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Abstract
This is the second of four articles that explore the effects of age-related changed in impairment evaluations according to the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth and Sixth Editions; specifically, this article completes the review of the internal medicine sections. With respect to the digestive system, the normal aging process affects gastrointestinal impairment ratings as found in the AMA Guides, Fifth and Sixth Editions, for gastroesophageal reflux disease, peptic ulcer disease, pancreatitis, diverticulitis, irritable bowel syndrome, fecal incontinence, and hemorrhoids. Cancers of the digestive system and infectious hepatitis were reviewed by the National Institutes of Health in The Burden of Digestive Diseases in the United States (2008), which should be reviewed when an impairment rating or apportionment is needed or for an individual with these conditions alleged to be the result of a compensable injury or illness. The normal aging process does not significantly affect the impairment ratings for renal disease (upper urinary tract disease), but, for individuals over 70, an age adjustment should be incorporated into the impairment rating. The AMA Guides, Fifth and Sixth Editions, also do not provide age-related modifications for urinary incontinence, but a rating physician may apply a discretionary apportionment. For diseases of the scrotum, testicles, epididymis, and spermatic cord, as well as for prostatic hypertrophy, neither edition of the AMA Guides makes age-related modifications; neither are modifications because of aging are made for the female reproductive tract, although raters are told to consider the physiological differences.
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1.
Cocchiarella L, Andersson GBJ, eds. Guides to the Evaluation of Permanent Impairment, 5th ed. Chicago: American Medical Association; 2001.
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Rondinelli RD, ed. Guides to the Evaluation of Permanent Impairment, 6th ed. Chicago: American Medical Association; 2008
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3.
Taffet GE. Normal aging. Up-to-date; literature current through July 2018.
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Everhart JE. Gastroesophageal reflux disease. In: Everhart JE, ed. The Burden of Digestive Diseases in the United States. US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Washington, DC: US Government Printing Office, 2008; NIH Publication No. 09-6443 pp. 69–72.
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Everhart JE. Peptic ulcer disease. In: Everhart JE, ed. The Burden of Digestive Diseases in the United States. US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Washington, DC: US Government Printing Office, 2008; NIH Publication No. 09-6443 pp. 119–122.
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Everhart JE. Pancreatitis. In: Everhart JE, ed. The Burden of Digestive Diseases in the United States. US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Washington, DC: US Government Printing Office, 2008; NIH Publication No. 09-6443 pp. 73–76.
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7.
Matrana MR, Margolin DA. Epidemiology and pathophysiology of diverticular disease. Clinics in Colon and Rectal Surgery. 2009; 22:141–146.
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Pemberton JH. Colonic diverticulosis and diverticular disease: epidemiology, risk factors, and pathogenesis. Up-to-date; literature current through July 2018.
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Everhart JE. Functional intestinal disorders. In: Everhart JE, ed. The Burden of Digestive Diseases in the United States. US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Washington, DC: US Government Printing Office, 2008; NIH Publication No. 09-6443 pp. 77–87.
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Whitehead WE, Borrud L, Goode PS, Meikle S, et al.Fecal incontinence in U.S. adults: epidemiology and risk factors. Gastroenterology. 2009; 137:512–517.
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Everhart JE. Hemorrhoids. In: Everhart JE, ed. The Burden of Digestive Diseases in the United States. US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Washington, DC: US Government Printing Office, 2008; NIH Publication No. 09-6443 pp. 65–68.
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13.
Lukacz ES. Evaluation of women with urinary incontinence. Up-to-date; literature current through July 2018.
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Clemens JQ. Urinary incontinence in men. Up-to-date; literature current through July 2018.
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15.
Cunningham GR, Kadmon D. Clinical manifestations and diagnostic evaluation of benign prostatic hyperplasia. Up-to-date; literature current through July 2018.
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