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Online ISSN 1827-1677
REFINDABLE AND REIMBURSABLE COSTS OF REHABILITATION.
PRELIMINARY GUIDELINES FOR FORENSIC DOCTORS, LAWYERS AND INSURANCE ADJUSTERS
Malavenda P. 1, Lamberti G. 2, Ricchiardi P. 3
1 Presidente della Società Piemontese di Medicina Legale, Torino, Italia;
2 Direttore S.C. Neuriabilitazione ASL CN1, Cuneo, Italia;
3 Dirigente Medico-Legale I livello, INAIL di Cuneo, Cuneo, Italia
The medicolegal physician is routinely called upon to evaluate arthroplasty cases, the majority of which involve the hip, many the knee and shoulder, and occasionally other joints as well. Besides determining the degree of permanent impairment, two other issues relevant for assessment are the duration of illness and the cost of treatments. The medicolegal physician is called upon to give an expert opinion a posteriori which must equally provide for ensuring that the patient will obtain the best therapeutic benefit possible from adequate postoperative care and that such care is recognized and approved as being necessary, useful, and appropriate, while excluding those not useful for clinical stabilization. Because physical therapy is a fundamental part of rehabilitation care after arthroplasty, the medicolegal physician is called upon to evaluate the congruity of treatment in terms of rehabilitation time and cost. While the costs may be influenced by a given socioeconomic context, the congruity of treatment time and methods follows defined clinical parameters which, together with established medicolegal methodology, can aid in responding to questions concerning the type and duration of physical therapy necessary, useful and appropriate for obtaining optimal clinical healing.