The Social Security Administration has issued an Emergency Message titled Additional Guidance for Evaluating Evidence in Cases Involving the Musculoskeletal Disorders Listings. It's designed to convey the news of the Temporary Final Rule on "close proximity of time" published recently in the Federal Register but it also addresses the need for assistive devices, such as a cane or walker or motorized wheelchair.
Did the VP write this? "Close proximity of time" is used repeatedly, as is flexibility... a word usually not associated with muscular skeletal disorders.
ReplyDeleteReally??! Musculoskeletal problems are excruciating sometimes even when a medical mobility device is not needed 100% of the time, It's one of the most painful things one can experience in some cases. To micromanage musculoskeletal problems like this is not only inhumane, it creates a "standard" for denial is all I see. If only adjudicators could FEEL the pain, they'd understand. Most doctors don't ever feel that kind of pain, but they know it exists. Micromanagement is NOT the way to treat these disorders. It actually disgusts me that they would do this. Some can only sit for 15 minutes, then stand for 15...rinse and repeat. But that doesn't mean they need a device to do so, but who is gonna hire someone that only can get half their work done (at an office job setting while sitting/standing). Some need to "walk it off" even after surgery to continue what they are doing. As an employer, I would have serious qualms about only 1/2 the work being done due to such disabilities. I would refer them back to SSA.
ReplyDeleteThe goal is to stop our employees from denying listing-level 1.00 cases because the tx notes don’t contain all the objective findings consistently across time, with the delusional belief that a pt is getting a thorough physical exam that is accurately scribed at every appt in order to verify their diagnosis. This includes charting errors like “WC” in the S but “nml gait” in the O = they allege use of WC but it says nml gait objectively, so WC use cannot be established to meet the listing.
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