Chapter 1: Conceptual Foundations and Philosophy

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Summary of Updates to AMA Guides Sixth Edition 2022

  • Language describing the new evidence-based editorial process explains why the latest edition of the AMA Guides is rooted in science and best evidence.
  • Encourages documenting evidence and the standard used to determine the impairment rating in reports.
  • No changes to impairment ratings or methodology.

Chapter 1: Conceptual Foundations and Philosophy

  • Section 1.1 History of the AMA Guides
    • Description of changes: Insertion of paragraph to describe the evolution of the sixth edition of the AMA Guides, including the new evidence-based editorial process and panel.
  • Section 1.2a Previous Criticisms of the AMA Guides
    • Insertion: “New editions of the AMA Guides were unable to be published quickly enough to reflect emergent improvements in science and evidence-based medicine.”
  • Section 1.3b Applications of ICF Model to the AMA Guides, International Appeal and Applications
    • Insertion: “The concept of impairment evaluation as it relates to the ICF model continues to evolve. Incorporation of the biopsychosocial model of health will provide a platform for further research and exploration of these concepts into the future.”
  • Section 1.6 The Case for Simplification and Ease of Application
    • New Section title: Evidence Requirements
    • Description of changes: details the evidence requirements for updating the sixth edition.
  • Section 1.8e History of Clinical Presentation
    • Removed: “…those with minimal or intermittent moderate symptoms, in impairment class 1; and those with constant symptoms that persist despite treatment, in impairment class 4.”
    • Inserted: “...those with mild symptoms will be in class 1; and those with very severe constant symptoms that persist despite treatment will be in impairment class 4.”
  • 1.8g Objective Test Results
    • Insertion: “Each chapter will delineate the key factor of the impairment class within a given grid.”
    • Insertion: “Typically, a combination of the key factor and non-key factors will be used to determine a place within a class and grade, and the key factor may vary within chapters or between chapters.”
  • 1.9 AMA Guides Editorial Process and Digital Delivery (New Section)
    • Description of changes: additional information about the mission and goals of the AMA Guides Editorial Panel and the importance of using the most current evidence-based medicine to complete impairment ratings.
    • Sixth edition methodology will serve as the foundation for all changes to the AMA Guides moving forward.
    • Figure 1.3, AMA Guides Editorial Process is also provided.
  • Minor editorial updates throughout the chapter have been made to improve readability and for clarity.
  • 1.

    Ranavaya MI, Rondinelli RD. The major US disability and compensation systems: origins and historical overview. In: Rondinelli RD, Katz RT, eds. Impairment Rating and Disability Evaluation. Philadelphia, Pa: WB Saunders Co; 2000:316.

    • Search Google Scholar
    • Export Citation
  • 2.

    Ranavaya MI, Andersson GB. The impairment and disability evaluations. In: Mayer TG, Gatchel RJ, Polatin PB, eds. Occupational Musculoskeletal Disorders: Function, Outcomes & Evidence. Philadelphia, Pa: Lippincott, Williams & Wilkins; 2001.

    • Search Google Scholar
    • Export Citation
  • 3.

    Yaron R. The Laws of Eshnuna, Section 42. Jerusalem-Leiden: The Magnes Press, The Hebrew University; 1988:69.

  • 4.

    Fischer Drew K. The Lombard Laws. Philadelphia, Pa: University of Pennsylvania Press; 1973:62.

  • 5.

    American Medical Association. A guide to the evaluation of permanent impairment of the extremities and back. JAMA. 1958;166(suppl):1122.

    • Search Google Scholar
    • Export Citation
  • 6.

    American Medical Association. In: Guides to the Evaluation of Permanent Impairment. Chicago, Ill: American Medical Association; 1971.

  • 7.

    American Medical Association. Guides to the Evaluation of Permanent Impairment. 3rd ed. Chicago, Ill: American Medical Association; 1988.

    • Search Google Scholar
    • Export Citation
  • 8.

    American Medical Association. Guides to the Evaluation of Permanent Impairment. 4th ed. Chicago, Ill: American Medical Association; 1993.

    • Search Google Scholar
    • Export Citation
  • 9.

    Cocchiarella L, Andersson GBJ, eds. Guides to the Evaluation of Permanent Impairment. 5th ed. Chicago, Ill; AMA Press; 2001.

  • 10.

    Rondinelli RD, ed. Guides to the Evaluation of Permanent Impairment. 6th ed. Chicago, Ill: AMA Press; 2008.

  • 11.

    Burd JG. The educated guess: doctors and permanent partial disability percentage. J Tenn Med Assoc. 1980;783:441.

  • 12.

    Clark WL, Haldeman S, Johnson P, et al.Back impairment and disability determination: another attempt at objective, reliable rating. Spine. 1988;13:332341.

    • Search Google Scholar
    • Export Citation
  • 13.

    Hinderer SR, Rondinelli RD, Katz RT. Measurement issues in impairment rating and disability evaluation. In Rondinelli RD, Katz RT, eds. Impairment Rating and Disability Evaluation. Philadelphia, Pa: WB Saunders Co; 2000:3552.

    • Search Google Scholar
    • Export Citation
  • 14.

    Pryor ES. Flawed promises: critical evaluation of the AMA Guides to the Evaluation of Permanent Impairment. Harvard Law Rev. 1990;103:964976.

    • Search Google Scholar
    • Export Citation
  • 15.

    Rondinelli RD, Duncan PW. The concepts of impairment and disability. In Rondinelli RD, Katz RT, eds. Impairment Rating and Disability Evaluation. Philadelphia, Pa: WB Saunders Co; 2000:1733.

    • Search Google Scholar
    • Export Citation
  • 16.

    Rondinelli RD, Dunn W, Hassanein KM, et al.Simulation of hand impairments: effects on upper extremity function and implications toward medical impairment rating and disability determination. Arch Phys Med Rehabil. 1997;78:13581563.

    • Search Google Scholar
    • Export Citation
  • 17.

    Rondinelli RD, Katz RT. Merits and shortcomings of the American Medical Association Guides to the Evaluation of Permanent Impairment, 5th edition: a physiatric perspective. Phys Med Rehabil Clin N Am. 2002;13:355370.

    • Search Google Scholar
    • Export Citation
  • 18.

    Spieler EA, Barth PS, Burton JF, et al.Recommendations to guide revision of the Guides to the Evaluation of Permanent Impairment. JAMA. 2000;283:519523.

    • Search Google Scholar
    • Export Citation
  • 19.

    Brigham CR, Uejo C, Dilbeck L, Walker P. Errors in impairment rating: challenges and opportunities. J Workers Compensation. 2006;15(4):1942.

    • Search Google Scholar
    • Export Citation
  • 20.

    World Health Organization. International Classification of Functioning, Disability and Health: ICF. Geneva, Switzerland: World Health Organization; 2001.

    • Search Google Scholar
    • Export Citation
  • 21.

    World Health Organization. International Classification of Impairments, Disabilities and Handicaps: A Manual of Classification Relating to the Consequences of Disease. Geneva, Switzerland: World Health Organization; 1980.

    • Search Google Scholar
    • Export Citation
  • 22.

    29 Code of Federal Regulations. Part 1630. Americans with Disabilities Act (ADA): Equal employment opportunity for individuals with disabilities. 56 Federal Register (144):3572635753(1991).

    • Search Google Scholar
    • Export Citation
  • 23.

    Nagi S. Disability and Rehabilitation: Legal, Clinical and Self-Concepts and Measurement. Columbus, Ohio: Ohio State University Press; 1969.

    • Search Google Scholar
    • Export Citation
  • 24.

    Pope AM, Tarlov AR. Disability in America. Toward a National Agenda for Prevention. Washington DC: National Academy Press; 1991.

  • 25.

    World Health Organization. ICIDH-2 International Classification of Impairments, Activities and Participation: A Manual of Dimensions of Disablement and Functioning Beta-1 Draft for Field Trials. Geneva, Switzerland: World Health Organization; 1997.

    • Search Google Scholar
    • Export Citation
  • 26.

    Weigl M, Cieza A, Andersen C, et al.Identification of relevant ICF categories in patients with chronic health conditions: a Delphi exercise. J Rehabil Med Suppl. 2004;44:1221.

    • Search Google Scholar
    • Export Citation
  • 27.

    Talo SA, Rytökoski UM. BPS-ICF model, a tool to measure biopsychosocial functioning and disability within ICF concepts: theory and practice updated. Int J Rehabil Res. 2016;39(1):110. doi:.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28.

    Youngstrom MJ. Occupational therapy practice framework: The evolution of our professional language. Am J Occup Ther. 2002;56:609639.

  • 29.

    Hamilton B, Granger CV, Sherwin FS, et al.A Uniform National Data System for medical rehabilitation. In: Fuhrer MJ, ed. Rehabilitation Outcomes: Analysis and Measurement. Baltimore, Md: Paul H. Brookes Publishing Co; 1987:137147.

    • Search Google Scholar
    • Export Citation
  • 30.

    Krebs DE. Measurement theory. Phys Ther. 1987;67: 18341839.

  • 31.

    Merbitz C, Morris J, Grip JC. Ordinal scales and foundations of misinference. Arch Phys Med Rehabil. 1989;70:308312.

  • 32.

    Wright BD, Linacre JM. Observations are always ordinal; measurements, however, must be interval. Arch Phys Med Rehabil. 1989;70:857860.

    • Search Google Scholar
    • Export Citation
  • 33.

    Mayer T, Kondraske G, Beals S, Gatchel R. Spinal range of motion: accuracy and sources of error with inclinometric measurements. Spine. 1997;22:19761984.

    • Search Google Scholar
    • Export Citation
  • 34.

    McCarthy ML, McAndrew MP, MacKenzie EJ, et al.Correlation between the measures of impairment according to the modified system of the American Medical Association, and function. J Bone Joint Surg Am. 1998;80:10341042.

    • Search Google Scholar
    • Export Citation
  • 35.

    Gloss DS, Wardle MG. Reliability and validity of American Medical Association's guide to ratings of permanent impairment. JAMA. 1982;248:22922296.

    • Search Google Scholar
    • Export Citation
  • 36.

    Concato J, Shah N, Horwitz RI. Randomized, controlled trials, observational studies, and the hierarchy of research designs. N Engl J Med. 2000;342:18871892.

    • Search Google Scholar
    • Export Citation
  • 37.

    Harbour R, Miller J. A new system for grading recommendations in evidence-based guidelines. BMJ. 2001;323:334336.

  • 38.

    Atkins D, Best D, Briss PA, et al.Grading quality of evidence and strength of recommendations. BMJ. 2004;328:14901494.

  • 39.

    Acute Low Back Problems in Adults. Rockville, Md: Agency for Health Care Policy and Research, US Dept of Health and Human Services; 1994. Clinical Practice Guideline No. 14, AHCPR publication 95–0642.

    • Search Google Scholar
    • Export Citation
  • 40.

    Cieza A, Ewert T, Ustun TB, et al.Development of ICF Core Sets for patients with chronic conditions. J Rehabil Med. 2004;36:911.

  • 41.

    Grill E, Stucki G, Scheuringer M, et al.Validation of International Classification of Functioning, Disability, and Health (ICF) Core Sets for early postacute rehabilitation facilities: comparison with 3 other functional measures. Am J Phys Med Rehabil. 2006;85:640649.

    • Search Google Scholar
    • Export Citation
  • 42.

    Bennett KA, Osborne RH. Interobserver measurement reliability in anthropometry. Hum Biol. 1986;58:751759.

  • 43.

    Helmer-Hirschberg O. Analysis of the Future: The Delphi Method. Santa Monica, CA: RAND Corporation; 1967. https://www.rand.org/pubs/papers/P3558.html

    • Search Google Scholar
    • Export Citation
  • 44.

    Institute of Medicine. Clinical Practice Guidelines We Can Trust. Washington, DC: The National Academies Press; 2011. doi:.

  • 45.

    Criteria Committee of the New York Heart Association. Diseases of the Heart and Blood Vessels: Nomenclature and Criteria for Disease. 6th ed. Boston, Mass: Little, Brown & Co; 1964.

    • Search Google Scholar
    • Export Citation
  • 46.

    Fox SM III, Naughton JP, Haskell WL. Physical activity and the prevention of coronary heart disease. Ann Clin Res. 1971;3:404432.

  • 47.

    Epler GR. Disability evaluation. In: Fishman AP, ed. Pulmonary Diseases and Disorders. New York, NY: McGraw-Hill; 1988:567575.

  • 48.

    Ware JE. Health survey update. Spine. 2000;25: 31303139.

  • 49.

    Ferris BG. Epidemiology standardization project: American Thoracic Society. Am Rev Respir Dis. 1978;118(6, pt 2):1120.

  • 50.

    Anagnostis C, Gatchel RJ, Mayer TG. The pain disability questionnaire: a new psychometrically sound measure for chronic musculoskeletal disorders. Spine. 2004;29:22902303; discussion 2303.

    • Search Google Scholar
    • Export Citation
  • 51.

    Beaton DE, Wright JG, Katz JN, Upper Extremity Collaborative Group. Development of the QuickDASH: comparison of 3 item-reduction approaches. J Bone Joint Surg Am. 2005;87:10381046.

    • Search Google Scholar
    • Export Citation
  • 52.

    Lower limb outcomes questionnaire. American Academy of Orthopaedic Surgeons Web site. http://www.aaos.org/research/outcomes/outcomes_lower.asp. Updated August 2005. Accessed October 23, 2007.

    • Search Google Scholar
    • Export Citation
  • 53.

    Moser KM, Bokinsky GE, Savage RT, et al.Results of a comprehensive rehabilitation program: physiologic and functional effects on patients with chronic obstructive pulmonary disease. Arch Intern Med. 1980;140:15961601.

    • Search Google Scholar
    • Export Citation
  • 54.

    Doyle D, Hanks GWC, MacDonald N, eds. Oxford Textbook of Palliative Medicine. New York, NY: Oxford University Press. 1993:109.

  • 55.

    Rondinelli RD, ed. Guides to the Evaluation of Permanent Impairment. 6th ed. Chicago, Ill: AMA Press; 2022.Page intentionally left blank.

    • Search Google Scholar
    • Export Citation
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