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FORUMS > AMA GUIDES 5TH & OTHER RATING QUESTIONS
Replying to Thread: Sleep and Shoulder Surgery...
Created On Saturday 8, November, 2008 1:58 PM by ChiroGeek


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ChiroGeek
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Posts: 417
Joined: Nov 2004

Saturday November 08, 2008 1:58 PM

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Hi all,

IW ends up having a failed shoulder surgery that in turn interferes with his sleep. An AME internists notes the Epworth Sleepiness Test yields only a 2 and therefore gives the patient a 2% WPI based upon table 13-4. NO "formal studies in a sleep laboratory" have been done.

Is such a rating valid without these official sleep studies? The AME is an MD, JD, so there must be a reason he didn't order the studies?

Also, is the outcome of the Epworth directly related to the WPI on table 13-4? For example, would a score of 9 be a 9% WPI?

Thanks in advance.

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gaiassoul1@yahoo.com
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Sunday November 09, 2008 9:16 PM

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answered this in the Legal thread...but in an effort to be complete, you can search it here you do not have to take my word.

Unless there has been a neurological injury, giving a WPI for sleep is inappropriate and in contradiction to the AMA Guides.

Sleep is an ADL and is already contemplated in the failed surgery portion of the WPI for the shoulder and any applicable pain add on.

You may get this past unknowlegeable Defense attorneys or it may help keep your applicant business happy, but it is not correct.

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denyse
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Tuesday November 11, 2008 2:02 PM

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I concur with ginger. I have yet to see a valid Chapter 13 industrial impairment (since sb 899 enacted over 4 years ago). I believe the better method is too simply include this in a pain add on, which the board (not judge's instructions) doesn't seem to care if there is inadequate or no documentation. The wiser play is through the GAF (mild insomnia). Big bucks with little defense. Then again a lot don't want to amend the application to include psyche.

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