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Who does the paper work?

Kris-NYKKris-NY Posts: 2,207
edited 06/11/2012 - 8:47 AM in Health Insurance Issues
It's only 9 am and I know it's going to one of those frustrating days. I was planning to run some errands and then realized that I had a bunch of calls to make and that most of them would mean waiting for calls back.

I've been out of work for 3 months now as the doctors try to decide whether there is a surgery option or if medication and PT are the answer. So far it looks like meds but I have one more surgery consult next week.

I've been seeing my neurologist for the past year once a month with a break of a few months after the surgery. His office has been doing the paperwork for disability each month. I also started seeing a PM doc who handles all meds now and just started seeing a Physiatrist.

Last week I fractured my arm which the neurologist attributes to the high level (3600mg/day) of neurontin making he unsteady. After doing his exam he suggests that we consider changing to another neuro drug so he has started reducing the neurontin. Then he tells me that I'm fine and don't need to keep seeing him. That the PM office can take care of me. huh?? OK I guess I understand what he is saying.

So here's the problem. The PM office will not do the disability paperwork. They say they are not qualified to do the exam and determine that I am unable to work. I have a call into them to see what they might suggest. I asked when I was on the phone if the physiatrist (same office) could do this since he is a rehab sports med specialist and they couldn't answer.

So I'm wondering who does your paperwork?


  • dilaurodilauro ConnecticutPosts: 9,833
    My physiatrist completed all the paperwork that the company I worked for required.

    But also, I was seeing this physiatrist for the previous 2 years, so she was really my main doctor.

    I dont know for sure, but beside a physiatrist I would think that a neurosurgeon or neurologist or pain management doctor would be qualified to complete that.

    Perhaps a PCP could do that, but from my experiences, when it became something more serious, they would route me to a specialist.

    The form for my STD was very brief. I filled out about 90% of the form, and my doctor just put in a one liner and requested 13 weeks of STD
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Thanks Ron. I am hoping that the physiatrist will take over but need them to confirm. The problem is I get new forms every month and need a disability note each month. I've been going to the neurologist but I guess he feels we know what is wrong so there is nothing for him to do. But the different insurances want me to be seen every month by the same doctor.
  • Is this for SSDI, Kris, or disability through work/state?

    If for SSDI, I have an attorney, but *I* am the one who has gathered every report, had it competed, and faxed/e-mailed/mailed to the attorney. (I already get copies of everything myself, so I wanted to make sure *they* got them too.)

    As for completing forms, the only form I really needed to have completed by a physiciain was a Residual Function Form. My surgeon, who does not do *any* paperwork for *any* of his patients, had given me a letter of support, as had my PCP. When it came to that RFF, I asked my PCP to fill it out. It was about 8 pages long and a real pain in the butt, but he gladly did it for me, and didn't charge either.

    If this isn't for SSDI and you have tons of paperwork, but no lawyer, you may just find that you are your own best "manager" of the situation.

    Yet one more job for the jobless, eh? Please sir, may I have another? But I think you could do this one if absolutely necessary. (But call that physiatrist, tell him what's up, I think his office could do this for you if he manages all of your care/treatments right now.)

  • I'm not up to SSDI -- yet.

    This is for NYS disability, my short term disability (STD) policy and my no-fault insurance. No fault is the easiest since all they need is a disability note faxed to them once a month. The state disability sends a form that needs to be filled out each month. Right now the neurologists office charges $35 each month. The STD wants a disability note and then all of the office notes. Plus they have their own forms every other month or so which costs me another $35.

    I don't understand why all of this has to be every month. I could see every two months since the doctor has already indicated that they have no idea when or if I can return to work.

    I'm trying to figure out if it is my doctors who are making this so hard or if it is always like this. I know I could find an office where they would be happy to fill out all the paperwork as long as I came in once a month so they could bill the insurance for all kinds of tests. The idea just kills me.
  • I'm out of my league here, but any chance your physiatrist (if he accepts this mission) could call their offices, explain that he expects with your condition that he will be treating you for at least the next ____ let's say, 3 months), and ask if he can submit a form when each period expires? Failing that, you could sniffle a bit to the doc, tell him all this is impacting you so much what with you hubby's injury and now *your* injury... There are a few good souls out there who at least try to help you, I've found. Thank the Lord for them!

    >> Now going back to the SSDI hole I live in <<
  • SpineAZSpineAZ WiscPosts: 1,084
    I had STD and LTD through my employer. My pain management doctor would not do the initial disability forms as he felt my orthopedic spine surgeon was the one who could best gauge my level of functional ability. However, the PM doc would provide any back up documentation needed. So I had my orthopedic spine surgeon do the forms and then went and got a copy of all my pain management records and attached that to the form.

    I also have a private disability policy that pays above and beyond my LTD. For this my PM doc finally agreed to do the paperwork as long as he could see the form the Orthopedic Spine Surgeon completed first. So the OSS sent his completed form to the PM doc, who then also completed a form.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • Well I had lots of returned calls which was great. Usually these guys are very good about that.

    The neurologist's office is going to continue doing the paperwork. His secretary said not to listen to him -- lmao. I spoke with him directly and he is making some changes to the meds which is good as well.

    As far as the PM office, they said that NYS does not consider pain a disability :) so their practice does not do the paperwork. And since the Physiatist is part of their practice he also won't do the paperwork.

    The best news is that while I was out I picked up a great sandwich for lunch:)
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