Agreed Medical Evaluation (AME)
An Agreed Medical Evaluation (AME) is an evaluation conducted by a provider who is selected by agreement between an injured workers’ attorney and the claims administrator and their attorney, to conduct a medical examination and prepare a medical-legal report to help resolve a dispute. The AME will also serve to ‘apportion’ the claim, in other words determine what portion of the work injury led to the disability, and what portions came from other sources or causation, if any.
California Regulations prohibit advertising as an Agreed Medical Evaluator (AME) other than stating that such services have been provided in the past. Dr. Whitehead has indeed served as an Agreed Medical Evaluator (AME) in past cases. Feel free to call Dr. Whitehead for any further information on the AME process, including scheduling availabilities and timeframes.
No listing here is meant to imply that there is any official or state-sponsored appointment, title or status as AME nor that any special tactical advantage, certainty of outcome, guarantee, warranty, favorable expectation, or prediction as to case outcome should be expected, if a decision is made to assign any AME case to this evaluator.
What can be counted on will be a professional evaluation based on skilled analysis of all case information and documentation; a thorough face-to-face evaluation with the client; careful consideration of case issues in the context of ethical and clinical standards and current clinical research; and a timely, well-written, concise evaluation report which answers all of the case referral questions in clear and practical language.
In a Workers Compensation setting, AME reports are used to help determine an injured worker’s eligibility for workers’ compensation benefits. In psychological injuries, which are referred to as Injury to the Psyche cases in the workers’ compensation world, the determination of the injury can be complicated. This is because of the many special rules and regulations that apply to psychological stress and injury claims.
Injury to the Psyche claims can develop out of general or specific stresses encountered in the workplace. Examples include sexual harassment, hostile work environment, stress and trauma from workplace robberies, and other complex workplace situations and dynamics between workers, supervisors, and co-workers. The determinations can be very complex, and the AME must do an excellent job of analyzing and reporting what has happened, and how this has affected the worker. The AME also has to consider the special State of California rules and regulations that apply in such cases.
Injury to the Psyche claims can also arise from physical injuries that lead to chronic pain, such as a back injury, neck injury, shoulder injury, severe hernia, broken bones, machinery accidents that create physical injuries, and any other problems that lead to chronic pain. Chronic pain can sometimes lead to the development of depression, anxiety, mood instability, sleep problems, and other related problems.
Head injury and brain injury are also assessed by AME’s. These can result from blows to the head during robberies, exposure to toxic substances, vehicle accidents, machinery malfunctions, and a variety of other incidents in which brain function has been affected. Dr. Whitehead even once evaluated an injured worker who was thrown from a horse at work, landed on his head, and fell into a 3 month coma. In such cases, the effects of injuries on memory, attention, concentration, reasoning ability, and other general cognitive effects have to be evaluated thoroughly and fully reported.
It is the job of the AME to fully and fairly assess all these complex and challenging issues, and provide written and supportable opinions that help the case to move on to being finalized.