... history of the underlying condition. © 2017 American Medical Association. All Rights Reserved. 2017 American Medical Association Evaluating physicians need to understand the context of a case or jurisdiction to appropriately answer the questions asked by their clients. Medical and legal...

... treated with SCS and ISO. Does SCS or ISO change the impairment associated with the underlying conditions for which these treatments are performed? Although the AMA Guides to the Evaluation of Permanent Impairment ( AMA Guides ) does not specifically address this question, the answer follows directly from...

... or workers compensation agencies' requests for information on the medial aspects of COVID-19. © 2020 American Medical Association. All Rights Reserved. 2020 American Medical Association COPD COVID-19 Causation Coronavirus Impairment Rating Occupation SARS SARS-CoV-2 Underlying Condition...

.... Delayed and failed recovery and unnecessary disability (DFRUD) refers to a lag in, or lack of, expected recovery from a medical condition and/or unnecessary resultant disability. Causation is complex, and we are not doing well at managing this group of workers using a biomedical model. The traditional...

... asymptomatic conditions or underlying pathology that may or may not have been known or causing symptoms or disability prior to or at the time of the industrial injury. The key inquiry for the reporting physician is to determine whether any underlying pathology or previously asymptomatic conditions...

... or ISO change the impairment associated with the underlying conditions for which these treatments are performed? Although the Guides does not specifically address this question, the answer follows directly from the principles upon which the Guides impairment rating methodology is based. Namely...

...Christopher R. Brigham, MD; J. Mark Melhorn, MD; Charles N. Brooks, MD; Steven D. Feinberg, MD; James B. Talmage, MD Causation analysis involves determining what conditions are related to a compensable injury or illness; apportionment is the allocation of responsibility among two or more probable...

... of certain types of visual loss on the ability to perform activities of daily living (ADLs). Permanent visual impairment is defined as a permanent loss of vision that remains after a patient reaches maximal medical improvement in the underlying medical condition. To assess vision loss, physicians must...

... to the Evaluation of Permanent Impairment, ( AMA Guides ), Fifth and Sixth Editions, provide guides to the rating of permanent impairment for hernias. Both stress that impairment evaluation is predicated on the existence of a causal relationship between the individual's condition and an event or exposure...

... Impairment rating for conditions that affect the spinal cord is discussed in the AMA Guides to the Evaluation of Permanent Impairment ( AMA Guides ), Fourth Edition, Section 4.3. Spinal cord lesions produce varied and characteristic patterns of neurologic loss, depending on the portion of the cord...

... explain in the distant future interval worsening of the underlying condition might result in additional impairment. The Sixth Edition also explains: Thus, MMI represents a point in time in the recovery process after an injury when further formal medical or surgical intervention cannot be expected...

... remain idiopathic. The patient must be at maximum medical improvement (MMI) before permanent impairment is rated, but determining MMI is challenging, particularly if neuropathy is secondary to an underlying medical condition such as hypothyroid or diabetic neuropathy or toxic exposure. A table...

... aspect of a patient's condition that requires an impairment rating. Facial disfigurement may be the result of a complicated process, for example, a burn that involves multiple organ systems, each with a loss of function that requires an impairment rating. These ratings fall into one of four classes...

... a condition will worsen over time. An evaluator may determine someone is at MMI and rate impairment based on current function, physical findings, and clinical study results but at the same time explain that, in the distant future, interval worsening of the underlying condition might result in additional...

... for future progression of their disease. (6th, 26) The AMA Guides goes on to explain that: Thus, MMI represents a point in time in the recovery process after an injury when further formal medical or surgical intervention cannot be expected to improve the underlying impairment. Therefore, MMI...

... cord injury) that is ratable according to another chapter of the Guides; (b) Only some of the individuals with the underlying condition have the pain syndrome (e.g., phantom limb pain in an individual with a lower extremity amputation); (c) The conventional impairment rating provided in another...

... of employment ( Ballard v. WCAB , 36 CCC 34; 1971). If the employee came with an underlying condition that was aggravated or lit up by employment, then the employer paid for the resulting permanent disability. To prove apportionment, the employer had the burden of establishing that the injured worker had...

... might not be affected by an underlying nonindustrial condition, such as heart disease or spinal stenosis, whereas a heavy physical job might. Only labor-disabling disability present prior to the industrial injury can be rated as pre-existing. Any disability that results from the progression of a pre...

... underlying conditions did not improve clinical outcomes. 9 A joint clinical practice guideline from the American College of Physicians and the American Pain Society recommended imaging not be obtained in patients with non-specific low back pain. Routine advanced imaging is not associated with improved...

... These findings suggest that the rate of degeneration may be explained by more than one factor and that the underlying condition that led to surgical treatment initially is not “cured” by surgery. In the cervical spine, risk factors for adjacent segment degeneration include a single level fusion including C5...