Doctor Must Give His Opinion If You Ask Him

[betrayed]

question: If a patient ask me to fill a form out for him in order to obtain a drivers license, or obtain SSN or VA benefits am I required to do this.

Answer: If you are asked to fill out a form to assit a patient in obtaining disability or pension benefits, you are required to provide a descriptive statement and opinion with respect to that patient's medical condition, employability, and degree of disability.

from

VHA Practitioner’s Guide to Information Law

http://www.vehu.med.va.gov/vehu/vehu2005/p...r-%20FinalA.pdf

Allan originally posted this in social chat and only 19 people have read it

During my last appointment with new a psychiatrist I wrote him a 6 page letter with my complete medical background, my vocational rehabilitation background. I ended the letter with this:

Even though I feel this may be unusual, I don’t feel it’s unfair to ask you your opinion; do I have the capacity to work? I don’t expect you to answer this immediately, I would like for you to take all the time necessary before coming to your conclusion. I also have to ask you consider the following:

Can you reasonably expect a man to work who has had 112 days in a medical facility in 2006, Can you reasonably expect employer to put up with this? Can you reasonably expect a man who is in chronic pain to work? Can you reasonably expect a man who is mentally incapacitated to work? Can you reasonably expect a man who has panic attacks and angina attacks every time he has stress or does any strenuous to work?

Can you reasonably expect a man who is under the influence of Fentanyl 75mcg/h twenty-four hours a day along with Oxycodone and Clonazepam to work? Can you reasonably expect a man to drive a vehicle to get back and forth as he is always under the influence and would be breaking the law?

When I got a copy of the progress notes from that visit, at the end of the progress note he noted the 6 page letter and stated he would address this at our next visit, and words to the effect he did not want this to become a dominant factor in my treatment. I will now print this entire manual out and take it to the doctor during my next visit. I will pull it out only if he does not answer my question.

Allan you have provided one hell of a piece of ammunition to use in our battles with the VA. When I was in the pysch ward last time I asked my doctor the same question and he stated that his opinion did not matter. I sure wish I had this document then.

directive_2000_029.pdf

practioners_guide_to_information_law.pdf

VA_HIPAATRAINpage17of26.pdf

Edited March 12, 2007 by Tbird

[huskerfanfl]

The GAF is not a test it is a point value that is given based on what you told the psychiatrist or psychologist. The lowest of your ratings in I believe it is family, social, and employment will be your score. There is an individual factor as well, but there is not an assessment given

[john999]

You have to realize that every time you speak to a VA doctor he is going to put that in writing and that is the evidence that can hang you or help you win a claim. It does get in the way of treatment I think. You can never tell some doctor at the VA that you are feeling better because that will come back to haunt you. I trust my VA shrink but I would never tell him anything that might be used to hurt me.

[betrayed]

YES, there is a formal format for a GAF. I pasted it about 10 posts down from this one. Its dated February 24th. As you can see, its has a formal assessment format.... by the numbers, by the line item.... with scores for each line item.

Thats what I want.

this is what your talking about?

Patients’ baseline functioning and 1-year outcomes were assessed with respect to

eight indices: Three indices of psychological functioning focused on:

-emotional distress as assessed by responses on 5-point scales varying from “not

at all” to “extremely” to 12 items (such as “feelings of worthlessness”, “thoughts of

ending your life”, and “spells of terror or panic”) drawn from the Depression and

Anxiety Scales of the Brief Symptom Inventory (BSI; Derogatis, 1993);

-psychiatric symptoms as assessed by responses on comparable 5-point scales to

10 items (such as “feeling that you are watched or talked about by others”, and

“the idea that someone else can control your thoughts”) drawn from the BSI

Paranoid Ideation and Psychoticism Scales; and

-substance use problems, as assessed by 18 items rated on 4-point scales varying

from “never” to “frequently” reflecting a standard set of problems due specifically to

alcohol and/or drug use, such as “legal problems”, “problems with your job”, and

“problems with your neighbors.”

Three indices of social functioning focused on:

-residential stability as assessed by living in a stable setting in the community for

most of the past 12 months and never or seldom losing a place to live in the three

months prior to follow-up (yes/no);

-the number of friends with whom the patient felt at ease; and

-the quality of relationships with friends as measured by 5-point ratings on six items

drawn from the Life Stressors and Social Resources Inventory (Moos & Moos,

1994) such as “Do you confide in any of your friends?” and “Do your friends really

understand how you feel about things?”

In addition, we obtained information on two indices of occupational functioning: (1)

part-time or full-time employment status (yes/no), and (2) annual income.

[huskerfanfl]

Try one of the links below

http://www.whfreeman.com/abnormalpsychology/DSM02.htm

http://dpa.state.ky.us/library/manuals/mental/Ch22.html

http://en.wikipedia.org/wiki/Global_Assess..._of_Functioning

Edited February 28, 2007 by huskerfanfl

[huskerfanfl]

NO. Thats the Global Assessment Scale (GAS)..... not the GAF assessment tool. The tool is what is used to make an evaluation, then, a total score that is transfered to the GAS to determine the degree of disability. The GAF should be a list of evaluation indices of functions.

I cannot locate it. PLEASE help.

1968,

I hate to break it to you, but that is the GAF (Global Assessment of Functioning). It is the same GAF that was being used when I was doing work on my Master's Degree in Marriage and Family Therapy. When you people are talking about the GAF, those links are what the GAF number is talking about.

[Alex]

The critical item on the GAF, provided that you have a mental disorder eligible for service connection on Axis I, is Axis V. Scores of 50 or below are candidates for 100% ratings, or at least for 70% ans IU for someone not working.

Alex