Point Person: Medical Records Team (Carolyn Lawrence), Preceptors
Disability paperwork is initiated by the patient and may go through federal Social Security Disability or private insurance (generally short- or long-term disability through their employer).
Eligibility
These are generally big decisions and should only be known by providers who know the patient well. Consider the following questions:
- Is the patient well-known to you?
- Is the indication for disability clear?
- Has a recent OT evaluation been done?
Of note, if you are seeing a patient with Medicare who is under 65 and not on dialysis or blind, then they are disabled. If a physical disability is not obvious by medical history, they likely have disability due to mental illness, designated by another provider.
Many patients may obtain attorneys who hire different doctors to assess them for disability. This frequently happens without our involvement.
Initial Authorization
If the patient is well-known to you (answer to all three questions above is “yes”):
- Complete the paperwork to the best of your ability. Jan and Elissa have resources to assist if you have questions.
- Have an attending review and sign.
If the patient is not well-known to you (answer to any of the above questions is “no”):
- Consider if the indication for disability is better handled by another physician, e.g. mental health disability might better be referred to the patient’s psychiatrist.
- Schedule the patient for an MD visit and/or direct the patient to set up a “functional capacity evaluation“. These are detailed hours-long evaluations that can be done regarding physical disability. Here is a list of non-Duke sites for these evaluations: Functional Capacity Evaluation Sites
- Complete the paperwork (if appropriate) after the above are complete.
