Aadep

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http://www.aadep.org/

based on the thread on here about MMI,etc. Any of you belong to the above organization? Is it worth joining?

Apparently some states want you to be 'certified' by them in order to see WC pts and those looking for disability.

The organization claims they try to be objective and get people back to work,etc. For someone that's coming from an anesthesia background do you think it would help as they help you navigate through terminology like MMI, impairment scales,etc. Correct me if I'm wrong, but especially with some of these WC cases, it seems that learning this terminology will help quantify the injury so that malingerers have less ground to stand on....thoughts?

on the flip side, when I looked at some power points from some of their presenters they do not seem to be interventionally inclined. For example, one of them states " there is not evidence that surgery or facet injections help for cervical radiculopathy". Well of course facet injections do not work for cervical radiculopathy, it's not what the injection is intended for!!!

Doing PMR since 2001 and Pain since 2004. Never heard of them. THere are lots of folks who want your dollar for lots of reasons. ADd this org to the list.

Same for SEAR or SEAL or whatever it is, and the ICE academy or group.
None of it useful or valid or needed.

In general WC organizations neither acknowledge nor permit treatment of patients with chronic pain. They believe pain is a symptom of an injury and cannot fathom pain would exist for more than 2 months. If it does, the worker is simply faking, the doctors treating them are all frauds, and the goal of WC becomes finding technical ways to jettison the person from the company payroll without having to engage in any long term obligations for treatment. They adopt adversarial posturing and frequently physicians end up giving depositions or testifying in court against the insurance carriers.

Originally Posted by algosdoc

In general WC organizations neither acknowledge nor permit treatment of patients with chronic pain. They believe pain is a symptom of an injury and cannot fathom pain would exist for more than 2 months. If it does, the worker is simply faking, the doctors treating them are all frauds, and the goal of WC becomes finding technical ways to jettison the person from the company payroll without having to engage in any long term obligations for treatment. They adopt adversarial posturing and frequently physicians end up giving depositions or testifying in court against the insurance carriers.

so are you implying that an oganization like this would be useless (FADEP)?

I went to their course last year because in Texas they require one of those courses and an exam to be a "certified examiner". You can treat work comp patients without the certification but to be a designated doctor or to be able to do disability ratings, the exam is needed.

I cringed in most of the lectures - because many of the lecturers are FPs and occ med docs who are anti-interventions and the assumption is that most workers fake the extent of their injuries. I sat through a lecture going over cases where the entire room groaned and rolled their eyes when the lecturer said, " and then, the pain management doctor diagnosed the patient with CRPS..." They hate CRPS or don't believe in them and they don't believe in interventions as well. They see the patients and pain docs as their enemies - and the animosity in the room was palpable.

I do think that there is overutilization of procedures and non-qualified "pain doctors" in the work comp system - but it seems most of the peer reviewers are ADEP members - and they are in the role where they are incentivized to deny procedures. For CRPS patients in particular, this leads to a delay in treatment - which can be detrimental for return to work prognosis.

Originally Posted by axm397

I went to their course last year because in Texas they require one of those courses and an exam to be a "certified examiner". You can treat work comp patients without the certification but to be a designated doctor or to be able to do disability ratings, the exam is needed.

I cringed in most of the lectures - because many of the lecturers are FPs and occ med docs who are anti-interventions and the assumption is that most workers fake the extent of their injuries. I sat through a lecture going over cases where the entire room groaned and rolled their eyes when the lecturer said, " and then, the pain management doctor diagnosed the patient with CRPS..." They hate CRPS or don't believe in them and they don't believe in interventions as well. They see the patients and pain docs as their enemies - and the animosity in the room was palpable.

I do think that there is overutilization of procedures and non-qualified "pain doctors" in the work comp system - but it seems most of the peer reviewers are ADEP members - and they are in the role where they are incentivized to deny procedures. For CRPS patients in particular, this leads to a delay in treatment - which can be detrimental for return to work prognosis.

I believe 1/10 to 1/100 CRPS diagnoses are with merit.
SML

Originally Posted by axm397

I went to their course last year because in Texas they require one of those courses and an exam to be a "certified examiner". You can treat work comp patients without the certification but to be a designated doctor or to be able to do disability ratings, the exam is needed.

I cringed in most of the lectures - because many of the lecturers are FPs and occ med docs who are anti-interventions and the assumption is that most workers fake the extent of their injuries. I sat through a lecture going over cases where the entire room groaned and rolled their eyes when the lecturer said, " and then, the pain management doctor diagnosed the patient with CRPS..." They hate CRPS or don't believe in them and they don't believe in interventions as well. They see the patients and pain docs as their enemies - and the animosity in the room was palpable.

I do think that there is overutilization of procedures and non-qualified "pain doctors" in the work comp system - but it seems most of the peer reviewers are ADEP members - and they are in the role where they are incentivized to deny procedures. For CRPS patients in particular, this leads to a delay in treatment - which can be detrimental for return to work prognosis.

see...i figure going to one of these courses might be helpful in the sense that you can learn what they are looking for when they deny payment. This may then give you some insight in trying to advocate for your patients.

SEAK is actually pretty good if you're looking for bread and butter expert witness skills. Just remember: everyone is a stakeholder in something.

Originally Posted by axm397

I went to their course last year because in Texas they require one of those courses and an exam to be a "certified examiner". You can treat work comp patients without the certification but to be a designated doctor or to be able to do disability ratings, the exam is needed.

I cringed in most of the lectures - because many of the lecturers are FPs and occ med docs who are anti-interventions and the assumption is that most workers fake the extent of their injuries. I sat through a lecture going over cases where the entire room groaned and rolled their eyes when the lecturer said, " and then, the pain management doctor diagnosed the patient with CRPS..." They hate CRPS or don't believe in them and they don't believe in interventions as well. They see the patients and pain docs as their enemies - and the animosity in the room was palpable.

I do think that there is overutilization of procedures and non-qualified "pain doctors" in the work comp system - but it seems most of the peer reviewers are ADEP members - and they are in the role where they are incentivized to deny procedures. For CRPS patients in particular, this leads to a delay in treatment - which can be detrimental for return to work prognosis.

Everywhere I have practiced Work Comp and pain management are incompatible. WC simply does not have allowances in either laws or the pea-brained minds of WC adjusters to handle it.

The best thing you can do for a WC pt who has chronic pain is declare them at MMI, let them settle, then treat their pain. Everything else is an exercise in futility and frustration.

WC is not set-up to handle pain. It is, by it's very nature, subjective, and therefore, not taken into account. 99% of what we do in pain management is palliative. WC is set up to restore pts to previous level of function (working FT) or compensate them mfor their losses.As Palliative treatments will not restore a chronic pain pt to FT work, de facto, pts undergoing palliative treatments are at MMI. You'll make your life a lot easier when you start thinking this way.

The problem ensues when the patient and his/her lawyer refuse to give up the WC claim, waiting for the lottery winnings at the end. The pt pays lip service to "all I want to do is get better" but we all know the overwhelming vast majority of WC cases over 6 months old have almost zero chance of RTW. Let them fight their battles and come back to you when it's over. It simply is not worth it to be caught up in their battle, especially when they expect you to pick up the battle standard and run with them.