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Thread Title: pain v. DRE increase
Created On Monday September 01, 2008 8:24 PM

denyse
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Monday September 01, 2008 8:24 PM

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When I read page 570 (Excess Pain) it seems to link the two together. I see countless examples of a max DRE + pain. Why?

If pain, or medication to relieve pain all deal with the impact on ADL, why are doctor doing the dogpile?

denyse
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Wednesday September 03, 2008 10:04 AM

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saw a recent DRE II lumbar (8% WPI) + 3% pain
DRE II thoracic (8% WPI) + 3% pain
DRE II cervical (8% WPI) + 3% pain

Some might argue that this represents a 18% increase for DRE/pain. Pain is maxed at 3% per injury (Cali law). PP. 570 suggests DRE and pain are analogous. If not, what is the difference?

Please not the lumbar now exceeds the low end post surgical value (10%). Does this make sense?

ama andy
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Wednesday September 03, 2008 4:20 PM

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I have seen a few reports and I have never seen a doctor give 11 WP for all three spine regions. I do not believe anyone would rate out all three elevens, most likely one 11 and two eights. If you ascribe to the idea that adjustment within the DRE range is analogous to pain, then i guess you would advocate rating out an eight and two fives in your example.

denyse
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Wednesday September 03, 2008 8:32 PM

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I have a DEU report in front of me that has the same scenario. My take is that they are rating this liberally at the consultative level and forcing the employer to make a choice (cost to defend vs. probable outcome). I concur with your analysis, but recognize the risks associated with taking the hard line. I think the in pro per creates the greater liability as you can't negotiate. I just wanted to put it out there as this now appears to be a moving target.

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