheduled. By the time some trials are put on the docket there is no more
disability claim. The claimant is dead.
One thing for
certain, although one must have naught but contempt for those who carry out
contemptible laws, this law was written by our congress. The law must be
rewritten to allow the patient’s doctor more a greater say; to permit his
conclusions to play a role in the final determination. Currently they are purposely
excluded. The government is afraid that corrupt doctors everywhere will succumb
to bribes or blandishments and put everybody on disability indiscriminately.
Even if that were to happen it would be less a corruption than that which
currently occurs. The law should be
written to permit the hearings to take place in the presence of the patient,
his or her doctor, and some impartial panel. The way things are the patient has
no advocate in the proceedings. Thus grievous
crimes are being committed against many defenseless individuals.
Perhaps what is
most bothersome, that of which I am most ashamed, is that the process of
disability determination is devious and secretive.
No proud people
should tolerate this.