Medical Evidence and Exams in the COVID-19 Age
COVID-19 has thrown a wrench in our way of life. Not only has it affected our personal and business lives, but it has also changed the way that medical professionals work. Many visits are now done via telemedicine and telehealth, either through video or phone call. Although this is safer and more convenient, it presents some challenges in disability claims.
What’s the big deal?
Disability claims live and die by the medical records. This is true for Social Security disability claims, and also for claims with insurance companies (short-term disability and long-term disability). Within those medical records, there’s a particular section that’s especially important: the objective exam findings. This is the part of the records documenting how you responded to certain tests and examinations.
For example, if you have a problem in your back or shoulder, your doctor may test your strength, range of motion, reflexes, and tenderness. What is recorded from these exams is crucial to your claim. In fact, these findings may even be more important than the complaints that you voice to your doctor.
One of the biggest reasons that Social Security disability claims, STD claims, and LTD claims get denied is because the objective exam findings don’t match up with the subjective complaints. So undergoing an actual exam and having that exam documented is essential to your claim.
With COVID and telemedicine appointments, it is impossible to undergo a thorough physical exam. (This is not as true for mental health, therapy, and psychiatry visits.) Your doctor can ask you how your shoulder strength is or how your joint mobility is, but it’s very hard to measure a patient’s verbal responses. Without that evidence, your claim is vulnerable.
What can we do about this in the COVID era?
Where possible, request to be examined in person. Most medical offices have protocols in place now for in-person visits. In the Kansas City area, we have found that most medical offices are seeing patients in-person at least part of the time. If so, ask how they are scheduling physical exams and how to comply with their rules.
Sometimes an in-person visit will require a longer wait or will inconvenience the office. But if you politely explain that a physical exam is important for your conditions, many offices will see you in-person.
If your doctor’s office is not allowing any in-person visits yet, you can ask for the earliest available date. If that is not possible, you can ask for a referral or for testing at a location where you can be seen in-person. For example, if your hands are tender and swollen and an exam is not possible, an x-ray or MRI can still show that you have osteoarthritis. Your doctor can make recommendations (medication, further testing, physical therapy, etc.) based on the x-ray or MRI without physically testing your grip strength and pain.
Documenting disability was a challenge before COVID, and it is even more of a challenge now. But knowing what the decision-makers are looking for is half of the battle. As best you can, try to be seen and examined. If that is simply impossible, voice your health complaints as best you can and weigh your options.
Feel free to contact our office via call, text, or e-mail with questions about how to navigate your disability claims. We are located in North Kansas City, not far from downtown. We remain open for business (but do ask that you contact us in advance before physically dropping in).