FMLA/Disability-Legal?

roser13, ASN, RN · Mar 3, 2017

I have insight from both sides of the equation. My husband has been on long term disability for 15+ years, and we can certainly vouch for the fact that it is essential for (at the very least) a conscientious, well-trained medical clinician to fill out the disability paperwork. FMLA paperwork is more clearly black and white, without the nuances contained in disability paperwork, and can often be routinely filled out by clerical staff.

On the other hand, I have worked in 2 different medical practices that either have a "disability specialist" (MA whose primary job is filling out FMLA & disability forms, who uses signature stamps on the forms), or have the specific MD's nurse/MA fill out the paperwork for the surgeon to sign.

In my opinion, medical offices do their disabled patients a great disservice by not taking disability paperwork more seriously. Those who are lucky enough to have never been through the disability process (either private policy, group policy or SSI) have little to no understanding of how critical the answers to the insurer's questions are. Simply scrawling a phrase or two on the answer lines provided on the claim form is next to worthless. A successful long term disability claim takes pages of documentation and complete written rebuttal of any allegations by the insurance company as to the non-disabled status of the patient. For various reasons, group LTD policies provided by employers (what most of us have) are the most difficult to enforce. A medical office that doesn't place a priority on appropriately filling out disability claims for its patients is seriously undermining its patients well-being.

bd1122 · Mar 3, 2017

I completely agree with this. Some questions on other forms besides FMLA/Disability forms ask question that I would have no idea unless I was in the room with the patient while the doctor was examining them, and that's not always the case. If I have a question I cannot answer, I leave it blank and have the doctor fill it out, but they get so annoyed about it. If I were a physician I wouldn't want to sign anything I didn't fill out myself. I always feel bad for the patients as well, because I always feel that the actual doctor can justify their problems more than what we can.

cayenne06, MSN, CNM · Mar 4, 2017

If I were a physician I wouldn't want to sign anything I didn't fill out myself. I always feel bad for the patients as well, because I always feel that the actual doctor can justify their problems more than what we can.

It would be *crazy* for me to spend the time filling out all the forms people need when any clinical staff can transcribe from the chart. If I trust the BP reading my MA takes, I should also be able to trust her to transcribe it accurately to a form.

But of course I agree with you. The medical justification should come directly from the provider, because as you said that gives the patient the best chance of getting what they need. I work with a very at-risk population and I take these forms very seriously. These kind of things should be a team effort.

I am sure there are lots of docs/APRNs who go out of their way to avoid this kind of paperwork, and that is frustrating. But I think most of the time, it comes down to the fact that we already spend more time overall on documentation than we do on direct patient care, and we are trying *really* hard to give our patients good care while still functioning as an overpaid data entry clerk. I know everyone in the clinic is carrying a heavy load, but if there is an administrative task that can be fully or partially completed by a non-provider, it should be. If it is slow I am the first one emptying trash cans and scrubbing instruments, so this isn't about me being "too good" for paperwork. It's just triaging job duties.

cayenne06, MSN, CNM · Mar 4, 2017

Oh, and I would *never* sign an uncompleted document like an FMLA. Nor would I fill out a pre-signed form! Talk about opening yourself up to trouble.

roser13, ASN, RN · Mar 4, 2017

Oh, and I would *never* sign an uncompleted document like an FMLA. Nor would I fill out a pre-signed form! Talk about opening yourself up to trouble.

Aahhhh, but so many providers do, in fact, blindly sign.

bd1122 · Mar 4, 2017

The physicians definitely do not have time for all of the forms we get, nor does the nurse or MAs. We are an extremely busy practice and seriously get maybe a 15-20 min lunch, if we are lucky. If the paperwork had questions that could be transcribed straight from the chart, I would not even complain, but that is definitely not the case. I won't be at this job much longer because I will be moving to another city, but I just wanted to get more insight for the person who will take my position. Thanks for your input, it is greatly appreciated.

Trauma Columnist · Mar 4, 2017

I sign FMLA/disability paperwork A LOT. I complete it with the pt in a face to face encounter. I also keep copies of the paperwork from the previous years so that I can ensure I'm being consistent. Although I'm not a physician, my time is valuable also. I do ask the office RNs to complete the pts name, address, DOB, and to obtain the pt signature allowing me to share the protected health info PRIOR to me meeting with the pt. I copy a med list, latest and pertinent labs and I have the staff provide a copy of all paperwork to the pt for their review.

It IS time-consuming but as others have mentioned it is necessary to provide for some pts.