Critical Reviews™ in Physical and Rehabilitation Medicine

ISSN for PRINT: 0896-2960

For Online Access

Best Paper Award Selection - Editorial Board Site

2000, Volume12

Issue 4

104 pages

Issue price - $163.00

Richard T. Katz
Associate Professor of Clinical Medicine, Physical Medicine and Rehabilitation, St. Louis University School of Medicine, 4660 Maryland Avenue, Suite 250, St. Louis, MO 63108

Many physicians are asked to participate in disability ratings. Disability rating physicians should understand the relationship between impairment, disability, and handicap. Disability related to low back pain has a long history, high prevalence, and huge costs. Patients may receive disability from various programs not limited to Worker's Compensation, Social Security, and Long Term Disability Insurance. The extent of disability in the job site must be viewed in relationship to occupational strength requirements classification, as well as reasonable accommodation under the auspices of the Americans with Disabilities Act. The American Medical Association Guides to the Evaluation of Permanent Impairment (Guides) is used in some capacity in most worker compensation jurisdictions, and serves as an important reference work in others. The fourth edition of the Guides is the mandated edition in most jurisdictions, and the fifth edition is in preparation. Many psychosocial problems complicate simple low back pain problems. Rating low back disability based on pain complaints only, without objective underlying impairment, is a precarious practice, and argument is made it cannot be reliably performed.

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