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generally do not want to participate in an IME. They may be contentious and disagreeable, particularly in the context of litigation. Extensive scientific findings have indicated that eligibility for compensation is the most dominant factor for chronic pain claims. 7 There is a high prevalence of psychopathology in examinees that ranges from mild, such as an adjustment disorder, to severe, such as personality disorders and drug addiction. Second to compensation, personality disorders have been identified as a significant risk factor. 8 , 9 , 10 , 11 Because an IME is
Organization of individuals involved in disability evaluations www.nadep.com SEAK, Inc - Medical and Legal Information Systems Seminars, distance learning resources, and publications www.seak.com Resources Federal Judicial Center Reference Manuals on Scientific Evidence, including Reference Guide on Medical Testimony www.air.fjc.gov/public/fjcweb.nsf/pages/16 DISABILITY General Impairment.com Impairment information, focusing on the AMA Guides www.impairment.com Disabilities.com Disability management site for individuals
. References 1. Feinberg , SD , Brigham , CR , Ensalada , L . Assessing impairment and disability in the pain patient . AMA Guides Newsletter. January/February 2016 . 2. Barth , RJ . Chronic pain: fundamental scientific considerations, specifically for legal claims . AMA Guides Newsletter. January/February 2013 . 3. Patterson , CS , Barth , RJ , Brigham , CR , et al . Malingering and other validity considerations . AMA Guides Newsletter. January/February 2012 . 4. Aronoff , GM . Chronic pain and the disability epidemic . Clin J Pain
normative data. Some systems include standardized work samples that are similar to an actual job (usually not the one of the tested subject). Although these activities are not necessarily related to a specific job, they are often proposed as a way to evaluate abilities thought to be critical across a wide range of jobs. Lifting is the most common task assessed, followed by standing, sitting, walking, crawling, climbing, pushing, and pulling. Few systems have been subjected to rigorous scientific evaluation of predictive validity. One recent study of the ERGOS system has
systems receiving similar thorough analysis, until a compendium of 13 guides were published as a complete book, which became the first edition of the AMA Guides to the Evaluation of Permanent Impairment in 1971. Since that time, it has been refined five more times, resulting in the recent release of the Sixth Edition of the AMA Guides ( Rondinelli, 2008 ). It has become the international gold standard publication that incorporates the most updated clinical and scientific knowledge for the objective, evidence-based evaluation of impairment in individuals
appropriate treatment, and that the patient has reached a relative plateau in terms of migraine severity and frequency” (6th ed, 342). However “nonmigrainous headaches are not ratable using the AMA Guides. ” Unless there is factual evidence to scientifically show that migraine headaches were due to the injury, the headaches would not be ratable.
resolves within several weeks, it generally results in no permanent impairment. However, it may be chronic. Hence, this case is unusual concerning etiology, distribution, and duration. Neither the fifth nor the sixth edition of the AMA Guides addresses costochondritis. The scientific knowledge base indicates that psychological and social factors play a considerable role in developing chronic pain. The context of a workers' compensation or personal injury claim may reinforce subjective complaints. Personality disorders and psychological issues are also risk factors
-IV criteria” (page 359). (This quote serves as an example of the problematic aspects of DSM referencing within the Guides, but discussion of those problems is reserved for the next section of this article.) Adherence to the current DSM protocols is necessary if there is going to be any utilization of the scientific literature regarding mental illness and impairment because such literature is essentially organized and indexed by diagnosis. Unfortunately, the text of Chapter 14 occasionally strays from its stated dedication to DSM. Section 14.1b, Description of Clinical
between healthcare professionals and their legal counterparts. Carpal Tunnel Syndrome as an Example Common perceptions or popular opinions of causation should be based on the best available scientific evidence, not because the proposed linkage is appealing, pervasive, or seems to make sense. For example, the speculation that carpal tunnel syndrome is caused by arm use is widely accepted and this belief has been forwarded by the lay press despite several quality scientific investigations finding little relationship between carpal tunnel syndrome and occupation or
specific agent may be carcinogenic. 6 Many state laws that grant firefighters the legal presumption that cancer was caused by firefighting reference the IARC analysis; however, many states accept other cancers as presumptively caused by firefighting, despite the scientific evidence provided in the IARC monographs. The 2010 IARC Monograph notes that the available studies of firefighters used to support carcinogenic exposures from fighting fires are older and that firefighting procedures have changed so that today's firefighters have less exposure to the carcinogens in
