Doc for asthma tests for disability hearing needed, Atlanta
February 4, 2016 6:22 AM Subscribe
My mom has a hearing for SSI next month. Her lawyer has requested that she have some tests done, primarily asthma and COPD related. Can anyone tell me what to ask for when calling the doc office, or recommend a doctor?
Her lawyer has a doctor, but the doctor fills out *all* the forms and does other tests for a flat fee of $500. We are hoping to spend less than that, and do not need the other forms filled out.
Can you recommend a way to find a doctor that will do this? She does not have insurance, so will be paying cash (or we will put it on a credit card, but can do cash if that will get us a discount!). She doesn't need any other office visit/prescriptions/anything done, just these tests.
I do not even know what to ask for - the paperwork says things like -
Doctor, please comment on whether your patient/our client has the following
ASTHMA, With -
A. Chronic asthmatic bronchitis, which must be evaluated using the following criteria for COPD (Chronic restrictive ventilatory disease, OR chronic impairment of gas exchange due to clinically documented pulmonary disease)
B. Attacks (frequency, medicine, treatment, etc)
Has anyone done this and can recommend someone or tell me what to ask for?
Thanks!
Her lawyer has a doctor, but the doctor fills out *all* the forms and does other tests for a flat fee of $500. We are hoping to spend less than that, and do not need the other forms filled out.
Can you recommend a way to find a doctor that will do this? She does not have insurance, so will be paying cash (or we will put it on a credit card, but can do cash if that will get us a discount!). She doesn't need any other office visit/prescriptions/anything done, just these tests.
I do not even know what to ask for - the paperwork says things like -
Doctor, please comment on whether your patient/our client has the following
ASTHMA, With -
A. Chronic asthmatic bronchitis, which must be evaluated using the following criteria for COPD (Chronic restrictive ventilatory disease, OR chronic impairment of gas exchange due to clinically documented pulmonary disease)
B. Attacks (frequency, medicine, treatment, etc)
Has anyone done this and can recommend someone or tell me what to ask for?
Thanks!
The lawyer likely wants her to get pulmonary function studies (PFS) which measure how well her lungs work. One way to be found disabled is to have lung function so poor that you are said to meet one of SSA's listed impairments, know as the Listings.
PFS will measure, via spirometry, how much air she breathes in and out both before and after administration of bronchodilators. SSA wants to know the post bronchodilator values. The tests will produce two numbers SSA cares about: her FEV1 and FVC. Other tests will show other items in the Listings that are used less often: DLCO, and her gas exchange.
It is extremely hard to meet the Listings, especially the ones that relate to COPD and asthma. They are an intentionally set very high threshold. I would be very surprised if her lung function was so poor as to meet the Listings, because, in over twenty five years of doing this work, I can count on one hand the number of claimants I've seen who met those Listings. Moreover, SSA is very particular about how pulmonary function tests are administered and how they are documented before accepting the results.
Google the term "SSA pulmonary listings" and one of the first hits will be a link to the Listings themselves. That will give you an idea of what SSA is looking for.
Google the term "pulmonary function tests" and you'll get some hits explaining the tests.
One other way to meet the asthma Listing is to have asthma attacks frequently enough and severe enough to meet the listed criteria. Again, it is very hard to meet this Listing because, with today's medications, doctors can keep those kind of serious attacks from occurring. Keep in my mind that the Listing defines an attack in a very specific way. No test will help meet that Listing, only a longitudinal medical record will.
The valuable medical evidence in a disability claim is a reasonable, well explained opinion from a long time and regular treating physican as to how her impairments limit her, not a purchased examination obtained one month before the hearing.
posted by pasici at 7:09 PM on February 4, 2016
PFS will measure, via spirometry, how much air she breathes in and out both before and after administration of bronchodilators. SSA wants to know the post bronchodilator values. The tests will produce two numbers SSA cares about: her FEV1 and FVC. Other tests will show other items in the Listings that are used less often: DLCO, and her gas exchange.
It is extremely hard to meet the Listings, especially the ones that relate to COPD and asthma. They are an intentionally set very high threshold. I would be very surprised if her lung function was so poor as to meet the Listings, because, in over twenty five years of doing this work, I can count on one hand the number of claimants I've seen who met those Listings. Moreover, SSA is very particular about how pulmonary function tests are administered and how they are documented before accepting the results.
Google the term "SSA pulmonary listings" and one of the first hits will be a link to the Listings themselves. That will give you an idea of what SSA is looking for.
Google the term "pulmonary function tests" and you'll get some hits explaining the tests.
One other way to meet the asthma Listing is to have asthma attacks frequently enough and severe enough to meet the listed criteria. Again, it is very hard to meet this Listing because, with today's medications, doctors can keep those kind of serious attacks from occurring. Keep in my mind that the Listing defines an attack in a very specific way. No test will help meet that Listing, only a longitudinal medical record will.
The valuable medical evidence in a disability claim is a reasonable, well explained opinion from a long time and regular treating physican as to how her impairments limit her, not a purchased examination obtained one month before the hearing.
posted by pasici at 7:09 PM on February 4, 2016
Response by poster: Pasici - thank you- that helps!
I do realize that it would be far better to have a regular doctor who has been treating her for a while do these tests. Unfortunately, when you can't work and don't have insurance, you don't get the option of having that!
Thatnks, FergieBelle - I will give them a call!
posted by needlegrrl at 5:23 AM on February 5, 2016
I do realize that it would be far better to have a regular doctor who has been treating her for a while do these tests. Unfortunately, when you can't work and don't have insurance, you don't get the option of having that!
Thatnks, FergieBelle - I will give them a call!
posted by needlegrrl at 5:23 AM on February 5, 2016
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I can specifically recommend Kathleen Sheerin, MD and John Zora, MD.
When you call to make the appointment, just state your purpose. This likely won't be the first time they have been asked to do this. And the scheduler can get you in to see an appropriate caregiver--you probably want someone more focused on pulmonology vs. allergies, although I'm sure any physician would be qualified to do what you want accomplished.
Good luck!
posted by FergieBelle at 7:14 AM on February 4, 2016 [1 favorite]