Impairment Evaluations Monthly Meeting Summary - January 6, 2026

On January 6, 2026, we convened a small-group Impairment Evaluation Virtual Forum with physicians and allied health professionals actively engaged in impairment ratings, IMEs, and medicolegal work. These sessions are held on the first Tuesday of each month and are free. Typically, we serve clients across the United States, Canada, Asia, Australia, Africa, and Europe. The session was intentionally interactive, emphasizing candid discussion, practical problem-solving, and shared learning rather than formal presentations. For more information on attending visit www.amaguides.com or contact [email protected].

Below are several highlights and takeaways that may be of interest to those navigating impairment evaluation, AMA Guides Digital, and the rapidly evolving role of AI in medicolegal practice.

Transition to AMA Guides Digital (2024/2025)

Participants consistently noted a learning curve with the AMA Guides 2024 and 2025 - particularly the shift away from traditional grade modifiers. While the intent—to reduce subjectivity and variability—is broadly understood, many expressed the need for more hands-on, applied training. There was agreement that expanded, practical educational resources will be essential as additional jurisdictions transition to the digital framework. Content on the AMA Guides 2025 is being developed and available this spring at amaguides.com.

Best Practices in IME and Impairment Report Writing

A recurring theme was the importance of report quality and clarity, especially in contested cases. Discussion emphasized:

• Professional formatting and readability (e.g., consistent headers, automated tables of contents).
• The value of a concise executive summary to orient readers quickly.
• Clear organization: history synthesis, symptom integration, timelines, client questions, and structured reasoning.
• Thoughtful use of standardized templates or boilerplate language, always tailored to the specifics of the case.
• Leveraging freely available educational resources on IME best practices and comprehensive history-taking.

Well-structured reports were seen as critical not only for credibility, but also for defensibility.

Artificial Intelligence in Medicolegal Work: Tool, Not Author

AI was the dominant topic of the session. The group broadly agreed that AI is rapidly becoming necessary to maintain quality and efficiency in modern medicolegal practice—if used correctly.

Key principles discussed:

• AI should be treated as a supporting tool, not an opinion-maker.
• Effective use requires:
• The clinician remains the author and assumes full responsibility for the final report.

Concerns were raised that some attorneys and organizations remain wary of AI due to deposition and courtroom scrutiny. The consensus response was clear: AI should be framed as augmented intelligence, analogous to other diagnostic or organizational aids, with transparent physician oversight.

HIPAA Compliance and Redaction

Strong emphasis was placed on data security:

• Identifying patient information must never be uploaded into non-compliant tools.
• Practical redaction strategies were discussed, including PDF redaction workflows and efficient global replacement of identifiers prior to AI use.
• Clarification was provided that all demonstration materials used in the session were fully anonymized.

Practical AI Use Cases

Several concrete applications were discussed:

• Mechanism of injury and causation research, using AI to generate background context that is then tailored to the individual case.
• Summarization of large medical record sets, often spanning thousands of pages, with clinician validation.
• AI-supported patient interviews, producing detailed, standardized histories that can support downstream analysis and reporting.

Education and Knowledge Dissemination

Participants highlighted the importance of expanding education beyond single live events. Upcoming efforts will focus on:

• The current state of AI in workers’ compensation.
• Practical guardrails for responsible AI use (“the good, the bad, and the ugly”).
• Science-based causation analysis.

There was strong interest in follow-on virtual education to broaden access and reinforce learning.

Case Discussion: Contralateral Joint Pathology and Altered Gait

A detailed case scenario explored whether contralateral ankle and knee pathology could reasonably be attributed to altered gait from a prior unilateral ankle injury.

Key discussion points included:

• The importance of jurisdiction-specific legal thresholds for causation.
• Biomechanical evidence suggesting injured limbs are often underloaded, not overloaded.
• Avoiding simple temporal assumptions (“after this, therefore because of this”).
• Careful evaluation of alternative explanations and risk factors such as age, obesity, family history, and pre-existing disease.
• The value of structured, evidence-based causation analysis (e.g., Bradford Hill-type reasoning).

The provisional consensus, based on the facts presented, was that causation was unlikely, while acknowledging the need for individualized case assessment.

Final Takeaways

Several themes resonated across the discussion:

• AI is a tool, not a substitute for clinical judgment.
• Jurisdiction matters—legal standards vary widely.
• High-quality medicolegal opinions require rigor in science and clarity in communication.
• The digital AMA Guides represent a meaningful shift toward objectivity, but require thoughtful education and adaptation.

These sessions are offered as a collegial forum to explore emerging challenges and best practices. If you are involved in impairment evaluation, IMEs, or workers’ compensation and would like to participate in future discussions, you are welcome to join us.

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