Current through Register Vol. XLI, No. 45, November 8, 2024
Section 23-16-5 - Evidentiary Requirements5.1. The evidentiary weight to be given to a report will be determined by how well it demonstrates that the evaluation and examination that it memorializes were conducted in accordance with the Guides and that the opinion with regard to the degree of permanent whole body medical impairment suffered by a claimant was arrived at and composed in accordance with the requirements of the Guides. 5.1.1. The report must state the factual findings of all tests, evaluations, and examinations that were conducted and must state the manner in which they were conducted so as to clearly indicate their performance in keeping with the requirements of the Guides. For any evaluation and examination of a. compensable back injury, the back" examination form previously adopted, by the health care advisory panel must be completed and submitted with the narrative report. A copy of the current edition of the back examination form is attached hereto and is incorporated herein as if fully set forth. A report and opinion submitted regarding the . degree of permanent whole body medical impairment as a result of a back injury without a completed back examination form shall be disregarded.5.1.2. The .opinion stated in the report as to the degree of permanent whole body medical impairment must reflect the process of calculation as .stated in the Guides so as to demonstrate how the degree of permanent whole body medical impairment was arrived at and calculated.5.1.3. As stated in the Guides, at page 1/5, section 1.5: "The physician performing an impairment evaluation must provide more than a number or percentage. The physician should provide as comprehensive a medical picture of .the patient as possible, using the Report of Medical Evaluation form (p.11) as an outline. If this is done, the person receiving the evaluation will be able to determine how the medical information fits with the nonmedical information and will have the basis for an improved understanding of how the impairment may affect the patient's employability and daily activities." (Insertion in the original).5.1.4. To the extent that factors other than the compensable injury may be affecting the claimant's whole body medical impairment, the opinion stated in the report must, to the extent medically possible, determine the contribution of those other impairments whether resulting from an occupational or a nonoccupational injury, disease, or any other cause.5.2. The qualifications of the expert giving the opinion on the degree of permanent whole body medical impairment must be shown by way of an attachment to the report or by annually filing an appropriate document with the division. The attachment may be. in the form of a resume or curriculum vitae and must be sufficient to qualify the opinion giver as an expert in the field of whole body medical impairment determination. Failure "to so qualify the opinion giver shall affect the evidentiary weight given to the opinion and findings in the reports offered by that opinion giver. Those individuals who are conducting examinations and providing reports and opinions for injuries within their field of practice or specialty and who have been trained in the Use of the Guides shall be deemed an expert for the purposes of these rules. Additional qualifications such as board certification or eligibility to become board certified shall go to the weight to be afforded the report and opinion. Acceptable training must be accomplished by attendance at a training event or accomplished in a manner which is sanctioned for continuing medical education credit purposes. On an individual-by-individual basis, consideration will be given to other persons who do not meet the above stated criteria.5.3. In any claim for occupational pneumoconiosis benefits (section 6.1), for noise induced hearing loss (subsection 6.2), or for mental and emotional loss (subsection 6.3), the application of these evidentiary requirements of this section 5 shall be based upon the guidelines referred to in subsections 6.1, 6.2, and 6.3 in lieu of the Guides. All of the other requirements of section 5 shall be accordingly applied.