Catastrophic Central Nervous System Injury Rating
Stephen L. Demeter
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Lorne Direnfeld
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Richard Katz
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James B. Talmage
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Christopher R. Brigham
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Abstract

We present a case involving a catastrophic injury that resulted from a completely obstructed airway when an examinee choked on food. She had cardiopulmonary arrest and developed a hypoxic-ischemic encephalopathy associated with profound neurological losses. The evaluation of the consequences of severe central nervous system injury necessitates evaluation and rating of all the sequelae of that injury. The first step is clinical assessment, followed by thoughtful application of these data to the processes and criteria provided in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides). The approaches discussed in the fifth and sixth editions of the AMA Guides are similar.

  • 1.

    Cocchiarella L, Andersson GBJ. AMA Guides to the Evaluation of Permanent Impairment, 5th ed. Chicago: American Medical Association; 2000.

  • 2.

    Rondinelli RD, ed. AMA Guides to the Evaluation of Permanent Impairment, 6th ed. Chicago: American Medical Association; 2008.

  • 3.

    Barth PS. Rating cognitive impairment, part 1: case example illustrates need for adherence to AMA Guides, Sixth Edition, methodology. AMA Guides Newsletter. Jan/Feb 2017:3-10.

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