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Steven Feinberg
,
Kenneth Kingdon
, and
Robert Rassp

Editorial Comment This article provides insight into the assessment of impairment and disability in California. Between 2007 and 2015 there were approximately 67,000 permanent disability awards per year in California based, at least in part, on the AMA Guides to the Evaluation of Permanent Impairment, Fifth Edition. 1 This article should be read in conjunction with the article “Flawed Approaches to Determining the Most Accurate Impairment Rating: The California Experience,” which appears in this issue and discusses why many novel California

in AMA Guides® Newsletter
Jesse E. Bible
,
Dan M. Spengler
, and
Hassan R. Mir

disability payments would have already stopped at that time. At MMI, some injured workers may have recovered completely without any residual impairment, whereas others are left with some permanent impairment. To help establish a standardized method to classify impairment, the American Medical Association (AMA) developed the Guides to the evaluation of permanent impairment ( Guides ), which rates impairments for each organ system in the body [ 7 ]. The most recent sixth edition of the Guides came out in 2008 and has evolved to a diagnosis-based model [ 7 ]. The

in AMA Guides® Newsletter
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Richard T. Katz

Dr. Barth has provided several useful insights in his article. The controversy concerning posttraumatic headache is important to discuss. However, while Dr. Barth correctly points out that there is an effort to make the Guides more evidence based, that does not mean we can ignore the realities of present day practice and impairment rating. Posttraumatic headaches are a frequent reality in a generalist or specialist physician's office. While pain remains as likely the greatest challenge to impairment rating secondary to its subjectivity, the editors of the

in AMA Guides® Newsletter
James B. Talmage

Question: In the absence of a compensable hearing loss, can impairment be assigned for tinnitus? Our state makes use of the Fourth Edition, however I am also interested in how this is dealt with in other editions. Answer: The AMA Guides hearing impairment section has changed little from the First to the Sixth Edition. In the first 2 editions of the Guides , tinnitus is not discussed. In the Third Edition, pages 165-166, it states that tinnitus is a symptom and is not measurable, and thus impairment should be based on tinnitus severity, and the

in AMA Guides® Newsletter
Restricted access
Richard T. Katz

I thank the authors for their thoughtful summary of the new Mental and Behavioral Disorders (M&BD) Chapter with the Sixth Edition. I believe the chapter is a significant step beyond the Fifth Edition. Like all chapters within the Guides , the chapter is a consensus opinion of many authors, and thus reflects many points of view. While validity in impairment ratings remains a ripe area for research for all of the organ system chapters, the M&BD chapter is no exception. Some recent insignts in this area have been published in response to the swell of

in AMA Guides® Newsletter

This article is excerpted from Occupational Injuries and Illnesses (LexisNexis), Ch. 100, originally written by Brian J. Caveney, MD, JD, MPH, and updated annually by Thomas A. Robinson, JD, co-author, Larson's Workers' Compensation Law. Origins and Development of AMA Guides Ever since humans were nomadic hunter-gatherers, some members of the tribes inevitably would be injured or disabled from accidents, battles, or diseases. Surely many were left for dead, but one element that separated humans from all other species was the emergence of a

in AMA Guides® Newsletter
Christopher R. Brigham

The Guides to the Evaluation of Permanent Impairment is the most widely used and accepted reference for evaluating permanent impairment. Unfortunately, many individuals and entities erroneously consider the concepts of impairment and disability as interchangeable when they are not. The Guides defines impairment as the “loss, loss of use, or derangement of any body part, system or function” (4th ed., 315). Disability, on the other hand, “may be defined as an alteration of an individual's capacity to meet personal, social or occupational demands, or

in AMA Guides® Newsletter
E. Randolph Soo Hoo

evaluated using the same 5-step sequential evaluation process. If disability is not granted at this level, the claimant has the option to progress to the other appeals levels. The AMA Guides and Social Security Disability Anecdotally, many who are unfamiliar with either the AMA Guides or the SSA disability process believe the AMA Guides rate disability. Conversely, some believe that the SSA rates disability in percentages. The confusion is understandable because both the AMA Guides and SSA use the terms “disability” and “impairment.” The AMA Guides

in AMA Guides® Newsletter

Case exercises are an effective way to increase your understanding of the appropriate application of the AMA Guides . The following is one of over seventy cases that are included in the new edition of the Guides Casebook . 1 This case illustrates the process of assessing impairment for carpal tunnel syndrome by the Fourth, Fifth, and Sixth Editions. Case Presentation Subject: Ms Jones, a 45-year-old woman. History: Ms Jones worked on an assembly line, and her work involved repetitively packing boxes. She had the insidious onset of numbness

in AMA Guides® Newsletter

Case exercises are an effective way to increase your understanding of the appropriate application of the Guides . The following is one of over seventy cases that are included in the new edition of The Guides Casebook 1 . This case illustrates the assessment of spinal impairment by the Fourth, Fifth and Sixth Editions. Case Presentation Subject: Ms Jensen, a 31-year-old woman. History: Ms Jensen experienced the onset of acute low back and left leg pain while lifting and twisting at work. Ms Jensen's relevant history included no similar prior

in AMA Guides® Newsletter