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Steven D. Feinberg
Christopher R. Brigham
, and
Charles N. Brooks


Assessment of impairment and disability experienced by patients with chronic pain is challenging. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) assesses impairment primarily based on objective findings, but pain is subjective. The sixth edition of the AMA Guides provides a pain-related impairment (PRI) of up to 3% in rare situations. Otherwise, pain is considered to be reflected in the conventional impairment rating system. There are still many unanswered questions.

in AMA Guides® Newsletter
Daniel C. Schainholz


The assessment of visual impairment using the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, requires a thoughtful ophthalmologic evaluation and careful application of the functional vision tests and arithmetic criteria provided in Chapter 12, The Visual System, and other chapters, as applicable. The interpolation of the multiple dimensions of the visual system into the enumeration of a single impairment percentage may involve complex mathematical manipulations. Properly enumerated, the value can be utilized rigorously in impairment evaluations, functional evaluations, and even for academic research.

in AMA Guides® Newsletter