The disability insurance merry-go-round

So. Disability insurance forms. Why oh why did the bureaucrats get away with omitting the obvious item: a big-arse checkbox at the top of the six pages of paper, saying:

“Is everything EXACTLY THE FUCKING SAME as it was 28 days ago? Y/N”

But no. I must be forcibly reminded at least once a month that I am a patient, not a regular person. I have to dutifully attend my doctor’s surgery with wads of paper, and rearrange my week so I have adequate pre- and post-visit rest, and organise my day to make sure I do nothing else but attend the appointment. Because the insurance company has a stipulation that they will only pay me disability insurance as long as I am “under the treatment of a medical practitioner”. For an untreatable illness. Every time I do this, I have to trade off normal human activities – playing with my kid, sitting up to dinner with my family – so that I can go and sit in a grey waiting-room chair, and waste my doctor’s time, and tick boxes.

Gack, I get sick of this. And they have arranged yet another “IME” for me next month with yet another new doctor. (IME = “independent” medical examination, by a doctor chosen and paid for by the insurance company). Every time I go to one of these, I feel like the company is just holding their breath waiting for me to strike a “non believer” doctor so they can bring my life down around my ears by withdrawing my income.

Why are the gazillion IMEs and massively intrusive insurance examiner reports I’ve had already not enough? I have not had a single IME report in the past suggesting that I’m faking it, or that I’m unmotivated to rehabilitate and return to work when I’m well enough. But for some reason, I must be constantly reminded that “We are ALERT to MALINGERERS, so don’t you even think about getting away with anything, Missy. We’re watching you.”

Dependence sucks.

Categories: Miscellaneous

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14 replies

  1. I am so with you. I was on short-term disability for 10 weeks after my rotator-cuff surgery. After every doctor visit I got a letter from the insurance company saying “We see you had a doctor’s appointment on Sept 21. We assume you’re returning to work on Sept. 22 and will therefore be terminating your benefits. If you’re not returning to work, your doctor should fax us all of your medical records including all the crap he faxed us two weeks ago, with no detail left out. It’s not good enough to say that you can’t return to work, we need a full medical management plan, and even if he’s sent it before, we need it again, and will need it again in two weeks when you have your next appointment.”
    OK, I paraphrase.
    The doctor’s office dealt with this gracefully, but it annoyed me to death.
    Vicki’s last blog post..Meme For The End Of The Year

  2. That sounds like such an asshole of a process.
    annaham’s last blog post..They’re in Our Schools–Everybody PANIC!

  3. Governments would get better value if rather than waste time and money hassling individuals with long term issues, instead put more effort into finding them productive jobs that make best use of their abilities while accomodating their issues.
    An example: Imagine a Chief Financial Officer, unable to work full time, probably unemployable in industry, is still productive part time (even if the hours are irregular) doing fairly senior work in a smaller organization. Worthy non-profits desperately need such skills (but rarely need them full time), and it would be smart and cost-effective for governments to act as a broker in these circumstances.
    This is really just a special case of the work-life balance issues that our society manages so poorly, and desperately needs competent political leadership.
    BTW: Lauredhel – You’re use of the term “untreatable” is defeatist. “Difficult to manage”, “requiring significant accomodation”, etc, might be much more positive ways of looking at it – and make it harder for the powers-that-be to consider such issues intractable, action futile, and thus justify inaction. Instead, the more positive labels demonstrate the need for smart intervention and political action. My own chronic condition (epilepsy) cannot be “cured”, but needs significant management, knocks me about unpredictably, and requires a fair amount of accomodation.
    Dave Bath’s last blog post..Sue Big Carbon like Big Tobacco

  4. This isn’t government, it’s a private policy. Sorry I didn’t make that clear.
    My outlook is in no way “defeatist”. The illness I have is “untreatable” at this point in time, in the sense that there is no “medical treatment” for it: I chose the word carefully. The crux of living with this illness (not “treating” it, but living with it) is in self-management and positive personal action, which I have well under control (if you like, I can refer to you to some previous posts on this).
    The medical profession cannot provide any of this for me – there is no “medical treatment” – and the absolute heart of my rant is me being forced into a compliant-little-patient role frequently and in a way that actually compromises my self-management and undermines the pacing and lifestyle management and accommodations that I’ve found work best for me.

  5. Vicki: Your paraphrase is a very close one, yes? It certainly sounds familiar. Kudos to your doc’s office for navigating the sea of crap.

  6. Oh I am so sorry. I thought US Gov’t disability was bad, but it seems they only make you go through that crap for a year leading up to and then during your disability evaluation. I’ve even had my 4 year review come and go and I didn’t even have to do anything. Now if I could only get them to pay for what I really need, therapy, I would be ecstatic.
    My heart goes out to you. That is so ridiculous and I know how hard and tiring that can be. *sends good vibes and kitty love* (Logan’s rubbing against the computer so I’m assuming he wants to send love too)
    Lost Clown’s last blog post..Please

  7. Lauredhel,
    Aaah: I was confused. “untreatable” i was treating as a synonym for “unmanageable”. It seems you have other tactics/strategies to help you manage. Being a pedantic so-and-so, it seems that the “treatment” offered by the medical profession should include training others with your issues in techniques like the ones you are using and help you. Trivial example from my case – having keys ALWAYS attached on a chain rather than free in my pocket, and my mobile in my left hand pocket, lest my right hand throw important stuff away when I’m partialling. This is management, but unfortunately the medicos don’t pass on this sort of thing! They rarely even point to the [insert-condition-here]-support groups that collect such management hints!
    As for “private police”… aha! I guess they are taking a very short term all-stick-no-carrot approach, along with many businesses who don’t fully understand the value of stuff in people’s heads (e.g. corporate memories) – and I suspect YOUR head is full of stuff that gives the business value – it’s just that they probably don’t value it enough.
    Best wishes.
    Dave Bath’s last blog post..Sue Big Carbon like Big Tobacco

  8. Oh God do I identify. The last time I went to my ex-PCP, I was basically told that in order to get the painkillers I needed (and make no mistake, even on my 14+ pills a day, my quality of life is exponentially better than it was without them, and I’d be devastated to lose that freedom) I would have to see the doctor for EVERY REFILL. That is, see the doctor EVERY MONTH in order to get the medicine I needed to work, to shower, to go grocery shopping without overbearing pain. Hell, just to climb the stairs to my apartment door.
    Fuck that. I’m sorry, but fuck that. Do people with diabetes run into these roadblocks? Or high cholesterol? Or poor eyesight? “To get your next month’s supply of contact lenses, you must be seen by your ophthalmologist. Every time.”
    amandaw’s last blog post..If I had all the energy in the world

  9. My family has similar frustrations in arranging things for my Aunt – she has significant disabilities (both mental and physical), and has been in supported accomodation since she was sixteen years old. She is now in her early fifties, but every six months, needs to re-convince the government that she NEEDS her Disability Support Pension, and that she has a ‘life skills improvement’ program going on.
    As an example of the stupidity, she’s been sent on TAFE courses in accounting, and computing, and god knows what else to make her more ‘employable’ – all this for a woman who reads at a tweleve-year old level, and who cannot handle money beyond about twenty dollars without getting confused! Not to mention the constant health checks to see if she’s improving at all… *sigh*
    Surely some sort of “yep, you’ve been getting the DSP and living in supported accomodation for more than twenty years, we’re just going to assume things are not getting better” flag could be put on her case?!

  10. Dave Bath: exactly. I’ve confessed before to my bad habit of trying to make one word do the work of fifty, and that’s what I was doing here with “untreatable”.

  11. Thanks everyone for your support, and a sympathetic “Argh!” to those of you experiencing similar things.

  12. Makes you wonder how much money could be saved by using some common sense for these things. I don’t know how much disability pensions etc pay these days, but I’m guessing that most people could make more if they were able to participate normally in the workforce, so your true malingerers are going to be pretty small in number. Assuming everyone is malingering is a pretty expensive way of doing business.
    Mindy’s last blog post..Why we should pay more attention to D&D

  13. Mindy: just for a datapoint, my insurance pays me less than half of what I could earn in a week’s work, with no after-hours or overtime. This is assuming either a fairly relaxed week of work, or a place giving out a lot of client discounts. (please don’t think I’m crying poverty – we do fine, far better than many; I’m just addressing the relativity side of things.) Given the choice, I’d certainly choose paying off my mortgage in one-fifth the time.

  14. Lauredhel,
    As someone whose dayjob is in currently in a form of insurance where I didn’t need the explanation for IME, (workers’ comp, in this case) I’m sorry. We tend not to have ‘untreatable’ cases as such, we similarly acknowledge when an injured worker has reached ‘maximum medical improvement’, basically, meaning that they’re as good as medical treatment can get them. If their condition can be controlled with self-management, we make sure they’re given the services they need to develop those strategies, etc. Which isn’t to say we’re all lovely and nice, but it’s certainly what I strive to do, and what I’m required to strive to as a part of my job.
    I must admit, whilst I vaguely recall the obsession with ‘doctor-shopping’ IMEs from about 6 years ago in my own branch of insurance (and even then it was being phased out), the concept makes me o.O quite a bit. I don’t know how much litigation there is in disability insurance (my guess would be less than w/comp), but at the very least it looks patently obvious and ridiculous when you get to court, and the magistrates (and lawyers) all know who the hackslash doctors are and tend to laugh you out of court.
    Also, with regard to malingerers, at least in terms of W/Comp, it’s usually a very small number (despite what some of my employer clients like to think *eyeroll*), because, well, from my perspective there’s far too much effort involved. And really, any case officer worth their salt knows that the best way to weed out a malingerer is to treat them as you would someone who’s genuine and really wants to get better.
    Plus, most states’ W/Comp (and Comcare), you get 6 months at your average weekly rate, and it drops down considerably after that (NSW is a legislated rate that’s indexed, ACT is 65% of what you were getting before, or minimum wage, whichever is higher, assuming you were originally getting more than minimum wage).
    arielladrake’s last blog post..Whee.

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