Academy of Chiropractic

Quickie Podcast 1245
Clinical Information 281 CI

From the Desk of Dr. Mark Studin
Academy of Chiropractic

Preamble: Many of the issues I bring to you are very small, yet each issue is just that, an issue. If you take care of the small issues, then you will be able to build and more importantly, focus on the bigger issues...a larger practice and more family time. -Mark Studin 2006

"Pro-Rating Impairments"


Dr Studin: So what's the issue?

Guest Dr: I decided to recommit myself to the course cause I wasn't seeing the results. I feel like I should've seen in the time that I've been awarded with you.

Dr Studin: I've lectured in your area many times, hundreds of lawyers, it works. No different from Where you are, where everyone else is. It's not the lawyers that don't work. It's usually the doctor that doesn't have the knowledge or the credentials to communicate what's going on. Now you started talking about um, uh, x-ray digitizer. so why don't you delve into that a little more and I will pick up the conversation after you pose the issue.

Guest Dr: So the issue was once I went through the council to gain, cause I read them all initially and I'm going through them all over again.

Dr Studin: are you doing the podcasts?

Guest Dr: Yeah, I'm listening to the podcast. And what I came across then, something that actually kind of bothered me a little bit last time was the impairment rating for ligament laxity and you say that kind of letting the attorney know that Hey 60% of your clients can have a 25% impairment rating. And I was bothered by that cause wait a minute I said to designate doctor work here in Texas and sort of an impairment rating by the state and they know the AMA guides that you only get that 25% if it rises to a certain degree.

Dr Studin: the issue is based upon working with a doctor Previously he certified that based upon his algorithm that he has computer program he found and he used the number 70% actually met that standard. Now I've not done that independently. It's not my work. I'm just reporting what was told to me, Here's what we've done now. First of all, how do you certify to an attorney that there's a 25% whole person impairment? My goodness, that's the same as the few submit. That's the same as an amputated leg. That's a big number. Now have you taken the spinal trauma pathology course or the connective tissue pathology course?

Guest Dr: I haven't taken those yet.

Dr Studin: Therefore you don't understand the physiology behind that statement and that's a problem, that's where academics come in, Because you're a qualified to argue that, all you know how to do is apply an impairment rating based upon formulas you're doing qualified by the state of Texas and the courses that you took. But any lay person can look at a report and come up with a number.

It's the doctor that has to make the diagnoses and apply that number based upon human physiology and you don't understand the human physiology at the moment well enough because if I talk about collagen and then the last one being replaced with just collagen not having a less than in there creating internal actions and as evidenced by the literature which says that tissue shall never ever repair certifies that's permanent. You see, these are the things you need to understand the need to see visually so you can teach it. They could get the lawyer to understand what's going on. With that being said, most of the x-ray digitizing platforms out there, and right now we're recommending if you're not doing it yourself to use spinal kinetics. However, we also realize that it's an all or none deal. So in the cervical, and I know you're familiar with the numbers because you do work with it, if it's 3.3 millimeters, it doesn't qualify a raised race to the standard of 25% whole person impairment. So therefore there's no lacks of ligament. However, The entire system predicated on meeting the AMA guides for impairment rating, not tissue pathology big difference between tissue pathology and impairment rating. Now there is literature which says that in translation the ligament is tolerance is 0.6 millimeters. That's it. the ligament its tolerance is 7 degrees in angle deviation, both of them, the sagittal plane, but 11 degrees is required for 25% holders of impairment. So does that mean if you're 3.3 millimeters, you're perfectly fine and you're a hero? Of course not. I guess the literature says that ligament starts to become pathological in 0.6 millimeters. So what we've done is we've created, and we just actually today we just released it this morning, there is a program called SYMVERTA. We've been working on it for almost three years, and it's the only program of the world that Prorates impairment rating based upon the literature standard and it's all evidence-based. It's not our opinion. So we will go between that 0.6 millimeters and the 3.5 millimeters and we'll pro rata the impairment for cervical and the 0.6 to 4.5 in the lumbar and pro-rata the impairment, it does it in automates and it's wonderful and it's easy to use and it's incredible. You do that yourself and you could bill for it. By the way, I think the average bill, not that I'm setting fees, I'm just saying what people tell me they charge $450 an exam to do that to your office. And how would you explain this to the attorney? And by the way, you're really determining strengths brain. That's all this is because it's connective tissue disorder. So how could you say it's 25% because it says so in the book, all you do is take a ruler out and you measure, you're just the reporter. How do you know what's permanent? Because the literature says it never gets better. It's all evidence-based, remember This is also the standard of both medical and chiropractic academia. This is what is being taught currently because I'm the one that's teaching it.

Guest Dr: And the mistake I was making is actually when I sent you that email saying that very few rests at that level and I spoke to another doc and of course that's killing it in Austin because I wasn't digitizing. So I actually currently just started digitizing.

Dr Studin: So you've been cutting corners?

Guest Dr: Yeah, I hadn't even didn't done to digitize them yet. But I did take the spine biomechanics course. I did the MRI course and all the bootcamp and I actually literally just purchased the own X and every construction course.

Dr Studin: you need to conclude your trauma qualification, Right now you have other doctors in your region that have already done that, so what you need to do is your competition is making you irrelevant, your competition is making you what elements you got to be careful. You've got to make your competition irrelevant. And the only way to do that is through academics and academia, it's not negotiable. 

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