Korean J Pain.  2010 Mar;23(1):28-34.

Comparative Analysis of the Independent Medical Examination Reports and Legal Decisions in Pain Medicine

• Nahm FS
• Lee PB
• Kim TH
• Kim YC
• Lee CJ

Abstract

BACKGROUND
An independent medical examination (IME) is a critical process for awarding reparation for injury. However, conducting an IME in pain medicine is very difficult, not only because pain is a subjective symptom, but also because there are no proper objective methods to demonstrate it. This study was conducted to compare IME reports and the court decisions on the disability status of the patients.
METHODS
We analyzed 79 IME reports and 25 corresponding court decisions on the disability status of patients. The diagnoses, causal relationships between the patients' status and the trauma, McBride's degree of disability, the American Medical Association's impairment ratings, the estimated annual cost for future treatment, and the necessity of care-giving were compared and analyzed.
RESULTS
The diagnoses in the 79 cases were complex regional pain syndrome (CRPS) type I (58 cases), CRPS type II (7 cases), peripheral neuropathy (5 cases), myofascial pain syndrome (4 cases), herniated intervertebral disc (2 cases), and fibromyalgia (1 case). The types of accidents were road traffic accidents (50 cases), military injuries (14 cases), industrial accidents (11 cases), and others (4 cases). The IME reports and the court decisions stated considerably different McBride's degrees of disability (P = 0.014). However, there was no significant difference in the estimated cost for future treatment between the IME reports and the court decisions (P = 0.912).
CONCLUSION
IME reports should be accurate, fair, and based on objective findings. Feedback on IMEs from the court decisions is helpful for reference use.

Keyword

disability evaluation; pain; work ability evaluation

MeSH Terms

Accidents, Occupational
Accidents, Traffic
Awards and Prizes
Causalgia
Disability Evaluation
Fibromyalgia
Humans
Intervertebral Disc
Jurisprudence
Military Personnel
Myofascial Pain Syndromes
Peripheral Nervous System Diseases

Figure

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  Fig. 1 Histogram of the court decision on the casual relationship between the accidents and the patients' status (%).

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  Fig. 2 Histogram of cost for future treatment estimated by the physicians (Korean won/year).

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