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AMA Guides Impairment Ratings Erroneously Elevated – Best
Practices Approach is Expert Review of All
Impairment Ratings
The AMA Guides to the Evaluation of Permanent
Impairment, Fifth Edition are the standard for
defining the impact of an injury or illness.
Unfortunately the vast majority of ratings are
incorrect, typically overrated and the errors
are often undetected. This observation was
observed in our
2005 study and reconfirmed in
our current study. The conclusion is that all
impairment evaluation reports should be reviewed
by an expert on the Guides – this intervention
is very cost-effective.
California Study
Of 658 California impairment critiques performed
between July 2006 and February 2007, 571 (87%)
were incorrect, with the average original rating
18.7% whole person permanent impairment (WPI)
and the average revised (corrected) rating 4.9%
WPI. Review of 73 consecutive cases from one
client revealed an error rate of 82% among the
ratings performed, with the average original
rating of 12.3% WPI and the revised (corrected)
rating of 3.7% WPI.
View Press Release. The
marked difference in ratings between the old PDRS were predicted in our May 17, 2005
Workers
Compensation Insurance Rating Bureau study
View a presentation by Dr. Brigham presenting
the findings, examining the causes of the
errors, and providing specific strategies you
can use to assure accurate ratings -
View Handout
National Study
Of 874 national impairment critiques performed
between July 2006 and February 2007, 751 (86%)
were incorrect, with the average original rating
18.5% whole person permanent impairment (WPI)
and the average revised (corrected) rating 5.2%
WPI. In the automobile casualty arena every
impairment rating was incorrect.
View Press
Release -
View
Presentation -
View Handout
Quick Links
Solutions
We provide comprehensive solutions, including
the
expert review of all ratings –a very
cost-effective strategy - ranging from
low cost
impairment screen ($95),
impairment rating reviews ($495 or less), to
detailed impairment physician reviews. In
addition to persuasive reports, we database the
results. Referrals can be made conveniently
online. We also offer
consultation and
training
– including our highly acclaimed
www.guidesiq.com online training and
webinars.
It is very important that you choose the best
resource for your reviews. We are the only
organization that answers yes to each of these
questions.
| 1. |
Does the reviewer have substantial
experience with the Guides? (i.e.
performed or reviewed >
500 AMA Guides ratings) |
| 2. |
Does the review process involve, as
appropriate, an experienced physician
who is appropriately credentialed? (ABMS
board certified, Certified Independent
Medical Examiner, Certified Impairment
Rater) |
| 3. |
Do the participants understand the
specific challenges of workers’
compensation in California and does the
organization have an office in
California? |
| 4. |
Is there nationally recognized
leadership in regards to the Guides?
(Therefore resulting in higher quality
review, better access to resources, and
greater credibility.) |
| 5. |
Can referrals and records be
provided via the Internet? |
| 6. |
Are reviews performed in a timely
manner, typically within 5 days, with a
low-cost screening review option? |
| 7. |
Are detailed narrative critique
reports available that will clearly
explain any errors and the rationale for
the correct ratings? |
| 8. |
Does the organization collect and
analyze data on every review and also
provide you that data electronically? |
| 9. |
Can the organization provide you
with both case specific summary and
narrative reports, and group data? |
| 10. |
Does the organization have an
effective quality assurance process? |
Specific Recommendations
| 1. |
Implement on a trial basis for three
months the best practices approach of
having all impairment ratings screened
by Brigham and Associates, Inc. and
analyze the cost-effectiveness of this
intervention. |
| 2. |
Encourage all physicians to perform
a self-assessment of their knowledge of
the AMA Guides and to obtain needed
training (www.guidesiq.com) |
| 3. |
Assure claims and legal staff have
needed understanding of the AMA Guides.
(www.guidesiq.com) |
| 4. |
Encourage physicians to seek
assistance in performing impairment
evaluations (resources available at
www.impairment.com) |
We look forward to being of service.
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