Abstract
Impairment evaluations not performed following processes defined in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) usually result in erroneous ratings. Common lower extremity impairment rating (IR) errors include using the diagnosis-based approach for more than one diagnosis within a region, and incorrectly assessing gait abnormalities, motion loss, nerve injuries, and complex regional pain syndrome. Rigorous adherence to the AMA Guides methodology and recognition of common IR errors can prevent the promulgation of erroneous impairment ratings.
Abstract
Humans interpret and react to symptoms. We only seek care for a symptom when it becomes a concern. 1 Variation in symptom intensity and magnitude of capability relates more to unhelpful thoughts, feelings of worry and despair regarding symptoms, and feelings of insecurity around role and livelihood (mental and social health opportunities) than pathophysiology. 2 Work claims are meant to address pathology that results from injury. Injuries have predictable recovery trajectories. When the recovery trajectory seems off track, consider pre-existing non-trauma pathology and mental and social health opportunities. Appropriate management of new pathology under the work claim and pre-existing pathology and mental and social health opportunities outside the work claim, along with a supportive environment that anticipates these aspects of normal human illness behavior, can help people get and stay healthy in the context of workers' compensation.
