AAOS Now

Published 5/1/2008

New AMA Impairment Guidelines add five axioms

The American Medical Association’s (AMA) Guides to the Evaluation of Permanent Impairment, 6th Edition, is now available. The guides incorporate the following five new axioms, resulting in a significant change in methods to determine impairment:

  • Disablement as defined by the International Classification of Functioning, Disability, and Health (ICF)
  • Increased diagnosis-based impairments
  • “Simplicity”
  • Functionally based impairment ratings
  • New methodological congruity within and among organ systems

The Guides to the Evaluation of Permanent Impairment reflect the most significant evolution in impairment assessment. A diagnosis-based grid has been developed for each organ system with five classes of impairment severity, based on consensus-based dominant criterion. This results in a significant learning curve to apply the guides appropriately.

Why do you need to know about the Guides to the Evaluation of Permanent Impairment?
This text serves as the standardized physician reference on permanent impairments and is broadly applicable to workers’ compensation, personal injury, and disability claims. In addition, 40 of 51 workers’ compensation jurisdictions mandate or recommend use of the Guides to the Evaluation of Permanent Impairment.

Plan now to attend
Find out how you can use the guides at the 10th Annual AAOS Occupational Orthopaedics & Workers’ Compensation Course, Nov. 7-9, 2008. The course covers issues such as how the application of a standardized methodology enhances the relevancy of impairment ratings, improves internal consistency, and promotes ease of application to the rating process. It also describes how functionally based histories, physical findings, and broadly accepted objective clinical test results are integrated to determine the impairment class, grade modifiers, and adjustment factors. For more information, visit the AAOS Web site at
www.aaos.org/courses