QUESTION: My question pertains to use of the AMA Guides, Fifth Edition, when providing an impairment rating for a woman who was involved in a motor vehicle accident, who has persistent pain in the pubis and groin consistent with aggravation of a preexisting degeneration of the symphysis pubis (confirmed by computed tomography [CT] scan of the pelvis). She appears to be a reliable historian, and it is my impression that she has impairment. Table 15-19, Whole Person Impairment Due to Selected Disorders of the Pelvis (5th ed, 428), provides only ratings for fractures and healed fractures. I am uncomfortable with assigning 0% for an obvious injury and ongoing symptoms that do not strictly conform with the provisions of Table 15-19. What should I do?

ANSWER: In Section 1.5, Incorporating Science with Clinical Judgment, the AMA Guides states, “In...

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