Determination of loss of quality of life

Factors Considered by Vocational Rehabilitation Professionals in Employability and Earning Capacity Assessment

The purpose of this study was to identify the factors that contributed to vocational rehabilitation assessment of earning capacity. Rehabilitation professionals who attended a national forensic rehabilitation conference were asked to rate the importance of 26 variables in development of opinions of earning capacity. Exploratory factor analysis revealed four themes in the responses: intrinsic characteristics of the worker, transferable skills components, worker traits, and labor market conditions. Multivariate analysis of variance found no significant differences in mean importance of the factors among forensic rehabilitation professionals practicing in different legal forums or in retention by plaintiff, defense, or neutral status, as well as no significant interactions. The results of this study will assist in the establishment of a standardized methodology for developing opinions of earning capacity consistent between forums of practice and competing parties in adjudication of vocational disability claims.

American Academy of Disability Evaluating Physicians (AADEP) position paper: complex regional pain syndrome I (RSD): impairment and disability issues

OBJECTIVE

To provide an overview and methodology for the evaluation of impairment and functional residual capacity in complex regional pain syndrome I (CRPS I, RSD). This paper is intended to provide assistance to physicians asked to evaluate impairment- and disability-related issues and is not primarily geared to guide treatment of the CRPS I patient.

METHOD

Conference and literature review by neurology, anesthesiology, pain medicine, physiatry, and disability evaluating physicians followed by description of issues, options, and recommendations based upon the committee's deliberations and the widely used AMA Guides to the Evaluation of Permanent Impairment, fourth and fifth editions. The authors present functional criteria for assessing the severity of CRPS. These criteria were developed by committee consensus opinion based on multidisciplinary clinical experience considering daily functional issues. They can be used in conjunction with CRPS-ADL Classes of Impairment in order to categorize an individual into a specific class for purposes of permanent impairment rating. Future reliability and validity studies of this rating scale are pending future use, acceptance and, hopefully, additional studies.

RESULTS

Evaluators should perform a comprehensive assessment of patients with CRPS I to make an accurate diagnosis and exclude other conditions that could explain the symptoms and signs of the condition. While radiological, laboratory, and other diagnostic studies may be of assistance in making the diagnosis, in the final analysis, this is a clinical diagnosis. Impairment is based on objectively validated limitation in activities of daily living (ADL).