Search for other papers by Christopher R. Brigham in
Current site
Google Scholar
PubMed
Abstract
This article continues a discussion of the results of a nationwide study that reviewed 2100 impairment ratings and found a large number of errors (see the May/June issue of The Guides Newsletter). Spinal impairment ratings, for example, often are erroneous. Although the AMA Guides to the Evaluation of Permanent Impairment, (AMA Guides) clearly specifies use of the Diagnosis related estimates (DRE) method, evaluators sometimes incorrectly use the range-of-motion (ROM) method, which is fraught with potential error and typically results in higher impairment ratings. The most common problem associated with rating the lower extremities is combining multiple duplicative impairments. Multiple impairments typically are combined rather than added because the latter usually results in overrating impairments. A sidebar highlights red flags to erroneous AMA Guides ratings, and evaluators can take a number of steps to ensure accurate ratings. The first of these is to ensure an unbiased rating, preferably by a board-certified physician who, ideally, also has certification in the performance of independent medical and impairment examinations. The client requesting the evaluation should provide a cover letter describing the specifics of the evaluation, and the evaluator's report should comply with standards defined in the AMA Guides. All submitted reports should be reviewed by a physician experienced in the use of the AMA Guides; this cannot be accomplished by a nonphysician reviewer.
-
1.
Battie MC, Videman T. Lumbar disk degeneration. Epidemiology and genetic influences. Spine. 2004;29(23): 2679–2690.
-
2.
Haralson RH. Spinal impairment evaluation: fifth edition changes. The Guides Newsletter. January-February 2001:1–3.
-
3.
Brigham CR, Brooks CN. Upper extremity impairment evaluation: fifth edition revisions. The Guides Newsletter. May-June 2001:1-5, 12.
-
4.
Brigham CR. Grip strength: an uncommon impairment. The Guides Newsletter. September-October 2003:6-7, 11.
-
5.
Brigham CR. Lower extremity impairment evaluation: fifth edition revisions. The Guides Newsletter. July-August 2001:5–7.
-
6.
Robinson JP, Turk DC, Loeser JD. Pain, impairment, and disability in the AMA Guides. The Guides Newsletter. November-December 2004:1–11,19.
-
7.
Brigham CR. No double dipping for pain. The Guides Newsletter. March-April 2005:10–11.
-
8.
Brigham CR, Leclair NJ. Fibromyalgia syndrome: impairment and disability issues. The Guides Newsletter. July-August 2001:8–12.
-
9.
Brigham CR, Brooks CN, Talmage JB. Thoracic outlet syndrome. The Guides Newsletter. January-February 2004:6–9.
-
10.
Brigham CR. Combining values. The Guides Newsletter. March-April 2002: 1–4,12.
-
11.
Peterson KW, Babitsky S, Beller TA, et al. The American Board of Independent Medical Examiners. J Occup Environ Med. 1997;39(6):509–14.
-
12.
Brigham CR, Walker P. Referral letter for the performance of an independent medical evaluation. The Guides Newsletter. January-February 2005:8–9.
-
13.
Brigham CR. Impairment evaluations standards: a checklist. The Guides Newsletter. September-October 2001:8–10.
-
14.
Brigham CR. Independent medical evaluation report standards. The Guides Newsletter. September-October 2002:4–9.
-
15.
Nierenberg C, Brigham C, Direnfeld LK, Burkert C. Standards for independent medical examinations. The Guides Newsletter. November-December 2005: 1–9.
| All Time | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 409 | 409 | 77 |
| Full Text Views | 25 | 25 | 0 |
| PDF Downloads | 0 | 0 | 0 |
