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Permanent clinical impairment file review report standards 1.4

ALL MEDICAL DOCUMENTARY FILE REVIEW SUMMARIES CONDUCTED IN SUPPORT OF CASE MANAGEMENT MUST ACCURATELY RECORD INFORMATION ON FILE AND BE OBJECTIVE AND PROFESSIONAL IN ALL RESPECTS.

The standard format is as follows:

Heading
From:		Claim number:
To::		Date:
Claimants name:
Date of birth
Date of accident:

I. Issue  - Assessment of Impairment

II. Responsibilities Accepted on Claim

a) discussion if necessary

III. Review of History  - if necessary

IV.Review of I.M.E

a)discussion if necessary

V. Assessment of Impairment

a) identification of impairment
b) guides used
c) calculations
d) statement of impairment and relationship to compensable accident

VI. Comments - if necessary

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