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Old 04-08-2012, 06:05 PM   #1
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Bad Doctor Report

I am on disability with various problems. For my back problems, last year I found a wonderful neurosurgeon, who said good PT with specific exercises can really help me. My medical history is long and depressing.

Out of nowhere, my neurosurgeon decides that all my test are negative! The last few visits, he was totally rude and asked why I was on Medicare. I just read his medical notes, the last 2 office note visits, were awful. I read more of the notes and 6 months ago, he thought I had all these problems but they are not surgical, but a problem. I liked this neurosurgeon, because he seemed to understand that I want to do everything I can to not have surgery. All of sudden, he is soo rude!

My question is this, what do i do if disability gets his notes? Can he send these notes to medicare? Should I be freaking out like I am? Should I call my lawyer? My primary care doctor and my other doctors will all back me up, they know I am in hell.

Has this every happened to anyone? I am so worried with these new computer systems that are all linked up to different hospitals and networks, that disability will see the last 2 office visit notes. Can medicare or my insurance companies get these records without my knowledge, can he just send them to medicare without my approval or my lawyers?

One doctor said to me after an evaluation, you look good, but you are a mess. I told my primary care doctor about that and he laughed and said that is so true.

Please let me know if this has happened to you.

Thank you

 
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Old 04-08-2012, 10:02 PM   #2
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Re: Bad Doctor Report

It sounds like you are worried about a possible CDR (Continuing Disability Review) being triggered by some electronic record getting to SS showing that you have medically recovered- is this correct?

If so, there are some things that are working in your favor. First, you would need to show that you medically recovered enough to earn SGA (Substantial Gainful Activity), and your condition will be evaluated based on your current functioning, as it would be compared to your functioning when you were last reviewed or when you were approved, whichever is more recent (Comparison Point Decision).

So even in the worst-case scenario, and your neurosurgeon's notes show "medical improvement", but you continue treatment and your condition shows to have not improved because you see more doctors that document that fact......you will still be considered disabled by the time the next CDR rolls around. To illustrate, let's say person A was approved for SSDI in 2000, then "medically improved" in 2005, only to become disabled again in 2006 and have his 1st CDR at that time, probably the only dates that are relevant are 2000 and 2006, not the recovery spike in between.

Another thing working in your favor is that you are seeing other doctors, so other medical opinions will be considered, some given more weight than others (specialists are usually given more weight). Lastly, something would actually have to trigger that CDR, such as work activity or your medical review diary date. For example, if in your approval you were given a MIP (Medical Improvement Possible) date, your review diary date will come every 3 years. Electronic notes just sitting there won't trigger anything, and by the time a CDR rolls around, you will probably have had sufficient time to continue to document the seriousness of your condition.

I happen to have severe anxiety so have to add a disclaimer to almost everything for no good reason, but this post is a good exposure therapy exercise----So here it is: I could be wrong on everything written above, please research this topic from valid sources. BTW, I completely understand your anxiety, as everything hinges on the doctor's word, and if you get someone who has had a bad week or you feel doesn't understand your condition, it is perfectly natural to worry. Just know the chances of your losing your benefits are quite slim if you continue to get medical treatment, follow that treatment and keep your doctors up to date on how your illness is affecting you.

Last edited by sunni123; 04-08-2012 at 10:07 PM.

 
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Old 04-08-2012, 10:14 PM   #3
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Re: Bad Doctor Report

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Originally Posted by sunni123 View Post
It sounds like you are worried about a possible CDR (Continuing Disability Review) being triggered by some electronic record getting to SS showing that you have medically recovered- is this correct?

If so, there are some things that are working in your favor. First, you would need to show that you medically recovered enough to earn SGA (Substantial Gainful Activity), and your condition will be evaluated based on your current functioning, as it would be compared to your functioning when you were last reviewed or when you were approved, whichever is more recent (Comparison Point Decision).

So even in the worst-case scenario, and your neurosurgeon's notes show "medical improvement", but you continue treatment and your condition shows to have not improved because you see more doctors that document that fact......you will still be considered disabled by the time the next CDR rolls around. To illustrate, let's say person A was approved for SSDI in 2000, then "medically improved" in 2005, only to become disabled again in 2006 and have his 1st CDR at that time, probably the only dates that are relevant are 2000 and 2006, not the recovery spike in between.

Another thing working in your favor is that you are seeing other doctors, so other medical opinions will be considered, some given more weight than others (specialists are usually given more weight). Lastly, something would actually have to trigger that CDR, such as work activity or your medical review diary date. For example, if in your approval you were given a MIP (Medical Improvement Possible) date, your review diary date will come every 3 years. Electronic notes just sitting there won't trigger anything, and by the time a CDR rolls around, you will probably have had sufficient time to continue to document the seriousness of your condition.

I happen to have severe anxiety so have to add a disclaimer to almost everything for no good reason, but this post is a good exposure therapy exercise----So here it is: I could be wrong on everything written above, please research this topic from valid sources. BTW, I completely understand your anxiety, as everything hinges on the doctor's word, and if you get someone who has had a bad week or you feel doesn't understand your condition, it is perfectly natural to worry. Just know the chances of your losing your benefits are quite slim if you continue to get medical treatment, follow that treatment and keep your doctors up to date on how your illness is affecting you.
I couldn't have said it better myself!!! There is no way that those notes he wrote would trigger a review of your disability benefits, so I wouldn't worry. But I WOULD get another doctor. Seems like he has stopped caring. I know it is hard to switch when you have seen him for years, but if he feels like that, he isn't going to provide quality care.

 
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Old 04-09-2012, 06:09 AM   #4
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Re: Bad Doctor Report

Actually, this post is what concerns a lot of ppl on disability income. For all of us here, SSDI and/or LTD is/are the only source(s) of income we have, and the thought of it being taken away after fighting so hard to get it is really a scary thought. Plus, we are dependent on medicare now to pay for our medical treatment since we have lost any private insurance we had when we were working.

Both SS and private LTDI carriers will review all claims periodically to ensure the claimant is still disabled. Even those claimants with a SS MINE disability rating who are given 7 year CDR's should have cause for concern. Although unlikely, the possibility is always there that benefits will be terminated at some future point as long as you remain on disability. I would surmise to say if this happens to any of us, we would be devastated financially, emotionally, and medically. It is not a very pleasant thought and it is one we would rather not even think about.

What disturbs me about what footny wrote has to give cause for future concern of continuing disability benefits when it comes time for a disability claims review. Often, some innocuous remark or comment that a doctor has written in the patient's medical records will be misconstrued by the disability examiner as the patient has improved enough to be able to return to work. (SGA).

Many people with chronic medical conditions will some have good days and bad days but unless the medical condition has been cured or can be managed adequately with drugs, we are all still unable to maintain fulltime employment required by employers because of the excessive absenteeism due to the chronic nature of our medical conditions.

I met a guy in another forum who told me he had a doctor who believed no one should be on disability unless they have been given a terminal diagnosis, were legally blind or paralyzed and confined to a wheelchair.

Obviously, many chronic medical conditions can prevent one from working a fulltime job. The SSA even lists them but your medical records from your doctor must (say) show you have them.

Lastly, I will say this. Anyone on any long term disability (SSDI,LTD,SSI) needs a supportive doctor and needs to see this doctor regularly to ensure future disability benefits until the end of max. benefit duration. If your doctor starts saying negative things like footny's doctor (why are you on medicare, SSDI, etc) and you know in your heart although you may have made some improvements but are still unable to sustain fulltime work earning SGA, I would immediately find me another doctor to start documenting my medical condition and begin a new longterm relationship with him or her.

 
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Old 04-09-2012, 06:14 AM   #5
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Re: Bad Doctor Report

I agree with what Sunni and NELady said btw. As NElady said, this doctor seems like he has stopped caring. That is ok. Just find yourself another doctor who you have a better rapport with.

 
Old 04-09-2012, 07:14 AM   #6
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Re: Bad Doctor Report

Can I chime in here too . . .

If it were me in your shoes, I would get an appt with my doctor - ALL my doctors who knows your issues well... say your GP ASAP. --And the sooner the better. Have him/them do a quick run down/follow up of all medical issues to CONFIRM there have been no real changes ***as close to the date this doctor berated you*** -which will at minimum will negate this doctors change of heart & your treatment. Explain to them 'in passing' 'off the record' to your doctor/s (and the more doctors you have a history with and can go to the better. The ones who can confirm there have been no significant changes in your medical condition better). Explain how all things were nicey nice then he took a road south -- blind sided you about being on Medicare-that, after he had previously confirmed you had issues & was treating you then POW - miraculously, all of a sudden you don't have those issues anymore.

That way JUST IN CASE if you feel SSA may somehow get involved, they would request ALL your medical records and NOT just take the word one that man who has had a bad personality conflict in his own head aka God Syndrome -- and you will have your other confirming doctor reports near the same time this Dr on a power trip went crazy and took it out on you.

Just curious.. Why do you think he took this hard change of heart? Do you think he saw you somewhere doing something? Did he see somebody else that he thought maybe was you? Thats really odd that a doctor would conflict is own medical Dx/treatment plans.

 
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Old 04-09-2012, 07:28 AM   #7
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Re: Bad Doctor Report

Good post...I am thinking along these same lines.

 
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Old 04-09-2012, 08:33 AM   #8
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Re: Bad Doctor Report

You are all correct, something did happen. But not on my part. My primary care is aware of this and I am waiting for him and my lawyer to call. I am thinking I should ask for an addendum. I wish I could go into more detail, you would all be disgusted!

 
Old 04-09-2012, 08:37 AM   #9
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Re: Bad Doctor Report

Questions footny? How long have you been on SSDI and what CDR timeframe did they (the SSA) give you when they approved your claim?

 
Old 04-09-2012, 08:51 AM   #10
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Re: Bad Doctor Report

Quote:
Originally Posted by footny View Post
I am so worried with these new computer systems that are all linked up to different hospitals and networks, that disability will see the last 2 office visit notes. Can medicare or my insurance companies get these records without my knowledge, can he just send them to medicare without my approval or my lawyers?
The answer is probably yes since they already have consent forms for release of medical info. that you signed during the application phase of the SSDI process but a request still has to be made by the requestor. Normally, when new updates are needed to substantiate continuing disability, they usually notify you but they don't have to I suppose. Your doctor will not just send your medical records to SS without a request so I don't think you have to worry about this. I wonder why, like Jacki asked, this doctor now all of a sudden has this change of heart?

Last edited by BlueSkies14; 04-09-2012 at 08:57 AM.

 
Old 04-09-2012, 09:42 AM   #11
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Re: Bad Doctor Report

On the topic on these medical release forms..

As I as reading - something in my old memory banks recalled from lord knows where.,. that you can - (or could) somehow stop the use of all of those medical release forms by way of a letter to doctors letting them know there is no longer a reason anyone should be looking into your medical history without CURRENT medical approval -- HIPPA. That may not be exactly how, but there is a way to stop the use of them. However, I do not know if SSA can nosy in our biz - even tho we are getting SSDI, until our review comes up without notifying the claimant and with NEW authorization letters. I am sure that if we do not RE-sign new authorization letter there is a way SSDI can obtain our records without our permission. But I believe they too must at least TRY to follow the HIPPA laws like everyone else... I do not see a reason why SSDI should have the 'patriot act type indulgence at will' into our medical records in a dark smoke filled room atmosphere.

When we hire an atty, you noticed/remember we signed (I think I signed 30 or more) of these medical release forms without any date on them. ALL of these forms should have been shredded by your atty/representative once your case was closed. Maybe in the case of the atty still having the blank forms, you should send a letter to all your doctors letting them know you are no longer represented by John Doe, Esq., and to please notify you of any medical inquires made from this date forward. **And just a by the by on that, keep in mind that if the doctor charges your atty for the records, he can then bill you. So if your case is over, make sure your doctors are aware.

(Boy, I'm glad we had this talk.. I have some calls to make to find out how to stop those blank forms from popping up)

Hugs

Last edited by Jacki345; 04-09-2012 at 10:29 AM.

 
Old 04-09-2012, 09:53 AM   #12
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Re: Bad Doctor Report

Yeah, this concerns me too Jacki. I would at least like to be notified in advance. The fact that they are / might be able to do this anytime without my knowledge disturbs me. I have nothing to hide but I would at least like to know.

Last edited by BlueSkies14; 04-09-2012 at 09:54 AM.

 
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Old 04-09-2012, 10:00 AM   #13
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Re: Bad Doctor Report

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Originally Posted by Jacki345 View Post
However, I do not know if SSA can nosy in our biz - even tho we are getting SSDI, until our review comes up without notifying the claimant and with NEW authorization letters.
Yeah, I think you are right Jacki.

 
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Old 04-09-2012, 10:42 PM   #14
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Re: Bad Doctor Report

I wonder though with having Medicare as insurance, most doctors offices have you sign consent to treat/auth to give insurance any info they want. Sooooo even if you went and voided all those auths, just to get a claim filed they will probably make you sign another auth to Medicare. They could "technically" I suppose share that info with SSA, although I would be surprised. Just throwing it out there that most of us sign auths for insurance at our doctors office giving them free reign!!

 
Old 04-10-2012, 05:23 AM   #15
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Re: Bad Doctor Report

Good point NElady. You know I wish with the 2014 EMR mandate, all patients had the ability to go online and securely login to their their own personal health account with view only ability to look at their medical records. If you saw any mistakes or inaccuracies, you could then speak to your healthcare provider about correcting, but this is just wishful thinking on my part.

Hope everyone has a great day.

 
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