Chapter 13: The Nervous System

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Updates to AMA Guides Sixth Edition 2023

AMA Guides Sixth 2023 Errata (link)   

Chapter 13: The Nervous System

Content has been extensively re-written to better adhere to the principles of the AMA Guides, Sixth Edition by promoting the concept of Diagnosis Based Impairment. The structure of the chapter has changes and the way impairment ratings are performed has changed as well. 

Synopses of changes include, but are not limited to:

  • Change of chapter title from Central and Peripheral Nervous System to The Nervous System
  • Conformity of tables with all other Guides chapters
  • Identification of a Key Factor: Effect on ADLs consistent with known natural history of the diagnosis
  • Introduction of Grades within Classes along with Grade Modifiers
  • 3-Grade system with Grade A as the foundation
  • BOTC and adaptive measures can be used to Adjust Grade within Class
  • Update of the following Tables in conformity to the Guides Principle of Simplicity:
  • To maintain consistency with Chapter 14, The GAF has been incorporated into the MSCHIF as the MSCHIF-E; Aphasia has been incorporated into the Mental Status Examination within the MSCHIF-E; Modifies Episodic Disorders of Consciousness into Episodic Disorders; Consolidates 3 Tables on Pain into one (Neuropathic Pain); Defers Central Sleep Disorders to Chapter 14, consistent with the DSM-5
  • Creation of the QuickView Worksheet to improve Inter-Rater Reliability
  • Creation of a BOTC that is not burdensome on the evaluator
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