By J. Mark Melhorn M.D., Jacob Lazarovic M.D., Wanda K. Roehl C.S.P. (auth.), Izabela Z. Schultz, Robert J. Gatchel (eds.)
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Additional resources for Handbook of Complex Occupational Disability Claims: Early Risk Identification, Intervention, and Prevention
Wardle, M. G. (1982). Reliability and validity of American Medical Association’s Guide to Ratings and Permanent Impairment. JAMA, 248, 2292–2296. Greenberg, R. , Daniels, S. , Eley, J. , & Boring, J. R. (1993). Medical epidemiology . Norwalk: Appletion & Lange. Guck, T. , Meilman, P. , Skultety, F. , & Dowd, E. T. (1986). Prediction of long-term outcome of multidisciplinary pain treatment. Arch Phys Med Rehabil, 67, 293–296. Guest, G. H. & Drummond, P. D. (1992). Effect of compensation on emotional state and disability in chronic back pain.
The recommended method also incorporates the assessment of a person’s credibility, an area for which valid and reliable clinical assessment instruments do not yet exist, and the assessment of emotional status, typically not a domain of physical examination. This likely compounds the conceptual and methodological problems arising from this proposed approach to impairment determination. To complicate the matter, clinically-estimated impairment ratings are often used in compensation systems as a proxy for disability, without considering work-related contextual demands, and without performing employability assessments.
The contextual factors in this model are limited to specific task functions and job accommodation available at work. Excessive Reliance on Impairment Evaluation While Neglecting Workplace Environment Lack of discrimination between impairment and occupational disability encountered in both research and practice in disability determination and prediction is often associated with an excessive reliance on impairment in the absence of its contextualization. In particular, the compensation systems and courts in charge of legal disability determination often rely excessively on medical and psychological descriptions and ratings of impairment.