Book Review: AMA Guides to the Evaluation of Work Ability and Return to Work, Second Edition

Abstract

American Medical Association, 2011Reviewed by David A. Fetter, MD, FAAOS, FAADEP, CEDIRDiplomate American Board of Orthopaedic SurgeryFellow American Academy of Orthopaedic SurgeonsFellow American Academy of Disability Evaluating PhysiciansCertification in Impairment and Disability Rating - American Academy of Disability Evaluating PhysicianThe second edition of “Return to Work,” in one word, is a masterpiece. The authors are to be congratulated for their scientific approach to a topic that at times has nonscientific contributing factors to consider.The preface to the second edition acknowledges the increasing importance of evidence-based medicine concepts to support physician opinion reports. Today's health care medical provider is asked on an increasingly frequent basis to issue a report, including an opinion for work return, by insurance adjustors, attorneys, and other third parties, sometimes with little knowledge of complex medical issues. The primary care physician, occupational medicine, physical medicine, orthopedic, neurological surgeons, and other specialists are frequently involved in opining with “reasonable medical probability” and with civil penalties imposed for basing an opinion on “junk science” or only “personal anecdotal experience” if the opinion is contrary to evidence-based medicine concepts. For adjustors, administrative and civil law judges, and others involved in the daily decisions including workers' compensation and personal injury claims, it is imperative that the medical physician's opinion withstand Daubert and other legal challenges. It is important that physicians take as much time as required to continually update their knowledge to support their verbal or written opinions with evidence-based medicine concepts (EBM) as referred to throughout the second edition of Return to Work.The table of contents in the second edition includes new topics, specifically Chapter 24, “International Perspectives on Return to Work.” As the focus of health care shifts to diagnosis-based–evidence-based medicine treatment and duration of treatment, not only in the United States, but throughout the world, the authors note the importance of the physician-coded International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnoses. Although the introduction in the second edition for assistance in disability duration is mainly focused on the USA, the reference to other evidence-based medicine (EBM) guidelines including the Official Disability Guidelines (ODG) as well as the MDGuidelines applies worldwide.The Chapter 6 authors have updated the current concepts in regard to risk, function, and tolerance. The physician needs to read and re-read this chapter and know the difference as it applies to work capability prior to opining on ability to return to work. Although there are circumstances when an individual is unable to work even with modifications or is unable to return to a prior occupation/employment, the vast majority of common diagnoses (including cervicalgia, lumbago, and strains/sprains) for which billions of health care funds are expended and enormous lost time from work occurs, are topics addressed in detail. When an employee misses any time from work from a work-reported or other claim, the provider will want to document why an injured individual cannot return to work.A few words the reader can “take home” from Chapter 1 are summarized in a consensus statement by the American Academy of Orthopaedic Surgeons and a policy statement of the American Medical Association: early, safe return to work is in the best interest of our patients.In closing, I recommend this book to all medical providers, as well as adjustors, attorneys, administrative and civil law judges, and all who are involved in the evaluation, treatment, and disability determination of injured, or reported injured, individuals who are able to perform work. This book is a must.Please refer to the AMA's e-book library that allows easy access to read on a computer, phone, or notepad while traveling. The softbound book is available as an e-book in a PDF format.