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Lower Extremity Impairment

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Newsletter Articles
Guides Newsletter (2001) 6 (4): 5–7.
Published: 01 July 2001
...Christopher R. Brigham, MD Chapter 17, The Lower Extremities, in the AMA Guides to the Evaluation of Permanent Impairment ( AMA Guides ), Fifth Edition, continues to provide three means of assessing impairment: anatomic, diagnostic, and functional. Changes from the AMA Guides, Fourth Edition...
Newsletter Articles
Guides Newsletter (1999) 4 (1): 4.
Published: 01 January 1999
..., outlines the conditions that should be considered when evaluating a lower extremity. Examinee: Date: Evaluation of the lower extremity reveals findings which might warrant impairment ratings in the following categories. Final impairment is calculated based on clinical diagnosis, and in...
Newsletter Articles
Guides Newsletter (2017) 22 (2): 15–16.
Published: 01 March 2017
... multiple combined impairments of a lower extremity result in impairment greater than amputation of the entire lower extremity? In the Sixth Edition, Table 2-1, Fundamental Principles of the Guides states “No impairment arising from a member or organ of the body may exceed the amputation value of that...
Newsletter Articles
Guides Newsletter (2008) 13 (5): 7–8.
Published: 01 September 2008
...Christopher R. Brigham, MD The AMA Guides to the Evaluation of Permanent Impairment ( AMA Guides ), Sixth Edition, takes approaches to the lower extremities that are consistent with Chapter 15, Upper Extremities (reviewed in the March/April 2008 issue of The Guides Newsletter ). Because there is a...
Newsletter Articles
Guides Newsletter (1999) 4 (2): 8–9.
Published: 01 March 1999
... therapy for a permanent impairment, that decision should neither decrease nor increase the estimated percentage…” (4th ed., 9). The same rating methods used elsewhere in the lower extremity are applicable for the foot and toes. When evaluating these most distal portions of the limb, however...
Newsletter Articles
Guides Newsletter (1999) 4 (1): 1–3.
Published: 01 January 1999
...William S. Shaw, MD; Charles N. Brooks, MD The process of assessing lower extremity impairment described in the AMA Guides to the Evaluation of Permanent Impairment ( AMA Guides ), Fourth Edition, differs from that in previous editions. This article addresses common questions that arise in knee and...
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Newsletter Articles
Guides Newsletter (2018) 23 (1): 14–16.
Published: 01 January 2018
... extremity impairment and finally converts the final lower extremity impairment to whole person impairment. Two or more conditions often are found in the knees and require causation analysis in which the physician should choose the single causally related diagnosis that will yield the highest impairment...
Newsletter Articles
Guides Newsletter (2021) 26 (2): 13–17.
Published: 01 March 2021
...James B. Talmage, MD; Jay Blaisdell, MA; Christopher R. Brigham, MD Nerve lesions caused by traumatic events to the lower extremity's peripheral nerves are rated using Section 16.4 of the sixth edition of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides). Results from sensory...
Newsletter Articles
Guides Newsletter (1997) 2 (1): 2–4.
Published: 01 January 1997
...William S. Shaw, MD The AMA Guides to the Evaluation of Permanent Impairment ( AMA Guides ), Fourth Edition, introduces a new system of rating lower extremity impairments that allows use of more than one method for arriving at a rating. Such flexibility allows the rater greater leeway to assess...
Newsletter Articles
Guides Newsletter (2009) 14 (5): 8–9.
Published: 01 September 2009
... Impairment Training Workbooks are designed to review and reinforce the concepts described in the Sixth Edition. The following questions and answers, excerpted from the Guides Sixth Impairment Training Workbooks - Lower Extremities , 1 illustrate some of the principles of assessment common to...
Newsletter Articles
Guides Newsletter (2019) 24 (3): 14–16.
Published: 01 May 2019
... preferred method for calculating upper and lower extremity ratings, but, in instances specified by the regional grid, the evaluator may choose to use the ROM method, typically because it yields a higher impairment rating relative to the DBI method. In rare lower-limb cases when the injury is not fully...
Newsletter Articles
Guides Newsletter (2002) 7 (5): 10–11.
Published: 01 September 2002
..., respectively. Table 17-8, Impairment Due to Lower Extremity Muscle Weakness (5th ed, 532), inexplicably omits whole person (WP) and lower extremity (LE) ratings for Grade 0 great toe flexion (see the lower left corner). Presumably this should read: 5 (12) [17], as in the Fourth Edition, Table 39 (p. 77...
Newsletter Articles
Guides Newsletter (2012) 17 (2): 7–9.
Published: 01 March 2012
... generally are combined and converted to whole person permanent impairment before being combined with values from other regions. The article reviews the AMA Guides, Sixth Edition, approach to combining upper extremity impairments, lower extremity impairments, and combining spinal impairments. If multiple...
Newsletter Articles
Guides Newsletter (1999) 4 (2): 4–7.
Published: 01 March 1999
...Christopher R. Brigham, MD The approach to evaluation of lower extremity impairments in the AMA Guides to the Evaluation of Permanent Impairment ( AMA Guides ) differs from that given in previous editions. This article uses case studies to illustrate practical applications of current approaches to...
Newsletter Articles
Guides Newsletter (2011) 16 (2): 9–11.
Published: 01 March 2011
... interval, there is class 4 impairment with a default rating of 50% lower extremity impairment. The next step is to adjust this value within the class based on functional history, physical examination, and clinical studies. Tables 16-6, 16-7, and 16-8 (6th ed, 516, 517, and 519) outline the functional...
Newsletter Articles
Guides Newsletter (2019) 24 (2): 6–11.
Published: 01 March 2019
... impairments (DBIs) and proximal range-of-motion impairments. The AMA Guides provides impairment grids for lower and upper extremity amputations, which are divided into five impairment classes (0 through 4), and each impairment class is further divided (except class 0) into five grades (A through E), each with...
Newsletter Articles
Guides Newsletter (2021) 26 (2): 3–12.
Published: 01 March 2021
..., 4 to 6 weeks of recovery might be required before returning to sedentary or light work. 17 For those with persisting symptoms of fatigue or dyspnea on exertion, and for those with documented lower respiratory tract infection (pneumonia on imaging), a testing-based evaluation might help. The...
Newsletter Articles
Guides Newsletter (2006) 11 (6): 4–7.
Published: 01 November 2006
... arthroscopic debridement; results tend to be better in younger patients. In general, an acetabular labral tear, partial labrectomy, or labral repair warrants a rating of 2% lower extremity impairment. Evaluators should avoid double dipping (eg, using both a Diagnosis-related estimates and limited range-of...
Newsletter Articles
Guides Newsletter (2002) 7 (6): 13–15.
Published: 01 November 2002
... impairment if the DRE method were used and 6% if the ROM method were used. The table in this article provides values for converting foot to lower extremity impairment and for converting whole person impairment to regional spinal impairment. The Guides do not provide tables for converting foot to lower...