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  1. #1
    Join Date
    Feb 2012

    Default AMA Guidlines and Conduct of an IME Exam

    Kneebow here,

    Kneebow here,
    I was resently sent to an IME for the exam of RSD. According to the OBWC the IME was to use the determing diagnosis from the AMA guidlines 5th edition. It is stated in the IME paperwork that was sent from the OBWC that eight symptoms must be present. I saw the paper work sent from the BWC. Where did you get your information if I might ask? According to the paper work that was sent to the IME this is very relevant determining the diagnosis and it is used, unless the BWC is telling the IME wrong information.

    - - - Updated - - -

    Kneebow here,
    I was hoping to hear back from Chiron regarding the accuracy in his/her response given, but so far nothing.
    Can someone who is familiar with the AMA guidelines give a confirmation that this individual is correct in what he/she is stating, because if this is so.....then I have to bring this to my lawyers attention. These guidelines were used just as I said in my earlier thread with the IME examine for CRSP. Should these AMA guidelines 5th Edition not have been used as Chiron states " they are outdated"
    Thanks in advance,

    Quoting Chiron wrote in the Ohio forum:
    "That is not correct, and the AMA Guides 5th ed are not the relevant text for determining the diagnosis and is never used in that regard. Completely outdated now."

  2. #2
    Join Date
    Feb 2007

    Default Re: Clarification on Ama Guidelines 5th Edition Regarding IME Examine

    There are several editions of the AMA guides to rating disability. Depends on which one the OBWC has adopted. Could be 5th, could be 6th or if there is a later version. Which edition is a matter of law.

  3. #3
    Join Date
    Oct 1971

    Default Re: Clarification on Ama Guidelines 5th Edition Regarding IME Examine

    Should these AMA guidelines 5th Edition not have been used as Chiron states " they are outdated
    Depends on the specialty.

    AMA Guide References by Specialty
    The following table summarizes the appropriate references for Industrial Commission examinations by specialty:
    Specialty Description AMA Guides Edition

    Internal Medicine Fifth
    Neurology Fifth
    Occupational Medicine Fifth
    Orthopedics Fifth
    Physical Medicine & Rehab Fifth
    Psychiatry/Psychology Second and Fifth
    Pulmonary Disease Fifth
    Neuropsychologist Second and Fifth
    Cardiovascular Disease Fifth
    Dental Surgery AAOMS*
    Dermatology Fifth
    Otorhinolaryngology Fifth
    Gastroenterology Fifth
    Specialty Description AMA Guides Edition
    Ophthalmology Fourth
    Rheumatology Fifth
    Urology Fifth
    Allergy Fifth
    Endocrinology Fifth
    Maxillofacial Surgery AAOMS*
    Oncology Fifth
    Vascular Surgery Fifth
    Anesthesiology Fifth
    Gynecology Fifth
    Plastic Surgery Fifth
    General Surgery Fifth
    * American Association of Oral and Maxillofacial Surgeons’ Guidelines to the Evaluation

    See pg 4:

    Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.

  4. #4
    Join Date
    Jun 2012

    Default Re: Clarification on Ama Guidelines 5th Edition Regarding IME Examine

    Ohio Court of Appeals 10th District in Bradley vs D.O.T relied on AMA Guides 5th in denying RSD ( CRPS) as is their right. However in the real world it's not so straight forward

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    sry - had to sign off. What I mean is that the question of what is and how to diagnose CRPS is not set in stone but continues to evolve and be refined. THe AMA 5th criteria is quite old by now and numerous studies have commented on the difficulties of trying to fit everyone into that list when the nature of the syndrome is still not understood.

    I misunderstood your original question on diagnosis, and the AMA GUides criteria is not generally used except when the BWC is involved since that is not a medical system.

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    Injured workers will experience increased difficulty in applying for coverage of CRPS Type 1 as defense attys. are mounting more successful arguments, particularly in discrediting the opinions of the consultant physicians. The same does not apply to CRPS Type II.

    Recent position statements by national medical specialty societies, The American Academy of Neurology, the American Association of Orthopedic Surgeons, and others do not support CRPS Type I as a legitimate medical condition, instead a "social construct" , a "mythical concept". It has been pointed out that the condition of CRPS is most often found in workers' compensation patients. The role of psychiatric conditions has also been raised as there is a reported high correlation and a thorough forensic psychiatric examination with a focus on malingering as well as vigorous cross examination of the treating physician is becoming more common as the cost of such is minimal when claims of total disability and life time benefits.

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