Excerpted from SEAK’s course, “How to Start, Build, and Run a Successful Disability and File Review Practice”
The goal of this presentation is several fold. First, to learn the definitional aspects of disability, learn how to evaluate the information provided, and learn how to do a claim review. I need to emphasize that disability is not a medical condition. It is not a disease, it’s not a diagnosis.
Those of you who are watching this presentation may be doing so for different reasons, including how to do IMEs, panel reviews, or even learning about how to assess your own patients as it pertains to disability.
The first thing I wanna emphasize is that diagnosis does not equal disability. There are many instances when I review claims where the attending physician merely says, “The insured was disabled,” or provided a diagnosis assuming that it rose to a level of impairment. We need more than that. You can’t say an individual is disable or that he or she can’t work. As we can see from this slide, Franklin Roosevelt was able to function as President during 12 years…12 of the most turbulent years in our history.
Ludwig Beethoven composed the Ninth Symphony after losing his hearing. Ray Charles, blind from childhood, grew up to become one of the greatest soul singers in our country’s history. Joan Benoit suffered a massive knee injury in March of 1984. Three months later, she won the first women’s marathon at the Olympics. Stephen Hawking, one of the great minds of the late 20th century and early 21st century, was able to contribute his work despite the ravages of motor neuron disease. More than one professional athlete carries the diagnosis of epilepsy.