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AMA Guides Sixth 2023


Affiliated Organization(s)

Proposal Description

Public Comments

100440  International Academy of Independent Medical Evaluators
 Synopses of proposed changes include, but are not limited to:
  • Change of chapter title from Central and Peripheral Nervous System to The Nervous System
  • Adherence to the principles of the AMA Guides, Sixth Edition by promoting the concept of Diagnosis Based Impairment
  • 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 that 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 Digital 2022, 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

 Link to Comments

Link to Resolution


International Academy of Independent Medical Evaluators

The words “with normal motion” be removed from all sections in which it appears in Tables 15-2, 15-3, 15-4, and 15-5; elimination of the footnote from the DBI tables that says: “*If motion loss is present, this impairment may alternatively be assessed using Section 15.7, Range of Motion Impairment. A range of motion impairment stands alone and is not combined with diagnosis impairment.”

Revision of section 15-7 (and 15-3b) to reinforce DBI as preferred method, but, when presented with decreased ROM, a rater can consider that as an alternative method when the impairment isn’t able to be rated with the DBI paradigm.

Link to Comments


North American Spine Society

Proposal description (pdf)

Link to Comments

Link to Panel Resolution


American Academy of Otolaryngology - Head and Neck Surgery

Revisions to the ENT Chapter of the Guides that address:

  • Rotary Chair Testing
  • New dysphagia example
  • Inclusion of videonystagmography

Link to Comments

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