Early in my medical practice, I elected to work with individuals seeking disability because there was a shortage of doctors in my area willing to do these exams (they do not pay well and we had a physician shortage to begin with). My personal reason for involvement was that due to this shortage, many individuals who desperately needed disability were facing significant delays moving through the process, which often rippled out into causing significant problems in their lives and those around them.
While a few people I saw were suffering from self-created problems and some were either faking their condition or exaggerating their disability for money (which is the typical lens disability claimants are seen through), I found the majority had been through significant hardship that resulted in a life impairing disability (some of their experiences were pretty horrific). I took this as a sign a lot of vetting was done by the state before they were sent to me.
In many of these cases, I felt if the individual had been my patient, they would not have arrived at the place they needed to seek disability. Many of them either had iatrogenic complications from the poorer quality of medical care that individuals in state insurance programs like Medicaid have access to, and had problems that would be relatively fixable within a more integrative model of medical care if they had had access to one.
A frequent topic of discussion with my colleagues was whether granting someone disability was ultimately a harmful thing to do since it removes their motivation to address their illness. This is important because in almost all cases, being disabled and receiving disability is a far worse life than not being disabled and having employment. I always kept this in mind when I evaluated these claimants, and ultimately recommended disability for many of them.
I found the majority of claimants I saw did not want to be disabled, had tried over and over to get better, hated going through the process and were only doing this because they had no other choice left. It also made me particularly sad that many of them said I was one of the first doctors they met who treated them as a human being, something I once again view as a consequence of my working in a socioeconomically impoverished rural area where these patients only had access to the inferior quality of medical care afforded by state medical insurance.
From this job, I came to view the disability process as the last stop on the train for individuals who had been failed by the system. Due to the legal requirements of providing an impartial medical evaluation, I was not allowed to provide any type of medical advice to these individuals and I eventually quit the job because it just made me depressed and there was nothing I could do to help the people I saw.
Today I learned Ed Dowd (the Blackrock executive who broke the story of the spike in life insurance claims following the vaccine rollout) discovered something very, very concerning (which can be verified here):
Continue this story at Substack
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