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Thread Title: AMA Guides page 453
Created On Monday October 13, 2008 2:06 AM

constantine
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Monday October 13, 2008 2:06 AM

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hi there... just like to ask, is the provisions on page 453 of the guides under Chapter 16 - Upper Extremities, can be applied to the Lower Extremities as well? On page 453, it states. "If a contralateral normal joint has a less than average mobility, the impairment value(s) corresponding to the uninvolved joint can serve as a baseline and are subtracted from the calculated impairment for the involved joint."

an example was provided after that. can the same principle be applicable to the lower extemities? tnx a lot.

lesliedilbeck
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Monday October 13, 2008 8:43 AM

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Yes, we take the book as a whole. When guidance is given in one chapter but not discussed in another the same guidance can be applied. This is a flaw within the 5th edition. In the 6th there is congruity from chapter to chapter.

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Leslie Dilbeck, W.C.C.P., C.I.R.
Senior Consultant
Brigham & Associates, Inc.

denyse
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Monday October 20, 2008 1:05 PM

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It says can be used. Page 2 says he/she can use either (norm or contra). It says that if they use (on 453) the contral that they must document why. I don't see where they have to when using norm.

Case exposure wise, be careful on advancing this arguement, as many times the reason for lack of motion on the contra side is due to CT. Unless you have evidence to support the loss, this can be the subject for a CT pleading by a savvy AA who connects the dots.

(e.g.) 60 year old window washer with loss of motion on both sides, but only injured one side in the specific. It still comes down to managing exposure.

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