... rating methodology using the AMA Guides to the Evaluation of Permanent Impairment ( AMA Guides ), Sixth Edition section on The Upper Extremities. A 58-year-old male automotive mechanic fell at work on an oil-slickened floor and landed directly on his left outstretched hand and wrist, as well...

...James B. Talmage, MD; Christopher Brigham, MD Impairment evaluations not performed following processes defined in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) will result in erroneous ratings. Common errors in impairment rating (IR) for upper extremity are frequently seen...

...James B. Talmage, MD; J. Mark Melhorn, MD; Christopher R. Brigham, MD © 2017 American Medical Association. All Rights Reserved. 2017 American Medical Association QUESTION: Using the AMA Guides , Sixth Edition, how would I rate impairment for motion loss of upper extremity joints when...

...James B. Talmage, MD; Charles N. Brooks, MD; Mark H. Melhorn, MD; Christopher R. Brigham, MD © 2016 American Medical Association. All Rights Reserved. 2016 American Medical Association QUESTION: The AMA Guides Fifth Edition, Table 16-27 , Impairment of the Upper Extremity After...

...James B. Talmage, MD; J. Mark Melhorn, MD This article responds to the previous article in this issue of The Guides Newsletter (Two-point Discrimination in the Use of Upper Extremity Nerve Function in the AMA Guides ) and discusses why the AMA Guides to the Evaluation of Permanent Impairment ( AMA...

... © 2005 American Medical Association. All Rights Reserved. 2005 American Medical Association The Quick Reference groups pertinent Guides tables (5th ed, 482, 484, 489, 490, 492) from Section 16.5, Impairment of the Upper Extremities Due to Peripheral Nerve Disorders. ...

... impairment in these rare cases. In the first case, the evaluating neurologist used alternative approaches to define impairment based on the presence of thoracic outlet syndrome and upper extremity pain, as if there were a nerve injury. An orthopedic surgeon who evaluated the case did not base impairment...

...Christopher R. Brigham, MD; Charles N. Brooks, MD Chapter 16, The Upper Extremities, in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, presents several changes from the Fourth Edition. The changes are minor compared to those in Chapter 15, The Spine...

... Association Table 1 Relationship of Impairment of the Digits to Impairment of the Hand.(p.18). Table 2 Relationship of Impairment of the Hand to Impairment of the Upper Extremity.(p.19) Table 3 Relationship of Impairment of the Upper Extremity to Impairment of the Whole Person...

...James B. Talmage, MD Upper extremity entrapment neuropathies are chronic injuries to peripheral nerves, presumably from sustained pressure on the nerve in question. These conditions are controversial, and physicians disagree, unfortunately too often, about whether a neuropathy is present, what...

... or involving different neural elements, are combined, not added. As implied, the extremity neurological rating may then be combined with any other unrelated impairment of the limb, e.g., due to amputation, joint ankylosis, or vascular disorder. This article focuses on ratings for the upper extremity...

...James B. Talmage, MD © 1999 American Medical Association. All Rights Reserved. 1999 American Medical Association Following is a checklist for evaluation of upper extremity impairments according to the Guides . Page numbers are in parentheses. Digit Rate by Thumb...

..., medial and lateral epicondylitis, upper extremity amputations, and recurrent shoulder dislocation. On finding decreased motion at a finger distal interphalangeal joint (DIP) or thumb interphalangeal (IP) joint, the examiner should carefully assess the functional consequences and ensure the rating...

...James B. Talmage, MD The primary methods of evaluating impairment in the upper extremity are range of motion testing and neurological examination. For certain conditions that do not cause motion or neurological deficits yet leave the extremity significantly impaired, the editors of the AMA Guides...

... When performed according to criteria in the AMA Guides to the Evaluation of Permanent Impairment ( AMA Guides ), Fourth Edition, upper extremity impairment assessment requires a thorough physical examination of the involved (and contralateral) upper limb. Observation and palpitation require...

... a peripheral nerve impairment of the upper extremity: First, identify the nerve or nerves affected using relevant tables and figures. Second, locate the table that lists the nerve identified, and record the maximum loss attributed to that nerve for motor and sensory function. A table lists peripheral nerve...

... © 2010 American Medical Association. All Rights Reserved. 2010 American Medical Association Case Exercises from the Guides Sixth Impairment Training Workbook-Upper Extremites Physical examination and appropriate clinical studies provide information that is considered...

...Christopher R. Brigham, MD, MMS; Craig Uejo, MD, MPH; J. Mark Melhorn, MD; James B. Talmage, MD In the AMA Guides to the Evaluation of Permanent Impairment ( AMA Guides ), Sixth Edition, the chapter on the upper extremities is the longest and most complex, which reflects the complexities...

... impairments should be combined. The combining must occur at the same hierarchal level (eg, upper extremity impairment can be combined only with another upper extremity impairment from the same limb), and whole person impairment (WPI) can be combined only with another WPI impairment. In case of impairments...

... impairment to the peripheral or brachial plexus nerves are rated using Section 15.4e, Peripheral Nerve and Brachial Plexus Impairment, for upper extremities and Section 16.4c, Peripheral Nerve Rating Process, for lower extremities. Verifiable nerve lesions that incite the symptoms of complex regional pain...