You won't find this document in any medical record. It's here by chance. During my hospitalization at many hospitals, this was thrown into a box. It was written by my doctor at the time to Social Security. The motivation was money.
You see, as "semi-vegetative" sometimes I was there, sometimes I wasn't. When I was there, I was fine. My hospital bills weren't being paid on time. This could easily be fixed by a doctor telling Social Security I was competent to receive my money and not need a payee. The doctor was at-risk of losing me as a patient because of non-payment. If I controlled my money, I could pay a bill on time.