Low-Back Impairment Rating Practices of Orthopaedic Surgeons

Physicians' impairment ratings are an integral part of disability determinations. There are major difficulties in rating impairments manifested principally by pain (such as low-back pain), primarily owing to the relative absence of objective findings. Since there are no universally accepted criteria for rating low-back impairment, the authors have attempted to establish a notion of the impairment rating practices of orthopaedists through a survey. It is clear that many criteria apart from the physical examination are considered in rating low-back impairment, in spite of the fact that in most compensation or legal systems such ratings are supposed to consider only objective physical findings. Ratings are ordinarily not given until an average of 8.9 months after an injury and 9.7 months after surgery. Many orthopaedists probably give ratings in the absence of objective physical findings. Rating practices vary widely from physician to physician.