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The value to claims adjusting of Nerve Conduction Studies (NCS) and Electromyography (EMG), although well-known in neurology as tools to reliably and objectively assess the extent of nerve and muscle injuries, is little known within the insurance industry.
DISEASES OF PERIPHERAL NERVE AND MUSCLE ARE A KEY CONSIDERATION IN PATIENTS EXHIBITING WEAKNESS, PAIN, NUMBNESS AND TINGLING, OR FATIGUE.
In such patients, medical assessment is based primarily on history-taking and physical examination. In expert hands, this assessment can be very reliable, but nevertheless is subject to inaccuracies.
The examiner (physician, physiotherapist, or other) provides an opinion as to what is normal and what is not, subject to human biases and errors. Even if the examiner is completely impartial and consistent, the standard clinical approach to quantify weakness or sensory loss implicitly assumes that the patient is making maximum effort and reporting accurately -potentially a false premise.
There may be many reasons why patients do not make maximum efforts, or report accurately, during a neurological examination. Patients are often unable to make a full effort if it produces pain. Pain also distorts sensory perception and makes the sensory examination unreliable.
Pre-existing disease (past strokes, displaced disks, trauma) may produce symptoms and signs that cannot be distinguished from those of the current problem.
Psychiatric morbidity (conversion, depression) may lead to poor effort, even though patients genuinely feel they are trying as hard as they can. In the most extreme case, malingering patients or patients seeking compensation for non-existent or exaggerated ailments are often highly educated in the textbook symptoms of a particular injury, and are able to falsely report their experiences and mislead their physicians.
In the modern age of the Internet, where patients can look up their symptoms on the World Wide Web and, within seconds, find much information from lay publications, self-help groups, or the latest medical journal abstracts, it is not unusual to find individuals who are more knowledgeable about the symptoms of the disease they believe they have than the actual health professionals assessing them.
Because of the subjectivity of medical assessment, laboratory tests play a crucial role in accurate diagnosis and good management in all fields of medicine. For nerve and muscle disease, the ideal test would be one that assesses...