Dillemas of a WAO medical examiner

The year is 1994, you’re an insurance doctor who examines sick or disabled people. The outcome of the examinations determine whether or not people get WAO disability benefits. There is a lot of societal and political pressure on the system and the amount of people that receive WAO benefits. Determining the amount of work a sick or disabled person can still manage, most of the time people are not determined to be 100% percent unable to work. Besides that, the GMD (Gemeenschappelijke Medische Dienst), has set new and stricter rules on who qualifies as a WAO beneficiary. You will see multiple people each day, but who will you consider disabled or sick enough to get WAO benefits? [[To the first patient!]] </style> <img src=https://i2.wp.com/www.additudemag.com/wp-content/uploads/2006/12/GettyImages-1129223269.jpg?resize=1280%2C720px&ssl=1> </div>

The first patient of the day is a 30 year old man, who has sustained a brain injury from a car accident. He has the mental capacity of a teenager due to his injury and has been receiving WAO benefits for a couple of years, but now has to get re-examined. What is your decision? [[You think he could still work, as a cake decorator for example, so you decide to reject his WAO application]] [[You consider the man completely unable to work and allow him to keep his full WAO benefits]] </style> <img src=https://www.cdc.gov/traumaticbraininjury/images/mockup-homepage/GettyImages-938038202-symptoms-modified-medium.jpg?_=31945> </div>

The man is relieved to have been allowed to keep his WAO benefits, but technically you didn't follow the rules set by the GMD. You have other patients to see, so you don't think about it anymore. [[To the second patient!]]

The man is extremely disappointed and upset, but you have technically followed the examination criteria. You advise him to appeal in court, as you have to move on to another patient. [[To the second patient!]]

The second patient you see is a 26 year old man, who is partially blind. He only has 10% vision and has been receiving 70% WAO disability benefits so far. He also has to get re-examined, what do you decide? [[He could still be a receptionist and work! Deny his re-application to the WAO benefits!]] [[Keep his benefits as is, he can't fully integrate into the workforce.]] </style> <img src=https://www.hopkinsmedicine.org/sebin/j/x/diabetic-blindness.jpg> </div>

The man can't believe your suggestion of working as a receptionist and walks out angry. You move on to the next patient. [[To the third patient!]]

The man is happy with the outcome. You did get some suspicious looks from your coworkers, though. But you have more patients to see, so you move on. [[To the third patient!]]

The third patient is a 44 year old woman with multiple sclerosis. She claims to be in a lot of pain and has trouble moving around. This is her first application for WAO benefits and her first examination. What is your decision? [[She can still work, deny her application for WAO benefits.]] [[There is enough evidence to assume that this woman can't work anymore, so your conclusion is that she gets 100% WAO benefits.]] </style> <img src=https://images.theconversation.com/files/241960/original/file-20181024-169807-gk9t1v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip> </div>

The woman is very dissapointed, you tell her she can appeal if she wants to. [[To the fourth patient!]]

The woman is overjoyed that she gets 100% WAO benefits. Meanwhile, your supervisor is seen writing notes while looking at you. You have other patients to see, so you move on. [[To the fourth patient!]]

The fourth patient is 55 year old construction worker with a hernia, who has very poor mobility. What do you decide? [[He only gets 40% WAO benefits, he could still peal potatos!]] [[He gets 100% WAO benefits]] </style> <img src=https://www.spinesport.nl/wp-content/uploads/2019/04/spinal_disc_hernia.jpg> </div>

The patient is once again disappointed, but at least he's getting some compensation, right? You move on to the next patient. [[To the fifth patient!]]

The patient is overjoyed, but you notice that your supervisor has been watching you after he leaves. You quickly move on to the next patient. [[To the fifth patient!]]

The fifth patient is a 50 year old woman with rheumatoid arthritis, causing pain, swelling and stiffness in the joints. She currently gets 45% WAO benefits. She has to get re-examined, what is your decision? [[Dial it down to 35% benefits, she can still perform tasks such as taking samples!]] [[Keep the benefits the same, this illnes is severe enough.]] </style> <img src=https://images.medicinenet.com/images/slideshow/xl-sq-promos/joint-pain-stiffness.jpg> </div>

Your decision doesn't go over well with the women, who promises you that she'll see you in court. When she has finally left, [[You're summoned to your supervisor's office.]]

Your decision seems to be fair enough, and the woman leaves. Just when you're about to leave, [[You're summoned to your supervisor's office.]]

When you walk into the office of your supervisor, you get a sense of impending doom. Sure enough, your supervisor tells you that they are not happy with your abilities to judge patients. There are complaints from patients about not being treated fairly and the GMD thinks that you haven't always followed the guidelines set by them. You're asked to resign and collect your things. </style> <img src=https://ichef.bbci.co.uk/news/976/cpsprodpb/848E/production/_102143933_leavingoffice.gif> </div> Not to fear, though, you quickly find the same job at another clinic. There you can do it all over again! [[To the first patient!]]