"THE PATIENT IS DOING WELL."
"The patient is doing well."
Doctors love to write this in their patients' medical records. Sometimes they write, "The patient is improving," or "Ms. Public continues to improve with her new medications."
The problem is that low-paying administrative law judges sometimes seize upon these statements to justify a denial of disability benefits. I've seen judges use such statements by doctors to justify a finding that the claimant's symptoms are not as severe as alleged.
How do we deal with the common phrase, "Mr. Smith is doing well"? Consider the following:
"Doing well" is a relative statement. Doing well compared to what? Mr. Smith may be "doing well" compared today compared to yesterday. He may not be constantly suicidal since he started Prozac and, by comparison, the doctor may feel that this is "doing well."
Mr. Smith may be "doing well" relative to his catastrophic illness. His pain level may have dropped from a 10 to a 7 with a combination of Norco, Lortab, Ibuprofen and Flexeril. Some doctors may call that "improving" or "doing well."
Unfortunately, some doctors use this nebulous phrase, "doing well" about all their patients out of habit. If you are breathing and able to visit the doctor's office you are "doing well."
The questions is: Can the patient perform full-time remunerative employment according to Social Security Ruling 96-8(p)?
Most doctors like to describe their patient's progress in as positive a manner as they can. Seldom will a doctor put a note in the medical record that says, "I have tried everything known to modern medicine and Mr. Smith is still a wreck of pain and misery and I just don't know what to try next." It sounds so much better to write, "The patient is doing well," or "The patient continues to improve."
I don't think I've ever seen a surgeon write, "My surgery was a complete failure. It did not help the patient one little bit. In fact, he may be in more pain now than before I operated. His ability to sit, stand, walk, lift, push/pull, etc. were much better before surgery than after." Doctors, like the rest of us, tend to describe their work in the most positive terms possible.
Social Security disability advocates must point out the medical evidence that puts these statements into context. If possible, a medical source statement (form) should be obtained from the doctor which provides the functional restrictions of the patient.
The goal of the representative is to understand that judges may misuse doctor's careless statements to deny claims. The goal of the representative is to make it as difficult as possible for the judge to do this. Decisions should be based on the entire weight of the medical evidence, not a statement taken out of context.
Doctors love to write this in their patients' medical records. Sometimes they write, "The patient is improving," or "Ms. Public continues to improve with her new medications."
The problem is that low-paying administrative law judges sometimes seize upon these statements to justify a denial of disability benefits. I've seen judges use such statements by doctors to justify a finding that the claimant's symptoms are not as severe as alleged.
How do we deal with the common phrase, "Mr. Smith is doing well"? Consider the following:
"Doing well" is a relative statement. Doing well compared to what? Mr. Smith may be "doing well" compared today compared to yesterday. He may not be constantly suicidal since he started Prozac and, by comparison, the doctor may feel that this is "doing well."
Mr. Smith may be "doing well" relative to his catastrophic illness. His pain level may have dropped from a 10 to a 7 with a combination of Norco, Lortab, Ibuprofen and Flexeril. Some doctors may call that "improving" or "doing well."
Unfortunately, some doctors use this nebulous phrase, "doing well" about all their patients out of habit. If you are breathing and able to visit the doctor's office you are "doing well."
The questions is: Can the patient perform full-time remunerative employment according to Social Security Ruling 96-8(p)?
Most doctors like to describe their patient's progress in as positive a manner as they can. Seldom will a doctor put a note in the medical record that says, "I have tried everything known to modern medicine and Mr. Smith is still a wreck of pain and misery and I just don't know what to try next." It sounds so much better to write, "The patient is doing well," or "The patient continues to improve."
I don't think I've ever seen a surgeon write, "My surgery was a complete failure. It did not help the patient one little bit. In fact, he may be in more pain now than before I operated. His ability to sit, stand, walk, lift, push/pull, etc. were much better before surgery than after." Doctors, like the rest of us, tend to describe their work in the most positive terms possible.
Social Security disability advocates must point out the medical evidence that puts these statements into context. If possible, a medical source statement (form) should be obtained from the doctor which provides the functional restrictions of the patient.
The goal of the representative is to understand that judges may misuse doctor's careless statements to deny claims. The goal of the representative is to make it as difficult as possible for the judge to do this. Decisions should be based on the entire weight of the medical evidence, not a statement taken out of context.
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