AMA updates guidance on permanent impairment ratings

Chicago — The American Medical Association has updated its Guides to the Evaluation of Permanent Impairment, “used extensively in the United States and abroad as a critical input to determining fair compensation for individuals with work-related injuries.”

One of three key changes in the sixth edition is the removal of one of the three scales used to rate mental and behavioral impairment. AMA removed the Global Assessment of Functioning scale “due to questionable psychometrics and lack of conceptual clarity,” according to a July 9 press release.

The updated guidance went into effect July 1.

Another key change includes the addition of new psychological tests and batteries that have been developed since the previous guidance was published in 2008. The addition will help AMA “keep pace” with changes in standard practice of neuropsychological assessment.

The content update, the first since 2008, was approved and issued by the AMA Guides editorial panel. The changes were proposed by the American Psychiatric Association and the American Psychological Association to align AMA guidance with the terminology and methodology changes to the Diagnostic and Statistical Manual of Mental Disorders, an authoritative guide used by health care professionals worldwide.

“Evidence-based medicine and science related to the evaluation of permanent impairment associated with mental and behavioral disorders has advanced significantly since 2008,” Mark Melhorn, co-chair of the panel, said in the release. “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.”