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. 1993 Mar;158(3):263–267.

Suggested guidelines for rating cardiac disability in workers' compensation. Medical and Chiropractic Advisory Committee to the Administrative Director of the California Division of Industrial Accidents.

W L Clark 1, H L Alpern 1, W S Breall 1, R M Hyman 1, A Markovitz 1, J B O'Brien 1, R D Starke 1
PMCID: PMC1311751  PMID: 8460507

Abstract

Cardiac disability ratings in workers' compensation cases currently lack any consistent scientific basis, with varying medical evidence used by different examiners in the same case. Opinions about the extent of disability may differ with the same patient, delaying resolution and the delivery of benefits. We describe guidelines for determining cardiac impairment and suggest a schedule for rating disability based on evidence. Our experience is in California, but arriving at equitable ratings for disability purposes is a nationwide challenge. Exercise stress testing provides the best reproducible data to test the heart's ability to do work. When exercise stress testing is not possible or adequate, alternative or supplemental testing is necessary. Certain conditions, such as hypertension, arrhythmias, coronary artery spasm, and a history of coronary artery operations or myocardial infarction, may affect "cardiac disability" but may not necessarily be reflected in exercise testing.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ASTRAND I. Aerobic work capacity in men and women with special reference to age. Acta Physiol Scand Suppl. 1960;49(169):1–92. [PubMed] [Google Scholar]
  2. Astrand I. Physical demands in worklife. Scand J Work Environ Health. 1988;14 (Suppl 1):10–13. [PubMed] [Google Scholar]
  3. Bruce R. A., Kusumi F., Hosmer D. Maximal oxygen intake and nomographic assessment of functional aerobic impairment in cardiovascular disease. Am Heart J. 1973 Apr;85(4):546–562. doi: 10.1016/0002-8703(73)90502-4. [DOI] [PubMed] [Google Scholar]
  4. Ekblom B., Astrand P. O., Saltin B., Stenberg J., Wallström B. Effect of training on circulatory response to exercise. J Appl Physiol. 1968 Apr;24(4):518–528. doi: 10.1152/jappl.1968.24.4.518. [DOI] [PubMed] [Google Scholar]
  5. Haskell W. L., Brachfeld N., Bruce R. A., Davis P. O., Dennis C. A., Fox S. M., 3rd, Hanson P., Leon A. S. Task Force II: Determination of occupational working capacity in patients with ischemic heart disease. J Am Coll Cardiol. 1989 Oct;14(4):1025–1034. doi: 10.1016/0735-1097(89)90485-3. [DOI] [PubMed] [Google Scholar]
  6. Ilmarinen J. Physical load on the cardiovascular system in different work tasks. Scand J Work Environ Health. 1984 Dec;10(6 Spec No):403–408. doi: 10.5271/sjweh.2303. [DOI] [PubMed] [Google Scholar]
  7. Kilbom A. Physical work capacity of firemen. With special reference to demands during fire fighting. Scand J Work Environ Health. 1980 Mar;6(1):48–57. doi: 10.5271/sjweh.2634. [DOI] [PubMed] [Google Scholar]
  8. PASSMORE R., DURNIN J. V. Human energy expenditure. Physiol Rev. 1955 Oct;35(4):801–840. doi: 10.1152/physrev.1955.35.4.801. [DOI] [PubMed] [Google Scholar]

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