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Helping to Eliminate Erroneous Impairment Ratings
October 5, 2007

In this issue

Webinar: AMA Guides 4th Edition Training

Seminars in San Diego, November 16-17, 2007

Degenerative Disk Disease - Not Attributable to Driving

Physician Resource Checklist

Tip of the Day - Thoracic Spine Range of Motion: Kyphosis and Reproducibility Testing


 

Webinar: AMA Guides 4th Edition Training
ama guides 4th

The AMA Guides are challenging and most impairment ratings are erroneous. We are pleased to announce an exciting new web-based training program on the AMA Guides to the Evaluation of Permanent Impairment - Fourth Edition. This program was developed in response to numerous requests for this training. It is integrated with our GuidesIQ resources. Therefore, participants will receive both live web-based training and also access to the unique resources of GuidesIQ.

You will:

  • Acquire the knowledge and skills required to rate impairment
  • Perform case exercises - receive feedback on your answers
  • Critique actual reports - learn from example
  • Have 24/7 access to GuidesIQ - extensive web-based training and resources on the Guides
  • Learn directly from Christopher R. Brigham, MD, one of the world's leading experts on the Guides, Editor of the Guides Newsletter, Editor of the Guides Casebook, and outstanding trainer
The program is designed for a multi-disciplinary audience, including physicians, attorneys, claims professionals, judges and other fact-finders.

Program Schedule:

  • 2 series of four live weekly 1.5 hour sessions
  • 4 hours of independent exercises per series
  • Wednesday at 2pm EST
  • Allows for makeup sessions via internet library
Each session includes:

  • Viewing video content via internet
  • Listen to and communicate with Dr. Brigham and other experts
  • Active learning with case exercises along with didactic material

  • Bonus: Sign up now and receive 4 months of immediate complimentary access to www.GuidesIQ.com
This 4 part series is scheduled as follows:

AMA Guides - 4th Edition Series One:

  • October 31, 2007 - Chapters 1 & 2
  • November 7, 2007 - Chapter 3
    Hand and Upper Extremity
  • November 14, 2007 - Chapter 3
    The Lower Extremity
  • November 21, 2007 - Chapter 3
    The Spine
AMA Guides - 4th Edition Series Two:

  • December 12, 2007 - Chapter 4
    The Nervous System
  • December 19, 2007 -
    Chapters 5 - 13 Critical Issues
  • January 2, 2008 - Chapter 14
    Mental and Behavioral Disorders
  • January 9, 2008
    Advanced Case Exercises
Purchase Series One - $397

Purchase Series Two - $397

Purchase both Series One and Series Two - $697 - a $97 saving.

The Guides Webinars seminar fee includes participation, syllabus material (provided electronically) and technology usage fees. Attendees are responsible for conventional telephone toll charges to access number. Use of a computer with Internet access is required. More than one attendee may participate at each location; the fee is per attendee. We reserve the right to change the schedule, if necessary.

Group discounts for ten or more attendees are available, please contact Mindy Brigham.

For further information contact Mindy Brigham or Call 888.262.1202.

_______________________

On the Road to Ensuring Accuracy - IRIS

The best practices and most cost-effective claims management approach to impairment ratings is our Impairment Rating Integrated Solution (IRIS), which includes low cost screen of all ratings (Impairment Screen), detailed critique of erroneous ratings (Impairment Review), Impairment Profiling System data analysis (your cases and overall data, including impairments for specific diagnoses and physician profiling), and access to GuidesIQ.

The fee for this solution is nominal and the savings may be profound. For most impairment screens the cost is only $95 if the rating is correct or $195 if incorrect - a fraction of the cost of even a single percentage error. The fee for detailed critiques is based on the time involved for that case.

We will develop with you a process that is most effective for your organization. Ratings are reviewed typically within five days and invoices are sent for each case. The fee for the professional service is typically billed to the file. *If we review all of your ratings, we provide you on a complimentary basis our data analysis (otherwise quarterly licensing fee of $9500) and also access to GuidesIQ for your staff (otherwise annual membership fee of $897 per person). You also receive priority status. Most importantly you have a cost-effective mechanism to assure accurate impairment ratings.

We recommend a three month trial with this intervention. At the end of that time you assess the impact of this strategy and determine whether to continue and if any modifications are needed. Every client implementing this has continued with the screens and the return on investment has been several-fold.

Contact Mindy Brigham today and solve the challenge of erroneous impairment ratings.




We are pleased to announce that our latest seminars will be taking place on the 16th & 17th of November in San Diego. Details can be found in the article below. Can't make it? Don't worry, we have a number of other training activities that you can get involved in to enhance your knowledge on the Guides.

Visit our website www.impairment.com for our upcoming teleseminars and webinars.


  • Seminars in San Diego, November 16-17, 2007
  • group book

    Now you have a second chance to register and attend our seminars on advanced issues involving the AMA Guides. Don't miss out on this great opportunity.

    We are offering two different seminars on November 16 and November 17, 2007 at our Conference Facility in San Diego.


    Practical Application of the AMA Guides, 5th Edition

    November 16 - Presented by Leslie Dilbeck, WCCP

    Attendees will be reviewing medical reports to determine accuracy of impairment. A step-by-step approach will be taught for reviewing medical reports and how to handle erroneous impairment ratings.

    This seminar is oriented to claims managers, adjusters, case managers, defense attorneys, applicant attorneys, raters, judges, and physicians who have had prior training on the Guides, 5th Edition. Read More

    Clinical Assessment of Impairment

    November 17 - Presented by Craig Uejo, MD & Leslie Dilbeck, WCCP

    A hands-on approach to learning with live demonstrations of physical examination.

    This course is oriented to physicians (orthopedic, neurosurgery, neurology, occupational medicine, physical medicine and rehabilitation and pain medicine), chiropractors, and other health professionals who have had prior training on the AMA Guides, 5th Edition. Read More

    Click Here to Register For One or Both Seminars

  • Degenerative Disk Disease - Not Attributable to Driving
  • disk

    by Christopher R. Brigham, MD

    We have recently reviewed several cases involving truck and bus drivers with complaints of back pain and findings of degenerative disk disease. These cases have been inappropriately labeled as "cumulative trauma"; scientific evidence does not support this attribution. Thus some of our earlier thoughts in regards to this issue have changed as a result of more recent studies. In terms of the specific issue of occupation being that of driver, there is no evidence that driving damages the disc. Battie reported the following in an article published in 2002 in Lancet:

    • BACKGROUND: Back problems are reported more by occupational drivers than by any other occupational group. One explanation is that whole- body vibration caused by the vehicle leads to accelerated disc degeneration, herniation, and associated symptoms. We aimed to investigate the effects of lifetime driving exposure on lumbar disc degeneration in monozygotic twins with very different histories of occupational driving during their life. METHODS: We assessed 45 male monozygotic twin pairs from the population-based Finnish Twin Cohort who had greatly different patterns of occupational driving during their life. Data were obtained for driving exposures and potential confounding factors through an extensive, structured interview. We assessed disc degeneration with lumbar MRI. FINDINGS: Disc degeneration did not differ between occupational drivers and their twin brothers. We also did not identify any overall tendency for greater degeneration or pathology in occupational drivers than their twin brothers. INTERPRETATIONS: Although driving may exacerbate symptoms of back problems, it does not damage the disc. Our inability to identify structural damage should be encouraging to those employed in occupations involving motorised vehicles and operation of heavy equipment.

    (Reference: Battie MC, Videman T, Gibbons LE, Manninen H, Gill K, Pope M, Kaprio J. Occupational driving and lumbar disc degeneration: a case-control study. Lancet. 2002 Nov 2;360(9343):1369-74.)

  • Physician Resource Checklist
  • small check box

    Many of our clients have requested that we develop a checklist of the needed knowledge, skills, certifications and resources to achieve success. Physicians provide a valuable service by performing quality, reliable impairment evaluations and preparing excellent, supportable reports.

    Click Here to view this checklist with hyperlinks to the resources you need.


  • Tip of the Day - Thoracic Spine Range of Motion: Kyphosis and Reproducibility Testing
  • spine image

    by Ken Subin, MD, MPH, CIME, CIR

    The two-inclinometer technique used for measuring thoracic spine range of motion is discussed in Section 15.10, ROM: Thoracic Spine, of the Guides beginning on page 411. After proper identification of the T1 and T12 spinous processes, the angle of minimum kyphosis can be determined by setting both inclinometers to neutral O° position against a wall and then measuring thoracic kyphosis angle with the examinee in a standing or seated position. Thoracic flexion motion can also be measured in an erect standing or seated position. In order to determine if the motion values obtained are reliable, measurements should be obtained in both positions. The Guides state that the results should be "nearly identical".

















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