Disability..out of hand? - page 3

Lately, (maybe it's cause I'm getting older), I have noticed more and more people that I know getting on disability. Most of these same people were not "good work ethic" people to begin with. I get... Read More

  1. by   jfpruitt
    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.
  2. by   LasVegasRN
    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.
  3. by   mattsmom81
    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)
  4. by   wrightgd
    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
  5. by   Q.
    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.
  6. by   jfpruitt
    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.
  7. by   Q.
    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.
  8. by   LasVegasRN
    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.
  9. by   LilgirlRN
    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.
  10. by   Q.
    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???!!
  11. by   jfpruitt
    In 1996 or 97 the SSA rules changed where someone with Alcohol or Drug abuse was not deemed disabled. Every claim in this country that was coded in as a DAA case, had to be re-examined to see if these people had impairments outside the DAA that was disabling. About 80% of these people did not. So, their checks were cut. Well, these same men and women decided to reapply and try to get a check another way. Thats where a BIG surge of the disability cases the past few years have been. DAA claimants. Next, the big obesity claim. Well, that is sorta complicated. For a long time, SSA had a specific regulation for a obese person. People with a BMI of a certain number were automatically allowed!!! So, you could be 280+ and be considered disabled and have no other problems. Well, seeing how our fine country is overwhelmed with obesity, you can imagine the number of people that met this listing. Well, in 2000, this regulation was also abolished. Now, an obese person can still get SSA disability benefits, HOWEVER, they also must have an equally devasting condition, aka DM, HTN, OA, etc. So, SSA is changing regulations every year. As for frauds, what can I say? I work in the system where its very tough to determine. Its very frustrating to me as an examiner for disablity b/c I know it exists and there isnt a darn thing I can do.
  12. by   janmae1950
    Originally posted by traumaRUs
    This is really a sore subject with a lot of people. In Illinois (maybe other states too?), it is a lifelong disability to be an alcoholic - can't work, so you get state aid, etc..!!!! Now, while I agree that alcoholism isn't curable it can be controlled and should not result in long term disability. My son (who is 17) is severely mentally ill and could qualify for SSI (or so I've been told). However, when he takes his meds, he is just fine. So...he takes his meds, goes to school, works and is a responsible member of society. My oldest son (21) has asthma, been intubated x3, multiple meds, etc. Is he on SSI? No, he graduated from college, works fulltime and is a very productive member of our world.

    I think a lot is attitude...I also think that unfortunately some undeserving people get on SSI too.
    That was how it was in West Virginia and down there we called them "Crazy Checks"!
  13. by   janmae1950
    Originally posted by Susy K
    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.
    Insurance used to cover inpatient and outpatient alchohol and drug rehab. However, what has happened is that people are in and out of the rehabs over and over. I don't blame insurance companies for setting limits. I've known people personally who had been in 28 day programs 5-6 or more times each.

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