Get Wcm003 Permanent Mental Impaiment.doc

The WCM003 Permanent Mental Impairment.doc is an essential document for assessing work-related mental impairments. This guide provides step-by-step instructions to help users fill out the form online with confidence and accuracy.

Follow the steps to complete your form effectively.

1. Click 'Get Form' button to access the WCM003 form and open it in your preferred online editor.
2. Begin by entering the patient's name, worker's compensation (WC) number, date of service, and insurance carrier number at the top of the form.
3. In the scoring instructions section, ensure you meet the specific criteria for a DSM-IV diagnosis before assigning any impairment ratings.
4. Refer to the AMA Guides to Permanent Impairment, 3rd Edition (Revised) for comprehensive guidance on determining the mental impairment ratings.
5. Categorize the impairment by rating each area of function from 0 to 6, based on patient self-reports and clinical assessments. The areas include Activities of Daily Living, Social Functioning, Thinking, Concentration and Judgment, and Adaptation to Stress.
6. Calculate the overall category rating by averaging the two highest subcategory ratings in each area of function and then average these category ratings.
7. If necessary, apply clinical judgment to adjust the overall impairment rating by up to 0.5 points, making sure to document justification for any changes.
8. Finally, use the Category Conversion Table to convert the final numerical rating into a percentage for the overall permanent impairment rating.
9. Once all fields are accurately filled, save changes to the document. You can download, print, or share the completed form as needed.

Take the next step by filling out the WCM003 form online to ensure accurate assessment of permanent mental impairment.