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  1. #1
    Join Date
    Mar 2008
    Posts
    93

    Default Rating RST and CRPS

    If I am reading this correctly rsd or crps should not be rated or determined by the ACOEM guidlines they state that there are specific issues that are not covered under acoem yes or no ?

  2. #2
    Join Date
    Oct 2006
    Posts
    9,108

    Default Re: Rsd

    reading what?

  3. #3
    Join Date
    Mar 2008
    Posts
    93

    Default Re: Rsd

    the acoem medical guidelines provided by my pain management doc.

  4. #4
    Join Date
    Oct 2006
    Posts
    9,108

    Default Re: Rsd

    i'm a bit confused also.
    california uses AMA guidelines for rating; ACOEM is strictly for treatment

  5. #5
    Join Date
    Dec 2006
    Posts
    2,165

    Default Re: Rsd

    That is correct...AMA5th is used for diagnostic purposes and RATING RSD/CRPS. THe ACOEM Treatment Guidelines are what Physcicians are to refer to when recommending TREATMENT.

    HOWEVER, under ACOEM, there are treatment recommendations/chapters for the "ACUTE" and the "CHRONIC" phases of the injury...if symptoms persist for MORE than three months, then the injury is considered "CHRONIC"....

    Unfortunately, the treatment recommendations for MANY chronic injuries per ACOEM guidelines is SPARSE. And RSD is one of those diagnoses that is NOT adequately addressed under ACOEM.

    Therefore, is fall on the PTP to include "EBM" (Evidence Based Medicine") with ALL their treatment requests to ASSURE that the request will pass UR and be APPROVED.

    RSD has a VERY SPECIFIC treatment "algorythm", or "protocol" that has been WELL-ESTABLISHED in the Scientific Literature. The "algorythm" is basically a "road map" for WHAT type of treatment to begin with, and if the patient does NOT respond, what treatment to proceed to NEXT.

    Treatment can include medications, and a series of nerve blocks coupled with physical therapy if the blocks help decrease the pain. RSD is a VERY DIFFICULT condition to treat, and EACH patient is DIFFERENT. WHat works for one RSD patient may not work for another RSD paitient.

    Here is a LINK that describes the TREATMENT ALGORYTHM FOR RSD:

    http://www.rsdfoundation.org/en/en_c...html#Treatment

    You might want to print copies for your attorney and PTP...

  6. #6
    Join Date
    May 2008
    Posts
    329

    Default Re: Rsd

    feelin it, sorry to hear you have RSD/CRPS.

    I to have it, and have suffered for 4 years now.

    You my friend are in for along uphill battle with pain, thought I better prepare you now.

    I know alot about it, and so does Princess LA, so if you have any questions, I will help all I can, good luck.

  7. #7
    Join Date
    Mar 2008
    Posts
    93

    Default Re: Rating RST and CRPS

    Thank you for the help.

  8. #8
    Join Date
    Dec 2006
    Posts
    2,165

    Default Re: Rating RST and CRPS

    FeeingIt, there are two different rating systems for RSD/CRPS in the AMA5th: One method is uner the "Upper Extremity" Chapter, and it deals with OBJECTIVE factors ONLY, such as decreased range of motion of the affected joints. If rating uner THIS chapter, the evaluator can NOT INCLUDE decreased ability to perform activities of daily functioning.

    The OTHER method of rating is found under the NEUROLOGY chapter, and THERE, the impairment is based ONLY on your ability to perform "activities of daily living".

    You can EXPECT the IC to INSIST on using which EVER rating method will yield the LOWEST overall WPI%....

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