By way of context, it is no secret that there is a profound disagreement between many medical experts in the field of disability assessment as to the exact role that the AMA Guides play in determining catastrophic impairments under the Schedule. The prime dissident group rallying against the interpretation taken by the courts and arbitrators to date (the Desbiens approach) is centred around the position taken by Dr. Brigham, a prominent American advisor on disability issues.
Dr. Ameis, whose article on Impairment Evaluation is cited by Economical clearly falls into the Brigham camp. Indeed, Dr. Brigham is listed as a co-author of the article.
One of Dr. Brigham’s claims to fame is that he participated in the development of the original guidelines, and claims to have a special insight into what was intended by the committee which draughted the original guidelines. Dr. Ameis and Dr. Brigham have posited that the intention or original meaning of the provision was that no numeric rating could be given to psychological disorders, with the result that such disorders could not directly be added to the numerical physical rating to push the whole person impairment over the necessary threshold for catastrophic impairment.
It is clear from the Catastrophic report of the Custom Rehab team, headed by Dr. Rehan Dost, neurologist, that the Insurer’s experts were firmly in the Brigham/Ameis camp, finding a 20% whole person impairment, when, as they acknowledged in their own report, the amount under a Desbiens approach would have been 55%.
Indeed, Economical has acknowledged that should the Desbiens approach be found to be appropriate, Ms. Augello would meet the criteria for catastrophic impairment.