Disability Evaluation, 2nd ed.

Demeter SL, Andersson GBJ, eds. St Louis, MO 63146, Mosby Inc, 2003, hardcover, 956 pp, illus, ISBN: 0-32300959-X, $89.95.

This revised edition of Disability Evaluation was written and copublished with the American Medical Association (AMA) as a companion to the latest versions of the AMA Guides ,for the Evaluation, of Permanent Impairment and to provide updated information on the evaluation of impairments and disability. The AMA Guides set the standards for physician evaluations for impairments, disabilities, and handicaps. Analogous to the Guide to Physical Therapist Practice, the AMA Guides provide physicians with information on preferred practices, and they are organized to address all systems of the body. Seventy authors contributed to the 69 chapters in Ibis book; however, only one of these chapters is written by a physical therapist.

According to the text, the physician's role in the evaluation of impairment or disability is to contribute medical information and not to serve as the primary decision maker. In the model used to illustrate the flow of information to the final decision maker, physicians are at the bottom of a pyramid, with physical therapists, occupational nurses, and human resources personnel above them. The primal)' purpose of this book is to explain the methods used in disability' evaluation and to provide an evidence-based resource on the topic, filling in where the AMA Guides leave off. For example, in the chapter on radiologic imaging, specific studies using imaging were cited as one way to reduce the use of arthroscopy as a diagnostic procedure. In the chapter on pulmonary impairment, specific examples of impairment ratings are discussed and portions of the AAIA Guides' information are interpreted to improve the accuracy of ratings. Although the emphasis throughout the book is on physicians, physical therapist and other health care providers who provide disability and impairment evaluations and documentation would find portions of this book helpful.

This text is organized into 4 main parts: "Introduction," "Impairment," "Disability," and "Appendices." The 11 chapters of the "Introduction" part discuss the federal and stale workers' compensation programs and Social Security and present an overview of the legal system. New chapters on causality and evidence-based medicine were added to this part, and references throughout the chapters in part I have been updated from the first edition, which was published in 1996. Part II addresses impairment, and the 30 chapters in this part cover the musculoskeletal, internal medicine, neurologic, and psychiatric impairment assessments. The medical basis for determining levels of impairment is well presented, with classification systems incorporated where appropriate. Physical therapists will find part I informative, and they also will gain an appreciation for the role of the physician in establishing impairment and disability ratings. Part II will provide the medical viewpoint for establishing levels of impairment and disability' and will reinforce the various classification criteria that physicians use to determine different levels of impairment. Because tables from the AMA Guides are included in the text with explanations for application, physical therapists will gain a better understanding of the classification system that physicians use.

Within part III, "Disability," the individual chapters present information on the evaluation of disability, fitness for duty, functional capacity testing, and guidelines tot specific jobs (eg, work with the Federal Aviation Administration, requirements for commercial drivers, and Department of Labor guidelines for job categories). This last group of guidelines addresses lifting and carrying requirements that are used to classify the functional demands of a job. These chapters also address the same 4 main areas as part II: mnsculoskeletal, internal medicine, neurologic, and psychiatric concerns. Each chapter in the first 3 parts has an extensive bibliography containing citations that provide an evidence base for that particular topic; references in the revised chapters were updated through 2001.

The final section, "Appendices," has samples of the required evaluation forms, information on completing the forms, and a national resource list that includes federal agencies, the state rehabilitation agencies, and special interest organizations for a wide variety of diseases and conditions. This listing would be useful for anyone who needs additional information beyond that presented in the text; each listing is complete with mail, phone, and Internet contact information.

Disability Evaluation provides a comprehensive resource for anyone who completes disability evaluations, and its evidence-based format is valuable in light of the demands of current practice. In this second edition of Disability Evaluation, part I was completely updated, part II is now matches the latest version of the AMA Guides, and part III was expanded to address return-to-work issues. The references in this book provide a solid foundation for evidence-based practice in the area of disability evaluation, and, with this comprehensive starting point, physical therapists would find this book to be a good source for recent evidence-based literature. This is clearly a specialized text that could be used as a resource by clinicians completing this type of evaluation; its value is in providing information about all of the body's systems, legal concerns, regulations, and agencies in a single source.

Linda J. Tsoumas, PT EdD Springfield College Springfield, Mass

Dr Tsoumas is Associate Professor in the Department of Physical Therapy with teaching experience in the area of management patient with neurologic conditions, pediatrics, and administration.