Disability..out of hand?

jfpruitt · May 3, 2002

Well, to be frank, these people LIE!!!! I have worked for disability claims for 4 years now while attending nursing school. I do claims everyday and the majority of these people are allowed on mental disabilities vs physical ones. They Lie and say that they can not get out of bed in the morning from depression, yet, they are out on Friday nights with their buddies. Working for SSA is VERY frustrating for me. It is extremely hard to distinguish b/w the liars and cheats. I work it everyday, I KNOW!!!

LasVegasRN · May 3, 2002

jf - I can partially relate to what you are saying, only because I did disability management for 7 years. BUT I had to remember that what I was seeing was the worst cases. I didn't see the people who were on disability, recovered without incident, and went back to work.

Now, a word about mental disabilities... I have a very dear friend who is a Vietnam Vet. I think most would agree that they deserve disability and THEN some. He was a combat Vet, awarded a bronze star, the whole nine yards. I won't go into his whole story, but when he asked me to help fill out his SSA forms, it was horrible. The forms are geared towards people with PHYSICAL disabilities - it was clearly biased and in my opinion extremely unfair. They should have a form for mental disability assessments that is written so that a person with a 4th grade education can fill it out (that's what they're saying the norm of our nation is).

Anyway, I've seen him not be able to get out of bed in the morning from depression, flash-backs, and nightmares and go out on Friday night for a bender. I'm not trying to defend everyone, but I know from first-hand experience, they are not all liars.

Just MHO. :chair:

jfpruitt · May 3, 2002

Yes, I know there are those out there that are genuine. We do have forms for Mental Allegations. I'm getting pretty proficient at knowing the frauds at this point. It just really angers me that there are people out there to lazy to work and apply and sometimes allowed, while people like him who actually deserve it, can't. I work here, I know, its a screwed up system. I think we should go back to the face-to-face interviews. It is alot harder to lie to someone in person than on the phone.

LasVegasRN · May 3, 2002

I agree with the person to person interviews. Although, with my friend, it's wouldn't be a good thing, only because he's so intimidating in person and if he feels confronted... oh boy. I've had to testify on his behalf because of the rage control issues. But, it's part of the PTSD, unfortunately.

My frustration was with the people you KNEW were frauds, it was hard to get approval for surveillance.

mattsmom81 · May 3, 2002

I know there are lots of folks out there who learn how to 'work the system' and spend their lives revolving around getting something for nothing from government agencies....I have a sister who does it and it p*sses me off royally...she's been that way all her life and ran with a group of young women who taught her everything she knows (Minnesota is a great welfare state for unmarried mothers)

I'm glad fraud is investigated as well, but I do get tired of the attitudes from insurance companies, etc. that they're 'sure' you're guilty of fraud if you dare file a claim. I can't believe I have to pay an attorney to go after MY OWN insurance companies for coverage I paid for!! (and split the money with him, of course)

wrightgd · May 3, 2002

A good disability management program involves much more than a case manager who simply accepts a claim and starts sending checks in the mail... It involves working with qualified professionals... doctors, nurses, case managers, occupational therapists, mental health professionals, etc. to get that person back to the maximum level of recovery possible, as soon as possible. It is a very pro-active process. And as some have eluded to, it can involve investigating claims that don't seem to jive... Our DCM's are required to contact clients on a weekly basis. Not just to see how they are doing, but to verify that they aren't out working another job, or taking a "vacation"... If the client doesn't return the call for longer than two weeks, their benefit payments are discontinued... As with any "benefit" program, there will be some who look for every potential way to scam the system, and you have to be aware of those cases. On the other hand, you also have to trust people until they give you a reason to be suspicious.

If disability is out of hand, as the thread title suggests, then it's because the managers of the process have allowed it to happen. There are ways to keep these programs ontrack, it just takes proper management, and a willingness to work with the professionals involved, and the clients who need attention.

George

Q. · May 3, 2002

In reference to the post about alcoholism being a disability; I live in Wisconsin and alcoholism is NOT considered a disability, under federal laws I thought.

My father is an alcoholic and by all practical purposes, he is disabled. He is very, very, very ill as a result. We have tried numerous treatment modalities without success. Alcoholism is a disease like any other illness, yet, I do not believe that my father should not receive any aid, despite the financial drain it places on my sister and I and my mother. I would rather insurance companies offer more reimbursement and coverage for mental health services instead. Alot of de-tox and 30 day inpatient treatments are not covered.

jfpruitt · May 3, 2002

I think many of you are confusing the term "disability". There are many types of 'assistant' programs out there. Some through employers and some through private insurances. All of which have different criteria. However, Disability that is governed by the gov't is through SSA. SSA is where I work and there are strict rules that everyone in the country applying for disability must be reviewed. For example, according to SSA, Alcohol abuse is NOT a disabiling condition b/c the person can seek treatment and recover. however, I'm sure there are other programs out there that are not goverend by SSA that consider alcohol a disability. It all depends on where you are applying as to what is justified to receive a 'check'. SSA also has many different regulations regarding missed appointments and such. Here, we often cease a claim if the claimant does not respond within 2 weeks, or delays the case. These people are applying for themselves, it is not my job to do it for them. If they refuse to fill out paperwork that I need, I have no choice but to deny. Disability under SSA is a very complicated process that is hard to explain in a simple email, however, I assure you that it is very different from an insurance or workmans comp claim that says you are 'disabled". Most people do not realize the difference b/w the two.

Q. · May 3, 2002

jfpruitt-

That's what I was referring to yes - alcoholism NOT being a disability for SSI purposes.

I agree, and that is what I thought. That's why I was confused by the Illinois post.

LasVegasRN · May 3, 2002

Wrightgd,

Amen, brother. If the managers of the disability program would hold the clients more responsible and accountable for their own disability, the process would go much more smoothly. Too many companies and governing bodies are serving as "enablers" also, almost scared to withhold or delay anything for fear of an attorney or imposed penalty attack. However, some state laws encourage this "enabling" behavior - California is NOTORIOUS for that.

LilgirlRN, ADN, RN · May 4, 2002

I work in the ED. When a patient registers, their insurance info is on our facesheet, so wecan see who gets disability and who doesn't. It really amazes me some of the people who have it. Most of the time my curiosity gets the best of me and I have to ask why they are receiving it. We have one frequent visitor who gets a check because she is obese, weighs close to 400 lbs. She's young too only in her early 30's. I work with a nurse that is about her same height, weighs maybe 50 lbs less and she works just like the rest of us do. One of my coworkers, her dad gets a check for "being crazy". He told her how to do it, said when you go to apply if it's hot wear a coat, if it's cold wear shorts and no shoes, have food dribbled all down the front of your shirt and don't bathe for a few days. Keep looking over your shoulder like you're expecting someone to show up and sit and mumble to yourself.

Q. · May 4, 2002

Originally posted by LilgirlRN
We have one frequent visitor who gets a check because she is obese, weighs close to 400 lbs.

Ok this pisses me off. If alcoholism doesn't qualify because "you can get tx and be cured" then why can't someone who's obese lose weight? Trust me, both goals are JUST as difficult as the other.

One of my coworkers, her dad gets a check for "being crazy". He told her how to do it, said when you go to apply if it's hot wear a coat, if it's cold wear shorts and no shoes, have food dribbled all down the front of your shirt and don't bathe for a few days. Keep looking over your shoulder like you're expecting someone to show up and sit and mumble to yourself.

This also irritates me, because, the man you described sounds like my father because he's overmedicated with numerous medical complications as well. And this guy shirks the system to get funding? And we can hardly afford 30 day tx for my dad to get well???!!