Impairment Reviews

Impairment review is the analysis of an impairment rating report to determine the accuracy of the assessment and the numeric rating.

Impairment ratings are typically based on the AMA Guides to the Evaluation of Permanent Impairment (Guides). Impairment ratings should be correct and unbiased; unfortunately, most are not. Studies have documented the observation that most ratings are higher than the clinical data would support; however, sometimes, ratings may be lower than appropriate. We will help you ensure ratings are accurate.

Why are impairment ratings erroneous? Most physicians lack skills in the use of the Guides. Erroneous ratings also result from inaccurate clinical assessment, faulty causation evaluation, inaccurate determination of maximal medical improvement, use of unreliable data, lack of impairment analysis skills and/or bias.

“…our physician consultants are involved in editing or writing the [AMA] Guides; our opinions are authoritative. …all our analyses are completed by a board-certified physician who understands both clinical and claims issues.”

The critical review of an impairment rating requires knowledge, skill and experience in clinical analysis, causation evaluation and use of the Guides. We are unique in that our physician consultants are involved in editing or writing the Guides; our opinions are authoritative. Medical issues are often complex and require physician discernment; therefore, all our analyses are completed by a board-certified physician who understands both clinical and claims issues. This distinguishes Brigham and Associates, Inc. from other organizations and ensures our clients that our conclusions are both insightful and supportable. It is essential to determine that the clinical data used as the basis for the rating is both reliable and is the result of the injury. Our analyses are consistent with jurisdictional and system requirements.

We can provide you with an emailed summary or a detailed written report. Our reports are used for several purposes, including case management, evidence, feedback to the original rating physician, negotiation, cross-examination preparation and as a determinate in defining case reserve or settlement value. We will discuss with you strategies to remedy an erroneous impairment rating which may include assisting your counsel in developing an effective cross-examination.

We are also experienced in performing ratings that comply with any edition of the Guides, including the most recent Sixth Edition, and translating impairment ratings into California Permanent Disability Ratings (PDRS). Dr. Brigham served as the Senior Contributing Editor for the Sixth Edition of the Guides, with responsibility for the musculoskeletal chapters, and is Editor of the AMA Guides Newsletter.

Referrals may be made online. Our process is secure and efficient.