AAPM&R National Grand Rounds: Disability Evaluation: Essentials of Reviews and Determinations (enduring)-Case Study B

Case Study B

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### Summary:<br /><br />Based on Mr. Hurtman's history and a thorough examination, Dr. Able N. Willing provided an independent medical evaluation with the following key points:<br /><br />#### Diagnosis:<br />- Mr. Hurtman fell at work on February 25, 2021, leading to a right shoulder trauma.<br />- Following arthroscopy and surgeries for rotator cuff repair, subacromial decompression, and distal clavicular excision, he likely has residual functional impairments related to the shoulder area.<br /><br />#### Causation:<br />- Mr. Hurtman's shoulder injury is directly linked to the workplace incident where he fell while exiting an electrical panel. He had no prior shoulder issues and the injury was acute, linked with his work as an electrician.<br /><br />#### Treatments:<br />- The surgeries performed were deemed necessary due to his rotator cuff tear and are directly associated with his injury.<br />- No additional treatment is recommended at this time.<br /><br />#### MMI (Maximum Medical Improvement):<br />- Mr. Hurtman has reached MMI as of October 15, 2021.<br /><br />#### Permanent Partial Physical Impairment (PPPI) Rating:<br />- Using the AMA Guides 5th edition:<br />    - Left shoulder: 10% Upper Extremity Impairment (UEI) due to distal clavicular excision.<br />    - Right shoulder: Total of 4% UEI based on range of motion loss.<br />- Combined rating results in 14% right UEI.<br />- Functional review shows Mr. Hurtman has significant ADL and work-related limitations, resulting in a 42% subjective disability from his baseline.<br /><br />#### Functional Limitations and Restrictions:<br />- Significant loss in avocational interests like swimming, frisbee golf, and biking due to shoulder limitations.<br />- He should avoid repetitive or forceful arm activities above shoulder level and limit lifting with the left upper limb.<br />- His job should align with "Medium" work standards according to the USDOL Dictionary of Occupational Titles, considering specified lifting limits.<br /><br />#### Conclusion:<br />Dr. Willing maintains that these recommendations are made within medical probability and he remains open to reassessing if more information arises.

Keywords

Mr. Hurtman

shoulder trauma

rotator cuff repair

workplace injury

electrician

Maximum Medical Improvement

Permanent Partial Physical Impairment

functional limitations

Dr. Able N. Willing

medical evaluation