The AMA Guides state in Chapter 2 of both the Fourth and Fifth Editions “if the clinical findings are fully described, any knowledgeable observer may check the findings with the Guides criteria." Similar language is present in the Sixth Edition in Section 2.3 Use of the Guides. Due to the high error rate with impairment ratings it is essential that every impairment rating be reviewed by an appropriately qualified expert. Click Here to Print This Page

Twelve questions will assist you in selecting the most appropriate impairment reviewer:

1. Is the reviewer independent and unbiased?  The reviewer should not represent a specific bias (defense or plaintiff) rather the goal is to assure the accuracy of the rating. This is both an issue of integrity and credibility.

2. Does the reviewer have substantial experience with the Guides?  A useful standard is having performed or reviewed more than 500 AMA Guides ratings – often it takes years to obtain this level of experience. To effectively review ratings the reviewer needs to have considerable experience and training on the use of the Guides.

3. Is the reviewer credentialed to perform and review impairment ratings? Since this is a specialty skill, credentialing, such as Certified Impairment Rater™, is essential.

4. Is the review organization well established? It is important that the organization be solid with a several year history of providing quality services. Be cautious of organizations that lack maturity or have not yet proven their value and stability.

5. Does the review process involve, as appropriate, an experienced physician in the appropriate specialty? AMA Guides ratings involve both clinical and impairment rating skills, therefore the evaluator should either be or have direct access to a board-certified physician who can interpret physical findings and provide clinical assessment.  Since the Guides are most often used in workers compensation cases, a board-certified occupational medicine physician is often your best resource. The organization should have ready access to other specialists with impeccable credentials.

6. Is there, within the organization, nationally recognized leadership in regards to the Guides?  Access to this level of leadership results in higher quality review, better access to resources, and greater credibility.

7. Can referrals and records be provided securely via the Internet? It is important to have a process that is effective, efficient and secure.  For example, emailing of records is not secure unless encrypted (128 bit), rather uploading records within the framework of a secured firewall is recommended. The review organization should have the capabilities of integrating with your systems.

8. Are reviews performed in a timely manner, within 5 days, with a low-cost screening review option? Be wary of reviewers who advertise minimal cost reviews – it is probable that either they are less experienced or are using this as an entry for higher cost services. The fees for reviews must be appropriate, with lower cost options for initial screening and then the fees for more detailed assessments and reports based on the time and skills that are necessary. Your reviewer should also be able to provide reviews within a shorter timeframe when necessary.

9. Are detailed narrative critique reports available that will clearly explain any errors and the rationale for the correct ratings? Reports should be thoughtful and provide information in a manner which reflects professionalism and positive constructive feedback.

10. Does the reviewer collect and analyze data on every review and also provide you that data electronically? Beyond the value of the review for a specific case, it is very useful to collect and analyze group data which provides, for example, the value of specific diagnoses and performance of evaluators. For example, using such data we were able to assist one client in improving performance of their evaluators to a 97% substantial compliance rate compared to the observed substantial compliance rate in California of only 36%.

11. Can the reviewer provide you with both case specific summary and narrative reports, and group data? The reviewer should be able to provide the results of the analysis in formats based on your specific needs.

12. Does the reviewer have an effective quality assurance process? A process of total quality management is essential to assure that rating reviews are accurate and the system is such that the expectations of clients are always exceeded. This must be a highly disciplined, data-driven approach and methodology that focuses on developing and delivering near-perfect services.

Impairment.com is unique in meeting all of these criteria – we are your best solution to impairment rating reviews. We provide our clients with exceptional value and return on investment. Best practices includes screening all impairment ratings to assure accuracy and appropriate case management, and providing data essential for total quality management. Our core values are integrity, service and excellence.