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James B. Talmage
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J. Mark Melhorn
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Christopher Brigham
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Abstract

This Case Exercise presents and critiques the case of a 52-year-old right hand dominant male who received a Qualified Medical Evaluation regarding his right wrist injury; the examination report includes several erroneous conclusions that are discussed following the case presentation: The examinee is a retail clerk at a liquor store who complained of progressive right hand pain and numbness in 2004; the examination took place in 2006, and the examiner reports an extensive list of relevant reports reviewed. Because the patient declines a carpal tunnel release procedure, the physician declares the patient to be at maximum medical improvement and uses tables in the AMA Guides to the Evaluation of Permanent Impairment, Fifth Edition, to rate 19% whole person impairment and to apportion 90% to work activities. Readers can pause at this point to evaluate the case and then compare their results with the analysis. The author notes that the report does not discuss activities of daily living and does not report in detail the results of physical testing. Nor does the written report correctly explain how the rating was performed, with a detailed discussion of the rating process with reference to specific criteria and to specific tables, figures, and page numbers. As written, the report provides inadequate information to grade sensory or motor deficits and suggests the use of subjective reports, not objective findings.

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