Guidelines for the assessment of permanent impairment Version 3

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Table 3.1: Permissible Combinations of Lower Extremity Assessment MethodsLimb LengthDiscrepancyGaitDerangementMuscleAtrophyMuscleTestingRange ofMotion onAnkylosis Arthritis AmputationsDiagnosis-BasedEstimatesSkin LossPeripheralNerveInjuriesCausalgia &ReflexSympatheticDystrophyGait Derangement x - x x x x x x x x x xMuscle Atrophy x - x x x x x x xMuscle Testing x x - x x xVascularDisordersRange of MotionAnkylosisx x x - x xArthritis x x x -Amputations x x x -Diagnosis-BasedEstimatesx x x x x -LimbDiscrepancyLength- x x xSkin Loss x -PeripheralInjuriesNervex x x -Causalgia & RSD x x -Vascular Disorders x -x Do not combine with this method of assessmentSource: American Medical Association, The Guides Newsletter, January/February, 1998.Lower Extremity Section, pp3/75-3/93, The AMA 4 Guides to the Evaluation of Permanent Impairment, Fourth EditionOrganization – Format © 1992, Randall D. Lea MD, FAADEPSecond Revision Feb 1998Third Revision March 1999Anthony J. Dorto, MD, FAADEPReprinted with permission of American Academy of Disability Evaluating Physicians, DISABILITY, May 1999, Vol. 8, No. 2WCT Guidelines 1 October 2011 15
Table 3.2: Lower Extremity WorksheetIMPAIRMENT TABLE AMA4PAGEGait derangement 36 76Unilateral muscle atrophy 37 77True muscle weakness 39 77Range of motion 40-45 78Joint ankylosis 46-61 79-82Arthritis 62 83Amputation 63 83Diagnosis-based estimates 64 85-86Limb length discrepancy 35 75Skin loss 67 88Peripheral nerve deficit 68 89Peripheral vascular disease 69 89POTENTIALIMPAIRMENTSELECTEDIMPAIRMENTComplex Regional PainSyndromes Type I and IICombined Impairment RatingTWCGuidelinesSection 3.14Not usedAdapted from MAA 2007 Guidelines Table 3.4WCT Guidelines 1 October 2011 16
Page 1 and 2: GUIDELINES FOR THE ASSESSMENT OFPER
Page 3 and 4: ForewordThe Workers Rehabilitation
Page 5 and 6: Table of ContentsPage No.Foreword .
Page 7 and 8: Causation of permanent impairment1.
Page 9 and 10: 1.18 Using these Guidelines and the
Page 11 and 12: Adjustments for Effects of Prosthes
Page 13 and 14: stable and the assessment of perman
Page 15 and 16: 2.8 Although range of motion appear
Page 17 and 18: (ii) Rate the upper extremity impai
Page 19: 3.7 Use of worksheets is essential.
Page 23 and 24: Table 3.3. Impairment for ankylosis
Page 25 and 26: Table 3.4Tibial Nerve Impairment Va
Page 27 and 28: Table 4.1 Assessing spinal impairme
Page 29 and 30: Specific interpretation of the AMA
Page 31 and 32: Definitions of clinical findings co
Page 33 and 34: 4.22 When allocating the worker to
Page 35 and 36: Sexual Functioning4.30 Sexual dysfu
Page 37 and 38: 4.45 One or more end plate fracture
Page 39 and 40: 5.7 Headache or other pain potentia
Page 41 and 42: Table 5.2Criteria for rating impair
Page 43 and 44: Chapter 6Ear, Nose and Throat, and
Page 45 and 46: Scarring5% for loss of sense of tas
Page 47 and 48: 7.7 In order to measure the impairm
Page 49 and 50: impairment using precisely the meth
Page 51 and 52: Table 7.3TravelClass 1Class 2Class
Page 53 and 54: Table 7.7 Conversion TableClass1Cla
Page 55 and 56: Psychiatric Impairment Rating Scale
Page 57 and 58: 7.21 Examples1. A worker suffers a
Page 59 and 60: Chapter 8Impairment of Other Body S
Page 61 and 62: Pneumoconiosis (AMA 5 Guides, Secti
Page 63 and 64: 8.23 Hypertensive Cardiovascular Di
Page 65 and 66: The Digestive SystemIntroduction an
Page 67 and 68: Where there is a range of values in
Page 69 and 70: Appendix 1GlossaryCauda equina synd
Page 71 and 72:
WorkCover Tasmania - Template for R
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