The evaluation of impairment and disability due to pain is challenging. The Guides Fifth Edition has dealt with many controversial issues, and it is probable that controversy will always be associated with any standard used to assess impairment. This article reviews whether pain should be conceptualized as an impairment as opposed to recognized as a disabling factor.
In editions of the AMA Guides prior to the Fourth, each chapter focused on a single organ system and provided a description of the diagnostic and evaluative methods for assessing impairment at the organ system level and functional impairment of the whole person (ie, the impact of the organ system loss on the ability of the person to perform activities of daily living). Beginning with the Fourth and continuing with the Fifth Edition, a chapter was added that focused, not on...
