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. Have an observer (chaperone) present with you during the physical examination. Prepare your report as soon as possible following the evaluation while the case is still “fresh in your mind.” (Your client will also appreciate your promptness.) In your report reference both the facts and current evidence-based medicine to support your conclusions, including references to applicable scientific literature.
documented for the 1990s or earlier: recurrent seizures over decades, incoordination, inability to relax muscles, numbness, loss of control of fingers, blurred vision, headaches). Sleep apnea issues (a risk factor for neuropsycho-logical impairment). History of cancer and associated treatment (scientific findings have revealed an association between such a history and neuropsychological impairment). This discussion of apportionment highlights the importance of having evaluators request an opportunity to review records from an examinee's entire life as part of the
fundamental importance of this issue. For example, the groundbreaking Boeing studies 3 demonstrated that psychological factors, rather than physical injury, were predictive of who would develop claims of physical spinal impairment, and subsequently, who would file workers’ compensation claims. Given that scientific finding, and those which are presented in the remainder of this article, it is apparent that evaluators will have greater success in their attempts to provide credible explanations for claims of general medical impairment if they incorporate consideration of
the methods of the NIOSH monograph of 1997 and the 2008 edition of this monograph. Both works gather all the literature relating to musculoskeletal disorders in the work place, devise methods of evaluating the scientific merit of each article, and then conclude that the causal evidence between a disorder and the work place is either insufficient, moderate, strong, or very strong. On this basis a physician can step into an IME, deposition, or courtroom setting with the confidence that s/he has the weight of solid scientific evidence as a basis for clinical opinion
by the history. Focus on the portions of the history pertinent to the impairment rating. This passage from the AMA Guides repeatedly emphasizes the importance of healthcare record review for developing an adequate understanding of the examinee's history. A premise that an accurate history can be obtained from an examinee (instead of reviewing the examinee's healthcare records) has extensively failed scientific scrutiny. 1 Section 2.3 of the AMA Guides specifies the importance of diagnosis in the impairment evaluation methodology (6th ed, 23): “The
Medicine, Pediatrics and Preventive Medicine, administers examination and certification of qualified candidates for medical toxicology subspecialty. Medical toxicology is the scientific study of adverse health effects in humans resulting from exposure to chemical, biological, and physical agents. The medical toxicologist applies toxicology principles to the diagnosis and treatment of human intoxication (poisonings). The American Board of Preventive Medicine ( www.abprevmed.org ) also provides certification in occupational medicine, which includes the assessment of health
