This weekly roundup thread is intended for all culture war posts. 'Culture war' is vaguely defined, but it basically means controversial issues that fall along set tribal lines. Arguments over culture war issues generate a lot of heat and little light, and few deeply entrenched people ever change their minds. This thread is for voicing opinions and analyzing the state of the discussion while trying to optimize for light over heat.
Optimistically, we think that engaging with people you disagree with is worth your time, and so is being nice! Pessimistically, there are many dynamics that can lead discussions on Culture War topics to become unproductive. There's a human tendency to divide along tribal lines, praising your ingroup and vilifying your outgroup - and if you think you find it easy to criticize your ingroup, then it may be that your outgroup is not who you think it is. Extremists with opposing positions can feed off each other, highlighting each other's worst points to justify their own angry rhetoric, which becomes in turn a new example of bad behavior for the other side to highlight.
We would like to avoid these negative dynamics. Accordingly, we ask that you do not use this thread for waging the Culture War. Examples of waging the Culture War:
-
Shaming.
-
Attempting to 'build consensus' or enforce ideological conformity.
-
Making sweeping generalizations to vilify a group you dislike.
-
Recruiting for a cause.
-
Posting links that could be summarized as 'Boo outgroup!' Basically, if your content is 'Can you believe what Those People did this week?' then you should either refrain from posting, or do some very patient work to contextualize and/or steel-man the relevant viewpoint.
In general, you should argue to understand, not to win. This thread is not territory to be claimed by one group or another; indeed, the aim is to have many different viewpoints represented here. Thus, we also ask that you follow some guidelines:
-
Speak plainly. Avoid sarcasm and mockery. When disagreeing with someone, state your objections explicitly.
-
Be as precise and charitable as you can. Don't paraphrase unflatteringly.
-
Don't imply that someone said something they did not say, even if you think it follows from what they said.
-
Write like everyone is reading and you want them to be included in the discussion.
On an ad hoc basis, the mods will try to compile a list of the best posts/comments from the previous week, posted in Quality Contribution threads and archived at /r/TheThread. You may nominate a comment for this list by clicking on 'report' at the bottom of the post and typing 'Actually a quality contribution' as the report reason.
Jump in the discussion.
No email address required.
Notes -
I wouldn't put too much stock in that article. The treating physician has very little say in whether a claimant qualifies for disability. Disability isn't a medical condition, it's a legal status based on ability to work, and ability to work can't always be determined by a medical diagnosis (and when it can, that's what the listings are for). The determination of disability is made by and adjudicator in consultation with a doctor employed by the state. This doctor does not actually examine the patient but reviews medical records to find evidence of limitation. He offers an opinion of what the claimant is capable of based on the records, but the legal determination is ultimately up to the adjudicator.
I would also note that it's incredibly uncommon for any treating physician to offer an opinion about a claimant's ability to work, or even to actively participate in the process. Protocol calls for the adjudicator to attempt to call the physician who treats the condition they're claiming disability for, and the only times a doctor was ever willing to speak to me were in cases where the patient was in such bad shape that their disability was almost a given regardless, with the exception of one where a woman had an unusual condition but no money for regular treatment and an ER doctor actually got on the line to explain it to me. Other than that, they aren't even willing to fill out the forms we send them, and take a month to even send the medical records. Occasionally they'll mention in the chart that the patient told them they were applying for disability, but that's usually as far as it goes.
What we looked for wasn't whether the doctor commented on disability specifically, but on their ability to work. Even this was rare, though. There were occasional instances of orders not to lift above so many pounds or walk too far or whatever, but the determination was made based more on clinical signs than on opinions. Even when a physician made a clear statement that the claimant couldn't continue to do their job, our doctors would note the opinion, say they gave it "appropriate" weight, and make their own assessment based on objective markers. If the objective markers weren't there, our doctor wasn't going to recommend disability based on the treating physician's say so.
As far as education goes, that's not something our doctor would touch, or even look at. If you're under 50 and capable of doing sedentary work, you aren't getting disability regardless of your education level. "Education" is kind of a misnomer anyway; whether or not you can do a job doesn't depend on your education level but whether you've done the job in the past 20 years, and the level of Specific Vocational Preparation required as defined by the Dictionary of Occupational Titles. At this point it gets complicated, and beyond age 50 we start looking at transferable skills and the ability to adjust to other work. So you can have a law degree from Harvard but if you're over 50 and did manual labor your whole career it doesn't matter. If you're a high school graduate and only have done office jobs your entire career it doesn't matter. If you're under age 50 and are capable of doing unskilled sedentary work, you aren't getting disability except in unusual circumstances.
Yes from the physician perspective we want the least amount of responsibility here possible and try and be as vague as we can, send to other people when possible, and limit our level of commentary.
Unless specifically specialized in this you don't really get paid for it but accept a bunch of liability.
Classic example is potentially violent emotional support animals.
Keep us the fuck out of it.
More options
Context Copy link
More options
Context Copy link