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AMA Guides Sixth Edition
 
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.
 
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.
 
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.
 
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.
 
Using the latest evidence in diagnosis and clinical tests, the new Sixth Edition offers the following key features:
 
v Standardized approach across organ systems and chapters
v Expanded use of diagnostic approach to help physicians consider relevant clinical tests and patient outcomes in performing the rating
v Required clinical information needed to rate a given condition
v Clear step-by-step grading instructions in each chapter to promote consistent scoring of impairment ratings and to improve physician consistency
v Simplified methodology presented between chapters
v Contemporary, evidence-based concepts and terminology of disablement from the ICF
v The latest scientific research and evolving medical opinion provided by nationally and internationally recognized experts
v More comprehensive and expanded diagnostic approach
v Transparent process to allow the evaluator to document functional assessment, clinical tests and physical findings
v Uniform grids to help physicians calculate impairment ratings
 

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