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Substantial Medical Evidence

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Newsletter Articles
Guides Newsletter (2020) 25 (5): 12–15.
Published: 01 September 2020
...Steven D. Feinberg, MD This article describes special aspects of addressing and defining substantial medical evidence, causation, and apportionment in the California Workers' Compensation system. Substantial medical evidence is framed in terms of reasonable medical probability, and the opinion must...
Newsletter Articles
Guides Newsletter (2017) 22 (4): 6–11, 16.
Published: 01 July 2017
... parts of the body. The AMA Guides tells us that when there is no clear impairment rating, rating by analogy or use of other impairments that create a similar effect on ADLs should be considered, and the opinion must reach the level of substantial evidence. © 2017 American Medical Association. All...
Newsletter Articles
Guides Newsletter (2011) 16 (1): 1–6.
Published: 01 January 2011
... to the Evaluation of Permanent Impairment ( AMA Guides ), Fifth Edition, to determine impairment. WCAB noted that “medical opinion that departs unreasonably from a strict application of the [ AMA ] Guides can be challenged, and it would not be acceptable as substantial evidence.” In the present case, the rating...
Newsletter Articles
Guides Newsletter (2017) 22 (2): 5.
Published: 01 March 2017
... 2017 American Medical Association. All Rights Reserved. 2017 American Medical Association Cullen KL, et al. J Occup Rehabil. 2017 Feb 21. doi: 10.1007/s10926-016-9690-x . [Epub ahead of print] Pubmed: https://www.ncbi.nlm.nih.gov/pubmed/28224415 Direct link to article: https...
Newsletter Articles
Guides Newsletter (2016) 21 (4): 15–16.
Published: 01 July 2016
....” Here the authors are stern: “The practice of medicine depends on clinical judgment, incorporating history, examination, and testing in order to reach a level of substantial medical evidence. This is problematic when competing interests and money are involved, as they integrally are in disability...
Newsletter Articles
Guides Newsletter (2015) 20 (3): 6–10.
Published: 01 May 2015
... is evident in SSA's definition for disability for individuals aged ≥18 years: “Inability to engage in substantial gainful activity, due to a medically determinable impairment, either physical or mental, that is expected to last greater than one year or result in death.” 1 FIGURE 1. Applying...
Newsletter Articles
Guides Newsletter (2021) 26 (1): 9–17.
Published: 01 January 2021
... multiple meridians, as if the visual field were constricting while the Goldmann visual fields were being tested, is conclusive substantial evidence of non-physiologic causation. For the purpose of the evaluator, the Goldmann visual field plots are substantial medical evidence of visual system injury...
Newsletter Articles
Guides Newsletter (2006) 11 (4): 10–11.
Published: 01 July 2006
... and conclusions of law if they are supported by substantial evidence, are rational, and are in accordance with law. 33 U.S.C. §921(b)(3); O’Keeffe v. Smith, Hinchman & Grylls Associates, Inc. , 380 U.S. 359 (1965). In 1982, claimant began working for employer as a pipefitter. His duties included...
Newsletter Articles
Guides Newsletter (2022) 27 (4): 18–59.
Published: 01 July 2022
... of certainty required in the opinions rendered in an M&BD IME report is generally that of “reasonable medical certainty” or “on a balance of probabilities” (“weight of evidence” or “more likely than not,” also described as “chances greater than 50%”). Generally, there is no expectation to achieve a level...
Newsletter Articles
Guides Newsletter (2018) 23 (3): 7–9.
Published: 01 May 2018
... substantially in the next year, with or without medical treatment” but acknowledges the possibility of “some change.” Similarly the sixth edition states that MMI is the “point at which a condition has stabilized and is unlikely to change (improve or worsen) substantially in the next year, with or without...
Newsletter Articles
Guides Newsletter (2023) 28 (3): 1–10.
Published: 01 May 2023
.... In Class 1, there is evidence of vascular damage. Fndings could include a healed and painless amputation stump of a digit, amputated digit with evidence of PVD, a healed ulcer or Raynaud's phenomenon, which shows obstructive physiology that is only partially responsive to lifestyle changes or medical...
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 (2021) 26 (4): 10–11.
Published: 01 July 2021
... and disorders. This chapter from the AMA G uides to the Evaluation of Disease and Injury Causation focused on WBV and the low back rather than the neck (cervical spine). There is conflicting evidence in the medical literature regarding a causal relationship between WBV and neck pain. Studies have reported...
Newsletter Articles
Guides Newsletter (2021) 26 (1): 18.
Published: 01 January 2021
...Daniel C. Schainholz, MD, MPH; August Colenbrander, MD; Christopher R. Brigham, MD © 2021 American Medical Association. All Rights Reserved. 2021 American Medical Association QUESTION: I am going to evaluate permanent impairment for a person who had a corneal abrasion. I will assess...
Newsletter Articles
Guides Newsletter (2023) 28 (2): 1–38.
Published: 01 March 2023
.../1874473711104010004 . 122. Rondinelli RD , Genovese E , Katz RT , et al . AMA Guides to the Evaluation of Permanent Impairment. 6th ed . Chicago : American Medical Association ; 2023 . doi: 10.1001/978-1-64016-282-2 . 123. Social Security Administration website . Substantial gainful...
Newsletter Articles
Guides Newsletter (2018) 23 (4): 3–8.
Published: 01 July 2018
... such an impairment.” 10 The SSA defines disability as “the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of no less...
Newsletter Articles
Guides Newsletter (2017) 22 (1): 11–16.
Published: 01 January 2017
..., reporting, “In my opinion, the work activities caused (or did not cause) the patient's shoulder pain.” However, in the age of evidence-based medicine, with a progressively greater volume and better quality of data available in the medical literature regarding causation of conditions, this is no longer...
Newsletter Articles
Guides Newsletter (2002) 7 (1): 1–5, 9, 11.
Published: 01 January 2002
... that are not characteristic of any well-defined medical syndrome, or because the individual is diagnosed with a condition (e.g., fibromyalgia syndrome) whose reality or authenticity is questioned by a substantial proportion of physicians. Such controversial PRI is considered unratable in the present system. It is important...
Newsletter Articles
Guides Newsletter (2009) 14 (4): 7–12.
Published: 01 July 2009
... be based on facts and scientific evidence. 1 The legal premise of causation is that a given cause (A) and effect (B) are etiologically associated with a reasonable degree of medical probability or certainty, ie, a greater than 50% probability. The premise that, within a reasonable degree of medical...
Newsletter Articles
Guides Newsletter (2020) 25 (1): 3–11.
Published: 01 January 2020
... Edition, should be used in conjunction with the AMA Guides to the Evaluation of Permanent Impairment, ( AMA Guides ), Sixth Edition. A person who is prescribed opioids is not yet at maximum medical improvement (MMI) and cannot be rated. Referral for substantiation of the diagnosis and for initiation...