| AMA Guides Sixth Edition |
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The AMA Guides to the Evaluation of Permanent Impairment is the recognized
international standard used to define impairment. It is designed to be used as
support for legal systems seeking to compensate those with serious injuries or illnesses.
The new Sixth Edition, published in December 2007 by the American Medical Association,
reflects significant evolution in the impairment evaluation process. The Sixth Edition
provides a consistent methodology with a more rational basis to defining impairment.
It was designed by a consensus process to improve the reliability of impairment ratings
and therefore reduce conflict, increase fairness and ease resolution. Impairment values
overall are similar to the values assigned in Fourth and Fifth Editions; however corrections
have been made for certain ratings provided in prior Editions, and impairment ratings are
now provided for certain conditions which do result in permanent functional deficits yet
in the past were not ratable.
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Standardized methodology is applied to each chapter to enhance the relevancy of impairment
ratings, improve internal consistency and promote ease of application to the rating process.
This ordered method enables busy physicians to become proficient with the ratings for multiple
organ systems and anticipate how each chapter is organized and assimilates information.
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The Sixth Edition applies both terminology from and an analytical framework based on the
International Classification of Functioning, Disability and Health (ICF), to generate five
impairment classes which permit the rating of the patient from no impairment to most severe.
A diagnosis-based grid has been developed for each organ system. The grid arranges commonly
used ICD-9 diagnoses within the five classes of impairment severity, according to the
consensus-based dominant criterion.
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Functionally based histories, physical findings and broadly accepted objective clinical
test results are integrated where applicable to help physicians determine the grade within
the impairment class. The result is a decision that is both transparent and reproducible.
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Using the latest evidence in diagnosis and clinical tests, the new Sixth Edition offers
the following key features:
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Standardized approach across organ systems and chapters
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Expanded use of diagnostic approach to help physicians consider
relevant clinical tests and patient outcomes in performing the rating
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Required clinical information needed to rate a given condition
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Clear step-by-step grading instructions in each chapter
to promote consistent scoring of impairment ratings and to improve physician consistency
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Simplified methodology presented between chapters
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Contemporary, evidence-based concepts and terminology
of disablement from the ICF
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The latest scientific research and evolving medical opinion provided
by nationally and internationally recognized experts
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More comprehensive and expanded diagnostic approach
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Transparent process to allow the evaluator to document functional
assessment, clinical tests and physical findings
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Uniform grids to help physicians calculate impairment ratings
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