Document Detail


Pain, impairment, and disability in the AMA guides.
MedLine Citation:
PMID:  15301196     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Physicians use the American Medical Association's Guides to the Evaluation of Permanent Impairment, 5th edition to evaluate millions of disability applicants each year. As major contributors to the chapter in the Guides devoted to assessing impairment associated with pain, we confronted the difficulties of incorporating pain into the Guides' overall evaluation system. Analysis of these difficulties is complicated by the paucity of research on the Guides, and by ambiguities and contradictions that pervade it. We propose that the ambiguities can be reduced if impairment is consistently defined in terms of organ or body part derangement, and disability in terms of activity limitations at the level of the whole person. We also propose a distinction between objective factors that may influence a person's ability to perform activities following injury. We suggest that when physicians examine disability applicants, they should evaluate both objective measures of organ or body part dysfunction and subjective reports of applicants -- especially ones regarding pain. We conclude that a comprehensive medical evaluation of disability applicant encompasses more than an impairment assessment.
Authors:
James P Robinson; Dennis C Turk; John D Loeser
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics     Volume:  32     ISSN:  1073-1105     ISO Abbreviation:  J Law Med Ethics     Publication Date:  2004  
Date Detail:
Created Date:  2004-08-10     Completed Date:  2004-10-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9315583     Medline TA:  J Law Med Ethics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  315-26, 191     Citation Subset:  E; T    
Affiliation:
Department of Rehabilitation Medicine, University of Washington, USA.
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living / classification
American Medical Association
Disability Evaluation*
Disabled Persons / classification*
Humans
Pain / diagnosis*
Pain Measurement*
Practice Guidelines as Topic*
Trauma Severity Indices
United States
Grant Support
ID/Acronym/Agency:
AR/AI44724/AR/NIAMS NIH HHS; AR47298/AR/NIAMS NIH HHS; HD33989/HD/NICHD NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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