Whether you are a nurse, physician, employer, case manager or an adjuster this series will provide you with knowledge that will be invaluable in your management of psychiatric issues. Psychological illness, personality disorders and behavioral issues often contribute to the most serious challenges encountered in disability management. The costs, both financial and human, are marked. This unique offering will enhance your ability to assess and manage effectively these issues. Your leaders, Drs. Norma and Steve Leclair, are nationally recognized leaders in the psychology and disability fields with several years of practical experience - they are also highly effective trainers. Submit your specific questions at the Ask the Leclairs web page and learn the answers.

In this series we will discuss common diagnoses, treatment protocols, duration of treatment, required components of psychological evaluation, impairment analysis and how to support work restoration and effective return to work strategies.

Everyone involved with these cases should register for this series - only $297 (4 hours of training).

Schedule:

• Session 1: Major Depressive Disorders and Personality Disorders
  Thursday, May 3, 11am - 12pm PST
  
  
• Session 2: Anxiety Disorders Including Post Traumatic Stress Disorder
  Thursday, May 17, 11am - 12 pm PST
  
  
• Session 3: Psychological Evaluation and Impairment
  Thursday, May 24, 11 am - 12 pm PST
  
  
• Session 4: How to Support Work Restoration and Effective Return to Work Strategies
  June 7, 11 am - 12 pm PST

This year Brigham and Associates will be offering a 3 and 1/2 day series of training sessions in San Diego at our new training facility.

On Thursday July 26th we kick off the series with a day focused on GAF analysis and how to interpret it into impairment for purposes of determining permanent disability values. Our trainers will provide a practical approach for both medical and non-medical attendees.

On Friday July 27th will be a course devoted to case exercises. Our expert staff will provide a didactic approach to ensuring accurate impairment ratings.

On Saturday, July 28th and Sunday, July 29th our course will be designed to provide evaluators the skill set to perform impairment evaluations and interpret findings from the physical examination into an impairment rating. We will also address the issues of causation and apportionment from a medical perspective. Faculty in various medical specialties will be presenting at this event.

Be sure to save the dates for this series. You can attend one or all of the seminars provided. If you would like to sign up for this exceptional event please contact our office at 1-888-262-1202.

Our firm has just completed a study for 2006 which revealed that there is an 86% national error rate in impairment ratings. This is an astounding number which shows that there is opportunity for improvement in both impairment review and evaluations. Our firm strives to provide a full range of services in the field of impairment with the hope that this error rate will improve over time.

To access the California Study Results Click Here

To access the National Study Results Click Here

Chapter Seven: The Urinary and Reproductive Systems By Aimee Lazell, CIR, WCCP

This article is the seventh in a series intended to point out a few of the highlights from each chapter of the AMA Guides to the Evaluation of Permanent Impairment, Fifth Edition (Cocchiarella L, Andersson G, AMA Guides to the Evaluation of Permanent Impairment, Fifth Edition, AMA Press, 2001).

This article will discuss important points of reference for Chapter Seven of the AMA Guides, which addresses the urinary and reproductive systems. Section 7.1 Principals of Assessment in this chapter states that:

"Pathologic abnormalities in other systems (eg, the hematologic, endocrine, or neurologic systems) may produce urinary or reproductive system impairment. These abnormalities are combined with urinary or reproductive system impairments to produce a whole person impairment rating. (5th ed., 144)"

Typically, conditions in this chapter develop secondary to another injury. Other chapters such as the nervous system or spine will be combined in conjunction with this chapter to fully incorporate a patient’s condition.

A common trend we have been seeing in California is that some physicians include sexual dysfunction in conjunction with a musculoskeletal injury. Section 7.7 Male Reproductive Organs (5th ed., 156) has been applied inappropriately with minor spine injuries. Section 7.7b Criteria for Rating Permanent Impairment Due to Penile Disease gives the criteria for evaluating penile disease as in Table 7-5 (5th ed., 156).

Section 7.7a discusses objective techniques for evaluating penis function. These include penile tumescence studies, Doppler ultrasound penile blood flow evaluations, dynamic cavernosometry and cavernosography and angiography. It must be noted that impairment for sexual dysfunction is not based solely on subjective complaints relayed in a medical evaluation, but also on objective testing as listed above.

Watch for the next article in the series, which will highlight sections of Chapter 8 The Skin.

The monthly GuidesIQ subscriber calls provide a wonderful opportunity for discussing challenging issues and providing guidance. You are welcome to listen to the recording of the March 6, 2007 session, as our guest.

During this call we discussed the rating of plantar fasciitis (usually not associated with permanent impairment); lower extremity motion assessment (need to base impairment on consistent deficits), problems with inappropriate gait ratings (a common error), modifications of impairments (when and when not), rating a patient with a history of bilateral or multilevel radiculopathy (rate via DRE method if prior findings of radiculopathy not present at MMI), consideration of subjective factors, and rating spinal impairment with associated reported sexual dysfunction (objectify basis and dysfunction, otherwise encompassed with ADL and 3% range).

We also discussed our most recent findings of an observed error rate of 87% in review of consecutive, non-selected California impairment evaluation reports. Subscribers to GuidesIQ are able to participate in these monthly calls and listen to recordings of prior calls. For this month we are providing you with complimentary access to the call; we encourage you join GuidesIQ. If you are not yet a subscriber go to GuidesIQ and enter your name and email address. You will be taken to a new page where you can access the call in its entirety. If you are already a subscriber, the link appears on the home page once you have logged in.

Independent Medical and Impairment Evaluations: Cruising to Excellence

On this Alaskan Cruise passengers will have the opportunity to mix academics with leisure. Distinguished faculty from across the United States will be presenting a variety of topics. CME and QME credits will be offered at this family friendly event.