Tips for Assessing Joint Impairments

Saturday, March 10, 2007 | 0

By Dr. Christopher Brigham

Greetings, and welcome to this week's impairment tip.

This week's impairment tip is courtesy of Kenneth Subin, MD, MPH, CIME, one of our senior physician reviewers.

Extremity injuries are among the most common cases we review at Brigham and Associates, Inc. Accurate assessment of joint motion is essential to a thorough and credible report. Here are a few tips to help you complete your examination as recommended in the Guides.

* Whenever possible, active range of motion measurements should be utilized for the impairment rating. Assisted active motion or passive motion measurements should be rated only under certain conditions (ex. Bunnell's test for intrinsic tightness of the hand).

* Always measure the range of motion for bilateral extremities and, if applicable, reference the uninjured extremity as "normal" for the examinee and determine impairment for the injured extremity based on the examinee's "normal" values.

* Impairment values for motion units of a joint are added (ex. Wrist flexion and extension are motion unit).

* Be sure to utilize, and document in your report the use of, a goniometer for calculating joint motion as indicated in the Guides.

* Measurements for each joint motion should be recorded at least 3 times, and measurements should fall within 10% of each other to be considered consistent. The Guides also discuss that there should be consistency in measurements among different evaluators. If your examination findings are inconsistent with others, you should address this in your report and provide a detailed explanation of the possible reason(s).

We hope this information is helpful to you in your impairment rating process.

Brigham is the editor of the Guides Newsletter and Guides Casebook. To view more of these tips visit:

www.impairment.com/tips

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