April 21, 2014 07:45:49
Posted By John Reilly
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CIRCUMFRANCE DIFFERENTIAL - No, this is not a mathematics
exercise. When someone is complaining that they have great pain
in an "extremity" (arms being upper extremities and legs being
lower extremities), the IME doctor will often measure places on
both the allegedly affected leg or arm and the corresponding leg
or arm that is not affected by the condition or injury.
The theory is that if a person is in pain or has lost partial use
of a limb, his or her muscles will "atrophy" (gradually decrease
in size) due to lack of use. If there is a perceptible
difference (affected limb's muscles smaller than "normal" limb),
this is felt to be having an issue (pain or disability) with that
arm or leg. If there is no perceptible difference, the IME
doctor will often us this fact to try to demonstrate that there
is no evidence of a real problem - especially if the claim is
that the problem is long-standing or chronic in nature.
Of course, this method may not take into account sedentary
lifestyles in which muscle mass is not well developed in both
limbs in the first place. It may also not take into account that
a person may curtail, lower activity levels, cease or stop most
activity in an unharmed limb for a variety of reasons (fear of
hurting that limb too, getting plenty of help and support from
others, etc.). Bottom line here is to be aware of this test and
theory, be aware that the IME doctor is not measuring you to help
you get clothes that fit better, that the "test" is somewhat
subjective and unscientific, and that in all events there must be
a valid basis for comparison. John - jreilly@lawyers-online.us
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