title: Recommendations to guide revision of the Guides to the Evaluation of Permanent Impairment. American Medical Association.
abstract: The American Medical Association's Guides to the Evaluation of Permanent Impairment, Fourth Edition, is the most commonly used tool in the United States for rating permanent impairments for disability systems. The Guides, currently undergoing revision, has been the focus of considerable controversy. Criticisms have focused on 2 areas: internal deficiencies, including the lack of a comprehensive, valid, reliable, unbiased, and evidence-based system for rating impairments; and the way in which workers' compensation systems use the ratings, resulting in inappropriate compensation. We focus on the internal deficiencies and recommend that the Guides remains a tool for evaluation of permanent impairment, not disability. To maintain wide acceptance of the Guides, its authors need to improve the validity, internal consistency, and comprehensiveness of the ratings; document reliability and reproducibility of the results; and make the Guides easily comprehensible and accessible to physicians.
authors.affiliation: West Virginia University College of Law, Morgantown 26506, USA. espieler@wvu.edu
authors.forename: E A
authors.initials: EA
authors.lastname: Spieler
authors.forename: P S
authors.initials: PS
authors.lastname: Barth
authors.forename: J F
authors.initials: JF
authors.lastname: Burton
authors.forename: J
authors.initials: J
authors.lastname: Himmelstein
authors.forename: L
authors.initials: L
authors.lastname: Rudolph
mesh_terms: D000574:American Medical Association; D004185:Disability Evaluation; D017408:Guidelines as Topic / Q000592:standards; D015203:Reproducibility of Results; D014481:United States; D017410:Practice Guidelines as Topic