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Question about CPET -- Who Signs the Report? Does Anyone Know?

Discussion in 'General ME/CFS Discussion' started by KitCat, Apr 25, 2016.

  1. KitCat

    KitCat be yourself. everyone else is already taken.

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    Hello lovely Pheonix Rising people,

    I am new to this forum and loving it!

    Now straight on to an obscure technical question....

    1. Who signs or prepares a CPET report? Who signs or prepares the disability assessment portion? Is this done by a licensed physician (MD or DO)? Does anyone know?

    2. Has anyone here used a CPET report to create documentation with your own doctor? (Like, did your doctor copy any info out of the CPET report and then write it on any forms or letters for you?)


    I would love to hear back from anyone who has had a CPET and is willing to share with me. Thanks so much!

    I am on SSDI and SSI and try to help others with their claims... but I am totally new to CPETs and did not know about them before arriving here. I have been looking quite a bit online, but I have not been able to find any reliable information out there about the use of CPETs in social security claims. Pheonix Rising seems to be the main place this is being talked about. :)

    I am frankly a little scared of the 2-day CPET because in the short time I have been here I have already read two stories by people who have become debilitated by this exam and have not recovered. This is frightening to me, and I don't like that when I looked at the Workwell I did not see anything clearly warn CFS patients about the risks (unless I overlooked something?). On the other hand, I also read stories from a bunch of people who were very happy with their CPETs.

    I know that social security will not consider something "medical evidence" if it is not signed or prepared by an MD. Thus, my question. Would love to hear any thoughts or input if anyone is willing to share.
     
    Last edited: Apr 26, 2016
  2. halcyon

    halcyon Senior Member

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    Social Security Ruling 14-1p specifically mentions "exercise stress test" as a laboratory finding that can be used to establish an MDI (medically determinable impairment). I believe CPET fits this description.
     
  3. KitCat

    KitCat be yourself. everyone else is already taken.

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    Thanks so much Halcyon. Excellent point! :)

    Here's what I'm looking at:

    "A licensed physician (a medical or osteopathic doctor) is the only acceptable medical source who can provide such evidence."

    Everything I have read and been told is that this is how it works for SSA. If the report is not prepared or co-signed by an MD, then it would be considered supporting information, but not medical evidence.

    But now that I am writing this I am realizing that there may be some intricacies I have to look into here. Like, if an MD orders the test, then it becomes part of that MDs file -- perhaps that would make it medical evidence? That is a distinction I hadn't thought about and will have to look into.
     
    Last edited: Apr 25, 2016
    alkt likes this.
  4. Denise

    Denise Senior Member

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    @KitCat - It is the 2-day CPET with gas exchange that shows distinctive results for people with ME. As far as I know the 2-day test and appropriate interpretation is only done by Workwell Foundation (California) and Betsy Keller (Ithaca, New York).
    In some cases (with plenty of advance notice) people have also gotten neurocognitive testing before and after as additional documentation of impact.

    Additional information
    http://translational-medicine.biomedcentral.com/articles/10.1186/1479-5876-12-104
    http://www.healthrising.org/blog/20...er-exercise-testing-chronic-fatigue-syndrome/

    One person who has documented her experience has a collection of related posts http://www.occupycfs.com/exercise-testing-and-results/.

    I hope others can provide input on what it takes to get a healthcare professional to order the appropriate test.
     
  5. KitCat

    KitCat be yourself. everyone else is already taken.

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    @Denise, hmm... I'm not sure if that tag worked.

    This is super. thank you so much! I will read these links. I didn't know about the neurocognitive testing part, very clever.

    I did some more research and asked some people smarter than me and here is what I have figured out so far:

    To the best of my knowledge at the moment....

    1. If the cpet report is not signed by an MD, social security will not consider it medical evidence

    2. social security will still read it though, and it could help a little or it could help a lot

    3. how much it helps depends on a) what else is in your file b) discretion of the person deciding your case c) what outcomes the report finds d) sometimes: how old you are and how educated you are e) if the report includes specific information on functional limitations

    4. You wouldn't be able to get approved for social security just based on the cpet, you still need medical evidence

    5. If, by some miracle, you can figure out a way to get it signed or co-signed by an MD, then it could become medical evidence.

    6. the social security regulations give a test like the cpet exactly the same amount of importance as several other tests (tilt table, sleep study, mri, epstein barr test, etc) and all those tests are way less risky. The only difference I can see is if the cpet report includes specific conclusions about functional limitations. If it has that kind of info, social security could use that to help someone get approved based on medical vocational allowance.

    I still haven't figured this part out: Is the 2-day cpet signed by a workwell physician? Betsy Keller is definitely not a physician, that much I can figure out :)

    I need to learn more about this part.... do all reports include information on functional limitations? I saw a sample test report online that didn't, but it wasn't for a 2-day test. I also wonder how this information is presented, would it have the possibility to hurt someone's claim if the results weren't good? It's really hard for me to get a sense without seeing a report. I'm hoping someday to run across someone who will let me take a look at theirs.

    also, if anyone sees anything you think I got wrong here, please let me know. I want to learn more.

    this is for social security only, I know nothing about other kinds of disability claims
     
    Last edited: Apr 26, 2016
  6. KitCat

    KitCat be yourself. everyone else is already taken.

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    Oh thank you for posting the occupy cfids link. excellent info. Yes, it definitely seems like there is functional limitation information in the report she is describing, but it's hard to get a complete sense without seeing the report.

    Has anyone ever heard of anyone with cfs taking this test and the results showed that they were not as limited? Just curious.
     
    Last edited: Apr 26, 2016

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