Spine Examination in an Impairment Rating Exam

24 April 2012 / Impairment Physical Exam / Comments Off on Spine Examination in an Impairment Rating Exam

Doing the exam, I prefer to work from the top of the body down, the same format that is followed in the report dictation. This serves two purposes, it allows the examiner to again have a predictable format to minimize the chance of missed examination data, and, it helps the reader move logically through the findings.

 

Spine Examination

I use a bubble inclinometer for all measurements on the spine regardless of the DRE or Range of Motion Method being used. This is also helpful to insure accurate measurements, and validate asymmetric motion rating on Box 15-1 (page 382, Chapter 15, The Spine, AMA Guides 5th Edition, AMA Press, 2004). Become familiar with bony land marks to use the bubble inclinometer correctly. Use Chapter 15 Spine, AMA Guides 5th Edition, AMA Press, 2004 for full instructional details.

 

Examine both right and left sides on all extremity exams, as this is critical for subtracting the employee’s normal (if any) impairment baseline findings from the injured side when arcs are separated and subtracted in the rating calculations. "If a contra-lateral "normal" joint has 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". (page 453, Chapter 16, The Upper Extremities, AMA Guides 5th Edition, AMA Press, 2004).

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