Journal of Occupational & Environmental Medicine:
Letters to the Editor
Talmage, James B. MD, FAADEP, FACOEM; Martin, Douglas W. MD, FAADEP, FACOEM
President, American Academy of Disability Evaluating Physicians, Chicago, Ill
Past President, American Academy of Disability Evaluating Physicians, Chicago, Ill
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To the Editor:
We, the leadership of the American Academy of Disability Evaluating Physicians (AADEP) read with interest the article by Forst et al1 and the subsequent commentary by Rondinelli2 titled “Reliability of the AMA Guides to the Evaluation of Permanent Impairment” (J Occup Environ Med. 2010;52:1201–1205).
We would like to point out an error on page 1204 in Dr Rondinelli's commentary wherein he writes “A number of educational venues are available to afford opportunity for physicians to gain the necessary knowledge and expertise to perform ratings correctly (see, for example, courses8,9 and certifications8 offered regularly to physician raters); such courses typically require several days of intensive didactics and precourse preparation as well as some operating familiarity with the AMA Guides to complete the training course with optimal proficiency.”2
Within the above sentence, reference number 9 is to our organization, the American Academy of Disability Evaluating Physicians. We would respectfully point out that AADEP has offered a certification examination known as Certified Evaluator of Disability and Impairment Rating (CEDIR) since 2002, which was omitted from the article's reference.
Since the inception of AADEP in 1987, it has been our experience that little training in impairment rating evaluation occurs in either medical school and/or residency training programs and as a result, physicians involved in this aspect of medical evaluation typically seek training from organizations such as ours.
We agree with the authors that the six questions posed at the end of the article serve as a framework for further research and investigation. As they have pointed out, the differences in the AMA Guides edition rating methodologies have led to much debate. To that end, our CEDIR examinations are edition-specific; currently offering a CEDIR-IV, CEDIR-V, and CEDIR-VI that correspond to the varying state jurisdictional Guides edition usage.
As Dr Rondinelli has pointed out and as our data confirms, the number of physicians who perform impairment rating examinations is a very small slice of all practicing physicians, across all specialties. AADEP, by its structure as a membership organization that has been seated in the AMA House of Delegates since 2005 as a specialty society, has provided a venue for these physicians to maintain an ongoing collegial dialogue concerning many of the challenges and dilemmas that both the article and the commentary discusses.
James B. Talmage, MD
President, American Academy of
Disability Evaluating Physicians
Douglas W. Martin, MD
FAADEP, FACOEM, FAAFP
Past President, American Academy of Disability Evaluating Physicians
1. Forst L, Friedman L, Chukwu A. Reliability of the AMA guides to the evaluation of permanent impairment. J Occup Environ Med. 2010;52:1201–1203.
2. Rondinelli RD. Commentary on reliability of the AMA guides to the evaluation of permanent impairment. J Occup Environ Med. 2010;52:1204–1205.
8. American Board of Independent Medical Examiners. Available at: http://www.abime.org
. Accessed November 8, 2010.
9. American Academy of Disability Evaluating Physicians. Available at: http://www.aadep.org
. Accessed November 8, 2010.