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Disability Insurance And The Differences Between The Payment Types

I have now completed three weeks at my new job with the Disability Determination Services office.  I sort of knew there were two types of disability payments under SSI:  Title II and Title XVI.  Now I understand the differences much clearer.

I would urge everyone who can afford it to purchase disability insurance.  As the person training me put it, “If you are disabled, you are still ‘costing’ your family in addition to not contributing to the family income.”

The big difference between the two (II and XVI) is that Read more »

*This blog post was originally published at Suture for a Living*

SCUBA Diving With A Disability

Charles James Shaffer (U.S. Navy) learning to SCUBA | Charles James Shaffer (U.S. Navy) learning to SCUBAOutdoor recreation is intended for everyone, and can be enormously beneficial for persons with disabilities. I am in awe of disabled skiers, climbers, divers, and others who have learned to coordinate their bodies and take great enjoyment and a sense of accomplishment from their wilderness activities.

It behooves everyone in the healthcare profession to be aware of certain special medical concerns for persons who are disabled physically or emotionally. Additionally, family members and friends are often well aware of what they can do to help in providing a joint effort to support the disabled.

At the 2010 Wilderness Medical Society annual meeting in Snowmass, Colorado, JenFu Cheng, MD (a pediatric rehabilitation specialist from NJ), gave a wonderful presentation on the medical aspects of (scuba) diving with a disability. He pointed out that there may be up to nine million certified recreational scuba divers in the United States alone. His presentation, rather than focusing on persons who are fully capable physically and emotionally, examined the lesser-known benefits of being in the water for individuals in need of additional support. For instance, aqua therapy (largely enacted in swimming pools) takes advantage of the buoyancy of water to allow a range of mobility that is not possible on land. For example, aquatic exercise has been shown to improve lung capacity and mobility skills in children with cerebral palsy. Read more »

This post, SCUBA Diving With A Disability, was originally published on by Paul Auerbach, M.D..

Pimped Out Wheelchairs

atgw4.pngHumor site is profiling stories of five souped-up wheelchair projects. If you already have four wheels and a frame, might as well install a flame thrower on it. Or how about a motorcycle with a wheelchair docking system?

Link: The 5 Most Incredible Stories of Pimped Out Wheelchairs…

*This blog post was originally published at Medgadget*

Too Old To Be Practicing Medicine?

With apologies to the Beatles:

“When I get older, losing my hair, many years from now,
Will you see need me, will you still feed me,
When I’m ninety four?”

From the New York Post:

Former NYPD chief cardiologist Dr. Irving Kroop retired in 1986 — when he was 70 — with a $64,364 disability pension awarded because of a bad heart, according to sources and city records.

All the while, he’s maintained a private practice in Brooklyn and moonlighted at NYCERS, the New York City Employees Retirement System, which paid him $14,479 last year to help determine whether other city workers should get disability pensions.

“Hats off to the man — he’s 94 years old but disabled? And still going strong?” said an incredulous Carol Kellerman, head of the Citizens Budget Commission.

Kroop, who gets $155 an hour as a private contractor for city’s civilian pension board, shuffles into examining rooms with a cane and oxygen tank, sources say.

This story presents an interesting dilemma in this era of shrinking retirement income for our seniors who want to continue to work. Should there be an age limit for practicing doctors? How do we assess if a doctor is “disabled” as they age? Should we care? Read more »

*This blog post was originally published at Dr. Wes*

HIMSS: Sudden Disability Could Cause Your Financial Ruin

Marty Prahl is the lead contracted health IT architect at the Social Security Administration (SSA). His personal experiences have led him to become a passionate advocate for digital data sharing. Several years ago one of his uninsured relatives was diagnosed with a devastating disease. She applied for disability benefits through the SSA but the process took over a year for her approval. During that year her medical condition caused her to lose her job, and she had no means by which to pay her soaring medical bills. The bank repossessed her home, her husband left her, and she had to move in with Marty’s family. As they waited for her disability benefits to be approved, Marty tried to make payment on her bills, which put enormous financial stress on his family.

Living through this nightmare galvanized Marty into action – he decided to devote his IT career to speeding up and streamlining the disability determination process. Thanks to Marty’s work, and the many people who created the Nationwide Health Information Network (NHIN), the SSA is now participating in an electronic medical record and data sharing network. This means that transfer of the records required to make an individual disability determination (if everyone sending data to the SSA is part of NHIN) can occur in under a minute. If the information supports the disability claim, an approval could be made within 1-2 days.

Prior to becoming part of the NHIN network, the SSA had no choice but to receive information by fax and paper. In order to make a disability determination, all medical records (from all healthcare professionals involved in the patient’s are) had to be gathered and analyzed by hand. If a doctor’s office didn’t send in the patient’s medical record in a timely manner, then the process would halt. Of course, compensation for sending records to the SSA didn’t generally cover the cost of doing so for the doctor, so the financial incentive to get the documents in was low. It’s no surprise that this resulted in wait times of 3 months to 2 years.

But some people simply can’t afford to wait – disability determinations are the gateway to Medicare and Medicaid funding, and there are other programs available for those who don’t qualify for Medicare and Medicaid. But those programs cannot be accessed until an official disability determination is made by the SSA. There are approximately 3 million new disability claimants annually in the United States – and without electronic data sharing, those people will have to wait for the paper process to run its course.

However, early adopters like MedVirginia, in Richmond, VA are already members of NHIN and can easily share medical records with the SSA. If more hospital systems and providers joined the network, disabled patients would gain rapid access to much needed government insurance benefits, and hospitals would no longer be offering them potentially bankruptcy-inducing “charity care” while they wait for a determination from SSA.

So what should Americans do about this? Spread the word about NHIN, and ask your hospitals to join the network. The software is free and available online (the CONNECT “open-source” code is here). As for me, I guess I hope that if I’m ever in a terrible car accident I’ll be taken to a NHIN participating hospital. A couple of days seems like a much better wait time than 2 years for disability benefits. I think Marty would agree.

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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