Chapter 2 preempts everything in subsequent chapters that conflicts with or compromises the principles.
No impairment may exceed 100% whole person permanent impairment nor may impairment exceed the maximum assigned to an organ or extremity.
All regional impairments are combined at the same level first and then regional impairments are combined at the whole person level.
Impairments must be rated per the chapter relevant to the organ or system where the injury primarily arose or where the greatest dysfunction remains.
Only permanent impairment may be rated and only after maximum medical improvement is certified.
A licensed physician must perform impairment evaluations and chiropractic doctors should restrict ratings to the spine.
Valid impairment evaluation reports must contain the three step approach of clinical evaluation, analysis of findings, and discussion of how the impairment rating was calculated.
The evaluating physician must use knowledge, skill, and ability generally accepted by the medical scientific community when evaluating an individual, to arrive at the correct impairment rating.
The Guides are based on objective criteria and if findings conflict with established medical principles they cannot be used to justify an impairment rating.
Motion and strength determinations should be assessed carefully for self-inhibition.
Ratings of future impairment are not provided.
If there is more than one method to define impairment, the method producing the higher rating must be used.
Subjective complaints alone are generally not ratable.
Impairment ratings are rounded to the nearest whole number.
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