theAxe
Member
Posts: 75
Joined: Mar 2005
|
Wednesday September 03, 2008 8:53 AM
|
|
Scenario:
1. Rt. knee injury degenerative joint disease secondary to 10 year CT heavy work and natural progression results in extension lag of 10 degrees rating 8% whole person inpairment.
2. Same right knee has specific injury falling, very recent but P&S, resulting in moderate ACL laxity rating 7% whole person impairment.
QME evaluation is done...
AMA Guides state ROM and diagnosis rating cannot be combined, and doctor must choose the highest rating; resulting in doctor only rating the DJD range of motion deficit.
Problem:
Recent case law states doc must apportion disability to each injury separately, and accordingly doctor apportions the disability between the CT and natural progression - he cannot apportion any of the AMA rating based disability to the specific, as it was not a sigificant part of the degenerative disability, even though the ACL laxity definately contributes to the patient's right knee condition and disability.
Additionally noted is that even though the degenerative impairment is greater, the CT is denied and there is apportionment to non-industrial causes, while the slightly lower rated ACL laxity impairment is a clear result of the accepted specific injury.
What do the AMA Experts here think the doc should do that appropriately addresses this conundrum?
-------------------------
theAxe
|
|
