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Erroneous Rating Study: Part V
In the last issue we examined how erroneous
clinical assessment will result in an erroneous rating. In
this issue we will explore problems with inaccurate causation
assessment.
In assessing impairment it is necessary to
distinguish what impairment is related to the alleged injury
as opposed to impairment that may be due to other injury,
degenerative disease, or illness. The premise of causation is
that a given cause (A) and a given effect (B) are associated
within a reasonable degree of medical probability. If the
practitioner promotes the premise that, "within a reasonable
degree of medical probability (A) & (B) are causally
related," all three of the following separate notions are
assumed to be correct (medically probable):
- (A) The cause is medically probable - (A) is more likely
than not the cause and/or aggravator of the problem.
- (B) The effect is medically probable - (B) is more
likely than not the correct diagnosis or condition.
- (A) and (B) are related in a medically probable manner.
If either (A) or (B) or both are considered to be possible,
but not probable, the causal association cannot be upheld as
being medically probable. Further, no number of possible
causes can be taken together and viewed as a probable cause.
Causation analysis is the critical first step
to apportionment analysis. Impairment may be related to
multiple causes. Section 2.5h Changes in Impairment from Prior
Ratings on page 21 provides a discussion of the Guides
approach to apportionment. The Guides state:
"if a prior impairment evaluation was not performed, but
sufficient historical information is available to currently
estimate the prior impairment, the assessment would be
performed based on the most recent Guides criteria. For
example, in apportioning a spine impairment, first the current
spine impairment rating is calculated, and then an impairment
rating from any preexisting spine problem is calculated. The
value for the preexisting impairment rating can be subtracted
from the present impairment rating to account for the effects
of the intervening injury or disease."
In reviewing a case it is imperative to assure
that clinical and causation assessments were accurate, that
the rating was performed when at maximal medical improvement,
that examination findings were consistent, and what was normal
for the individual was determined. An unreliable examination
will result in an erroneous rating, and nearly always this
erroneous rating will be higher than is appropriate.
In the next issue of the ezine we will examine
some of the common errors in the rating process itself, i.e.
the use of Guides criteria. If you do not yet subscribe to the
ezine, visit www.impairment.com to subscribe – it is valuable
and provided as a public service.
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Happy Spring!
We hope you are enjoying beautiful weather in your area!
Stay tuned...We have been very busy producing new products
to help you gain a greater understanding of the Guides
which will be revealed next month!
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May Webinar
101 Series- Enroll Now! |
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AMA Guides Webinar 101 - The Fundamentals is an overview on
the use of the AMA Guides, with a focus on principles of
impairment evaluation, and assessment of spine, upper
extremity, lower extremity, neurological, and pain
impairments.
This seminar is designed for physicians, attorneys, and
claims staff with minimal or no experience in the use of the
Guides. It is also an excellent review for individuals who may
have attended an introductory course and desire further review
and clarification.
- All sessions are held from 2-4pm (P.S.T.)
- Session 1: Overview, Lower Extremity: Thurs. May 4
- Session 2: Upper Extremity, Thurs. May 11
- Session 3: Spine: Tues. May 16
- Session 4: Other Chapters, Strategies: Thurs. May 25
- Price: $395/attendee for 4 sessions
- Group Discounts Available
- To Register Call 619-299-7377
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Click Here to Register
On-Line |
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AMA Guides:
The Next Step: Advanced Skills & Practical
Application |
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Don't Miss this Seminar! Presented by Chris Brigham,
MD & Phil Walker, JD
This advanced seminar will provide attendees with the
knowledge to assess impairment in complex areas such as
multiple upper & lower extremity injuries and
corticospinal tract injuries. There will also be discussion on
common areas of misuse and abuse of the Guides along
with current trends seen with erroneous ratings.
Physicians, attorneys and claims staff are encouraged to
attend.
- Date: August 4, 2006
- Where: San Francisco Airport Marriott
- Time: 7:30am- 4:30pm
- Price: $395.00/attendee (Group discounts available)
- Register On-Line or Call 619.299.7377 or 888.262.1202
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Register Here! |
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ACOEM
Pre-Conference Presented by Brigham Walker! |
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Chris Brigham, MD & Phil Walker, JD will be teaching
the pre-conference, two day course on May 5 & 6: "Master
the AMA Guides" as part of the American Occupational
Health Conference (AOHC May 5-10, 2006). This seminar is
case-oriented and designed for physicians and others who want
to improve their ability to rate impairments. They have
received superb reviews: informative, lively, and not to be
missed!
- Start Date: Friday, May 05, 2006
- End Date: Saturday, May 6, 2006
- Event Time: 8:00am - 5:00pm
- Location: Hyatt Regency Century Plaza Hotel: Los
Angeles, CA
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Register Here! |
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Test
Yourself & Your Staff on the Guides! |
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Do you know how well you know the Guides or what
your weak area is when it comes to the Guides? Are you
better at the spine than the upper extremities?
As we travel from state to state and have the opportunity
to dialog with our clients we find that many have commonly
stated they “don’t know what they don’t know” when it comes to
the Guides. Most professionals new to use of the
Guides have this problem. Our firm recognizes the
difficulty in learning the Guides. We have developed
two tools in assisting physicians, attorney and claims
adjusters in determining their proficiency in the
Guides. The assessment is a great learning experience
and an excellent return on a very modest investment.
The first tool is a Mini-Assessment involving 20 items
which will take approximately 1 hour of time.
The weighting of questions is consistent with the ratings
performed. Approximately 25% of the items are on the
principles, 25% spine, 25% upper extremity, and remaining 25%
lower extremity and other areas.
If you want a more in-depth assessment we have developed
the AMA Guides Skills Assessment. This is a dynamic
assessment involving 60 questions which will take
approximately 2-3 hours of time.
Our firm believes that it is important to have a gauge on
your comprehension of the Guides so that you may know
how to best handle Guides issues. Take this test today!
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Click Here to Register & for
More Info |
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Bronze Bundle- Sale Of the
Month! |
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Great Savings on this AMA Guides Package!
You receive:
- AMA Guides 101 DVD (Reg. $395.00)
- AMA Guides 102 DVD (Reg. $395.00)
- Guides Casebook ($62.95)
- Quick Reference Chart (Reg. $29.95)
- Reg. Package Price: $595.95 - Over $280 Savings!
- Sale Price: $545.95- Over $330 Total Savings!
- You Must CALL for Sale Price & Reference this eZine!
- 619-299-7377 or 888-262-1202
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Check out other Products &
Packages |
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Upcoming
Events |
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Dr. Brigham is a featured speaker at the upcoming events:
- California Orthopaedic Association, San Diego, CA, April
21-23, 2006
- American Occupational Health Conference, Los Angeles,
CA, May 5-6, 2006
- California Association of Joint Powers Authority, South
Lake Tahoe, CA, September 20-22, 2006
Please visit us at our exhibit at these conferences. If you
are planning on attending any of the following, please email
us to let us know.
- Risk & Insurance Management Society 2006 Honolulu
Conference, Honolulu, HI, April 23-27, 2006 Booth #2238
- California Workers Compensation Defense Attorneys
Association, Lake Tahoe, CA, May 18-21, 2006
- National Workers' Comp & Disability Conference, Las
Vegas, NV, November 14-16, 2006
Email
Us to Tell Us Your Coming to an Event. We want to meet
you.
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