Guides to the Evaluation of Permanent Impairment, Sixth Edition

Cover; Title; Copyright; Preface; Editorial Panel and Advisory Committee; Contributors; Reviewers; Table of Contents; Tables; Illustrations; Chapter 1. Conceptual Foundations and Philosophy; 1.1 History of the Guides; 1.2 New Directions for the Sixth Edition; 1.3 The International Classification of Functioning, Disability, and Health (ICF): A Contemporary Model of Disablement; 1.4 Measurement Issues; 1.5 Balancing Science and Clinical Judgment; 1.6 The Case for Simplification and Ease of Application; 1.7 The Application of Functional Assessment.;The new edition of the Guides continues to build from this legacy by focusing on physician interrater reliability through an updated consensus approach that considers the latest evidence and patient function. The result is a new standard that seeks to evaluate impairment using a series of uniform grids for each chapter. Cover Title Copyright Preface Editorial Panel and Advisory Committee Contributors Reviewers Table of Contents Tables Illustrations Chapter 1. Conceptual Foundations and Philosophy 1.1 History of the Guides 1.2 New Directions for the Sixth Edition 1.3 The International Classification of Functioning, Disability, and Health (ICF): A Contemporary Model of Disablement 1.4 Measurement Issues 1.5 Balancing Science and Clinical Judgment 1.6 The Case for Simplification and Ease of Application 1.7 The Application of Functional Assessment. 1.8 The Need for Internal Consistency and a Uniform Template1.9 Summary Chapter 2. Practical Application of the Guides 2.1 Use of the Guides in Workers' Compensation and Other Disability Systems 2.2 Organ System and Whole Body Approach to Impairment Ratings 2.3 Use of the Guides 2.4 Rules of Application for the Guides 2.5 Concepts Important to the Independent Medical Examiner 2.6 Impairment Evaluation and the Law 2.7 Preparing Reports Chapter 3. Pain-Related Impairment 3.1 Definition and Classification of Pain 3.2 Controversies Surrounding Pain-Related Impairment. 3.3 The Rating System3.4 Future Directions-Need for Research and Dialogue to Establish the Validity of Rating Pain-Related Impairment 3.5 Conclusion 3.6 Examples 3.7 Appendixes Chapter 4. The Cardiovascular System 4.1 Principles of Assessment 4.2 Valvular Heart Disease 4.3 Coronary Artery Disease 4.4 Cardiomyopathies 4.5 Pericardial Heart Disease 4.6 Dysrhythmias 4.7 Hypertensive Cardiovascular Disease 4.8 Vascular Diseases Affecting the Extremities 4.9 Diseases of the Pulmonary Artery 4.10 Cardiovascular Impairment Evaluation Summary Chapter 5. The Pulmonary System. 5.1 Assessing the Pulmonary System5.2 Clinical Presentation of Pulmonary Disease 5.3 Environmental Exposures, Lifestyle Choices, and Pulmonary Disease 5.4 Clinical Evaluation, Imaging Studies, and Other Tests for Evaluating Pulmonary Disease 5.5 Methodology for Determining the Grade in an Impairment Class 5.6 Asthma and Other Hyperreactive Airway Diseases 5.7 Hypersensitivity Pneumonitis 5.8 Pneumoconiosis 5.9 Lung Cancer 5.10 Sleep Disorders and Other Impairments Related to Pulmonary System 5.11 Examples of Impairment due to Pulmonary Disorders. 5.12 Pulmonary Impairment Evaluation SummaryChapter 6. The Digestive System 6.1 Principles of Assessment 6.2 Upper Digestive Tract 6.3 Colon, Rectum, and Anus 6.4 Enterocutaneous Fistulas 6.5 Liver and Biliary Tract 6.6 Hernias 6.7 Digestive System Impairment Evaluation Summary Chapter 7. The Urinary and Reproductive Systems 7.1 Principles of Assessment 7.2 The Urinary System 7.3 Upper Urinary Tract 7.4 Urinary Diversion 7.5 Bladder 7.6 Urethra 7.7 Male Reproductive Organs 7.8 Female Reproductive Organs 7.9 Urinary and Reproductive Systems Impairment Evaluation Summary. Updated and AMA Guides Sixth offers the most current guidelines for correct impairment evaluation. Please This pubilcation was reprinted in July 2009 to incorporate the Clarifications and Corrections document in its entirety. All purchases made after July 2009 will be the latest Guides Sixth ediiton available. Not sure? The word Reprint is on the outside , back cover of all reprinted copies. The Guides to the Evaluation of Permanent Impairment, Sixth Edition, (Guides Sixth) from the American Medical Association, emphasizes the fundamental skills physicians need to evaluate and communicate patient impairments. 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 Guides Sixth 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 that arranges commonly used ICD-9 diagnoses within the five classes of impairment severity, acording to the consensus-based dominant criterion. Functionally based histories, physical findings and broadly accepted objective clinical tests results are integrated where applicable to help physicians determine the grade within the imairment class. The result is a decision that is both transparent and reproducible. Using the latest evidence in diagnosis and clinical tests, the Guides Sixth offers the following key The latest scientific research and evolving medical opinion provided by nationally and internationally-recognized experts. Standardized approach across organ systems and chapters. Expanded use of diagnostic approach to help physicians consider relevant clinical tests and outcomes in performing the rating. Required clinical information needed to rate a given condition. Clear step-by-step grading instructions in each chapter to promote consistent scoring of impairment ratings and to improve physician consistency. Simplified methodology presented between chapters. Contemporary, evidence-based concepts and terminology of disablement from the ICF. More comprehensive and expanded diagnostic approach. Transparent process to allow the evaluator to document functional assessment, clinical tests and physician findings. Uniform grids to help physicians calculate impairment ratings. Please note: Annual updates to AMA Guides Sixth are published to AMA Guides Digital (amaguidesdigital.com) and are not available in print. The AMA Guides 6th book was last reprinted in March 2021 to incorporate the Clarifications and Corrections document in its entirety, but does not include the 2021 version that is most current as of July 1, 2021. The AMA Guides® emphasizes the fundamental skills physicians need to evaluate and communicate patient impairments. 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 Guides Sixth 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 calculates a patient impairment rating from no impairment to most severe. Functionally based histories, physical findings and broadly accepted objective clinical tests 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 Guides Sixth offers the following key features: The latest scientific research and evolving medical opinion provided by nationally and internationally-recognized experts. Standardized approach across organ systems and chapters. Expanded use of diagnostic approach to help physicians consider relevant clinical tests and outcomes in performing the rating. Required clinical information needed to rate a given condition. Clear step-by-step grading instructions in each chapter to promote consistent scoring of impairment ratings and to improve physician consistency. Simplified methodology presented between chapters. Contemporary, evidence-based concepts and terminology of disablement from the ICF. More comprehensive and expanded diagnostic approach. Transparent process to allow the evaluator to document functional assessment, clinical tests and physician findings. Uniform grids to help physicians calculate impairment ratings. Please note: Annual updates to AMA Guides Sixth are published to AMA Guides Digital and are not available in print. The AMA Guides 6th book was last reprinted in March 2021 to incorporate the Clarifications and Corrections document in its entirety, but does not include the 2021 version that is most current as of July 1, 2021. The AMA Guides® (AMA), emphasizes the fundamental skills physicians need to evaluate and communicate patient impairments. 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 Guides Sixth 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 calculates a patient impairment rating from no impairment to most severe. Functionally based histories, physical findings and broadly accepted objective clinical tests 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 Guides Sixth offers the following key features: The latest scientific research and evolving medical opinion provided by nationally and internationally-recognized experts. Standardized approach across organ systems and chapters. Expanded use of diagnostic approach to help physicians consider relevant clinical tests and outcomes in performing the rating. Required clinical information needed to rate a given condition. Clear step-by-step grading instructions in each chapter to promote consistent scoring of impairment ratings and to improve physician consistency. Simplified methodology presented between chapters. Contemporary, evidence-based concepts and terminology of disablement from the ICF. More comprehensive and expanded diagnostic approach. Transparent process to allow the evaluator to document functional assessment, clinical tests and physician findings. Uniform grids to help physicians calculate impairment ratings. This reference for clinicians describes criteria for the assessment and rating of an individual's permanent impairment in the United States. Introductory chapters discuss such topics as impairment evaluation in Workers' Compensation cases and the physician's role based on the Americans with Disabilities Act. The main part of the text consists of individual chapters devoted to various systems of the body. Each of these chapters includes an overview of impairment assessment for that body system; a description and interpretation of common signs and symptoms of disorders; a summary of common investigative clinical procedures; case studies; and clinical criteria used to determine impairment ratings. Annotation c. Book News, Inc., Portland, OR (booknews.com)

The book contains black-and-white illustrations.

This updated standard in quality evaluations is the approved uniform way to evaluate, measure, and report impairment. The material in this new edition is scientifically and consensus based, and is prepared by society experts. The organization is improved for enhanced readability, use, and consistency among chapters making this edition more user friendly and less confusing. All body systems are covered with significant improvements in major chapters including cardiology, respiratory, musculoskeletal, and skin. Also covered are new conditions including HIV and latex allergy. This guide is mandated or recommended in over 40 states, Australia, and Canada.

Widely accepted as the most reliable medical reference on impairment evaluation since its inception in 1971, the Guides is highly valued by physicians who use its authoritative chapters to determine how to assess for impairment. The new edition of the Guides continues to build from this legacy by focusing on physician interrater reliability through an updated consensus approach that considers the latest evidence and patient function. The result is a new standard that seeks to evaluate impairment using a series of uniform grids for each chapter. Features and Benefits Required clinical information needed to rate a given condition Contemporary, evidence-based concepts and terminology of disablement from the ICF Standardized approach across organ systems and chapters that allows evaluators to document functional assessment, clinical tests and physical findings Uniform grids for each organ system that arrange commonly used ICD-9 diagnoses within the five classes of impairment severity, according to the consensus-based dominant criterion Step-by-step grading instructions in each chapter to promote consistent scoring Covering every body system, the Sixth Edition provides a standardized approach to determine impairment assessment using patient history, physical examination and clinical tests. Uniformity and ease of use is stressed to provide a consistent rating for conditions in each of the body systems using evidence based methodologies and, when lacking, a consensus approach. Cover 1 Front Matter 2 Title Page 2 Copyright Page 3 Preface 4 Editorial Panel 7 Contributors 8 Reviewers 10 Contents 14 Tables 18 Illustrations 24 Chapter 1 Conceptual Foundations and Philosophy 26 Chapter 2 Practical Application of the Guides 44 Chapter 3 Pain-Related Impairment 56 Chapter 4 The Cardiovascular System 72 Chapter 5 The Pulmonary System 102 Chapter 6 The Digestive System 126 Chapter 7 The Urinary and Reproductive Systems 154 Chapter 8 The Skin 184 Chapter 9 The Hematopoietic System 208 Chapter 10 The Endocrine System 238 Chapter 11 Ear, Nose, Throat, and Related Structures 272 Chapter 12 The Visual System 306 Chapter 13 The Central and Peripheral Nervous System 346 Chapter 14 Mental and Behavioral Disorders 372 Chapter 15 The Upper Extremities 408 Chapter 16 The Lower Extremities 518 Chapter 17 The Spine and Pelvis 582 Appendix 628 Appendix A 629 Appendix B 632 Glossary 634 Index 642 Conceptual foundations and philosophy Practical application of the guides Pain The cardiovascular system The respiratory system The digestive system The urinary and reproductive The skin The hematopoietic system The endocrine system Ear, nose, throat, and related The visual system The central and peripheral nervous Mental and behavioral disorders The upper extremities The lower extremities The spine. "The emphasis of this edition is on expanding the spectrum of diagnoses recognized in impairment rating. It is desigend to encourage attention to and documentation of functional consequences of the impairment as a part of each physician's detailed history"--Provided by publisher. "The emphasis of this edition is on expanding the spectrum of diagnoses recognized in impairment rating. It is desigend to encourage attention to and documentation of functional consequences of the impairment as a part of each physician's detailed history"--Résumé de l'éditeur