AMA Guides Cross Examination Questions: Attacking and Defending Reports

By Phil Walker, JD and Christopher R. Brigham, MD

1) Doctors training and Qualifications a) Has he/she read the entire book? b) Has he/she been trained on the AMA Guides? What training, when and how many hours? c) Has he/she been certified for competency in impairment assessment? i.e. a Certified Independent Medical Examiner (www.abime.org), Fellow of the American Academy of Disability Evaluating Physicians or AADEP Certification in Evaluation of Disability and Impairment Rating (www.aadep.org), or Certified Impairment Rater (www.impairment.com)? d) Has he/she published anything about the Guides? e) Has he/she taught about the Guides? 2) Doctors experience in working with the Guides a) How many AMA Guides impairment evaluations has he/she performed? b) Was report reviewed by anyone to see if impairment calculation accurate? c) Do other evaluators agree with the impairment rating? 3) Materials reviewed a) Did he/she review the same material as others? b) Did he/she list the materials in the report? 4) AMA Guides title a) Did he/she correctly cite the name of the AMA Guides to the Evaluation of Permanent Impairment in the report? b) Did he/she use the correct edition? 5) Report elements a) Compare report to checklist for reports to see if all elements included (Guides Newsletter, November December 2005) 6) Doctor bias a) Is he/she the treating doctor, or plaintiff (applicant) or defense requested examiner? Can he/she be unbiased in that situation? b) Does he/she consider himself/herself the patients or clients advocate? 7) Steps of evaluation a) Did he/she do the evaluation himself/herself? b) Verified reliability of all historical, physical examination, and other data? 8) Criteria application a) Correct body system? b) Correct method of impairment calculation? c) Correct measurements? d) Correct use of charts converting measurements to percentages? e) Correct combining of impairment ratings? 9) Pain rating a) Did he/she rate pain in addition to the objective findings? 10) Specificity a) Did he/she identify the specific tables and charts from which he or she got their values?

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