December 18, 2009
For people who have chronic health conditions, managing medical needs is only one part of adjusting to what often are life-altering disorders. Unfortunately, many people find themselves unprepared for the level of disability as well as the depression and economic impact on their families.
Arthritis, for example, afflicts many people at a young age while they are actively engaged in the workforce. Their level of disability often is exacerbated unless they receive care from physicians who have been trained to appropriately diagnose, treat or refer patients for effective early intervention.
Helping people sort out their abilities, disabilities and vocational and benefit options is the important work of the Disability Assessment Services and Research Clinic. An integral part of the Arizona Arthritis Center at The University of Arizona College of Medicine in Tucson, the clinic is the only comprehensive assessment center in Arizona that evaluates a person’s medical, psychological and vocational abilities.
The Disability Assessment Services and Research (DASR) clinic includes the state-of-the-art ERGOSTM Work Simulator that measures all physical demands of work, including strength, range of motion, work endurance and standing and sitting work tolerance. Arizona Arthritis Center fellows rotate through the clinic to assess patients, giving these physicians the opportunity to learn how arthritis affects the entire person.
Musculoskeletal conditions, primarily back problems, are the leading cause of disabilities and represent a huge economic burden. In Arizona, of the 5,300 state employees who are on disability, 65 percent are due to musculoskeletal ailments, including arthritis. “If caught within the first couple of years and treated with proper early medical intervention, some of the deformity could be prevented and people could remain in their jobs,” says DASR clinic Director David W. Smith, D.ED, DABPS, DACFE, MACF.
A Clinic of Hope
“We are a clinic of hope,” says Dr. Smith. “After an assessment session, we have a total picture of a person’s life. We see how arthritis has affected their lifestyle, whether they have the ability to perform their job, whether they can be trained for a new vocation, and what benefits are available to help them minimize the economic impact on their families.”
The primary goal of the clinic is to keep people working. In some cases, the clinic can help a person transition from a physically-demanding job to a vocational training program that leads to a more sedentary job that doesn’t worsen the person’s physical condition. In cases where a person is totally disabled, the clinic helps with applying for Social Security Disability Insurance (SSDI) and investigates whether the person is entitled to a long-term disability policy through his or her employer.
“Many people don’t realize or understand all the benefits available to them, and not all employers are forthcoming with this information,” says Dr. Smith.
No One Turned Away
The clinic sees about 500 patients per year through a contract with the Arizona Department of Economic Security (DES) and another 150 people without charge, who are referred by other physicians, primarily rheumatologists.
“We don’t turn anyone away, but we sure could use some funding to provide assessments for people who can’t pay and to expand the program to provide early intervention to more people,” says Dr. Smith, who hopes to develop an endowment at the Arizona Arthritis Center to cover the cost of assessments for people who can’t pay.
“We are getting more and more calls from physicians in the community. Any medical doctor can refer a patient, and we’d like to continue to see everyone, regardless of their ability to pay. Unless it happens to you, you don’t see how devastating disability can be,” says Dr. Smith.
Comprehensive Services for Arizonans
Since 1994, the Disability Assessment Services and Research clinic has conducted comprehensive, integrated psycho/social, neuropsychological, medical and vocational assessments to assist public, private, state and federal programs in their work with individuals who have medical, physical, mental, psychological, neuropsychological and psychiatric disabilities. Services are provided in Tucson, Phoenix, Yuma, Safford, Bisbee, Douglas, Nogales, Sierra Vista and other Arizona cities.
The clinic offers the following services:
- Physical and occupational therapy: stretches, exercises and techniques to promote strength, range of motion and reduced pain caused by injuries or illness.
- Nutrition assessment: assists patients in evaluating current dietary habits and provides guidance on modifying choices for better overall health, especially in the context of inflammatory diseases.
- Acupuncture: offered to patients on a referral basis as an alternative treatment for pain.
- Tai Chi, Yoga and massage: classes offered as part of an integrative mind-body approach to chronic illness for overall body awareness, stress management, low impact exercise and chronic pain relief.
- Health coaching: “Fit for Life” is a six-month intervention program based on self-management modules and a tailored exercise program with a volunteer ‘heath mentor’ to provide ongoing support and accountability for each enrolled participant.
For more information about the Disability Assessment Services and Research clinic, call (520) 626-2982, or visit the Web site, www.arthritis.arizona.edu/index.php/patient-empowerment/life-compass/disability-clinic.html