AOMSI - Strongsville Chiropractic Neuroloystrongchironeuro.com/newsletters/aomsi.pdfAlthough every...
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A MEDICAL-LEGAL NEWSLETTER FOR PERSONAL INJURY ATTORNEYS – By Dr. Vincent M. Simokovich AOMSI In previous newsleers I discussed the importance of having an impairment rang done when warranted in a soſt ssue injury case, and how it “unlocks” the claim value by allowing for consideraon of persistent funconal loss. Without an impairment rang, there is no aenon paid to ‘dues under duress’ or loss of enjoyment in life’ by Colossus or similar programs. Aſter a discussion I had yesterday with a local aorney, I felt it was important to interrupt my “Colossus” newsleer sequence to insert this one into the mix. What would you say if I told you that approximately 60% of car crash vicms have bodily injuries and impairments that, based on the AMA Guides to Impairment, are equivalent to a limb amputaon, and that more than 90% of the me it goes undiagnosed? Today I am going to cover an important element of an impairment rang that, when present, is a significant value driver in a personal injury case. Alteraon of moon segmental integrity (AOMSI) is defined in the 5 th edion of the AMA Guides to the Evaluaon of Permanent Impairment as an increase in translaonal or angular moon (ligamentous laxity), or decreased moon resulng from developmental changes, fusion, a healed fracture, a healed infecon, or surgical arthrodesis (fusion) With the type of soſt ssue injuries typically seen by a chiropractor who is trained in trauma management, the most likely impairment in the category of AOMSI is going to be ligamentous laxity. So how does the AMA objecvely evaluate impairment due to ligamentous laxity? It’s really simple. An x-ray flexion/extension study is done, and measurements are taken. A posive finding in the cervical spine would be angular moon between two segments that is greater than 11 degrees.
Transcript of AOMSI - Strongsville Chiropractic Neuroloystrongchironeuro.com/newsletters/aomsi.pdfAlthough every...
A MEDICAL-LEGAL NEWSLETTER FOR PERSONAL INJURY ATTORNEYS – By Dr. Vincent M. Simokovich
AOMSI
In previous newsletters I discussed the importance of having an impairment rating done when warranted
in a soft tissue injury case, and how it “unlocks” the claim value by allowing for consideration of persistent
functional loss. Without an impairment rating, there is no attention paid to ‘duties under duress’ or loss of
enjoyment in life’ by Colossus or similar programs. After a discussion I had yesterday with a local attorney,
I felt it was important to interrupt my “Colossus” newsletter sequence to insert this one into the mix.
What would you say if I told you that approximately 60% of car crash victims have bodily injuries and
impairments that, based on the AMA Guides to Impairment, are equivalent to a limb amputation, and that
more than 90% of the time it goes undiagnosed?
Today I am going to cover an important element of an impairment rating that, when present, is a
significant value driver in a personal injury case.
Alteration of motion segmental integrity (AOMSI) is
defined in the 5th edition of the AMA Guides to the
Evaluation of Permanent Impairment as an increase in
translational or angular motion (ligamentous laxity), or
decreased motion resulting from developmental changes,
fusion, a healed fracture, a healed infection, or surgical
arthrodesis (fusion)
With the type of soft tissue injuries typically seen by a
chiropractor who is trained in trauma management, the
most likely impairment in the category of AOMSI is going
to be ligamentous laxity.
So how does the AMA objectively evaluate impairment
due to ligamentous laxity? It’s really simple. An x-ray
flexion/extension study is done, and measurements are
taken. A positive finding in the cervical spine would be
angular motion between two segments that is greater than
11 degrees.
Another method is to measure the forward or backward translation of the vertebra in relation to the one
below and if there is movement beyond 3.5mm it would be considered positive for ligamentous laxity.
As you can see in the table above (category 4), AOMSI carries a high value. In fact, the impairment value of
AOMSI is almost equivalent to a limb amputation. The process is very similar for the lumbar spine.
When AOMSI is found it indicates that a ligament has been stretched beyond its elastic limit, that internal
disruption of the ligament fibers has occurred, and that the permanently injured ligament will not provide
stability to the joint. In other words the ligament has been functionally destroyed. It proves serious bodily
injury in the absence of a herniated disc. This one significant finding, when documented properly, can be the
difference between a fair and equitable settlement vs. the typical ‘lowball’ offer from the adjuster in a soft
tissue injury.
Proper documentation of AOMSI includes the treating doctor performing a flexion/extension study, and then having the x-rays “digitized” so that an accurate measurement can be performed. X-ray digitization can be ordered for a minimal overall cost. The company I use is Spine Metrics.
Although every injury patient may not need this service, and no one tool is the ‘Holy Grail’ in proving bodily
injury, x-ray digitizing helps the treating doctor to properly diagnose the patient’s injuries, render an accurate
prognosis, and create a treatment plan appropriate for the level of injury. For the attorney, x-ray digitizing
will provide the documentation of bodily injury that allows you to prevail at a higher level.
As always if you have any questions, concerns, comments or constructive criticism regarding this newsletter
and its content, please shoot me an email. I welcome your input as I learn from it as well. If you have not
received my first two newsletters on Colossus and would like to receive them, please send me and email.
Strongsville Chiropractic Neurology ● 12481 Pearl Rd. ● Strongsville, OH 44136
Dr. Vincent M. Simokovich ● Phone: 440-878-4357 ● Fax: 440-878-8702
Personal Injury ● Expert Opinions ● Workers Compensation ● Second Opinions
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