AMA Guides® Newsletter - Issue Archive

Articles

1. Virtual Medical and Impairment Assessments

   Christopher R. Brigham, Helene Fearon, Steven Feinberg, Barry Gelinas, David Langham, J. Mark Melhorn

   Pages 3–11

   DOI: 10.1001/amaguidesnewsletters.2020.MayJun01

   Abstract

   Virtual independent medical evaluations (IMEs) have become and are likely to remain common even after the coronavirus disease 2019 (COVID-19) pandemic ends, but virtual health care and virtual examinations are not simply a matter of moving to a new platform—rather, they require a transformation that affects all stakeholders. Innovative solutions necessitated by virtual IMEs potentially can improve both quality and efficiency. The American Medical Association (AMA) defines telemedicine as health-related services that are synchronous and asynchronous and include a variety of tools and platforms that allow clinicians to connect with one another and patients (a box provides information about AMA's ongoing telehealth initiative). Physicians who plan to perform virtual evaluations must have the appropriate policies, procedures, and security in place; resources are available from the AMA Guides series of publications. Each component of the virtual IME, including each data element, should be assessed to determine best practices and how to use virtual technologies successfully. The credibility of virtual IMEs may hinge on the examiner's ability to explain both what was done and why it was as efficacious as an in-person alternative or perhaps as useful as any other alternative under the circumstances. One challenge is to master the tools used in virtual IMEs and another is to obtain stakeholders' acceptance of the virtual process, but this will come with time, experience, and effective physician performance.
   Show more

2. The AMA Guides in Pennsylvania “Post-Protz”: Act 111 and Case Law Update

   Justin D. Beck, Judge David B. Torrey

   Pages 12–19

   DOI: 10.1001/amaguidesnewsletters.2020.MayJun02

   Abstract

   Medical evaluators must understand the context for the impairment assessments they perform. This article exemplifies issues that arise based on the role of impairment ratings and what edition of the AMA Guides to the Impairment of Permanent Impairment (AMA Guides) is used. This discussion also raises interesting legal questions related to retroactivity, applicability of prior precedent, and delegation. On June 20, 2017, the Supreme Court of Pennsylvania handed down its decision, Protz v. WCAB (Derry Area Sch. Dist.), which disallows use of the “most recent edition” of the AMA Guides when determining partial disability entitlement under the Pennsylvania Workers’ Compensation Act. An attempted solution was passed by the Pennsylvania General Assembly and was signed into law Act 111 on October 24, 2018. Although it affirms that the AMA Guides, Sixth Edition, must be used for impairment ratings, the law reduces the threshold for total disability benefits from 50% to 35% impairment. This legislative adjustment benefited injured workers but sparked additional litigation about whether, when, and how the adjustment should be applied (excerpts from the laws and decisions discussed by the authors are included at the end of the article). In using impairment as a threshold for permanent disability benefits, evaluators must distinguish between impairment and disability and determine an appropriate threshold; they also must be aware of the compensation and adjudication process and of the jurisdictions in which they practice.
   Show more