...Christopher R. Brigham, MD; Charles N. Brooks, MD; James B. Talmage, MD Impairment evaluations not performed following processes defined in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) usually result in erroneous ratings. Common lower extremity impairment rating (IR) errors...

...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...

... 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 a manner...

...William S. Shaw, MD; Charles N. Brooks, MD © 1999 American Medical Association. All Rights Reserved. 1999 American Medical Association The approach to evaluation of lower extremity impairments in the Guides 4th edition differs from previous editions. Using case studies, this article...

...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...

...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...

... 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...

...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...

..., 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...

... 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...

..., permanent impairment. Procedures for rating extremity neural deficits are described in Chapter 3, The Musculoskeletal System, section 3.1k for the upper extremity and sections 3.2k and 3.2l for the lower limb. Chapter 4, The Nervous System, section 4.4, provides additional information, including one...

... 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...

...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 whole person impairment ratings before combining. In most lower extremity impairment cases only one evaluation method is used, but certain circumstances justify combining impairments. Examples in the lower extremity include diagnosis-based estimates with short leg, degenerative joint disease...

... 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. © 2012...

... 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. © 2002 American Medical Association. All Rights Reserved. 2002...

... combine lower extremity impairments usually use only one evaluation method, but, if more than one method is used, the physician should use the Combined Values Chart. © 2002 American Medical Association. All Rights Reserved. 2002 American Medical Association Physicians must account...

..., and report standards. Upper extremity and lower extremity impairment evaluations are discussed in terms of clinical assessments and rating processes, analyzing important changes between editions and problematic areas (eg, complex regional pain syndrome). © 2004 American Medical Association. All Rights...

... of 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...