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Disability assessment and determination in the United States

Linda Cocchiarella, MD, MSc
Section Editor
Joann G Elmore, MD, MPH
Deputy Editor
H Nancy Sokol, MD


Disability evaluation is an important aspect of clinical care. Accurate evaluation significantly affects the wellbeing of both patients and society, given the impact of disability status on financial remuneration, return to work, personal and workplace productivity, and access for existing and future health care needs.

Both treating and consulting clinicians are often asked to evaluate their patients for disability. Input from treating clinicians is crucial to disability evaluation because they often have the most in-depth and longitudinal knowledge of the patient's conditions and function, may be aware of medical and psychosocial contributions to ongoing disability, and can best advise on severity, permanency, and possible accommodations needed for an impairment.

When treating clinicians are unable to provide a disability evaluation, or when an insurance carrier has concerns that the treating clinician cannot be impartial, a consulting clinician may be hired to provide an opinion as an "independent" medical examiner. There is no doctor-patient relationship between the independent medical examiner and the patient.

Assessment of disability is complex, variable and challenging even among clinicians experienced in disability determination. A number of factors give rise to these challenges [1]:

The determination of disability requires a synthesis of clinical and nonclinical information.


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Literature review current through: Sep 2016. | This topic last updated: Sep 17, 2015.
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