Warning: This one's a personal rant.
In my opinion, the Australian government is usually a fair and reasonable one, whichever party is in power. They have a good record on things like human rights, a social saftey net, anti-discrimination legislation and other things that concern me. They also, of course, have their bad points, but this article is not about politics. Nor is it an advertisement for Australia, although I may write one of those one day too.
No, this article is about one particular leglislative reform that the Australian Govermnent may be trying to bring in which would seriously damage the social safety-net given to invisibly disabled people in our country. Amongst a raft of other reforms they want to introduce to our welfare system is this one:
Letters and forms from the patient's doctors will no longer be used in Social Security Determinations. Medical information about the client will be gathered solely by an appointment between the client and a Government-appointed doctor.
This is the scariest thing I have heard in a long time. And those with invisible disabilities are the most at risk for it.
Imagine, you're a government-appointed doctor changed with weeding out the people who are trying to rort the system. You possibly get a pay rise or a bonus or something for finding "cheaters" even. First patient, a paraplegic. He wheels himself into your office in his green and blue wheelchair complete with spinal X-ray showing which vertebra is smashed to pieces. You ask him if there is any movement possible, no, none. You test his leg reflexes, they're absent. Obviously not faking it. Okay, he passes.
Next patient, an old man with arthritis. He hobbles in, he's nearly old enough for an old-age pension but not quite, so you need to assess his level of disability. He's obviously disabled though, with swollen, hot, red-looking joints. You test his grip strength, very low. No cheating here, he passes.
Next patient, a college-age young woman. At first glance she looks perfectly healthy. At second glance you notice she does look a little tired, perhaps a slight case of depression? You look down at her application. Under "Disability:" she has listed "Chronic Fatigue Syndrome". You know from experience that people trying to cheat the system often write "Chronic Fatigue Syndrome" on their forms, and skepticism starts to form in your mind. You look up again, noting her rosy cheeks and neatly combed hair.
You ask her for a list of symptoms and she says nothing, pulling an entire page of writing out of her handbag and offering it to you, "These are the symptoms I get regularly, sorry about the writing but one of them is short-term memory loss so if I just try to say them I forget." You try to keep an open mind, but writing down symptoms is a classic of the cheaters, it saves them memorizing a list. The handwriting is slighly hard to read, but you start off, reading them out. "Fatigue, Muscle aches, headaches, nausea, allergies, diahorea, constipation" You raise an eyebrow at the listing of both of the last two, surely the one excludes the other. You mention this to the girl and she stammers for a second then says, "I get different ones on different days ...". You finish reading the improbably long list (wouldn't anybody with that many symptoms look sicker? She walked in okay!) and get her up on the examining table. A brief examination reveals no obvious signs of disease, back at your desk her grip strength is normal.
You look down her list of medications and notice a common anti-depressant listed, you ask her about it and she looks confused for a moment before brightening, "I take it to help me sleep, that's right". No way, this one's got to be a cheater. Or just a bit depressed and looking for a way to get out of going to work. "I'm sorry," you say, "But you seem perfectly fine, I'll have to mark you as healthy." The girl bursts into tears at that, confirming your suspicion about that touch of depression. You usher her out of the office and call, "Next".
This situation, by the way, is not uncommon. Patients with Chronic Fatigue Syndrome have a notoriously difficult time obtaining benefits they deserve, even in Australia. How much worse off are they going to be when, having finally found a local doctor that believes in them and knows about CFS, that doctor's advice is ignored by the Department of Social Security?
CFS is far from the only invisible disability that people are going to have trouble with. How about Fibromyalgia, Multiple Chemical Sensitivities and Hypermobility Syndrome? Or a host of psychiatric but not-easily-detectable disabilities such as PSTD?
If I get called up for review, I'll definitely plan on using my wheelchair that day, and bringing the few bits of paper that do demonstrate abnormalities in blood and urine test results. Along with a witness, preferably my doctor herself.
After that I'll just have to cross my fingers and hope for the best. I hope my review isn't soon.
