Search Results
the latest scientific information in assessment of upper extremity impairments have been provided. (This is reflected particularly in Section 16.7 Impairment of the Upper Extremities Due to Other Disorders.) Measurement of finger motion has been clarified to also detect limitations due to restricted excursion of tendons. Impairment rating for nerve entrapment syndromes has been clarified. (The Fourth Edition “Table 16. Upper Extremity Impairment Due to Entrapment Neuropathy” was removed. After carpal tunnel release at MMI, there are three possible scenarios: 1
Permanent Impairment (AMA Guides). However, those looking to use this decision to reverse the 6-decade long history of collective and ongoing scientific work of the medical profession in creating an evidence-based impairment assessment tool should reflect on Justice Baer's dissenting opinion in Protz. The justice stated, “requiring the use of the most recent AMA Guides is not delegating the authority to make law; it is simply declaring the applicable standard by which physicians should conduct impairment rating evaluations.” It is impractical for a specific
responsible for an effect (injury, disease, impairment, etc.). Only probable causes (at least more probable than not) are included. Hence, the first step in apportionment is scientifically based causation analysis. Second, one must allocate responsibility among the probable causes and select apportionment percentages consistent with the medical literature and facts of the case in question. Arbitrary, merely opinion based unscientific apportionment estimates which are nothing more than speculations must be avoided. When appropriate current impairment can also be apportioned
process used in impairment assessment, incorporating available scientific evidence and prevailing medical opinion” (5th ed, 1). (A March 2002 Errata addresses errors found within the first printing of the Fifth Edition.) The Third Edition, Revised (published in December 1990), Fourth (published in June 1993), and Fifth Editions (published in November 2000) were each edited by different individuals. Alan L. Engelberg, MD, MPH, served as editor for the Third Edition, Revised; Theodore C. Doege, MD, MS, and Thomas P. Houston, MD, served as editors for the Fourth Edition
current scientific methodology and treatment that is accepted by that profession. A brief discussion of the Daubert standard as it relates to WC psychological injury is provided later. Additional Issues That Cause Imprecision in WC Systems Specific problems that relate to psychological injury lead to imprecision and occur in all WC systems. This includes a psychological condition that does not necessarily equal impairment in functioning; the lack of comprehensive evaluation from a biopsychosocial model; the lack of a current DSM diagnosis determined with an
argued that scientific studies have failed to show repetitive motion causes injury. 3 While UNE has been attributed to various causes including prolonged vibration exposure, 4 , 5 this review will examine 1 particular aspect of the RSI debate—is there scientific evidence to support a causal relationship between UNE and repetitive elbow flexion and extension in the workplace? Ulnar Neuropathy at the Elbow As stated, UNE is the second-most common upper extremity compression neuropathy. The elbow is also the most common site of ulnar nerve compression. 6 While
certainty A causal event took place. The patient experiencing the event has the condition (eg, impairment). The event could cause the condition. The event caused or materially contributed to the condition within medical probability.” The last 2 bullet points are key to understanding if a low-speed collision, whether involving cars, trucks, forklifts, or other vehicles, caused IDD. Injury Causation Analysis Injury causation analysis (ICA) is the scientific method used to analyze the mechanism and magnitude of injury for people who experience incidents
psychosocial processes, including a high level of somatic anxiety, and an attempt to convince the examiner that he or she is truly suffering, or a “cry for help” on the part of the patient. In a broader sense, the present results represent an initial step toward establishing a scientific basis for the impairment rating system described in the AMA Guides . 2 As other observers have noted, 2 , 3 there needs to be a shift from the consensus-based rules that the AMA Guides currently uses to an evidence-based system for making decisions about impairment. References
). Using the information in the above table, one can choose either approach to causation apportionment (quantitative vs qualitative). The simplest is the qualitative approach; this value was derived above. On the other hand, to appear to be more scientific and precise, each risk could be “weighted” so that unequal contributions were taken into account (the quantitative approach). Using this method, one can choose to: Apply the value given (eg, OR = 2.36). Determine the average value when more than 1 value is given (eg, OR = 2.3, 3.6, and 2.5; 2.3 + 3.6 + 2.5 = 8
without low back pain who were genetically predisposed to develop low back pain because they either had had or still had neck pain. 92 Over a 5-year follow-up, there were 16 episodes of major trauma (visceral injury or major bone fracture). In addition, 170 of the 200 persons sustained at least 1 of the 652 recorded minor trauma episodes. One of the 200 persons had a lumbar disc herniation, but it occurred unrelated to any episode of trauma. In summary, there is insufficient scientific evidence to attribute the cause of lumbar disc herniation to any minor trauma
