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Hi again Gerrit, Now I will address your disability questions. First let me ask some questions. 1. Do you have private or governmental insurance or a combination? 2. If you receive these benefits will you have enough (with savings, spouse income etc. to live on in a reasonable fashion? 3. How much do you want to (have the energy and motivation) to continue work? In other words if you were in an environment where what you produced didn't matter would you want to continue working or do you think its time to quit? 4. How much do you think your production has been compromised? Do you think that your employer is losing money on you? How much does your employer know about your illness? When was he told? How did he/she react? 5. Is there a possibility in the job situation and with your insurance program of working part-time?. I did that for about 8 months and it helped me a lot in the transition. Now regarding your questions: "Kleynscheldt, Gerrit" wrote: > I have a question that I have not yet seen addressed anywhere: > In a debilitating illness like PD one is initially able to carry on with > your duties as an employee. At some point a stage is reached where you are > diagnosed as being unable to work and thus declared disabled. > 1. This cross-over stage seems to be very subjective, depending on the > report by (inter alia) the neurologist, who compares you with the worst > cases that he has come across. Yes it is subjective. And at least here in the States you can be almost guaranteed a fight no matter where you are in the course of the disease. It in crucial to have your doctor behind you and to write the correct things to the insurance company or Social Security. If as you have said your neurologist does not know a lot about PD find one who does. I don't know the availability of movement disorder specialists in South Africa but I suspect that there must be Movement Disorder Clinics in the larger cities. The job of the physician is to evaluate how the symptoms that you have interfere with your work as defined by a job description given to him by you or your employer. He should be relying on you and your employer for the data. > > 2. It is very difficult to convey the non-visible effects to an > outsider. How does the Dr measure exactly how much the arm is numb, how > much fatigued I am, exactly how little energy I have, how much of my > procrastination can be blamed on PD, etc. Again that is difficult. Remember- and he should too- that loss of initiative is a SYMPTOM of PD. So is fatigue. Your employer can provide a lot of the data and it may be to his advantage as well as yours for you to receive disability - if your production is suffering.. > > 3. At the workplace I become a passenger, doing work but not performing > well at it and seeing my colleagues get ahead while I barely survive each > day. That is discouraging especially if you have taken pride in your work in the past. > > 4. Compared to my colleagues of the same age - by the time they go on > pension to a well deserved rest I will be in an advanced state with my PD. > Should the insurer not consider paying the disability earlier so that I can > also have a period of relative sunshine before PD takes a stronghold? They > know that they will definitely have to pay the benefit, but they postpone > their decision, without a visible advantage. Yes I agree- but it won't fly. Unfortunately every check that you don't get is money in their pockets- and if they are lucky maybe you will die young and they won't have to pay at all. > Has anyone thought about this and how is the insurer and/or employer > approached so that the case is looked at holistically and with empathy, > rather than the current and (for them) safer route of clinical reports.-- I have thought a lot about this. I have done some psychiatric disability evaluations when I was practicing and had to borrow money from my family several years ago when my insurer played these games and I wasn't working. If you answer the questions above I will try to suggest some approaches which might be effective (but in this business then again may not). Charlie ****************************************************************************************** Charles T. Meyer, M.D. Middleton (Madison), Wisconsin [log in to unmask] *****************************************************************************************************************************************