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Medically unexplained illness in short- and long-term disability - Source: Disability and Rehabilitation, Sep 10, 2007

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By HK Chandler, et al. • www.ProHealth.com • September 20, 2007


Purpose: Compared to patients with explained illness, patients with medically unexplained illness (MUI) may be at elevated risk of applying for disability. Accordingly, patients with MUI may account for a disproportionate number of disability claims and for a disproportionate percentage of salary reimbursement costs.

The study was conducted to determine: (a) The prevalence of MUI among disability insurance claimants; (b) the cost of salary reimbursement; and (c) the impact of psychiatric comorbidity on length and cost of disability.

Method: An insurance database of 26,451 short-term disability (STD) recipients with long-term disability (LTD) coverage was analyzed to determine the prevalence and salary reimbursement costs of MUI.

Applicants with medically explained and psychiatric illness were included for comparison.

Results:

  • The prevalence of MUI among STD recipients was lower than clinical and community rates.

  • Rates of application and receipt of LTD benefits for MUI were similar to explained illness.

  • When LTD payments were projected to retirement age, costs associated with unexplained back pain and Fibromyalgia were comparable to those of explained illness.

  • The length of disability and salary reimbursement costs were greater when comorbid psychiatric illness was present.
  • Conclusions. Patients with MUI did not account for a disproportionate number of disability claims or amount of the money spent on salary reimbursement. Comorbid psychiatric illness increased the length and cost of disability.

    Source: Disability and Rehabilitation. 2007 Sep 10; 1-7 [E-publication ahead of print] PMID: 17852256, Chandler HK, Ciccone D, Macbride RJ, Natelson B. Department of Psychiatry, New Jersey Medical School, Newark, New Jersey, USA.





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