...Christopher R. Brigham, MD Impairment values are more often combined than added, and the Combined Values Chart in the AMA Guides to the Evaluation of Permanent Impairment can be used to calculate the combined value of two numbers. The values are derived from the formula A + B(1 – A) = the combined...

...Christopher R. Brigham, MD Evaluating physicians may need to account for the effects of multiple impairments using a summary value. In the AMA Guides to the Evaluation of Permanent Impairment ( AMA Guides ), Sixth Edition, the Combined Values Chart provides a method to combine two or more...

... values that should be combined and typically results in an inflated rating. The Combined Values Chart in the AMA Guides to the Evaluation of Permanent Impairment, Fifth Edition, includes instructions that guide physicians about combining impairment ratings. For example, impairment values within a region...

... percentages allow for pain that may accompany the impairing condition. If possible, the evaluator should remove a patient's protheses during evaluation. Physicians should consult the Combined Values Chart if the effects of treatment prevent adequate impairment management. A patient's decision to decline...

... or combined, particularly during the assessment of hand or limb injuries. Combining is accomplished by using the Combined Values Chart presented in the Appendix of each edition of the AMA Guides to the Evaluation of Permanent Impairment ( AMA Guides ). With a few exceptions, the general rule is that all...

... for the patient; multiply the graded percentage by the total motor impairment found in step two. Fourth, determine the total deficit for the nerve by combining the motor and sensory deficits using the Combined Values Chart. Fifth, combine the total nerve deficit with other appropriate impairments. A table...

... (if premenopausal). Neurogenic sexual dysfunction is combined with other related impairments using the Combined Values Chart. © 2016 American Medical Association. All Rights Reserved. 2016 American Medical Association Impairment assessment of female sexual dysfunction (FSD) using the Fifth or Sixth...

... be calculated separately and their whole person values combined using the Combined Values Chart in AMA Guides to the Evaluation of Permanent Impairment . At present, no ideal system can rate impairment following MTBI, and physicians must thoroughly understand both the underlying disease process...

... to a combination of neurologic and urologic pathology, including pathology in the upper urinary tract, ratings from both sections can be combined using the Combined Values Chart. © 2000 American Medical Association. All Rights Reserved. 2000 American Medical Association Impairment rating for conditions...

.... Evaluators should consider the effect of using the Combined Values Chart on the final assessment and must carefully distinguish factors that are combined vs those that are added or subtracted. A sidebar discusses important changes to the State of California's Workers’ Compensation. © 2004 American Medical...

... be familiar with numerous relevant sections in Chapter 13, The Central and Peripheral Nervous System, as shown in a table in the article. Individual impairments can be combined using the Combined Values Chart in the AMA Guides . Also, the AMA Guides requires the examiner to grade mental status impairment...

..., proximal interphalangeal, and distal interphalangeal joints are in full simultaneous flexion, and it measures extension when all three joints are in full simultaneous extension. Based on an example and using the Combined Values Chart in the Fifth Edition and the traditional method (the only method allowed...

...), of the AMA Guides , Sixth Edition, item six instructs the following: “Combine lower extremity percentages using the Combined Values Chart in the same extremity as appropriate. If both lower extremities are involved, convert impairments to whole person and combine.” In addition, Section 16.3f, Combining...

..., given an individual with 8% and 6% WPIs that should be combined, one can simply add since the total is 14% either way. The Combined Values Chart (5th ed, 604-606) allows users to combine any 2 numbers between 1 and 99 without using the formulas. (Calculations have been made and rounded, when...

... for problems with station and gait (9%), using the Combined Values Chart (5th ed, 604-606), there is a total of 34% impairment of the whole person. Combining this with the additional impairment related to problems with bladder dysfunction (9%), using the Combined Values Chart, there is a total of 40...

... person impairments are then combined using the combined values chart ( Mountain City, 252). The issue facing the court was what to do when the worker's injury was to both a scheduled and a non-scheduled body part. The Colorado statute was ambiguous on this point. The court held that: When...

... System. The AMA Guides (5th ed, 306) states, “If impairments involve several nervous system areas (eg, the brain, spinal cord, and/or peripheral nerves), calculate separate whole person impairment ratings for each area and combine them using the Combined Values Chart (p. 604). As discussed...

... 40. Therefore, there would be a total of 30% impairment of the whole person for lack of sexual functioning. These are combined using the Combined Values Chart. Combining the rating of 60% for loss of bladder function with 50% for loss of bowel function, using the Combined Values Chart...

... for this unusual situation must be fully explained in the report accompanying the rating. Multiple spine related impairments in different regions may be combined using the Combined Values Chart (page 604). Thus both a cervical spine diagnosis and a lumbar spine diagnosis may each be rated and the impairments...

... dysfunction) (6th ed, 338) assigns a 15% WPI owing to the absence of sexual function. According to Table 13-17 (dysesthetic pain) (6th ed, 339), the patient's dysesthetic pain is mild to moderate. The individual uses gabapentin for pain management and is assigned a 4% WPI. The Combined Values Chart combines...