Doctors' notes to employers and insurers.

If physicians do not write notes for employers and disability insurers carefully, patients may lose employment and/or disability benefits. Employers want to know whether workers can perform the job adequately and safely under reasonable conditions. Whether the inability to do the job is due to a legitimate medical problem is irrelevant for protecting jobs. The physician should therefore be careful to distinguish between 'hurt', which may cause workers pain, but allow them to do a job, and 'harm', which means a particular job may worsen the patient's condition. The physician must also be well informed about eligibility for disability payment. When writing a note, doctors should ask themselves several questions: Is there a definite diagnosis? Is the patient receiving optimal medical therapy? What are the irreducible limitations imposed by the patient's disease? What are the contraindications? Is the disability temporary or permanent?