Impairment Tutorial: Rating Central Nervous System Disorders
William Shaw
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Lorne Direnfeld
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Abstract

The term nonverifiable radicular complaints is an oxymoron because if the complaint is radicular one should know the cause, but the word nonverifiable contradicts such knowledge. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) explains that nonverifiable radicular complaints “follow anatomic pathways but cannot be verified by neurologic findings.” A frequent error in impairment rating is to assign patients to Category II based on incorrect use of nonverifiable radicular complaints when Category I or 0% impairment is the correct rating. Some physicians inappropriately use the Range of Motion model and cite tables from the third edition. Other physicians may place a patient in Category II using the Injury Model without a specific basis in the AMA Guides, but the key point is that a diagnosis of nonverifiable radicular complaints indicates that the physician can identify the nerve root involved. Absent the latter, the patient does not have nonverifiable radicular complaints. The Injury Model is the preferred method in rating spinal injury in the AMA Guides, Fourth Edition, and this model clearly intends to place patients with some back pain, some leg pain, and some leg numbness—but not a true radicular pattern—in Category I.

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