...James B. Talmage, MD; Robert B. Snyder, MD; J. Willis Oglesby, MD Shoulder injuries can present a puzzling picture for physicians. It is important to understand how biases affect physicians when they are making decisions regarding shoulder surgery. This article discusses what can be considered...

...Christopher R. Brigham, MD; William T. Grant, MD; Waqas Ahmad, MBBS, MHA, BSc Jurisdictions use impairment ratings differently, and physicians must understand the specific requirements in each jurisdiction. This article discusses a case of severe spinal cord injury for a jurisdiction that only...

... and action by physicians. In this article, the history of these terms and their applicability for the AMA Guides to the Evaluation of Permanent Impairment and related publications will be discussed. This example of a common condition in a workers' compensation population suggests...

... on this knowledge, the physician will then apply the processes and criteria provided in specific chapters. All impairment rating reports should be divided into three main sections: clinical evaluation, analysis of the findings, and discussion. To obtain the highest level of competency, the rating physician should...

...Garson Caruso, MD, MPH; Les Kertay, PhD The first part of this two-part series discusses psychological influences in delayed and failed recovery and resulting unnecessary work disability; the second part discusses theoretical and practical aspects of the issue, including evaluation and treatment...

... ( AMA Guides ) is used. This discussion also raises interesting legal questions related to retroactivity, applicability of prior precedent, and delegation. On June 20, 2017, the Supreme Court of Pennsylvania handed down its decision, Protz v. WCAB (Derry Area Sch. Dist.), which disallows use...

... of disturbances of the nervous system, divided for discussion here into four parts—the central nervous system (CNS), the peripheral nervous system, vision, and hearing—and offers guidance in using the AMA Guides, Fifth and Sixth Editions, in a variety of specific disorders within each group. For example, the CNS...

...Fabien Gagnon, MD, PsyD; Les Kertay, PhD Claims of occupational psychiatric disability have increased considerably over the past 20 years. To avoid psychiatric disability overdiagnosis, it is important to improve the clinical assessment of mental health work disability. This article discusses...

... tests (cognitive screeners) as a relatively quick, practical tool to initially assess patients and aid in decision making. Several cognitive screeners will be discussed in detail below. A patient's performance on such tests may indicate that more comprehensive testing is needed. Cognitive screeners have...

...James B. Talmage, MD This is a brief introduction to maximum medical improvement (MMI), which is pertinent to permanent impairment assessment. The definition and explanation of MMI according to the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) , Sixth Edition, is discussed. ©...

... of these data to the processes and criteria provided in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) . The approaches discussed in the fifth and sixth editions of the AMA Guides are similar. © 2020 American Medical Association. All Rights Reserved. 2020 American Medical Association...

... include other practitioners, eg, psychologists and chiropractors. Depending on the referral request, the IME typically discusses disability (the definition depends on the local jurisdiction) based on deficits in the person's activities of daily living. In the IME, the evaluator may be asked to consider...

... sexual dysfunction. In both editions, sexual dysfunction is discussed in Chapter 7, The Urinary and Reproductive Systems, and Chapter 13, The Central and Peripheral Nervous System. In the fifth edition, the maximum impairment rating for female sexual functioning is 35% whole person impairment...

...—or the lack thereof—between pathology and aging, as well as degenerative changes and symptoms, to facilitate causation analysis. For a fuller discussion of causation analysis for the spine, readers can consult the AMA Guides to the Evaluation of Disease and Injury Causation, Second Edition . © 2019 American...

.... Chapter 1, Disability and Legal Compensation Systems in the United States, gives an overview of compensation systems in the United States. (A more detailed discussion of these systems is provided in AMA's Guides to Navigating Disability Benefit Systems: Essentials for the Health Care Professional. 1...

.... An evaluator's impairment evaluation report should clearly document the rater's review of prior medical and treatment records, clinical evaluation, analysis of the findings, and a discussion of how the final impairment rating was calculated. The resulting report is the rating physician's expert testimony to help...

... the mean (average) of these three measurements. The article also discusses adjustments for functional history when the ROM method does not adequately capture the full impairment. © 2019 American Medical Association. All Rights Reserved. 2019 American Medical Association Range of motion (ROM...

..., and the Sixth Edition states, “sensory deficits can be challenging to grade, since the clinical examination is based on subjective reports by the patient. Grading is based on the results of sensibility testing and two-point discrimination, to improve inter-rater reliability.” The discussion of “sensibility...

...Jay Blaisdell; James B. Talmage, MD Facial disfigurements, including those caused by burns (thermal, chemical, or electrical) or trauma, are rated in the AMA Guides to the Evaluation of Permanent Impairment ( AMA Guides ), Sixth Edition, Chapter 11, which also discusses occupational overexposure...

... entrapment at the elbow (cubital tunnel syndrome). The AMA Guides, Sixth Edition, does not include a listing for quadrilateral space syndrome, and the author discusses the challenges of teasing out functional limitations when multiple diagnoses are present within the same limb. Evaluators should note...