By Michael J. Brown, Esq. †
We all probably sense that insurance companies have taken over the world. This is becoming more and more true in medicine. Early in my career I wrote the disability decisions for Social Security. In my office they had various physicians who would review the medical portions of the case. I am fond of telling my clients that I use to go to medical school for an hour each day. I would show up into the office early and pick up a file that interested me, that involved an orthopedic issue or cardiac condition or neurology, and I would go find a brain to pick.
The doctors who were on staff were quite gracious with their time and I learned quite a bit of medicine which I use in my practice to this day. Early in my practice, I used that knowledge to my great advantage because I learned how to read “doctorese”. I learned how to read the written notes of the doctors, their abbreviations and shorthand, and used it to my advantage in prosecuting my client’s cases. Sadly, I can no longer do this as everything is now computerized.
The insurance companies require physicians to place all their information into their computer programs for billing purposes. As you may guess, these records are about as interesting to read as stereo instructions. It is important to remember that the computerized records are designed not only for the insurance companies, but for other doctors to read. The doctors are trained to read this time of record, as well as the details of the diagnostic codes they contain.
The problem is that the doctors and their staff have to spend a lot of time inputting information so that it is not only rejected by the computers as inadequately formatted. Unfortunately, where a doctor’s written notes were often times vibrant and forceful, the computerized records are bland, boring and almost mind-numbing. From my perspective they do not give the full flavor as to how serious a patient’s condition actually is. This is a serious problem when presenting a Social Security disability case to an Administrative Law Judge (ALJ).
Indeed, often times the patient is relaying information either to the doctor or one of the staff and the information is not adequately captured into the computer program because of time constraints. So, when I wrote earlier that it is important to let your doctor know, not only about what hurts, but the history of the problem that you are having, it is equally important this information gets into the computer program. It is important when you are giving your information to the nurse or the medical assistant who is typing the information into the record that you request what they are typing in to make sure they haven’t missed anything.
When you go into a doctor’s office, often times you have a variety of issues that are causing you concern. You want to make sure your concerns are in the medical record. With Social Security, if it is not in a medical record, it does not exist.
For example, I have had many times where I have a client who is complaining of a heart condition and also has a significant problem with their knee. The doctor is looking primarily at the heart condition, for obvious reasons, and the knee does not get mentioned. But my client will tell me they mention it to the doctor.
The problem is the complaints of the knee pain or limited range of motion of the knee, are not getting into the medical record. So, if I bring this up at a hearing, the Judge will state, “well where is it in the medical record Mr. Brown”, and I have to say, “well Judge, the family doctor was looking at the cardiac more than the knee”. It is more powerful where I can point to an exhibit and say, “Your Honor, at Exhibit 3F on page 17, my client was complaining of significant pain and limited range of motion to the knee to the doctor and the doctor notes there was crepitus in the knee”.
The important takeaway here is not only tell your doctor what is going on but to make sure that it is getting into that computerized monster that the insurance companies force doctors to use.
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As a partner at Wolf & Brown Law Offices, Attorney Michael J. Brown was passionate about providing his clients with expert representation and fighting for the benefits they deserve. Before Mr. Brown passed away in 2025, after a 30+ year career in disability law, he offered his valuable perspective on engaging with the Social Security Administration and navigating the often adversarial benefits claims process. Much of Mr. Brown’s advice can be applied to veterans facing similar challenges with the VA.
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Perspective on disability law from Michael J. Brown, Esq. †