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More on Disability Decisions

Chattanooga, Tenn.

I can well sympathize with Dr. Joseph Silverman’s conclusion in his letter in the November 17, 2000, issue that his willingness to participate in a telephone conference, concerning a patient receiving disability benefits, resulted in feeling that his views had been misrepresented. I would hope, however, that he will reconsider his stated plan never to participate in such a conference again.

As he writes, "Disability decisions are extremely complicated, and discussions regarding disability situations deal with subtle distinctions." Consequently, the input of a thoughtful, treating clinician is invaluable in obtaining a full picture and making the best possible decisions. Willingness to participate in person-to-person communication may not only cut down on paperwork, but also permit a more rapid response for the patient in question.

As a reviewer who depends on the professional goodwill of his colleagues, let me suggest the following alternative for busy psychiatrists: If one is not offered, ask for a summary of the conversation, which can then be edited and returned to ensure that it adequately reflects your thinking, while keeping a copy for your records. When appropriate, include an invoice for time spent in preparation of the edited version.

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