Appropriateness of Surgery for Sciatica. Vader JP, Porchet F, Larequi-Lauber T, et al. Spine 2000;25:1831-1836.

Exploration of Physicians’ Recommendations for Activities in Chronic Low Back Pain. Rainville J, Carlson N, Polatin P, et al. Spine. 2000;25:2210-2220.

Can physicians agree on impairment rating, disability evaluation, work abilities (restrictions), and treatment recommendations? Frequently, third parties seek second or even third opinions to these questions. If a single physician deviates markedly from clear consensus, a second (or even third) opinion should easily establish the fact that the first physician's stated opinions differ from consensus. If, however, there is no consensus, then multiple physician opinions will differ, and even “fourth opinions” will leave the gray-area issues in dispute.

There have been few studies on physician agreement on impairment rating. Some of these were previously reviewed in the Guides Newsletter.1...

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