Flash Rating

This AMA Guides 5th Edition impairment rating has been performed using Flash Rating technology. Flash Ratings are compliant with all relevant administrative rule sets, such as the AMA Guides and state regulation. Benefits of Flash Ratings include higher accuracy, improved sensitivity for Activity of Daily Living (ADL) function, and full parity with Almaraz-Guzman ratings.

Other advantages of Flash Ratings include improved assessment of apportionment and elimination of the need for additional “pain add-on” or AMA Guides Section 1.2 ratings.

Flash Ratings remove the “noise” and errors of conventional chapter ratings due to low data integrity resulted from variation across different medical evaluators. The Flash Rating is designed to reflect the true loss of an industrial injury.

In conjunction with retired workers’ compensation judge Hon. Steve Siemers, Dr. John Alchemy and RateFast have authored an educational course “Activities of Daily Living AMA Guides 5th Edition A Practical Approach and Application.” This course has been approved by the California DWC Medical Unit to be used for continuing education credits for qualified medical examiners (QMEs). The course explains the foundational understanding of properly interpreting activities of daily living (ADL) values in impairment ratings. Flash Ratings utilize this rating theory.

To understand the application of the AMA Guides 5th Edition and Flash Rating, one must first understand three key concept. Items 1, 2 and 3 are cited in the rating:

  1. Whole Person Impairment (WPI) is an estimate of Activity of Daily Living loss. “The whole person impairment percentages listed in the Guides estimate the impact of the impairment on the individual’s overall ability to perform activities of daily living, excluding work, as listed in Table 1-2.” Page 4. The WPI is the “estimate” of the ADL functional loss, not the reverse. Calculating ratings based on ADL loss is direct and defensible WPI value creation, as opposed to the ratings determined based on estimates, flawed measurements, and incomplete references to tables from The Guides.
  2. Impairment can be manifest by pain and fatigue (e.g. ADLs). “An impairment can be manifested objectively, for example, by a fracture, and/or subjectively, through fatigue and pain.” Page 5.
  3. There is fixed 1:1 relationship of %WPI to %ADL functional loss. “For example, an individual who receives a 30% whole person impairment due to pericardial heart disease is considered from a clinical standpoint to have a 30% reduction in general functioning as represented by a decrease in the ability to perform activities of daily living.” Page 5.
  4. The AMA Guides use interpolation and impairment average weighting methods which are described and illustrated in multiple sections throughout the AMA Guides 5th Edition (References: Interpolation: Pages 20, 453, 455, 456, 457, 459, 460, 461, 462, 463, 464, 466, 467, 468, 470, 471, 472, 474, 475, 476, 478, 538, and 549; Impairment average weighting: Pages 284, 289, 296 and 328). The rating value in this report is calculated by using the trapezoidal numerical method of loss under the injured worker’s ADL curve with an integral function using interpolation (y = y1 + ((x – x1) / (x2 – x1)) * (y2 – y1). The upper bound of the maximum value of the body system/body part is referenced in the PR-4 Report.

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