The AMA Permanent Impairment Guides
In this article I want to offer a short rundown of the AMA Guides to Permanent Impairment. Before we talk about what these guides offer, let’s discuss the term impairment.
Impairment is a loss. A Loss of use or a derangement of any body part, organ, or organ system. For example, if I had my arm amputated, it would obviously be a loss. If I lost the use of something, that would also be a loss. Let’s say I cut the nerve to my arm and can no longer use it as before, that would be a loss as well.
A derangement is any body part’s derangement. Derangements usually occur due to damage, due to an injury of some kind. It’s a derangement of any body part, organ, or system.
The AMA Impairment Guides, Easy to use but what are they?
These guides could be called the AMA Guide to Body Derangement, or Guide to Permanent Injury, or the Guide to Body Damage. They all mean the same basic thing. But the AMA settled on Permanent Impairment Guides. There are several editions: Third, Fourth, Fifth, Etc.
These guides are the most consensus driven way for a doctor to look at any injury and report the effect that the injury has on the person’s activities of daily living. The impairment guide takes an injury and determines what needs to be present for that criteria to be met and then assigns a percentage of loss to that injury.
Like in the above example, if I lost my arm, the guide states that is an impairment and it applies a percentage of loss to it. This says that consensus wise, we the AMA, we doctors agree that is what the injury is and what it does to a person.
It’s the only accepted guideline in the world for determining if a condition is permanent or not. That’s why they’re called the Permanent Impairment Guides. So, it’s a way to determine if the person has a condition that causes permanent problems for the patient. In other words, it changes their life. That’s why they’re important.
These guides are extremely important in injury work because there are questions that need to be answered.
The first thing that needs to be addressed is whether the injuries are permanent. A doctor can give his opinion and say, “Yes, they’re permanent.” That is like a doctor looking at a patient without the benefit of an x-ray and stating that a patient has a broken leg. We need something to verify the condition.
That is what these guidelines do, they say, “This is what all the doctors agree to and if there is body damage this is the negative impact it is going to have on the patient’s life.”
For treating doctors doing injury work, this is a must. Right?
You’re stuck in a medical-legal situation, facing depositions and trials and an attorney is going to ask the question:
How did you arrive at the fact that the condition was permanent?
For example, with a spinal derangement it says is there a fracture? Is there ligament damage that causes excessive motion? Is there ligament damage that cause a herniated disc?
Remember, when you injure a body part, you must damage or derange something. The guidelines say, “Here’s the key derangements to the spine, here’s the guidance for providers to assess them, and here’s how to determine the effect they will have on a patient’s long-term future.”
These guides can cause confusion.
The AMA Guides are impairment guides, they’re body derangement guides. They take any derangement and determine what negative effect it will have on a person’s activities of daily living outside of work.
Now, if that impairment also causes the inability for that person to work or has diminished this ability in some way, the condition itself is a disability.
So, disability is how an impairment affects a person’s ability to earn a living and straight impairment is how the condition affects the person’s activities of daily living.
Everybody wants something that is objective.
The employer, insurer, lawyer, and the patient all want a fair and objective process. Objective in this case, simply means that it can be easily verified. Any reasonable person can look up a condition and find the reference information in these guides. These guides can be cited and used to deliver the consensus of the medical field on any injury or condition.
This makes them one of the easiest things to use in the world. SmartInjuryDoctors® definitely use them. They use them because it’s the only objective way to determine if you have a permanent condition. These guides are so easy to use and straight forward, that you can essentially have a permanent impairment evaluation on day one.
Don’t let this confuse you. An impairment rating is done at the end of care. What were talking about is an impairment determination, and that is what you are doing in your examination and procedures. Procedures such as an MRI, CAT scan, or standard x-rays. You’re using these procedures to find derangement in body parts.
The effect they have on a person is called an impairment rating. And that is done at the point of maximum medical improvement. This is the state where you feel as a doctor that the patient is no longer progressing or improving as a result of treatment.
The bottom line, every doctor in the injury market should be using the AMA Permanent Impairment Guides.