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Disability Examinations (SSI) Physician: My Experience

I have had a ton of people reach out to me asking about what it's like working as a disability (SSI) physician.

Since it seems to be something of interest to physicians looking for additional work that borders clinical and non-clinical, I thought I would share my experience in detail in a post.

If you want to learn more and have questions that my post does not cover, contact me on my contact form and send me your questions. I have talked to several physicians on the phone and am happy to try to answer as many questions as I can that you might have.

While I obviously cannot share the company I work for, you can contact me on the website contact form, send me your contact information and I can share your information with my manager who might be able to help you find a position doing this.

Onto my experience:

I have been working as a disability (SSI) physician for almost three years now.  When I first started, I was looking for additional work that was part-time, low stress, and low liability. I found the position from an post by searching "moonlighting physician". This fit perfectly into my expectations because the work includes only one Saturday every month, pays 60 dollars per patient, and was low liability as there is no prescribing, patient-doctor relationship, or medical recommendations of any type (I will go into more detail later in post).

Then, when I was out shopping, I got a call from someone from the company who did an "interview" on the spot with me. She explained more of the role to me, went over the requirements for application (state medical license, experience with doing range of motion testing, driver's license, etc). She also explained that I would be shadowing another doctor who already had been doing this for a while. She said that I would shadow him as many time as I needed until I felt comfortable with the work. 

I sent in my application materials and set up a date to shadow. I shadowed a physician the following Saturday and asked additional questions. There is a standard physical examination template that is already pre-filled and you just modify it as you go, based on your findings and what you do or don't do. It was very helpful and I started less than a month later at the same clinic I shadowed him at.  

At first, I did things that way the person I shadowed did them, by writing down my findings and the returning to the next room to complete my report. This was kind of slow and eventually, I started taking my laptop with me into every examination room and completing the templates as I went (duh, lol).

I wrote down exactly my observations. For example, if a patient could perform the range of motion, but had pain during the movement, I noted the expression and description of the pain. Literally, what was there in front of my eyes. I also started asking patients if there was anything else that they wanted to mention, talk about, etc before they left and many have expressed that this helped them feel like they were listened to.

The process of applying for disability is an arduous journey, one that is very long and ultimately decided by non-medical individuals, so providing them with as much information and conveying empathy to patients helps improve a difficult process.

You will be working in likely,  a chiropractor office or some other type of medical facility and not in the company's facility. This company rents out medical offices and you just go there to do the examination. 

Some clinics also do pulmonary function tests and x-rays as well. I recommend keeping the interpretations to as pertinent as possible, since these are low quality films. For the PFT's, you are entering in values you get from the machine and not doing some type of intense interpretation of their lung function.

I work with a medical assistant and receptionist and sometimes with only a medical assistant that also does the receptionist role. I have enjoyed working with every staff member I've encountered, as they've all been efficient and excellent at their jobs. 

The electronic medical record system is very easy to use It contains templates that you can edit as you go along. 

Let's talk about money (payment):

It depends on your state, but for me it's about 60 dollars a patient and you see two patients per hour. There are usually 15-18 patients on average, but I have had days when almost half the patients no-show and then only saw about 8 patients. Because I don't get paid hourly, it's a bummer.

You are reimbursed for mileage if it is over a certain mileage (varies depending on company) and may be reimbursed for hotel rooms up to a certain amount (once again, depends on the company).

The company pays you very quickly.

You are a 1099 contractor, so no benefits and taxes, so make sure you consider that.

I see my direct deposit within 3-4 business days every time. They also reimburse you for mileage if you need to travel greater than 20 miles or so to get to the clinic.

This is usually a job for medical residents and residents usually leave the company after they finish, but you can stay on as long as you'd like. Since I live in the area and I love working for this company, I do it three Saturday's a month, instead of just one.

I like this type of work because it borders clinical and non-clinical. Because you do not diagnose, do medical interpretation, prescribe, recommend medical services, or have any kind of patient-physician relationship, it's lower liability and lower stress. I always recommend the patients talk to their regular medical provider for any questions they have.

Malpractice insurance is included with the company. 

I must note that I think in some states, these examinations do ask for the examiners to make the determination if the patient should or should not receive benefits, based on the physical examination. My state does not. In fact, I do not feel like you would be able to make a well-informed decision without looking at every aspect of the patient's life. Even if someone's physical examination was within normal limits, they could have severe mental health illness that limits their ability to work.

Also, patients see a psychiatrist for a separate mental health evaluation as part of their application.

I always make sure patients know that I do not determine the outcome of their application and that the decision is decided by the state. In fact, the state even states that "determination of disability is an administrative decision" that takes into account work history, lifestyle, etc.

I feel like I always need to make this clear, because, even though their paperwork already states it, some patients might think that if they don't somehow demonstrate they're disabled and are able to do portions of the physical examination, that they will not be approved.

In fact, I've had terribly sick patients be denied because of things like the state finding out they had a source of income that wasn't reported. 

If this is something you think you might want to do, click here and I can personally introduce you to my hiring manager.