...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...

...Stephen L. Demeter, MD, MPH; James B. Talmage, MD © 2019 American Medical Association. All Rights Reserved. 2019 American Medical Association QUESTION : I recently performed an IME on an individual alleging occupationally related, noise-induced hearing loss. The man was 63-years-old...

... exposure to an occupational or environmental trigger, or severe, uncontrollable asthma despite maximal/optimal treatment are also possibilities. Given this, many specialists believe that the minimum number and types of medications required for both maximal medical improvement and the best outcome...

... illness claims may be compensable if the condition arises during the course of employment, which requires that it be caused by occupational duties, exposures, or equipment used on the employer's premises. Expert impairment evaluators face three requirements: they must know the best scientific evidence...

... jurisdiction; for example, a patient may have an occupational injury or illness that results in impairment, but causation of the impairment may be multifactorial and may involve, for example, age-related degeneration, a pre-existing injury or illness, an occupational injury or illness, and/or subsequent trauma...

... information, without a rigorous medical examination to support an occupationally disabling condition, out of a desire to “help” the patient with psychological support and some financial benefits. The clinician in this circumstance means to help the patient but without regard to the long-term consequences...

...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...

... © 1997 American Medical Association. All Rights Reserved. 1997 American Medical Association Question: In evaluating occupational asthma, how do you determine maximal medical improvement and how do you apportion impairment in people who continue to smoke? Answer: While...

...James B. Talmage, MD; Mark H. Hyman, MD; Robert B. Snyder, MD The current pandemic of COVID-19 cases includes cases identified in emergency medical technicians, nurses, physicians, and others with occupational exposure to the SARS-CoV-2 virus. Many of these health care professionals have filed...

..., age, female gender, and obesity. Although in the past CTS was often considered an occupational illness, the recent medical literature suggests most cases previously labeled as occupationally related were neither caused nor aggravated by work. References 1 Katz JN , Simmons BP...

... the prevalence of neck pain by occupation with a cross-sectional dataset from the 2009 to 2012 National Health Interview Survey. 9 It found that the proportion of workers in the United States with neck pain was 13.3%. In transporation and material handling occupations, the percentage was less, at 12.8...

...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...

... causation and requires that all three of the following criteria must be met: 1) the patient has an illness compatible with a disease-producing agent or an injury; 2) the worker's exposure in the occupational environment potentially caused the disease or is a plausible mechanism of injury of sufficient...

... to a rear-end impact with a Δv of 5 mph or less is unlikely to result in injury” in most healthy, restrained occupants. Because velocity incorporates direction as well as speed, a vehicular occupant is less likely to be injured in a rear impact than when struck from the side. Evaluators must consider...

...-16 (6th ed, 175) discusses skin cancer, and this example is for a congenital syndrome with more than 50 persisting cancers at the time of rating, so the examples do not help rate the occupationally occurring skin cancers. For the individual with occupational allergic contact dermatitis...

... not only how to fairly rate permanent impairment according to the AMA Guides but also the specific needs of the groups that request these evaluations. Impairment ratings are required for scheduled injuries, hearing loss, and occupational disease cases covered by the LHWCA; physicians must express extremity...

... this in a cursory manner, often presenting their findings as an opinion. An established method of causation analysis using six steps is outlined in the American College of Occupational and Environmental Medicine Guidelines and in the AMA Guides to the Evaluation of Disease and Injury Causation, Second Edition...

... often result in dissatisfaction for litigants, uncertainty for judges, and friction between health care and legal professionals. Carpal tunnel syndrome (CTS) provides an example: Popular notions suggest that CTS results from occupational arm or hand use, but medical factors range from congenital...

... risk factors include genetics, age, female gender, and obesity. Although in the past CTS was often considered an occupational illness, the recent medical literature suggests most cases previously labeled as occupationally related were neither caused nor aggravated by work. While the patient had...