子宫内膜异位症与残疾:子宫内膜异位症与残疾:联邦法院对子宫内膜异位症患者提出的社会保障残疾保险和补充保障收入申请的上诉分析》。

IF 2.8 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Womens Health Issues Pub Date : 2024-05-01 DOI:10.1016/j.whi.2023.11.008
Martha Grace Cromeens JD, PhD, RN , Kathleen Knafl PhD, FAAN , Whitney R. Robinson PhD, MSPH , Erin T. Carey MD, MSCR , Zakiya Haji-Noor PhD, MPH , Suzanne Thoyre PhD, RN, FAAN
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引用次数: 0

摘要

背景:子宫内膜异位症是一种慢性非肿瘤性妇科疾病,通常具有破坏性的生理和社会心理症状,可导致残疾。在美国,子宫内膜异位症患者如果在退休年龄之前无法工作,可以申请社会保障残疾保险(SSDI)和/或补充保障收入(SSI)。鉴于伤残审查过程有多个步骤,因此更好地了解伤残决定是如何做出的非常重要。本研究旨在探讨美国联邦上诉法院在审查涉及子宫内膜异位症相关上诉问题的 SSDI 和/或 SSI 申请时所采用的方法和依据:我们检索了截至 2021 年 1 月的 Westlaw 和 Nexis Uni 记录,其中包括将子宫内膜异位症作为一种损伤的 SSDI 和 SSI 申请的联邦上诉。两名独立审查员筛选了全文案例并提取了数据。对法院有关子宫内膜异位症相关上诉问题的理由进行了框架分析:结果:87 起上诉涉及子宫内膜异位症相关问题。在所有判决中确定了三个主题--证据、治疗和时间。法院对各主题的讨论揭示了对子宫内膜异位症申请人构成挑战的理由和证据要求。法院认为对症状的主观报告不足以证明损伤,对治疗的积极反应也不足以证明治愈,或使申请人无法证明必要的连续 12 个月的损伤。一些法院期望索赔人采用避孕或子宫切除等治疗方法,但没有考虑到这些治疗方法的风险,也没有考虑到这些治疗方法可能与索赔人的需求和偏好相悖:结论:子宫内膜异位症患者在残疾申请中面临着证据障碍以及关于疾病、诊断和治疗的常见误解。在申请 SSDI 和 SSI 时,子宫内膜异位症患者往往处于不利地位,尤其是那些无法获得医疗服务的患者。医疗保健、政策和法律系统可以利用本研究的发现,为子宫内膜异位症等慢性疼痛患者创建一个更加公平的残疾申请和审查系统。
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Endometriosis and Disability: Analysis of Federal Court Appeals of Social Security Disability Insurance and Supplemental Security Income Claims by Individuals Suffering From Endometriosis

Background

Endometriosis, a chronic noncancerous gynecologic condition commonly characterized by disruptive physical and psychosocial symptoms, can be disabling. Individuals in the United States with endometriosis who are unable to work before retirement age can apply for Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI). Given the multi-step process of disability review, it is important to better understand how disability decisions are made. This study aimed to examine approaches and rationales of U.S. federal appeals courts reviewing SSDI and/or SSI claims involving endometriosis-related issues of appeal.

Methods

We searched Westlaw and Nexis Uni records, available as of January 2021, for federal appeals of SSDI and SSI claims including endometriosis as an impairment. Two independent reviewers screened full-text cases and extracted data. Framework Analysis was applied to courts’ rationales regarding endometriosis-related issues of appeal.

Results

Eighty-seven appeals addressed an endometriosis-related issue. Three themes—evidence, treatment, and time—were identified across the decisions. The courts' discussions across themes exposed rationales and evidentiary requirements that posed challenges for claimants with endometriosis. The courts found subjective reports of symptoms insufficient evidence of impairment and positive responses to treatments to indicate cures or prevent claimants from demonstrating the necessary continuous 12 months of impairment. Some courts expected claimants to use treatments such as contraception or hysterectomy without addressing the risks of such treatments or the fact that they might have been counter to claimants’ needs and preferences.

Conclusions

Individuals with endometriosis face evidentiary obstacles and common misconceptions about disease, diagnosis, and treatment in disability claims. SSDI and SSI endometriosis claims are systematically disadvantaged, particularly among those without access to care. The health care, policy, and legal systems can leverage the findings in this study to create a more equitable disability application and review system for those with chronic pain conditions such as endometriosis.

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来源期刊
CiteScore
4.50
自引率
6.20%
发文量
97
审稿时长
32 days
期刊介绍: Women"s Health Issues (WHI) is a peer-reviewed, bimonthly, multidisciplinary journal that publishes research and review manuscripts related to women"s health care and policy. As the official journal of the Jacobs Institute of Women"s Health, it is dedicated to improving the health and health care of all women throughout the lifespan and in diverse communities. The journal seeks to inform health services researchers, health care and public health professionals, social scientists, policymakers, and others concerned with women"s health.
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