Question

According to the Fifth Edition, when do I decide to rate according to the Diagnosis Related Estimates (DRE) method versus the Range of Motion (ROM) method?

Answer

You should use the DRE method preferentially and must use it to assess any patient who has sustained an injury. Use the ROM method for patients who have not sustained an injury (e.g., who have certain spinal diseases like anky-losing spondylitis) or are retiring and are being rated for administrative purposes and whose impairment is the result of many injuries, lifestyle, and aging. In addition, you should use the ROM method to rate certain conditions (e.g., recurrent radiculopathy) at the same or different level in the same spinal area. Multilevel alteration of motion segment integrity (e.g., multilevel arthrodesis) should be rated by the ROM method, as well as multilevel fractures...

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