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Medicine and Public Policy |

Medical Ramifications of the Federal Regulation of the Social Security Disability Insurance Program: Social Security and Medicine

[+] Article, Author, and Disclosure Information

Dr. Hadler is a recipient of an Established Investigatorship from the American Heart Association.

▸Requests for reprints should be addressed to Nortin M. Hadler, M.D.;

Department of Medicine, University of North Carolina School of Medicine; 932 Faculty Laboratory Office Building 231H; Chapel Hill, NC 27514.

Chapel Hill, North Carolina

© 1982 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1982;96(5):665-669. doi:10.7326/0003-4819-96-5-665
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Social Security Disability Insurance is a federally created and regulated insurance plan. The definition of disability as it relates to work capacity is exclusively the purview of government administrators. The primary physician's opinion has little, if any, impact on decision. Administering this insurance scheme requires the quantification of illness as it relates to work capacity (disability). What has evolved is a program that insures for the amount of "disease." The assumption is that with more disease, there is a greater likelihood of illness, even illness manifest as work incapacity. Leaving this underlying assumption tacit is responsible for the adversary climate that envelops the physician, the patient-claimant, and the administrators. It is also responsible for the paucity of clinical investigations into the critical issue of the amount and form of illness a diseased person will have.





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