AMA Guides® to the Evaluation of Permanent Impairment



For over 50 years, the AMA Guides® to the Evaluation of Permanent Impairment (AMA Guides®) have been the trusted authoritative source that physicians, patients, and regulators rely on for fair and consistent impairment rating information and tools. The AMA Guides® provide physicians with certainty that they are following the most current best practice and also play a key role in supporting fair and timely resolution of impairment-related claims, enabling patients to easily navigate on an administrative process that can  be burdensome at a time when they need to focus on their health and wellness.

The AMA Guides® provide a reliable, repeatable measurement framework for permanent impairment in patients that have suffered an injury or illness that has resulted in long-term loss of a body part or reduction of body function. Once a patient has reached Maximum Medical Improvement, physicians and authorized practitioners use the AMA Guides® to assess a patient’s impairment and document findings in an report. A properly completed impairment rating report produced using the most current AMA Guides® content is the gold standard for measuring permanent impairment.

Impairment ratings and impairment rating reports produced using the AMA Guides® are used extensively in the United States and abroad as a critical input to determining fair compensation for patients with work related injuries . Importantly, this determination of appropriate compensation is the realm of state legislation and regulation, not medicine. As such, development of compensation models is beyond the scope of the AMA Guides®; each jurisdiction makes its own determination of appropriate compensation formulas.

Curated through a transparent, stakeholder-driven panel process, the AMA Guides® represent the best medical practice. The AMA strongly recommends that states consistently adopt this best practice to quantify impairment, and apply compensation formulas and/or jurisdiction-specific adjustments only after a standard AMA Guides® impairment rating has been completed.

Recent Developments

In 2019, based on extensive industry feedback from physicians, state and specialty medical societies, regulators, and other industry stakeholders, the AMA initiated a program to update and modernize the AMA Guides®.

Key elements of that program include:
  • The AMA has convened diverse experts with deep expertise across a broad range of medical topics to serve as the AMA Guides® Editorial Panel (the Guides Panel). This group includes physicians, allied health professionals and regulatory and legal advisors with a shared objective:

    • Serve patients, physicians, government entities and related stakeholders by incorporating the best available information, science, evidence-based medicine, and tools within the AMA Guides® to the Evaluation of Permanent Impairment in order to enable fair and consistent evaluations.

  • The Guides Panel will utilize a transparent, stakeholder-driven process based on published criteria to evaluate proposals for changes to the AMA Guides®. This approach is designed to promote updates to the AMA Guides® that are rooted in evidence-based medicine whenever possible, and that represent the best available medical science.

The AMA is committed to reducing physician burden. With that in mind, the AMA Guides® will be delivered in a format that reduces the workload on the practitioner, while guiding the process to mitigate the risk of administrative error or oversight. Providing the AMA Guides in this form will increase quality and consistency while reducing the effort required to produce an impairment rating report.

AMA Guides® Editorial Panel Selection Criteria

The Panel was selected via a rigorous process which included a broad solicitation of nominations from organizations throughout the medical community that collaborate with the AMA in our broad efforts to collect input for all corners of medicine. The AMA convened a set of physician leaders and senior management to select the co-chairs from the nominees, and then worked with the co-chairs to complete Panel selection. While we view the domain of the Guides as medicine, we recognize they are applied in a universe that goes beyond medicine, and so we’ve engaged advisors from the broader community to ensure that the best medical guidance can be pragmatically adopted. The Panel was selected with the goal of representing diverse expertise in medical care and impairment rating that reflects the communities served by the AMA Guides®.

AMA Guides® Editorial Panel 

Co-Chairs
Douglas W. Martin, M.D., Medical Director, UnityPoint Health - St. Luke's Occupational Medicine
J. Mark Melhorn, M.D., Clinical Assoicate Professor, University of Kansas, School of Medicine, The Hand Center


Panel Members

Marie Acierno, M.D., Assistant Professor, Senior Associate Consultant, Mayo Clinic Arizona
Helene Fearon, Physical Therapy, Vice President, Fearon Physical Therapy, Inc. 
Steven Feinberg, M.D., Pain Medicine, Adjunct Clinical Professor, Stanford University Pain Service
David Gloss, M.D., Neurology, Director, Clinical Neurophysiology, Charleston Area Medical Center 
Robert Goldberg, D.O., Physical Medicine & Rehabilitation, Consultant, Workers' Compensation Board of the State of New York 
Rita Livingston, M.D., Preventive Medicine, MED/IDES Provider, U.S. Army Medical Evaluation Board and Medical Director, CEO, Live-Well Medical Consultants, LLC
Eric Auty Kanoalani Mayer, M.D., Physical Medicine & Rehabilitation, Staff Physician, Seton Spine & Scoliosis Center
Marilyn Price, M.D., Psychiatry, Psychiatrist, Law and Psychiatry Service, Massachusetts General Hospital and Assistant Professor, Psychiatry, Harvard Medical School
Noah Raizman, M.D., Orthopaedic Surgery, Orthopaedic Surgeon, Hand and Upper Extremity, Office of Orthopaedic Medicine and Surgery/Centers for Advanced Orthopaedics
Michael Saffir, M.D., Physical Medicine & Rehabilitation, Physiatrist, Orthopaedic Specialty Group and President Emeritus, Connecticut State Medical Society
Jan Towers, Ph.D., Nursing, Health Policy Consultant and Clinical Practice, Frederick Community Health Care for Homeless Clinic and Federally Qualified Health Center 

Panel Advisors

Abbie Hudgens, Administrator of the Tennessee Bureau of Workers Compensation, and President IAIABC serving as regulatory advisor of the Guides Panel. 
Barry Gelinas, M.D., DC, President-elect of the IAIME acting as international advisor to the Guides Panel
Chris Brigham, M.D., Managing Editor of the AMA Guides®️ Newsletter 

Submit your content proposal to AMA Guides®️ Editorial Panel

Click here to download the Proposal Submission form and email to guidesproposals@ama-assn.org once completed.

The AMA Guides Editorial Panel meets through web conference at least once a month and live in-person at least twice per calendar year.  Meetings are open to the public.  Fill out the form below to stay informed for upcoming Panel meetings. 

 

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