Author: Richard H. Adler

Traditionally, objective measurements of neck and back injuries such as palpable spasms, loss of lordotic curve on x-ray and disc protrusions have been thought reliable as “hard evidence” when measuring the extent of traumatic personal injury and the effectiveness of treatment. Subjective measures of pain and function were criticized as “soft evidence”. In recent years, however, subjective pain assessments as measured through pain questionnaires have gained substantial acceptance in use and are now considered reliable evidence of injury and function. Freise, RJ and Menke, JM (2001) “Functional Rating Index: A New Valid and Reliable Instrument to Measure the Magnitude of Clinical Change in Spinal Conditions,” Spine 26 (1) 78-87 (2001): Deyo, RA, and Diehl, AK (1983), “Measuring Physical and Psycho-Social Function in Patients with Low Back Pain,” Spine, 8 (6): 635-642.

As most health care providers know, all tools that assist in documenting the nature and extent of a patient’s traumatic personal injuries and the patient's improvement with treatment are vital. A well formatted and consistently used pain questionnaire carries with it many benefits including:

1. Providing a reliable means to measure change in the patient's physical condition;
2. Assisting in documenting the nature and extent of injury and need for care;
3. Illustrating improvements in function as a result of treatment;
4. Supporting the reasonableness and necessity of treatment for the injuries;
5. Satisfying the provider's duty to monitor changes in subjective and objective findings;
6. Aiding the provider in writing reports or testifying at deposition or trial as needed during the course of the patients personal injury insurance claims;
7. Aiding the provider in assessing residual limitations relating to activities of daily living (also known as activities under duress).

The Functional Rating Index is a new pain questionnaire which is achieving recognition as a reliable, valid and responsive instrument. It is also claimed to be superior to other instruments with regard to clinical utility. See Freise, RJ and Menke, JM (2001) “Functional Rating Index: A New Valid and Reliable Instrument to Measure the Magnitude of Clinical Change in Spinal Conditions,” Spine, 26 (1): 78-87.

We are enclosing a copy of the Functional Rating Index that was published in Spine (2001) for your review. Good record keeping protects the patient and the doctor especially in this era of insurance company claims cost containment practices. We hope this information aids you in your practice when providing care and treatment to those with traumatic personal injuries.

The experienced, top rated attorneys at Adler Giersch PS stand ready to provide free and informative consultations to your patients with personal injury and insurance claims through our offices in Seattle, Bellevue, Everett and Kent.