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Robert B. Snyder
and
James B. Talmage

Abstract

The decision about whether a case of documented COVID-19 illness is accepted as occupationally acquired and thus work compensable is made by insurers, or if contested, by judges or administrative bureaus. Causation for COVID-19 may be difficult to show because of the lack of accurate information and difficulty in meeting some of the criteria established by Bradford Hill. Nevertheless, physicians will be asked for medical records and documentation of illness. This article provides preliminary guidance to assist physicians in responding to insurers or workers compensation agencies' requests for information on the medial aspects of COVID-19.

in AMA Guides® Newsletter
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James B. Talmage
and
Robert B. Snyder

Abstract

Evidence shows that chronic opioid therapy is usually not beneficial; weaning patients off opioids many times results in less pain and better function, and opioid-induced hyperalgesia is real and frequent. Further evidence suggests that surgical outcomes are better if patients are weaned off opioids before surgery, and that the chronic use of opioids may adversely alter the assessment of maximum medical improvement (MMI).

in AMA Guides® Newsletter
James B. Talmage
,
Robert B. Snyder
, and
J. Willis Oglesby

Abstract

Shoulder injuries can present a puzzling picture for physicians. It is important to understand how biases affect physicians when they are making decisions regarding shoulder surgery. This article discusses what can be considered “normal” for shoulder function, how to determine when surgery is and is not indicated, and what might delay return to work in workers' compensation cases.

in AMA Guides® Newsletter
James B. Talmage
,
Mark H. Hyman
, and
Robert B. Snyder

Abstract

The current pandemic of COVID-19 cases includes cases identified in emergency medical technicians, nurses, physicians, and others with occupational exposure to the SARS-CoV-2 virus. Many of these health care professionals have filed workers' compensation claims that have been accepted. Each accepted claim will eventually need a physician to declare the individual “at maximal medical improvement” or the equivalent phrase in the jurisdiction involved. The next step is for the physician to rate permanent impairment, if present, so the case can be administratively closed. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) is used by many jurisdictions, but the AMA Guides does not mention COVID-19 or have guidance on how to assess individuals for impairment after recovery from this illness. This article provides preliminary guidance on rating permanent impairment within the respiratory, cardiac, vascular, neurologic, renal, gastrointestinal, and/or mental systems in COVID-19 survivors. Current references on the manifestations of COVID-19 illness in these body systems are included, which can be used as references to support documented impairment related to this illness.

in AMA Guides® Newsletter