Apportionment estimates the degree to which each of various occupational or nonoccupational factors may have caused or contributed to a particular impairment (4th ed., 315). Apportioning spinal impairment among different injuries is often challenging. The Guides does not provide specific instructions on spinal impairment apportionment. Thus, the evaluator must be familiar with both causation analysis and terminology, as well as with spinal impairment evaluation.

The Guides defines an aggravation as a

According to the Guides, if a subsequent incident occurs, but the impairment rating changes by 3% or less, this incident represents either exacerbation of preexisting symptoms or a recurrence of the original problem. Aggravation refers to a worsening of an underlying condition. In most jurisdictions the term aggravation refers to a permanent change. Exacerbation refers to a temporary increase in symptoms. Examiners should be familiar with specific...

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