The general standard for necessary care is any care, therapeutic treatment, or services reasonably expected to improve, restore or prevent the progression of any illness, injury, disease, disability, defect, condition or the functioning of any body member.
This is understood to include care provided to detect the existence of vertebral subluxation and the care provided to reduce or correct it.
If the care was provided to reduce vertebral subluxations then this is the outcome measure to be assessed. Further, care is considered reasonable and necessary if any of the following criteria are met:
1. It was reasonably expected to improve the patient’s condition at the time it was rendered;
2. It has improved the patient’s condition;
3. It prevented the onset of any permanent disability;
4. It assisted the patient to achieve maximum functional capacity in performing the patient’s daily activities
5. It alleviated the patient’s pain and/or mitigated the severity of the patient’s symptoms;
6. It ameliorated the patient’s condition;
7. It provided relief of the patient’s pain;
8. It prevented the worsening of the patient’s condition;
9. It slowed the natural progression of the patient’s condition or disease;
10. It was appropriate for the patient’s symptoms, reinjuries,exacerbations and diagnoses of the patient’s conditions or injuries;
11. It was provided consistent with the attending treating doctor’s diagnosis; and/or
12. It was provided consistent with the patient’s active symptomatology and/or abnormal physical/chiropractic findings.
The American Medical Association, in its Guides to the Evaluation of Permanent
Impairment, lists the following as acceptable means to rate impairment: 70
• Impairment due to loss of muscle power and motor function,
• impairment due to abnormal motion of the spine,
• impairment due to loss of motion segment integrity,
• impairment due to disc problems,
• impairment due to pain or sensory deficit, and segmental instability.
The above are, in fact, components of the Vertebral Subluxation Complex.71,72
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