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James Talmage
,
J. Mark Melhorn
, and
Mark H. Hyman
in AMA Guides® Newsletter
James B. Talmage
,
Mark H. Hyman
, and
Robert B. Snyder

Abstract

The current pandemic of COVID-19 cases includes cases identified in emergency medical technicians, nurses, physicians, and others with occupational exposure to the SARS-CoV-2 virus. Many of these health care professionals have filed workers' compensation claims that have been accepted. Each accepted claim will eventually need a physician to declare the individual “at maximal medical improvement” or the equivalent phrase in the jurisdiction involved. The next step is for the physician to rate permanent impairment, if present, so the case can be administratively closed. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) is used by many jurisdictions, but the AMA Guides does not mention COVID-19 or have guidance on how to assess individuals for impairment after recovery from this illness. This article provides preliminary guidance on rating permanent impairment within the respiratory, cardiac, vascular, neurologic, renal, gastrointestinal, and/or mental systems in COVID-19 survivors. Current references on the manifestations of COVID-19 illness in these body systems are included, which can be used as references to support documented impairment related to this illness.

in AMA Guides® Newsletter
Les Kertay
,
Marjorie Eskay-Auerbach
,
Mark H. Hyman
,
David Torrey
, and
WC Judge
in AMA Guides® Newsletter
James B. Talmage
,
Mark H. Hyman
,
Christopher R. Brigham
,
Sarah H. Gulick
, and
Leslie Burton

Abstract

Patients with coronavirus disease 2019 (COVID-19) may have persistent symptoms beyond the normally expected illness resolution. This disease was not diagnosed before late 2019, and therefore, we have more limited experience in understanding all of its outcomes. Thus, clinical, functional, and permanent impairment assessment is challenging. Symptoms including fatigue, dyspnea, and cognitive difficulties have been referred to as “post-acute COVID,” “long COVID,” or “long haulers.”

Patients who present for assessment of causation, maximum medical improvement (MMI), and permanent impairment can be challenging. For some examinees, after 6 to 12 months without outgoing improvement and with appropriate investigation, treatment, and rehabilitation, the examinee can be considered at MMI. However, because this disorder is new and appropriate treatment may be unclear, the time to achieve MMI is less certain. Physicians may use approaches in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), to help define MMI. As science evolves, so will our understanding of how to evaluate chronic problems associated with COVID-19.

in AMA Guides® Newsletter
J. Mark Melhorn
,
James B. Talmage
,
William E. Ackermann III
,
Mark H. Hyman
, and
Richard T. Katz
in AMA Guides® Newsletter