Private Disability Insurance
In contrast to the public programs like the Social Security Administration, private disability insurance tends to be fairly straightforward. There is an insurance contract that spells out the benefits and qualifications. There may also be a benefits coordinator for the patient’s employer who can be very helpful.
This doesn’t necessarily mean that getting benefits is easy. There will be specific forms to be completed by the attending physician for each insurance company. They may also require copies of medical records. The company may want an independent medical exam or functional capacity evaluation done. The attending physician and other medical care providers should cooperate fully with the process.
Clearly it is in a patient’s best interest to receive disability benefits if the patient qualifies for them and is disabled. Part of a physician’s duty to a patient is making and keeping adequate medical records. The physician should not hinder the process because he or she does not like dealing with insurance systems. On the other hand, the physician should be cautious about being too sympathetic with the patient. Like any other medical opinion, disability statements should be based on a specific diagnosis and objective medical evidence. They should not be a recitation of the patient’s complaints or allegations. If the patient drives himself to the doctor’s office, walks in unassisted, and waits for thirty minutes, then he clearly is able to walk fifty feet and sit for thirty minutes. Statements that defy common sense are not likely to carry weight with the insurance company.