Occupational Psychiatry--Independent Psychiatric Evaluations--Workers' Compensation
Organizational Consultation--Second Injury Fund Evaluations
C. Donald Williams MD CGP
|
Consultation Room |
The Tower Building |
Group Therapy Room |
|
|
|
|
|---|
|
Occupational Psychiatry--Independent Psychiatric Evaluations--Workers' Compensation Organizational Consultation--Second Injury Fund Evaluations C. Donald Williams MD CGP
|
|
|
Disability Evaluations Offer New Source of Income Robert Finn SAN DIEGO — Psychiatrists can easily expand their practices by evaluating applicants for Social Security disability benefits, Dr. C. Donald Williams reported at the annual conference of the Academy of Organizational and Occupational Psychiatry. “You're really doing a public service when you do these. It's a great way to become practiced in doing efficient evaluations, and it's a great introduction to doing independent medical evaluations,” said Dr. Williams at the meeting cosponsored by the American College of Occupational and Environmental Medicine. Since 65% of all Social Security consultant evaluations are mental health evaluations, psychiatrists willing to perform this service are in high demand. “They'll be delighted to schedule two to three per week for you, year in and year out,” said Dr. Williams, who is in private practice in Yakima, Wash. The first appointments can often be scheduled within a week of the initial call. The task involves a brief review of patient records and an in-person evaluation that takes 30-45 minutes—including the mental status exam and the preparation of a report. Psychiatrists who are practiced at performing these evaluations frequently can dictate a report in 10 minutes or less. Payment for this service varies from state to state. In the state of Washington, for example, payment for a full evaluation runs about $180, but the physician must provide his or her own transcription services. Other states provide toll-free telephone numbers where physicians can dictate their reports at no charge. The task involves evaluating people who have applied for the Social Security Disability Income (SSDI) or Supplemental Security Income (SSI) programs. SSDI is for people who have paid into the Social Security system, and SSI is a needs-based program more like welfare. Both programs require that applicants meet certain medical criteria for disability, which is defined as the inability to engage in substantial gainful activity by reason of a medically determinable impairment that can be expected to result in death or to last for 12 continuous months. Psychiatrists are not expected to make final eligibility determinations. Instead, the psychiatric evaluation enables a reviewer employed by the Disability Determination Service to make that determination. The psychiatrist typically will be asked to respond to three or four questions in the report. These may include a description of the claimant's activities in a typical day, ability to maintain pace and to manage his or her own funds, prognosis, and any signs of drug or alcohol abuse. The psychiatrist must provide DSM-IV diagnoses and must comment on the degree and the duration of the functional limitation resulting from the diagnosed condition. When meeting with the claimant, the psychiatrist should make the purpose of the interview clear. For example, the claimant must realize that the evaluation will not be confidential, and the results will be shared with the Disability Determination Service. And it's important for the claimant to realize that no treatment will be provided and no doctor-patient relationship will be established during the brief interview. Occasionally, psychiatrists will become involved in more complex cases. When a claim is denied, the claimant has the right to appeal. These appeals are handled by specially certified attorneys, who often contract with psychiatrists for more detailed evaluations of their clients. These typically include a lengthier report and a far more extensive review of records. Dr. Williams maintains a Web site at www.cdonaldwilliamsmd.com with information on Social Security disability evaluations.
|
|
