Colorado used to have a nice simple formula for the maximum (reasonable) charge for medical records. $14 for the first 10 pages, $0.50 for pages 11 through 40 and $0.33 for every page after that. It was a bit more for patient representatives, but on the whole you knew what you could expect. It kept the lid on offices that wanted to charge you an exorbitant fee for a “records review” before releasing records. Or copiers that wanted to change $1 a page just to copy records. Well, now that’s all gone. Continue reading Colorado medical record charges
If you have been approved for Social Security disability (Title 2 – Social Security Disability Insurance), you already know Social Security Medicare health insurance does not start until you receive 24 months of disability benefits.*
While this waiting period includes back period months, many people still have to wait a year or longer to become eligible for Medicare. So, you have some money coming in from Social Security. However it is not enough to get private health insurance. And, you may be getting too much in monthly Social Security benefits to be eligible for Medicaid. So, how do you bridge the Social Security Medicare health insurance waiting period? Continue reading Bridging the Social Security Medicare waiting period
Every feel overcharged? Wondering if your doctor’s office is charging your the same as everyone else? Or are you getting bilked when you want your medical records.
Ever wonder what Social Security consultative examiners – the doctors who meet with disability applications to decide if they are disabled – think of the Social Security disability process?
Writing in Guernica, Dr. Heather Kovich discusses her experiences as a (former) Social Security disability examiner:
There is also a stereotype of the doctors who do this work: lazy and disinterested. I found the job fascinating. The more I learned about the disability system, the more I pondered its complexities: it provides a safety net but keeps people mired in poverty. Helpful services, including job retraining, are available, but aren’t advertised. And the system rests on a deeply flawed premise””that there is a way to objectively determine who is able to work and who is not.
This was my job, “independent medical examiner.” On the basis of a forty-minute interview and examination, I was supposed to determine how disabled an applicant or “claimant” was.
I did hundreds of disability exams over the next year, and while I did meet two people who were obviously faking, for the most part the stories I heard were heartbreaking: car accidents, massive strokes, lost jobs, dead spouses. Many people who apply for disability have lived through a tragedy. But the stories also told of the inefficiencies of the disability system. That first day in Spokane I met a man who had worked in manual labor his whole life, but for years had been getting crushing chest pain after walking a few blocks. His blood pressure was dangerously high. His condition was obviously treatable, but he did not have insurance so he had not been to a doctor in years. He knew that if he qualified for permanent disability he would eventually get Medicare or Medicaid and get proper treatment. He had no idea he could go to a community health center, a federally financed clinic where he could pay on a sliding-scale basis. With the right treatment and a less strenuous job, he would probably have not needed disability. Emphasis added.
This is the catch 22 of the Social Security system: with the health insurance Social Security provides, you might not be disabled. However, without Social Security disability, you can’t get the medical care you need.
This isn’t strictly a Social Security problem, it is US health system problem. Continue reading Social Security consultative examiner speaks out
Social Security has physicians review disability cases as medical consultant’s to make opinions on individual’s abilities and limitations.
However, there are all sorts of doctors: general practitioners, primary care, cardiologists, pulmonologists, rheumatologists, orthopedists, podiatrists, dentists, and the list goes on!
So you have to know WHAT KIND of doctor Social Security used to review your file! What good is the medical consultant’s opinion if they don’t have expertise in with the disability in question.
One of my colleagues in the fight to help disabled individuals get their Social Security disability benefits, attorney Johnathon Ginsberg, tackles whether you have to submit unfavorable medical evidence to Social Security.
I see this frequently in cases where there was a workers’ compensation case. “Company doctors” often minimize symptoms and generate records indicating that a claimant has the capacity to return to work. Other times I see unhelpful records in cases where my client just did not “click” with his or her physician or psychiatrist.
So, does that mean you can hold back evidence that doesn’t help your disability case? Continue reading Do you have to give bad evidence to Social Security?
Let’s say you are reviewing your Social Security exhibit file before your disability hearing and you discover that some of your doctor’s (or other records) are not there. I have mentioned before that it is not unusual for the medical records in a Social Security file to be a year or more out of date.
What can you do if the records are not complete? Continue reading My Social Security file is missing records
The American College of Rheumatology has a great overview of what a rheumatologist is and when you should consider seeing one.
A rheumatologist is an internist or pediatrician who is qualified by additional training and experience in the diagnosis and treatment of arthritis and other diseases of the joints, muscles and bones. Many rheumatologists conduct research to determine the cause and better treatments for these disabling and sometimes fatal diseases.
What Do Rheumatologists Treat?
It can be very difficult to win Social Security disability benefits based on fibromyalgia. However, it can be done!
While Social Security no longer considers fibromyalgia as a “imaginary” condition, or a “junk” diagnosis, you still need to make sure the diagnosis of fibromyalgia is backed up by medical findings.
I have reviewed many medical records which mention fibromyalgia, but don’t say how the doctor made the diagnosis. There is no mention of physical examinations or findings. Social Security may throw out the diagnosis because of a lack of medical support.
Without a diagnosis, all you have are symptoms and Social Security cannot approve disability benefits on symptoms alone.
This can stop a case dead in its tracks!
So, what do you need to properly diagnosis fibromyalgia? Continue reading How to diagnose fibromyalgia
I am often asked whether seeing a specialist will help in a Social Security disability case.
Do I need to see a specialist? I have my own doctor. What else can a specialist tell me about my case? How can they help?
I have seen numerous cases where Social Security has downplayed the opinion of a treating physician because the doctor is not a specialist!
I have even seen some cases where the Judge rejected the primary care provider’s opinion at hearing because he thought the doctor was just “saying what the patient wanted the doctor to say.”
A lot of these problems can be eliminated with a specialist’s evaluation and medical opinion. Continue reading Can I win Social Security disability without a specialist?