QUESTION: Using the AMA Guides, Sixth Edition, how would I rate impairment for motion loss of upper extremity joints when there is also diminished range of motion on the opposite, uninjured side.

A right wrist injury resulted in decreased flexion of 30 degrees vs 50 degrees of the left wrist and decreased extension, also 30 degrees vs 50 degrees on left. Radial and ulnar deviation are normal and equal for both wrists.

In the Sixth Edition, Section 15.7a, Clinical Measurements of Motion, it states that “if the opposite extremity is neither involved nor previously injured, it must be used to define normal for that individual; any losses should be made in comparison to the opposite normal extremity” (page 461).

How should I rate impairment for the right wrist using the opposite, uninjured wrist as normal?

ANSWER: The...

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