For the first time since 2008, the American Medical Association (AMA) has updated its AMA Guides® to the Evaluation of Permanent Impairment (“AMA Guides”). The latest version of the AMA Guides is effective as of July 1, 2021. It is the first change or amendment made since its initial publication over a decade ago.
The amendment is the result of the AMA Guides Editorial Panel, which convened in 2019 to make sure that the latest edition of the AMA Guides® “reflects the most current in medicine and provides a basis for fair and consistent evaluations and impairment ratings.”
- The complete AMA Guides are available online in digital format. For subscribers, the AMA also provides a searchable database for both the latest version and the earlier issues.
Why are the AMA Guides® Important to Accident Victims?
As explained by the AMA, the AMA Guides® are “… the accepted authority on permanent loss of function and are relied on by physicians for assessment of permanent impairment. The AMA Guides incorporate science, evidence-based medicine and assessment tools to provide a rigorous methodology to enable a fair and consistent evaluation.”
The AMA Guides® are an expert reference resource in the evaluation and determination of injury damages and compensation necessary to compensate an accident victim for permanent or catastrophic harm. The AMA Guides are used by health care providers, accident victim advocates, safety organizations, government regulatory agencies, and others in the determination of permanent harm or impairment suffered by an individual.
They are a vital component in the assessment and advocacy of any accident victim’s scope of damages regarding harm and injury suffered in an incident caused by the failure of a legal duty of care and safety by another party, including an employer in an on-the-job work injury.
Illinois Workers’ Compensation Act Directive to Use AMA Guides
In the State of Illinois, for example, the Illinois Workers’ Compensation Act (“Act”) establishes the minimum standards and guidelines that must be followed in both acknowledging and thereafter paying the expenses associated with work-related injuries as defined by the statute. When doctors are assessing the level of impairment suffered by an on-the-job accident victim, the Act directs physicians in worker accident cases that they are to use “the most current edition” of the AMA Guides. For more, read the discussion regarding the AMA Guides® and Workers’ Compensation provided by the Illinois State Medical Society.
The July 2021 Changes to AMA Guides
As explained by the AMA, the substantive amendments to the AMA Guides regarding evaluating permanent impairment involve providing clarification and updated terminology around mental and behavioral health concepts to improve reliability.
1] Global Assessment of Functioning (GAF) scale excluded for impairment rating calculation
To rate mental and behavioral impairment the AMA Guides Sixth Edition released in 2008 uses three scales, Global Assessment of Functioning (GAF), Brief Psychiatric Rating Scale (BPRS) and Psychiatric Impairment Rating Scale (PIRS). The mental and behavioral health impairment rating is calculated by the median value of the GAF, BPRS and PIRS impairment scores. The GAF rating scale was removed in the update from DSM-IV-TR to DSM-5 due to questionable psychometrics and lack of conceptual clarity. For more accurate mental and behavioral health impairment ratings, the AMA Guides Sixth 2021 no longer calculates permanent impairment using the GAF rating scale. Impairment ratings are calculated by averaging scores from the BPRS and PIRS.
2] Newer editions of assessment tools and tests
New psychological tests and batteries have been published since the AMA Guides Sixth Edition was released in 2008. Updates available in AMA Guides Sixth 2021 keep pace with the changes that occurred over time to the standard practice of neuropsychological assessment and utilities newer batteries that have been developed and are more commonly employed in standard neuropsychological practice.
3] Updated descriptions of malingering and motivation
The literature on motivation and malingering is continuously updating, and editorial changes to AMA Guides Sixth 2021 were added to clarify language and include more recent literature references.
Explains AMA Editorial Panel Co-chair Mark Melhorn, M.D.:
“Evidence-based medicine and science related to the evaluation of permanent impairment associated with mental and behavioral disorders has advanced significantly since 2008. The content updates approved by the Guides Editorial Panel will help clinicians conduct mental health evaluations and better achieve accurate, equitable and consistent impairment ratings with updated terminology, methodology and assessment tools that mirror contemporary medical science and practice.”
Assessment of Permanent Impairment After a Work Accident Injury
For workers in Indiana and Illinois who have suffered serious and catastrophic harm in an industrial accident while on the job, it is vital to assess all aspects of injury that have been, and will be, experienced by the accident victim. This includes not only immediate needs for justice, such as covering immediate medical care expenses and lost wages, but the long-term effects of the debilitating event.
The new AMA Guides purport to provide “… the most current in medicine and provides a basis for fair and consistent evaluations and impairment ratings.” These new amendments, reflecting the input of both the American Psychiatric Association and the American Psychological Association, help to assess the psychological trauma and mental health disorders that may be the result of a severe accident injury.
For accident victims and their loved ones, no claim for justice can be complete without an evaluation of permanent impairment that includes consideration of these psychiatric injuries and behavioral impairments. See, Els, Charl, et al. “Workplace functional impairment due to mental disorders.” Mental Illnesses–Understanding, Prediction and Control (2011): 341.
For more, read:
- Industrial Accidents in Indiana and Illinois: Serious Injury or Death on the Job
- What are Catastrophic Injuries? Severe Bodily Harm Suffered by Accident Survivors in Indiana and Illinois
- Industrial Accidents in Indiana and Illinois: Serious Injury or Death on the Job
- Head Injury in an Accident: Varied Causes of Permanent Brain Injuries
- Traumatic Brain Injury Accidents: the Cost of Care and Treatment
- 10 Different Types of Traumatic Brain Injuries Caused by Accidents.
For workers in Indiana and Illinois, the updated version of the AMA Guides® to the Evaluation of Permanent Impairment (“AMA Guides”) is an important step in the proper and comprehensive assessment of damages to be provided to workers and their loved ones in the aftermath of a severe work injury, as well as other accident victims who are seeking justice in the wake of a catastrophic injury. Please be careful out there!
