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- Author or Editor: Jenny Walker x
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Abstract
Rating patients with head trauma and multiple neurological injuries can be challenging. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, Section 13.2, Criteria for Rating Impairment Due to Central Nervous System Disorders, outlines the process to rate impairment due to head trauma. This article summarizes the case of a 57-year-old male security guard who presents with headache, decreased sensation on the left cheek, loss of sense of smell, and problems with memory, among other symptoms. One year ago the patient was assaulted while on the job: his Glasgow Coma Score was 14; he had left periorbital ecchymosis and a 2.5 cm laceration over the left eyelid; a small right temporoparietal acute subdural hematoma; left inferior and medial orbital wall fractures; and, four hours after admission to the hospital, he experienced a generalized tonic-clonic seizure. This patient's impairment must include the following components: single seizure, orbital fracture, infraorbital neuropathy, anosmia, headache, and memory complaints. The article shows how the ratable impairments are combined using the Combining Impairment Ratings section. Because this patient has not experienced any seizures since the first occurrence, according to the AMA Guides he is not experiencing the “episodic neurological impairments” required for disability. Complex cases such as the one presented here highlight the need to use the criteria and estimates that are located in several sections of the AMA Guides.
Abstract
The AMA Guides to the Evaluation of Permanent Impairment, (AMA Guides), Fifth Edition, is the most widely used basis for determining impairment and is used in state workers’ compensation systems, federal systems, automobile casualty cases, and personal injury cases. The AMA Guides is used in most state workers’ compensation jurisdictions: 25 states use the fifth edition; 10 use the fourth edition, 1 state uses a hybrid of the fourth and fifth editions, and 2 states use the third edition, revised; 6 states use their own state-specific guidelines, and 6 do not indicate a specific guideline. Statutes may or may not specify which edition of the AMA Guides to use nor how to use them. In addition, many states use a statutory schedule for amputations, hearing loss, visual loss, hernias, and disfigurement, and other states use the AMA Guides for nonscheduled injuries. The AMA Guides often is used to quantify the extent of injuries resulting from an automobile casualty or personal injury. Insurers may use an impairment rating as a factor in setting reserves and determining the settlement value of a claim, and attorneys may use this information to quantify the effects of an injury. A four-page table displays uses of the AMA Guides in state workers’ compensation plans, including the edition most commonly used, the statute/code, comments, and relevant websites.
Abstract
The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) is the most widely used basis for determining impairment and is used in state workers’ compensation systems, federal systems, automobile casualty, and personal injury, as well as by the majority of state workers’ compensation jurisdictions. Two tables summarize the edition of the AMA Guides used and provide information by state. The fifth edition (2000) is the most commonly used edition: California, Delaware, Georgia, Hawaii, Kentucky, New Hampshire, Idaho, Indiana, Iowa, Kentucky, Massachusetts, Nevada, North Dakota, Ohio, Vermont, and Washington. Eleven states use the sixth edition (2007): Alaska, Arizona, Louisiana, Mississippi, Montana, New Mexico, Oklahoma, Pennsylvania, Rhode Island, Tennessee, and Wyoming. Eight states still commonly make use of the fourth edition (1993): Alabama, Arkansas, Kansas, Maine, Maryland, South Dakota, Texas, and West Virginia. Two states use the Third Edition, Revised (1990): Colorado and Oregon. Connecticut does not stipulate which edition of the AMA Guides to use. Six states use their own state specific guidelines (Florida, Illinois, Minnesota, New York, North Carolina, and Wisconsin), and six states do not specify a specific guideline (Michigan, Missouri, Nebraska, New Jersey, South Carolina, and Virginia). Statutes may or may not specify which edition of the AMA Guides to use. Some states use their own guidelines for specific problems and use the Guides for other issues.
