In CA and need help with state temp disability....please

[BrokeLoser]

What is the name of your state (only U.S. law)? California


I have a medically determined bad knee with severe arthritis and torn ligaments. I have had MRI's and x-rays that support this.
I have continued to live my life and work for a number of years despite the pain and my "bad knee". I have tried to avoid surgery.
I recently injured it while hiking and re-aggervated it and now I am in so much pain that I can't go to work. I have a physically demanding job and am very hard on my knees. I went to my ortho specialist and he prescribed injection treatments and physical therapy because he knows I am a bit against surgery. I asked him if he could put me out on short term disability and he said his office doesn't do that and I would have to see my primary care physician for that. So, I went and saw my primary with all my records in hand and asked him to put me on temp disability. He is acting reluctant to do so; he said he would get back to me in a day or so.
What am I suppose to do? If a patient tells a doctor they can't perform their normal, customary job duties and no "light duty" is available aren't they required to take me out of work on short term disability? Is it really up to them to determine how much pain I'm in and whether or not I can perform my normal job duties?

Thanks for the help

 

[cbg]

That's not how it works. A doctor doesn't "put you out on disability". Instead what you do is complete the paperwork applying for disability benefits; that paperwork comes in three parts, with you filling out part, your employer filling out part and your doctor filling out part. Then the paperwork is submitted to the disability carrier, who either accepts or denies the claim. Depending on your employer and your disability carrier, that process may vary a bit.

And before anyone reminds me, I am well aware that CA is one of the fives states that has mandatory or state disability. That does not change the fact that there is more to the process than simply having a doctor declare you disabled.

http://www.edd.ca.gov/disability/di_how_to_file_a_claim.htm

 

[BrokeLoser]

That's not how it works. A doctor doesn't "put you out on disability". Instead what you do is complete the paperwork applying for disability benefits; that paperwork comes in three parts, with you filling out part, your employer filling out part and your doctor filling out part. Then the paperwork is submitted to the disability carrier, who either accepts or denies the claim. Depending on your employer and your disability carrier, that process may vary a bit.

And before anyone reminds me, I am well aware that CA is one of the fives states that has mandatory or state disability. That does not change the fact that there is more to the process than simply having a doctor declare you disabled.

http://www.edd.ca.gov/disability/di_how_to_file_a_claim.htm

Thanks for your willingness to help. I understand what you mean and I am clear on the application process. However, to be approved and to begin receiving disability benefits your doctor must believe you can't do your normal work and follow through with filling out their part of the form for you....right?
I was on EDD disability in early 2013 I had to have my doctor certify that he believed I was medically disabled from doing my normal job; had he not done that I never would have been approved to receive benefits. Am I missing something?
This is straight from the EDD website and specifically the "eligibility" page:
"Your physician/practitioner must complete the medical certification of your disability. A nurse practitioner may certify to a disability within his/her scope however, he/she must perform a physical examination and collaborate with a physician or surgeon. A licensed midwife, nurse-midwife, or nurse practitioner may complete the medical certification for disabilities related to normal pregnancy or childbirth. (If you are under the care of a religious practitioner, request a “Practitioner’s Certificate,” DE 2502, from the SDI office. Certification by a religious practitioner is acceptable only if the practitioner has been accredited by Employment Development Department."
http://www.edd.ca.gov/Disability/DI_Eligibility.htm

 

[BrokeLoser]

This all just seems like if you end up with a "cool doctor" that believes what you tell them and is genuinely looking out for your best interest you don't have anything to worry about and if you end up with a lazy doctor that defaults to thinking you're just another loser trying to scam the system than you're probably in for an uphill battle. They should not have the right or power to roll the dice like that with your livelihood in their hands. What's a guy to do? Keep going to different Dr's until you find that "cool doctor"? Shouldn't your medical proof speak for itself? (MRI's and x-rays...etc)

 

[commentator]

There's something going on here that is causing your doctor to hesitate.

I'd suggest finding another doctor, and cleaning up your presentation a little bit before you see them. Remember, knee issues can sometimes be very subjective. You can have knees that in MRI's and x-rays look like they should belong to a 90 year old with no cartilage to speak of and be getting around with very little pain, or you can have knees which look like they are perfectly healthy and still in good shape and be reporting a great deal of difficulty.

But going in on a defensive whining note, asking your doctor to be "cool" by going along with your own reports of pain and discomfort, demanding that you be put on disability because you were put on last year, and referring to yourself as a broke loser is probably not making the best impression on your physician.

 

[BrokeLoser]

There's something going on here that is causing your doctor to hesitate.

I'd suggest finding another doctor, and cleaning up your presentation a little bit before you see them. Remember, knee issues can sometimes be very subjective. You can have knees that in MRI's and x-rays look like they should belong to a 90 year old with no cartilage to speak of and be getting around with very little pain, or you can have knees which look like they are perfectly healthy and still in good shape and be reporting a great deal of difficulty.

But going in on a defensive whining note, asking your doctor to be "cool" by going along with your own reports of pain and discomfort, demanding that you be put on disability because you were put on last year, and referring to yourself as a broke loser is probably not making the best impression on your physician.

While I appreciate your input please do not make false assumptions for the sake of sounding clever in a internet forum. I am honestly looking for resolve here. I have never once went in "defensive" and or "whining" nor have I ever 'demanded' to be put on disability. I have also never presented myself as a brokeloser to a doctor just as you have probably never referred to yourself as "commentator" to your doctor. I have been candid here for the sake of peoples understanding.
I guess I didn't think I needed a "presentation" as I am not the manipulative type and therefore don't think with a manipulative mind. I never thought for a second that I'd have to "sell" my condition given the proof and facts.

 

[cbg]

You may not think you're whining or defensive, but that is most certainly how you are coming across.

 

[BrokeLoser]

You may not think you're whining or defensive, but that is most certainly how you are coming across.

Here or in my doctors office? Where would it matter? Why would that even matter when you have a proven injury / condition? Why can't that stand on its own without all the trivial mumbo-jumbo?
So the more manipulative you are or the better you sell it the better your odds of getting your doctor to work with you? That's unbelievable to me...What's next, do I send my doctor flowers? It just seems way to discretionary on the doctors part. They should not be able to control your destiny like that...seems like another major flaw in our medical system.

 

[Ladyback1]

What is the name of your state (only U.S. law)? California


I have a medically determined bad knee with severe arthritis and torn ligaments. I have had MRI's and x-rays that support this.
I have continued to live my life and work for a number of years despite the pain and my "bad knee". I have tried to avoid surgery.
I recently injured it while hiking and re-aggervated it and now I am in so much pain that I can't go to work. I have a physically demanding job and am very hard on my knees. I went to my ortho specialist and he prescribed injection treatments and physical therapy because he knows I am a bit against surgery. I asked him if he could put me out on short term disability and he said his office doesn't do that and I would have to see my primary care physician for that. So, I went and saw my primary with all my records in hand and asked him to put me on temp disability. He is acting reluctant to do so; he said he would get back to me in a day or so.
What am I suppose to do? If a patient tells a doctor they can't perform their normal, customary job duties and no "light duty" is available aren't they required to take me out of work on short term disability? Is it really up to them to determine how much pain I'm in and whether or not I can perform my normal job duties?

Thanks for the help

Here's a question for you (maybe a couple):
1) how long do you anticipate this short term disability to last?
2) What if, after that anticipated time, you are no better?
3) Why are you so against surgery?

you don't say whether you have Osteoarthritis, or Rheumatoid Arthritis--I am assuming osteoarthritis, based on the injury you describe. A TKR (total knee replacement) and repair of torn ligaments could alleviate a great deal of your pain if it is osteoarthritis.

 

[BrokeLoser]

Here's a question for you (maybe a couple):
1) how long do you anticipate this short term disability to last?
2) What if, after that anticipated time, you are no better?
3) Why are you so against surgery?

you don't say whether you have Osteoarthritis, or Rheumatoid Arthritis--I am assuming osteoarthritis, based on the injury you describe. A TKR (total knee replacement) and repair of torn ligaments could alleviate a great deal of your pain if it is osteoarthritis.

1) I'm not real sure; the Dr. suggested injections and physical therapy for 6-8 weeks while resting the knee then we would reassess pain levels and etc. I told him I am not completely against surgery so long as we exhaust all other effort first. I'm a bit too young for a total knee replacement and I have heard the type of knee surgery that I would require doesn't always alleviate the pain.

2) If I'm no better after the injections and PT I guess I may have to have surgery.

I have been diagnosed with a high grade osteoarthritis.

Thanks for the help.

 

[cbg]

You are whining and being defensive here. I have no way of knowing how you behave in your doctor's office.

But it appears that you are looking for a law that is going to force the doctor to complete the disability paperwork. No such law exists.

 

[Nellibelle]

Here's a question for you (maybe a couple):
1) how long do you anticipate this short term disability to last?
2) What if, after that anticipated time, you are no better?
3) Why are you so against surgery?

you don't say whether you have Osteoarthritis, or Rheumatoid Arthritis--I am assuming osteoarthritis, based on the injury you describe. A TKR (total knee replacement) and repair of torn ligaments could alleviate a great deal of your pain if it is osteoarthritis.

"How long do you anticipate this short term disability to last?"

Irrelevant!

"What if, after the anticipated time, you are no better?"

Can seek State disability again. Is eligible for up to a year for State disability in California! After that, if he meets eligibility requirements, he can seek SSDI.

 

[BrokeLoser]

You are whining and being defensive here. I have no way of knowing how you behave in your doctor's office.

But it appears that you are looking for a law that is going to force the doctor to complete the disability paperwork. No such law exists.

Alright, we are kind of splitting hairs here aren't we? You have focused your attention on an irrelevant issue. What do you say we stop whining about me whining and we help find a solution to my problem. You know my dilemma plain and clear....right?

 

[cbg]

I already gave you the answer to your question long ago, either here or "down the street". If your doctor does not believe you need to be relieved from work, you either continue working or find a doctor who agrees with you. There is no law you can invoke that is going to force the doctor to complete the disability paperwork if he does not believe it it warranted, and you cannot get disability benefits unless he does.

That IS the answer. There isn't another one.

 

[BrokeLoser]

I already gave you the answer to your question long ago, either here or "down the street". If your doctor does not believe you need to be relieved from work, you either continue working or find a doctor who agrees with you. There is no law you can invoke that is going to force the doctor to complete the disability paperwork if he does not believe it it warranted, and you cannot get disability benefits unless he does.

That IS the answer. There isn't another one.

Thank you for the productive reply, I really do appreciate it.
I started this thread because I couldn't find much on this topic anywhere and it really surprised me. I knew I couldn't be the only one in this situation. I was more-less wondering how others respond to this situation and what they do about it.
I also find it alarming that there are no laws that protects patients in these situations. A friend of mine with no prior medical history related to the injury sprained his wrist while playing a family volleyball game, visits his doctor the next day, gets x-rays and because his doctor knows he has a physically demanding job suggests that he does not use the wrist for at least 2-4 weeks and tells him he should file for short term disability and tells him exactly how to do it. He begins getting paid back to the ninth day of his deemed disability within a few weeks.
Plain and simple; his doctor did the right thing...protecting the best interest of his patient, medically speaking.
And then there's my situation. A week since I visited my ortho, a week out of work, two Dr. visits on a 20% deductible plan (so probably $200 invested so far) and no clarification on whether or not I will get help filing for benefits. They have me pinned against the wall; I can't get an appointment with another Dr. for at least a week and if the new Dr. doesn't want his own MRI (which would take a week or two to order) and is willing to help, my first day of "disability" wouldn't begin until the first day I saw him. If he won't help and I have to see another Dr. the whole cycle begins again. How can this be allowed by law? I just can't wrap my head around it...how can my doctor arbitrarily decide that I'm lying and still capable of performing my normal job duties and deny to support me in a disability filing? Heck, my Dr. didn't even ask me what I do for work before telling me he'd have to think about it and get back to me in a day of so. I had to tell him what I do and what my job duties are and it didn't matter. How can this be right or LEGAL? Can you say....BROKEN SYSTEM!