Disability Evaluations

Clinic A/P, adults, Clinic A/P, Peds

Completing Disability Forms

  • Understanding the patient’s job requirements and limitations is the foundation.
  • PT and OT are helpful for accurately documenting range of motion and functional limitations.
  • Occupational Therapy referral to help out with filling certain forms.

The Disability Evaluation

The disability evaluation includes:
-Targeted H&P examination
-Diagnostic tests as appropriate
-Referrals as appropriate

Examples of referals

  • Orthopedic surgery,
  • PT / OT,
  • Physical medicine and rehabilitation,
  • Cardiology,
  • Neurology,
  • Rheumatology
  • Psychologists and psychiatrists for mental health issues

The Consultant’s Note
If a consultant is treating the patient’s condition, the consultant should complete the form if the disability is based on a condition they are treating. If the PCP must complete the form, the consultants note should be complete enough to “enable an independent reviewer to “determine the nature, severity, and duration of the impairment and, in adults, the claimant’s ability to perform basic work-related functions.”

“The consultative examination report should be complete enough to enable an independent reviewer to determine the nature, severity, and duration of the impairment and, in adults, the claimant’s ability to perform basic work-related functions.” AAFP

Applying for disability through the Social Security Administration.

“The physician should use the Administration’s Listing of Impairments, known as the Blue Book, which includes 14 broad categories of impairments by organ system or disease type that are subdivided by specific conditions. The Blue Book list of impairments is available at http://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm. The Blue Book contains clinical criteria, measures of functional limitation, and duration of involvement.”

Qualified Medical Evaluators

“Qualified medical evaluators (QMEs) are qualified physicians who are certified by the Division of Workers’ Compensation – Medical Unit to examine injured workers to evaluate disability and write medical-legal reports. The reports are used to determine an injured worker’s eligibility for workers’ compensation benefits. QMEs include medical doctors, doctors of osteopathy, doctors of chiropractic, dentists, optometrists, podiatrists, psychologists and acupuncturists.”

Further Reading
Am Fam Physician. 2015 Jan 15;91(2):102-109. Disability Evaluations: More Than Completing a Form. https://www.aafp.org/afp/2015/0115/p102.html

Qualified medical evaluator process. https://www.dir.ca.gov/dwc/medicalunit/qme_page.html Last Accessed March 2018

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