Guides to the Evaluation of Permanent Impairment, sixth edition

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lease 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. 

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