4/2000COPYRIGHT SCOTT HAINZ, D.C, DABQAURP DEFINITIONS

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP POSSIBILITY, PROBABILITY These are terms that refer to the likelihood or chance that an injury or illness was caused or aggravated by a particular factor.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP POSSIBILITY “Possibility” is sometimes used to imply a likelihood of less than 50%.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP PROBABILITY “Probability” is sometimes used to imply a likelihood of greater than 50%.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP CIVIL BURDEN OF PROOF n 51% or greater probability n “To a reasonable degree of medical certainty” n “More likely than not”

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP CAUSATION A physical, chemical, or biologic factor contributed to the occurrence of a medical condition.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP CAUSATION (considering two factors) 1.The alleged factor could have caused or contributed to worsening of the impairment, which is a medical determination.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP CAUSATION (considering two factors) 2.The alleged factor did cause or contribute to worsening of the impairment, which is a nonmedical determination.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP AGGRAVATION An ongoing effect which results in a physical worsening or accelerating of the underlying pathology. Sometimes you are asked to estimate the degree to which each of various occupational or non-occupational factors may have caused or contributed to condition.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP EXACERBATION A temporary increase in symptoms.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP RECURRENCE No identifiable incident as a trigger to the medical condition in question; rather, the patient has a resumption of symptoms or signs that can be related to the previously existing medical condition or injury.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP NEW INJURY With a new injury, an identifiable new incident must be shown to have caused the injury. If it is thought that a preceding factor or situation, such as one related to an illness or occupation, might have a role in the injuries development, then the causation must be established as described above.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP STANDARD OF CARE It is defined as a case and time-specific analytical process in all medical decision-making which produces a clinical benchmark of acceptable medical care.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP STANDARD OF CARE This standard must reflect the art (consensus of opinion of clinical judgement) and science (published peer review of literature) of medicine.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP STANDARD OF CARE This benchmark used to evaluate and guide the practice of medicine encompasses the learning, skill and clinical judgement ordinarily possessed and used by providers of good standing in similar circumstances.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP STANDARD OF CARE This standard must be uniform and timely for all health care personnel whether or not they are actually providing direct clinical care or reviewing the medical necessity of past, present, or future medical care.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP STANDARD OF CARE A violation of standard of care may result in underutilization of medical care, but also occurs when unnecessary care (overutilization) is provided.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP STANDARD OF CARE The standard of care is based on a national and clinical basis, rather than a local provider community or payor review basis.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP MALINGERING Malingering or exaggeration of symptoms of a disorder may be suspected when the individual’s symptoms are vague, ill- defined, over-dramatized, inconsistent, or not in conformity with signs or symptoms known to occur. The purposeful misrepresentation of the extent of disability.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP MAXIMUM MEDICAL IMPROVEMENT The time when the underlying condition causing the impairment has become stable, and nothing further in the way medical treatment can reasonably be anticipated to improve the condition.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP MAXIMUM MEDICAL IMPROVEMENT May be defined as “the date after which further recovery from, or lasting improvement to, an injury or disease can no longer reasonably be anticipated, based upon reasonable medical probability.”

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP DISABILITY n A physical or mental impairment that substantially limits one or more major life activities of an individual, a record of such an impairment, or being regarded as having such an impairment.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP DISABILITY n An alteration of an individual’s capacity to meet personal, social, or occupational demands, or statutory or regulatory requirements because of an impairment.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP IMPAIRMENT n The loss or use of, or derangement of, any body part, system, or function; an alteration or an individual’s health status that is assessed by medical means.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP PERMANENT AND STABLE n The clinical condition is not likely to improve with surgical intervention or active chiropractic treatment. Maintenance care only is warranted. The degree of impairment is not likely to change greater that 3% during the next 12 months.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP PERMANENT PARTIAL DISABILITY n Some ongoing disability, however able to perform certain activities.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP PERMANENT TOTAL DISABILITY n Totally and permanently unable to ever perform any gainful employment.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP TEMPORARY PARTIAL DISABILITY (TPD) n Defined as “injured worker is back to work, part-time or “light duty” and may be earning less than they earned at the time or injury or accident”.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP TEMPORARY TOTAL DISABILITY(TTD) n Defined as “claimant (patient) in unable to return to work at any type of substantial and gainful employment”.

4/2000COPYRIGHT SCOTT HAINZ, D.C, DABQAURP DEFINITIONS OF WORK

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP WORK n Occasionally: activity or condition exists up to 1/3 of the time n Frequently: activity or condition exists from 1/3 to 2/3 of the time

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP SENDENTARY WORK n Defined as “Exerting up to 10 pounds of force occasionally, and or a negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects, including the human body”.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP LIGHT WORK n Defined as “Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects”.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP MEDIUM WORK n Defined as “Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to more objects”.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP HEAVY WORK n Defined as “Exerting 50 to 100 pounds of force occasionally, and/or 25 to 50 pounds of force frequently, and/or 10 to 20 pounds of force constantly to move objects”.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP VERY HEAVY WORK n Defined as “Exerting in excess of 100 pounds of force occasionally, and/or in excess of 50 pounds of force frequently, and/or in excess of 20 pounds of force constantly to move objects”.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP MAXIMUM MEDICAL IMPROVEMENT Return to pre-injury/illness status or failure to improve beyond a certain level of symptomatology or disability, whatever the treatment/care approach.

4/2000 Copyright SCOTT HAINZ,D.C., DABQAURP NATURAL HISTORY The anticipated clinical course of recovery for uncomplicated disorders either without treatment/care, or with conservative treatment/care.