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Iatrogenic Impairment

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Newsletter Articles
Guides Newsletter (2022) 27 (2): 3–7.
Published: 01 March 2022
... touch points from which iatrogenic injury, through inaccurate impairment and disability determinations, can occur. The problems may not be outright negligence or fraud, and may instead be lack of knowledge. We acknowledge the possibility (perhaps likelihood) that a treating clinician who writes a sick...
Newsletter Articles
Guides Newsletter (2019) 24 (3): 3–9.
Published: 01 May 2019
... biomedical model posits that disease or injury produces symptoms and signs that cause impairment and result in disability. This approach too strictly separates mental phenomena and bodily function (Cartesian dualism) and leads to scientific reductionism when actually six domains are active in worker...
Newsletter Articles
Guides Newsletter (2003) 8 (4): 8–9.
Published: 01 July 2003
... or, less frequently, spondyloschisis. The AMA Guides to the Evaluation of Permanent Impairment ( AMA Guides ) notes that the two common types of spondylolisthesis are isthmic (related to the presence of spondylolysis and occurring in the immature spine) and degenerative spondylolisthesis (usually found...
Newsletter Articles
Guides Newsletter (2000) 5 (3): 1–3.
Published: 01 May 2000
... to the Evaluation of Permanent Impairment. Evaluators must recognize that MCS claimants often present with comorbid psychiatric conditions, and iatrogenic disability also is a concern among MCS patients. © 2000 American Medical Association. All Rights Reserved. 2000 American Medical Association...
Newsletter Articles
Guides Newsletter (2021) 26 (6): 3–14.
Published: 01 November 2021
... of evidence. The evaluating clinician should be particularly mindful of potential behavioral influences, medically unexplained physical symptoms, deconditioning, activity intolerance, and the potential for administrative or medical iatrogenicity. Unresolved questions include the association between post-COVID...
Newsletter Articles
Guides Newsletter (2019) 24 (4): 3–14.
Published: 01 July 2019
... from excess; and overcoming barriers to intervention. To these ends, three activities can optimize the process: Intervene early; avoid iatrogenicity (ie, shorten claim durations and reduce costs); and stratify risk and employ stepped care. Barriers to meaningful intervention in DFRUD include questions...
Newsletter Articles
Guides Newsletter (2022) 27 (1): 3–6.
Published: 01 January 2022
..., covers lost wages, and pays financial compensation for losing a limb (permanent impairment); however, what about helping the injured employee find new work so they can support their family? And what about the symptoms of depression and anxiety, including post-traumatic stress? 8 – 10 Are those covered...
Newsletter Articles
Guides Newsletter (2021) 26 (6): 15–18.
Published: 01 November 2021
...Fabien Gagnon, MD, PsyD; Les Kertay, PhD Given the increase in psychiatric occupational disability claims over the past 20 years, better patient psychiatric assessment and management is critical. To minimize iatrogenic psychiatric disability and maximize positive outcomes, it is important...
Newsletter Articles
Guides Newsletter (2019) 24 (2): 15.
Published: 01 March 2019
... of fairness and justice in disability claims from both psychological and legal perspectives, (4) increased understanding of the functional impact of psychological impairment, (5) inclusion of age-related factors in predicting disability, and (6) the interdisciplinary growth of this field. Schultz IZ...
Newsletter Articles
Guides Newsletter (2020) 25 (4): 12–13.
Published: 01 July 2020
...Charles N. Brooks, MD; Christopher R. Brigham, MD; Marjorie Eskay-Auerbach, MD; James B. Talmage, MD © 2020 American Medical Association. All Rights Reserved. 2020 American Medical Association QUESTION: My question pertains to the rating of impairment for reported facet arthropathy...
Newsletter Articles
Guides Newsletter (2018) 23 (4): 11–13, 16.
Published: 01 July 2018
...Leon Ensalada, MD, MPH; Christopher R. Brigham, MD, MMS; Les Kertay, PhD An evaluator's failure to recognize illness behavior and to adjust for its effect on symptom presentation can lead to erroneous conclusions regarding impairment or disability; here the authors review the associated phenomena...
Newsletter Articles
Guides Newsletter (2019) 24 (3): 10–13.
Published: 01 May 2019
...Patrick R. Luers, MD Spinal impairment evaluation includes determination of the presence or absence of alteration of motion segment integrity (AOMSI). The diagnosis-related estimate (DRE) method is the principal methodology used to evaluate spinal AOMSI impairment in the fourth and fifth editions...
Newsletter Articles
Guides Newsletter (2015) 20 (6): 6–12.
Published: 01 November 2015
...) approach to treatment. There is clear scientific evidence that an FR treatment approach not only reduces disability but may also reduce impairment either directly by reducing pain complaints or indirectly by reducing or eliminating iatrogenic complications that result in increased impairment ratings...
Newsletter Articles
Guides Newsletter (2021) 26 (3): 8–13.
Published: 01 May 2021
... or illness. The pain may also begin without a known precipitant. While various authors have questioned the validity of the diagnosis, physicians will be asked to perform impairment ratings on patients diagnosed with CRPS. Hence, it is important to understand the issues associated with this syndrome...
Newsletter Articles
Guides Newsletter (2007) 12 (3): 1–3, 8-15.
Published: 01 May 2007
... symptoms). Treatment generally should be simple and consists primarily of reassurance and home exercise. Disability, both occupational and avocational, should be avoided or minimized. As with other impairment evaluations, the clinical assessment (history, physical examination, and review of diagnostic...
Newsletter Articles
Guides Newsletter (2005) 10 (5): 8–11.
Published: 01 September 2005
... this iatrogenic risk is always associated with the impairment evaluation process, Sullivan and Loeser pointed out that such risk is elevated when the conclusions of permanent impairment are offered by the treating physician. In concluding their argument against the simultaneous adoption of such dual roles...
Newsletter Articles
Guides Newsletter (2000) 5 (4): 1–3, 10.
Published: 01 July 2000
...Leon H Ensalada, MD, MPH; Christopher R. Brigham, MD, MMS The AMA Guides to the Evaluation of Permanent Impairment, ( AMA Guides ), Fourth Edition, notes that individuals may consciously exaggerate the symptoms of a disorder in the clinical or impairment evaluation setting, an activity...
Newsletter Articles
Guides Newsletter (2001) 6 (5): 1–4, 11.
Published: 01 September 2001
... is a disorder that significantly affects quality of life. It may also be a source of impairment and disability following injury. A range of sexual dysfunction exists depending on the extent of injury and pre-existing medical comorbidities and may cause secondary psychological sequelae, which should be evaluated...
Newsletter Articles
Guides Newsletter (2008) 13 (3): 14–18.
Published: 01 May 2008
... critiques chronic pain models and presents a useful construct based on well-validated psychiatric diagnoses. The AMA Guides to the Evaluation of Permanent Impairment ( AMA Guides ) attempts to evaluate pain in the context of the underlying, objectively defined impairment and considers pain...
Newsletter Articles
Guides Newsletter (2006) 11 (6): 4–7.
Published: 01 November 2006
... frequency in males and females. The AMA Guides to the Evaluation of Permanent Impairment ( AMA Guides ), Fifth Edition, is silent about rating tears, partial or complete excision, or repair of the acetabular labrum. Provocative tests to detect acetabular labrum tears involve hip flexion and rotation; all...