Special Features: Workers' Compensation Benefits
Alan Colledge
Search for other papers by Alan Colledge in
Current site
Google Scholar
PubMed
Close
and
Greg Krohm
Search for other papers by Greg Krohm in
Current site
Google Scholar
PubMed
Close
Restricted access

Abstract

The AMA Guides to the Evaluation of Permanent Impairment, (AMA Guides) specifies that impairment evaluation may be conducted by a treating or nontreating physician. A treating physician who is knowledgeable about the use of the AMA Guides may be the appropriate professional to evaluate impairment, but in cases that involve pain, disability, and medicolegal (forensic) issues, a truly independent medical examiner typically is most appropriate. All specialties share the same elevated risk of iatrogenesis when treating and evaluating/forensic roles are mixed because mixing compromises the quality of care and threatens the viability of the therapeutic relationship. Further, all treating specialties share the same bias toward offering treatment for most complaints—rather than engaging in the type of cautious skepticism that is required for competent impairment evaluation and other forensic duties. Finally, no treating clinician, regardless of specialty, can offer allegiance to judicial and administrative decision-makers. Treating clinicians often find themselves in a position in which they would be cutting off a source of their own income if they were to offer opinions that the clinical presentation is not valid, work related, or injury related, nor is the patient in need of further treatment. Such a financial conflict of interest can be eliminated only by referral to independent examiners and restricting treating clinicians from becoming involved in such decisions.

  • 1.

    Thompson Williams C, Reno VP, Burton Jr JF. Workers' Compensation: Benefits, Coverage, and Costs, 2002. Washington, DC: National Academy of Social Insurance; 2004.

    • Search Google Scholar
    • Export Citation
  • 2.

    Telles C, Laszlo A, Liu T. CompScope TM Benchmarks: Multistate Comparisons 1994-2000 (WC-02-09). Cambridge, MA: Workers Compensation Research Institute; 2003:3643.

    • Search Google Scholar
    • Export Citation
  • 3.

    Mont D, Burton JF, Reno V, Thompson C. Workers' Compensation: Benefits, Coverage, and Costs, 1999 New Estimates. Washington, DC: National Academy of Social Insurance; 2001.

    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 44 44 5
Full Text Views 23 23 0
PDF Downloads 0 0 0
Save