Completing Disability Forms Efficiently and Accurately: Curriculum for Residents

The completion of a patient's disability assessment form (DAF) is a task expected of family and internal medicine physicians. Residency curricula rarely address this task. Thus, some residents are reluctant to conduct functional assessments because of inadequate training, the time required to conduct such an exam, and fear of jeopardizing the doctor-patient relationship. This article describes a curricular intervention to prepare residents to complete a focused functional capacity assessment during a 30-minute office visit.

Developing the curriculum for DAF completion involved a literature review, conducting needs assessment interviews, and a review of existent residency training materials. Instructional strategies included lecture, panel discussions, and demonstrations. The learner evaluation strategies were knowledge tests, direct observation of residents, and a review of disability cases with an expert panel consisting of federally certified Social Security Administration workers. This work represents information gained from four pilot tests.

The residents' knowledge scores increased significantly. Knowledge of state, federal, and employer disability programs increased as well as their ability to distinguish sedentary, light, medium, and heavy work capacity when related to patients' medical conditions. All the residents could perform the assessment, but none of them were confident that they could complete the DAF in a 30-minute office visit. This was an expected outcome.

It is possible to teach family and internal medicine residents the knowledge and skills required to determine their patients' functional capacity as it relates to a specific problem. By applying what they have learned to their patients, they will eventually be able to complete a DAF during a 30-minute office visit. Residency programs are encouraged to incorporate a functional assessment curriculum.