Academy of Chiropractic’s Lawyers PI Program

Narratives #55

From the Desk of :
Mark Studin DC, FASBE (C), DAAPM, DAAMLP

“Reporting Atrophy”

This is about as easy as it gets and yet another issue that although clinically sounds leaves you with your head scratching. You ask yourself “what does this have to do with my patient’s current condition?” …and it often doesn’t make sense… This time it does and most of us aren’t prepared. 

Many carriers are severely downgrading cases if no atrophy is reported. They feel that if that there is no de-conditioning syndrome evidence, then the problem will resolve and is transient. The problem with this is many-fold as we all know that motor nerves (ventral roots) can be intact, while sensory (dorsal roots) can be irritated, compressed, etc… and have long-term pain sequella. 

The problem that arises with the carriers, is they are using the AMA Guides to their advantage and stating that unless radiculopathy is present, only a minor impairment can be considered. Therefore they are associated atrophy as the end result or sign of permanent long-term radiculopathy. 

Although there can be verification of long-term negative sequella from the dorsal roots, you have two choices, either verify the atrophy with a tape measured analysis, or collaborate your non-atrophy findings with other specialists to verify bodily injury and persistent functional losses in a non-atrophy scenario. 

RULE OF THUMB: 

Positive atrophy findings: The patient with atrophy becomes easy to document and verify functional losses

Negative atrophy findings: You must have collaborative findings indicating functional losses and AOMSI through x-ray digitizing qualifies