How will seeing a naturopathic doctor affect my disability claim?
February 6, 2017 5:34 PM   Subscribe

I have Chronic Fatigue Syndrome, and I'm on SSDI. The doctor I've had for 15 years, who helped me successfully file my claim for SSDI, is retiring. So I need a new doctor. A friend referred me to her naturopathic doctor. I think this ND would be a good choice, and it's not easy for me to find a suitable doctor. But I'm worried that having an ND instead of an MD might hurt me when my disability claim is reviewed.

My understanding is that once your SSDI claim has been accepted, reviews are usually accepted without a problem. But I am a bit worried about it because there is no definitive test for my disease, so they put more weight on the doctor's opinion. Also, just looking at links I found in Google, it looks like they do favor conventional doctors over ND's.

Will this be a problem? I know I can get an MD in addition to the ND, but that would get prohibitively expensive.
posted by Cinnamon Bear to Law & Government (8 answers total) 1 user marked this as a favorite
You should quickly clarify here if your naturopathic doctor is a medical doctor with an interest in naturopathy, or a naturopath calling themselves a doctor. The advice will be quite different.
posted by taff at 6:00 PM on February 6, 2017 [10 favorites]

taff has the preliminary question down. Also to consider is your age - under 40ish depending on your disabling condition(s) will determine whether you are likely to face a Continuing Disability Review. Check the written decision in your case if you aren't sure. Read all notices you receive thoroughly. Call SSA unsure.

Weirdly, considering how incompetent SSA can be their website is chock-full of accurate and easy to navigate info (relative to other govt. agencies). Check it out to get started or have a buddy/advocate help.

How it works with medical providers: key here is their trainingrevealed by certification. As I suspect you can guess then MDs and PHDs are given great weight in terms of giving credence to their professional opinion. LCSWs a bit less determinative weight but more than a Social Worker. Chiroropractors, Naturopaths etc. less. This is statutory, regulatory and case law driven.

Still though a practitioner further "down" (sorry) the degree hierarchy can be given more weight. This comes to depend on the Analyst or Judge's personal views on the medical degree chain or more importantly the length of time your Provider been treating you and the thoroughness of their notes.

Please remember too that it's not just your diagnoses that is considered nor is the fact that you were approved in the past. Your diagnosis is considered within the framework of the evaluation of course. Claimant's diagnosed disability then moves to the question of are they functionally unable to do their past work or ANY other work in the national economy. Your location vs. where that potential job is located is irrelevant.
Your statements and those of family/friends are considered but ya need written medical backup.

All of this is not to freak you out although I suspect it might.

If you get a written notice that SSA wants to consider your Continuing Eligibility you already know to be clear with your Provider about your daily functional limitations. Both to look after your health and to get their statements and your fuctional limitations in your medical records.

Keep a daily journal. Don't listen to anyone who tells you that approval is guaranteed. Look up a Legal
Aid office in your area. Free if you can find one taking clients. Private firms may be cool too just remember they get a % of back pay if due.

Best of luck and do not let them grind you down.
posted by pipoquinha at 6:57 PM on February 6, 2017

I agree with sculpin. Feel free to see the ND about your CFS (I am sure that many NDs have some sort of mechanism to make their treatment more affordable for people). Since there is no known cure, it's reasonable to seek solutions outside what conventional medicine has to offer. However, there are very many evidence based and proven effective conventional medical therapies for a host of other medical problems (not to mention preventative care issues) that I would not recommend an ND as your primary care doctor to treat.

Bias: I am a physician, and I'll be quite frank in saying that I certainly hope that a judge would not give the opinion of a naturopath the same weight as a physician. Much of the practice of naturopathy is pseudoscience. I don't blame people for giving it a try when all else has failed (I've done it myself), but the training is leagues apart from the standard medical training that your conventional doctor has and it would make no sense to draw an equivalence between them.
posted by treehorn+bunny at 8:12 PM on February 6, 2017 [11 favorites]

Thank you everyone. To answer the question, this person is a Naturopathic Doctor. I'm in California, and I believe this is a formal legal category here. She has the power to prescribe Schedule I drugs. But I think the disability system will still think of her as just a naturopath.

I'm 44, and my SSDI case is under review right now. My doctor very kindly came out of retirement to help me get through the review process. So I don't anticipate being reviewed for years to come after this is over. But it could happen again in a few years, right? So I feel I should plan ahead for that.
posted by Cinnamon Bear at 9:51 PM on February 6, 2017 [1 favorite]

If it makes you feel any better, the medical professional who manages the conditions I get SSDI for is a psychiatric ARNP (nurse practitioner), and I get through the review just fine every time. Not exactly the same, I know, but still it gets a bit of side-eye in some situations.

The first review I had was the long form version, and I found it scary too. But since then I've only been sent the short form, which is simple as long as you have kept a record of dates of all medical appointments and haven't been working.

CA .gov website for naturopaths with a link to license look-up. The requirements are in a pdf linked on the sidebar, too.
posted by monopas at 11:11 PM on February 6, 2017 [1 favorite]

I'm assuming you've read the SSA definition for Acceptable Medical Source (AMS), yes?
posted by mochapickle at 12:20 AM on February 7, 2017 [5 favorites]

The ability to prescribe is precisely what makes an ND so potentially dangerous. I discovered this firsthand and multiple subsequent times here in Oregon with patients on absurd levels of thyroid hormone or prednisone who crashed and burned after stopping their drug and we had to clean up. Consider a primary MD for whatever you feel most comfortable managing through them, including your disability claim, and see your ND if that's how you feel your health is best served, but given the stakes and potential misery and cost of a challenged claim, I can't imagine not having the MD at least for that part. As much as we can't stand paperwork, I could probably doodle a spaceship on most of the ones I see and it would fly through. FMLA claims get more challenge.
posted by docpops at 5:28 AM on February 7, 2017 [4 favorites]

Thank you everyone. I will try to find an MD.
posted by Cinnamon Bear at 4:54 PM on February 7, 2017 [1 favorite]

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