This time of year many patients bring me the disability tax credit form to fill out. Advised by their helpful accountant, they are sure they qualify for preferential treatment due to their chronic hangnail or halitosis. Many of my patients haven’t even read the form; to summarize, for an individual to qualify for this tax credit they must have a prolonged, severe disability that markedly restricts one or more activities of daily living. Physicians are asked to answer basic questions such as, Can your patient hear? Can they speak? Can they see? Basically, if you can understand that your accountant wants you to take this form to your physician and you can manage that task on your own, you don’t qualify. Refusing this request often puts me in a position of conflict with my patients.
I often have the same experience when patients request a disability parking permit. To qualify, an individual should be unable to walk 100 metres without risk to health or be unable to move, period. I have patients with sore backs and ankles who ask me for a permit. I have patients who are obese and find it difficult to be mobile due to their girth who want a permit (these are the individuals who should actually park farther away and walk more). I even had one active senior who wanted a permit just because she is old. When I told her she didn’t qualify and I wouldn’t fill out the request, she told me I was mean and scolded me, “Just wait until you are old one day.” Again, my refusal puts me in an awkward position of conflict with my patients.
The form currently causing me the most aggravation is the one designating persons with disabilities. If patients qualify for this designation they receive a monthly stipend, which admittedly isn’t a large amount. Many of my unfortunate patients rightfully qualify for this money, and my problem isn’t with them. The application form is long and has both a physician report and an assessor report component, the latter of which can be filled out by the physician or another allied health professional. Physicians are paid reasonably well to fill out this form. I have gone through these forms with patients, filled them out honestly, and the patients have been denied this designation. A new trend has my patients going to an advocacy group that fills out a suggested version of the report for me to transcribe onto a blank form. The problem is that these suggestions are outright lies. I have had a patient get dressed, prepare and have breakfast, climb the stairs out of their basement suite, walk five blocks to the bus, come to my office, and give me a form that says they need continuous help with dressing, grooming, and meal preparation. It also outlines how they can’t take public transportation, can’t walk a block, and are only able to climb two to five stairs. I even had one guy who completed the Sun Run claiming he couldn’t walk a block. These forms are dishonest and, frankly, fraudulent. I understand that these advocacy groups are trying to help their clients, but lying to have people collect unjustified income supplements is just plain wrong.
When I then complete these forms honestly my patients are often rightfully denied this designation, which again makes me the bad guy. I have even had these advocacy groups advise my patients to take the forms to an advocacy doctor who transcribes the lies, collects the fees, and ensures they qualify as disabled.
I will continue to be an advocate for my patients, but I won’t commit fraud. I wonder why these advocate groups and some physicians are willing to do so.
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