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Disability Insurance Allowances Lack Objectivity


Posted on Sep 30, 2007

disability benefitsJust who is telling the truth in the disability insurance standoff?

In Charlotte, North Carolina and across the country, the stalemate drags on between government and medical officials versus those claiming they’re too hurt to work.

In one examination room, a patient complains of lower back pain and sciatica, but can’t have a 30-minute MRI taken for $1,400. In another, a doctor examines a patient and determines there’s no reason this “healthy” individual can’t work.

So who’s right? Without hidden cameras or polygraphs, no one knows – neither the media, health officials, nor insurance claims adjustors. A doctor can’t “feel” someone’s lower back pain. (Our attorneys review how pain is valued in an injury case here.) Someone looking for a handout refuses to accept a “healthy” diagnosis. 

Can a physician arrive at a diagnosis in 15 minutes? Sure. In other cases, no. A neurosurgeon must examine the patient, an MRI, nerve tests, and more. Few cases can be treated equally with varying pain threshold levels. To be certain, there is no test yet to determine initiative, will, or responsibility. Patients “play the game.” Doctors may “check the blocks” to save on laboratory/radiology fees. Medical personnel may pigeonhole costly tests to protect their jobs. Measuring for accuracy and honesty is a blurry proposition.

A herniated disc may debilitate one individual, but not the next. Sciatica doesn’t stop you from walking or standing, but the reverberating pain from buttocks to toes quickly will allay fears of surgery and even risk of paralysis. Not every patient can be held to one measuring stick, which makes the scenario all the more subjective.

The Charlotte Observer found this out when it interviewed “players” on both sides. Doctors defended their diagnoses. Claimants maintain they can’t work. Patients appealed rejections and won after long waits. Others waited but were rejected again.

The Observer reported doctors in North Carolina spent $12 million to perform disability examinations on patients in fiscal year 2006. Forty patients seeking claims were interviewed by the newspaper and over half were dissatisfied with their medical exams, citing time, dialogue and in one case, poor physician dress code.

Doctors stand by diagnoses. State officials monitor physicians. Critics contend the government uses physical exams to reject claims.

"The exams are bogus," said Linda Fullerton, president of the Social Security Disability Coalition, which lobbies for the disabled. "The system is set up so you give up or die."

Regardless of public opinion, disability insurance allowance decisions are far too subjective to determine just where integrity lies. Ask for a complimentary case review with our disability lawyer in Fayetteville. Brent Adams & Associates has an attorney who is a Board-Certified Social Security Disability Benefits Specialist. Less than 50 lawyers in North Carolina have this designation. Medical exams may be frustrating, but we hope to ease the disability claims process for you.

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