The physician's role in performing an impairment evaluation is to provide an independent, unbiased assessment of the individual's medical condition, including its effect on function, and of limitations to the performance of Activities of Daily Living, or ADLs (as listed in Table 1-1). Although treating physicians may perform impairment ratings on their patients, it is recognized that these are not independent and therefore may be subject to greater scrutiny. Performing an impairmetn evaluation requires considerable medical expertise and judgment.
Thorough, complete and accurate reporting by the rating physician affords the best opportunity to communicate details of the impairment and its impact, if any, on the patient, in a forum acceptable to other medical professionals and interested parties, such as claims professionals, attorneys, and adjudicators. Reporting should follow the format and guidelines set forth by the Guides; this will help ensure that information provided is consistent, reliable, and sufficient to enable a fair and competent determination of benefits to which the patient may be entitled.
As an impairment evaluator, the physician must understand the regulations pertaining to medical practice and evaluations. It is also the physician's responsibility to provide the necessary medical assessment to the party requesting the evaluation, with the patient's consent, unless otherwise proscribed by law. The physician needs to ensure that the patient understands that the evaluations' purpose is for medical assessment, not medical treatment. The performance of an impairment evaluation does not establish a physician-patient relationship.
In some cases, the referring source may ask the physician rater to assess the medical impairment's impact on the affected individual's ability to work. This is beyond the scope of the Guides; however, with acquisition of additional knowledge and skills, physicians may be able to provide a reasonable opinion in that regard. This would require, at minimum, the understanding of the essential functions and various tasks of the specific occupation, as well as how the patient's medical condition interacts with the occupational demands. In many cases, the physician may n eed to obtain additional consultant expertise and input; this guidance will better define job-related functional abilities and limitations, as well as vocational demands pursuant to such determinations.