Yogendran Lalanthica, Rudolf Mark, Yeannakis Drew, Fuchs Kathleen, Schiff David
Department of Neurology, Division of Neuro-Oncology, University of Virginia School of Medicine, Charlottesville, Virginia, USA.
Disability Claims Representatives, Keswick, Virginia, USA.
Neurooncol Pract. 2022 Sep 25;10(1):5-12. doi: 10.1093/nop/npac076. eCollection 2023 Feb.
In the United States, diagnosis of grade 3 or 4 glioma qualifies patients for Social Security disability benefits. Low-grade gliomas (LGGs) can be similarly debilitating, with at least 31% of patients presenting with cognitive deficits and 80% with tumor-related epilepsy. A diagnosis of LGG does not in and of itself qualify patients for disability benefits; the burden of proof is substantially higher. We outline the American healthcare system process of medical documentation to support disability benefits, Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). We provide a template to assist providers in facilitating the application process for patients with LGG. The provider's role is not to simply "declare" a patient disabled, but to provide comprehensive documentation regarding diagnosis, treatment, disease status, symptoms, and functional status in the medical record. As cognitive symptoms and seizures are 2 key sources of disability in LGG patients, selective referrals to neuropsychology and epileptology may improve patient care and bolster documentation of the patient's symptoms in these domains. Likewise, connecting patients with social workers and disability claims representatives can assist them in navigating the complicated application process. We provide an extensive review for patient eligibility in the United States to receive disability. We map a comprehensive care process that may have relevance to multiple regions outside the United States. Providers are better able to help their patients navigate the disability application process when they understand how to address physical and cognitive changes for thorough care of their patient.
在美国,3级或4级胶质瘤的诊断使患者有资格获得社会保障残疾福利。低级别胶质瘤(LGG)同样可能使人衰弱,至少31%的患者存在认知缺陷,80%的患者患有肿瘤相关性癫痫。LGG的诊断本身并不能使患者获得残疾福利;举证责任要高得多。我们概述了美国医疗系统中支持残疾福利、社会保障残疾保险(SSDI)和补充保障收入(SSI)的医疗文件记录流程。我们提供了一个模板,以协助医疗服务提供者为LGG患者简化申请流程。医疗服务提供者的职责不是简单地“宣布”患者残疾,而是在病历中提供有关诊断、治疗、疾病状态、症状和功能状态的全面文件记录。由于认知症状和癫痫发作是LGG患者残疾的两个关键来源,选择性转诊至神经心理学和癫痫学领域可能会改善患者护理,并加强对患者在这些领域症状的记录。同样,将患者与社会工作者和残疾索赔代表联系起来,可以帮助他们应对复杂的申请流程。我们对美国患者获得残疾资格进行了广泛审查。我们绘制了一个全面的护理流程,这可能与美国以外的多个地区相关。当医疗服务提供者了解如何应对身体和认知变化以全面护理患者时,他们就能更好地帮助患者应对残疾申请流程。