Heather Kovich, a physician, has written an article for Guernica, a magazine, based on her experiences performing consultative examinations for Social Security. It is well-written. Indeed, it is so well-written that it should be appearing in a more prominent publication. It would fit nicely within the covers of the New Yorker. Kovich writes about people she has come to know who are affected by disability and their interaction with Social Security. Disability issues are frequently discussed in the press and in Congress by people who have little experience with actual disabled people. For a refreshing change this article about disability is written by someone who has gone to the trouble of actually getting to know some disabled people. I thought about putting some excerpts here but I could not give even the flavor of the piece within quoting far more than the copyright laws allow, so you'll just have to go to the Guernica site and read it.
This quote alone ought to be enough to make most people realize that she is not entirely objective:
ReplyDelete"On the basis of a forty-minute interview and examination, I was supposed to determine how disabled an applicant or “claimant” was."
WRONG. She wasn't supposed to do ANYTHING of the sort. She was supposed to determine their functional ability. An ALJ or SSA personnel would then determine disabiltiy based on that examination PLUS other things such as the SSA rules, CFR and vocational consideration.
Agreed. She may have misspoke, meaning only whether the "objective" medical examination report was favorable or unfavorable to the claimant -- not meaning that it was purposely slanted, but how the "facts" would read to an impartial third party -- and realizing that the CE is a major determinant in any DDS/ALJ determination. With more reflextion, she might have been able to express herself better.
ReplyDeleteSome CE are obviously biased in one or the other direction, even before seeing a claimant, which is usually transparent after reading about the same report from the MD or PhD. I find more disturbing the CE reports that avoid say the obvious (i.e., obviously under the influence, obvious faker, can not keep story stright, simple minded) in the King's English, rather than try to appear impartial and neutral, while dropping obvious observations or quotes to what they heard and observed, but not going on to draw the conclusion/medical diagnosis. This "cleverness" weakens the expert examiner's report.
Objective? Are ALJS objective? Ha.
ReplyDeleteMore than likely,every physician has an opinion about disability regardless whether it's voiced or not.
@ anon 1:47.
ReplyDeleteNothing about my comment (anon @ 9:57) was meant to indicate that ALJ's are objective. I was merely pointing that the author of the referenced article was not objective. Her job was to be an objective examiner, therefore, her critique of the SSA disability process should be closely scrutinized.
ALJ's are JUDGES. They JUDGE. Yes, we expect a degree of objectivity, but in reality we pay judges for their SUBJECTIVE application of rules in cases that do not clearly fit within the black/white structure.
We may not always like their decisions, but until someone can draft rules that clearly apply in ALL case, we must rely on subjective application to the rules that we do have.
@ anon 9:57.
ReplyDeleteDetermining how disabled someone is, as opposed to how functional they are, sounds pretty much the same to someone who hasn't been in SSA for 20 years. In the context of the article, and considering her audience, she is explaining things enough.
But perhaps you would have thought the article more credible is she used words in all caps?