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Thread Title: ROM method for CS and DRE method LS... Please comment.
Created On Tuesday October 14, 2008 5:40 AM


constantine
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Tuesday October 14, 2008 5:40 AM

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Hi, can you comment on this? Ive been encountering Impairment Rating Reports wherein the DRE method is used for a spine region and at the same time the ROM method for another spine region. Please enlighten. Is the method of impairment rating specified below can be acceptable?

"Cervical spine impairment is best represented in this case by use of the range of motion method. This is in consideration of the multilevel involvement within the cervical spine segment. The MRI study of the patient is significant for disc protrusions at four levels. Each level of involvement is considered significant as it produces central canal and neuroforaminal encroachment with impingement upon the exiting nerve roots.

Lumbar spine impairment is best represented in this case by the use of the DRE method. This is in consideration of a distinct injury with no current evidence of multilevel involvement. The patient is found to have residual paraspinal muscle tenderness and guarding with asymmetric loss of motion. He therefore meets the criteria for DRE Category II.

Whole person impairment rating of the above was combined.

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Michaelb
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Tuesday October 14, 2008 7:54 AM

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On one hand, an attempt to explain the reason for using ROM was done. However, I do not believe it rises to the level of ROM. There is no example how an impairment is caused. Typically, radiculopathy would be needed either bilaterally or at two or more levels.

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denyse
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Monday October 20, 2008 12:52 PM

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2 level herniation = ROM on cervical spine. No HNP on the lumbar with only limited objective findings = DRE II. I found this correct. Here is an interesting side bar. Page 381, item 7 says if ROM is used in one region, the DRE has to be used in the other. Weird.

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