QUESTION: Using the AMA Guides, Third Edition, Revised, I am rating a lower extremity injury. In 1995 he had a knee internal derangement that was treated surgically; however, this was complicated by deep vein thrombophlebitis and a post-phlebitis syndrome with stasis ulcer. The patient had a pulmonary embolism in 1995 which resolved without sequelae, is no longer on anticoagulants, and has ongoing skin problems associated with chronic ulceration secondary to his vascular disease (including malodor). Another assessor opined there was a 71% whole person rating based on combined impairments for the right knee, vascular disease, and skin disease (involving the right leg).
May multiple combined impairments of a lower extremity result in impairment greater than amputation of the entire lower extremity? In the Sixth Edition, Table 2-1, Fundamental Principles of the Guides states “No impairment arising from...
