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Your Guide to Ensuring Accuracy in Impairment Ratings
October 18th, 2007

In this issue

Webinar: AMA Guides 4th Edition Training

Seminars in San Diego, November 16-17, 2007

Favoring One Leg - Does This Harm the Other Leg?

Personality Disorders - Challenging Issues

IRIS Information


 

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.




Don't forget that our next pair of seminars will be taking place on the 16th & 17th of November in San Diego, California. Details can be found in the article below. We have other training activities and products available to enhance your knowledge on the Guides.

Visit our website www.impairment.com for a list of teleseminars, webinars and products.


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

  • Favoring One Leg - Does This Harm the Other Leg?
  • legstretch

    by Christopher R. Brigham, MD

    It is a myth that "favoring" one lower extremity will result in an injury to the opposite lower extremity. Review of the medical literature reveals no accepted medical studies that support such a relationship, nor is there any reasonable scientific logic that would support such a relationship. It is more likely than not that underlying degenerative changes in the opposite extremity will manifest themselves over time, thus it is expected that symptoms may follow in the opposite extremity, however the relationship is not that of the "injured" lower extremity contributing to an "injury" of the opposite extremity. This specific issue was addressed in an article entitled "Can 'favouring' one leg damage the other?" published in the Journal Of Bone and Joint Surgery in 1994. This article concluded "In summary, there are no hard data to support the belief that 'favouring' one leg adversely affects the other. Such data as we have, taken with the theoretical considerations, suggest that this sequence is unlikely."

    (Reference: Harrington, Ian J, Harris, W. Robert, "Can `favouring' one leg damage the other?", J Bone Joint Surg. (Br); 76-B:519-20, 1994)

  • Personality Disorders - Challenging Issues
  • brain

    by Christopher R. Brigham, MD

    It is imperative to have a solid understanding of personality disorders to appreciate some of the challenges associated with injury and illness. Personality disorders represent enduring patterns of inner experience and behavior that deviate markedly from those expected by the individual's culture. These inflexible and pervasive patterns reflect problems with cognition, affectivity, interpersonal functioning and impulse control, and lead to clinically significant distress or impairment in social, occupational or other important areas of functioning. By their very nature, personality disorders are often unrecognized by those who suffer from them, who tend to blame others for their problems. There may be comorbidity with various conditions, such as pain disorder, depression, anxiety disorders, posttraumatic stress disorder and substance abuse. Personality disorders may be undiagnosed by healthcare providers, which can be particularly troublesome when disability benefits are involved. Personality disorders are conditions that can complicate impairment and disability assessment. The DSM-IV[1] defines ten specific personality disorders in addition to an eleventh condition, Personality Disorder NOS, which allows for combined features of the various personality disorders as well as personality conditions which are not specifically listed. The ten personality disorders are divided into three clusters.


    Cluster B personality disorder, which includes Antisocial Personality Disorder, Borderline Personality Disorder, Histrionic Personality Disorder, and Narcissistic Personality Disorder, is more prevalent in the legal arena, perhaps because people suffering from these conditions feel comfortable with and may seek to be the focus of attention. Of this group, probably the most prevalent in the legal disability arena are borderline individuals. Such people may suffer from frantic efforts to avoid perceived abandonment, patterns of unstable and intense interpersonal relationships, an identity disturbance and impulsivity. They may exhibit suicidal behavior, gestures and threats, affective instability, chronic feelings of emptiness, intense displays of anger, transient dissociative symptoms and stress-related paranoid ideation. Histrionic individuals have a pattern of excessive emotionality and attention seeking behavior. Narcissistic individuals have a pattern of grandiosity, a need for admiration, and a lack of empathy for others. Antisocial individuals have long term disregard for the rights of others.

    Our skilled psychological consultants can assist you in identifying the challenges associated with these disorders.

    (Reference: Bourne D, Personality Disorders in the Disability Arena. The Guides Newsletter, November - December 1999; Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: APA: 1994.)








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