Thursday, May 8, 2008

Disabilty determination exam for Medi-CAL

I had a disability determination evaluation this week at the request of the Dept. of Social Services for California because I applied for Medi-CAL (at no one's request, I just want to have general medical coverage). The purpose of the exam (as I understand it- - I could be wrong) is for them to say "Yes she has repetitive strain injuries in both her arms that affect her from working and beyond that she functions normally." I have done a Qualified Medical Examination for my WC claim when they doubted my treating physican's diagnosis. The QME was very rigorous and I totally agreed with my doctor's findings. I assumed this evaluation would be similar and because haven't improved since then. On all of my reports from my doctor it says:
IMPRESSION:
1. Bilateral upper extremity RSI.
2. Mild median ulnar neuritis.
3. Rule out TOS.

This seemed to have rubbed the examiner the wrong way. He said, "So what's you're disability?..What is RSI?" When I told him: Repetitive Strain Injuries, and then he met my bewildered look with one of his own.
"Repetitive Strain Injury isn't a medical term. That's a cause. Your doctor's notes give me no medical diagnosis of your actual disability."

Let, me back up just a tad, when I got into his office, he had no idea who I was b/c he didn't have my files at first. Once he got them, it was obvious this was the first time he had looked at them. So he took all of 3 minutes to review/ skim and then launched into a hurried interview. I was still shaken about the lack of proof he had that I have a diagnosis and I feel I didn't answer his questions really well. The actual "examination" felt las routine as a ride operator's schpeel at a theme park. It was standard health stuff like heart rate, b.p., reflexes- but nothing really intensive with the arms. He did not do anything that would be irrefutable in support of a tendon realated injury. Adson's and Tinel's tests are unfakeable. He didn't do anything that I had done at my QME that involved precise, recorded measurement. When he did palpation, it seemed like it was too light and brief for anything to be determined. There were other things he had me do that seemed to be tests to rule out other additional disabilities. And at the end he wanted me to do windmills which I didn't do entirely.

All in all, it was a rotten exam. I feet like my doctor has let me down a bit and its going to affect me on this state disability determination ruling.

1 comment:

Anonymous said...

I hope that you have made some notes, while this is all fresh in your mind.......on the bare minimum exam that he did and what he did not do.

Sometimes, I swear this is a test......if we can get through all of the forms, exams, and hoopla they make us deal with......then we must not be disabled =-)

Finz from NT