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Changing ID Physician
Dec 29, 2004

I am currently receiving LTD Benefits and seen by three physicians, one who obviously is my Infectious Disease Specialist. I am awaiting a SS hearing with an ALJ which should be coming up within the next 2 months. All of my doctors are within the same health system about 1 hour from my home. In a recent request from my LTD, a one page Supplementary Report for Benefits, I was asked to have information provided from my attending physician. My attending filled out the request strongly in my favor of claim. His assessment on this form included the following: Class 4 Physical Impairment, NO answered to is patient a candidate for rehabilitation services, NO answered to job modification would enable patient to work with impairment, and NO answered to vocational counseling and/or retraining recommended. I have been curious as to what opinion my specialist might have since I have suspected from the beginning that he has been somewhat difficult in supporting my claim for being disabled, although he initially supported whatever I had asked from him in the early stages of my diagnosis 2 years ago. I have shown recent clinical improvement, but still continue to lodge my health complaints with the specialist on every occasion. In an effort to try to understand his position, I made a copy of the Supplementary Benefits Report and asked him to fill it out and have it sent back to me ( which he did ) and his opinion was vaguely ( if any ) in favor of a my continued claim of disability. His assessment included the following: Class 2 Physical Impairment, YES answered to is patient a candidate for rehabilitation services, w/ comment that exercise may help, Yes answered to job modification would enable patient to work with impairment w/ comment capacity limited to non-strenuous duty, and no response to vocational counseling and/or retraining recommended. I have all these types of reports upon completion sent to my attorney who then sends them to the LTD. My LTD Benefit Policy includes a Dual definition of disability "own occupation" for 36 months or 20 percent or greater loss of income I will never be able to return to my previous occupation. I am concerned that my specialist will continue to be difficult and would like to make a change. I have identified another specialist (there are not many of these where I live) who I believe might support me more favorably, but is outside the health system where my attending practices. I do not want to upset my relationship with the attending by going to another specialist whom he is unfamiliar with, but do not believe I can continue to work with my current specialist in supporting my claim (every step with him has been some type of negotiation). I would like advice as to how to deal with my attending in proposing this change, and also opinion on how this might be viewed by not only my LTD, but also SS. I may be over reacting to the assessment provided by my specialist, but I am of the opinion it is not in my best interest to continue trying to impress upon him that I am not well, and dealing with his arrogance has become a futile effort. Thank you again.

Response from Ms. Breuer

You are the employer of all of your physicians. You can fire them, change them or stay with them at will, and I'd be surprised if your attending even had a reaction. If you don't think the specialist's view is in your best interest, you have every right to shop.



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