Chapter 16: The Lower Extremities

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Summary of Updates to AMA Guides Sixth Edition 2021

  • Content update provides clarification and updated terminology around mental and behavioral health concepts to improve interrater reliability. Overview of updates to Mental and Behavioral Health Content:
    • Change from DSM IV to DSM 5 terminology and methodology 
    • Newer editions of Assessment Tools and Tests
    • Descriptions of Malingering and Motivation 
    • Removal of summaries of psychiatric diagnoses and conditions from the Glossary to mitigate discrepancies in a forensic setting
  • Removal of GAF results in more accurate mental and behavioral health impairment ratings
  • Minor editorial corrections to Lower Extremities and Spine and Pelvis content

Minor Editorial Enhancements

Editorial clarifications that have no substantiative impact on content, supporting evidence used, or impairment ratings. 

Lower Extremities (Chapter 16)

  • Functional History Modifier now has a box around it to promote consistency with the upper extremity Functional History Modifier. 
  • In all chapter tables, instances with ‘-‘ were replaced with ‘:’ to promote internal consistency. Example: Table 16-12, Peripheral Nerve impairment - Lower Extremity Impairments has been changed to Peripheral Nerve impairment : Lower Extremity Impairments.
  • Table 16-3: The word ‘meniscectomy’ was added within the Class 1 and 2 definition of meniscal injury.  
  • Example 16-10: subluxing was corrected to subluxating.
  • Example 16-11: The term ‘right knee’ is now bolded and returned on another line.