AMA Guides® Newsletter - Issue Archive

Articles

1. Body Member Impairments: Scheduled Awards and the Federal Employees' Compensation Act

   Christopher R. Brigham

   Pages 1–11

   DOI: 10.1001/amaguidesnewsletters.2010.SepOct01

   Abstract

   This article focuses on the use of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) in evaluating Office of Workers’ Compensation Programs (OWCP), Federal Employees’ Compensation Act (FECA) scheduled loss cases for an accepted work-related condition. Effective May 1, 2009, the Division of Federal Employees’ Compensation (DFEC), which administers FECA, adopted the AMA Guides, Sixth Edition, noting that DFEC has used the AMA Guides for more than fifty years, dating back to the first Guide for Extremities and Back (1958). The scheduled award provision of the OWCP FECA and implementing regulations set forth the number of weeks of compensation to be paid for permanent loss, or loss of use, of body members listed in the schedule. The FECA regulations that define impairment are consistent with the definition provided in the AMA Guides, Sixth Edition, except for impairments of the lungs. Also, pain is included as a component of the medical condition (diagnosis) and should not be measured separately unless the pain does not correlate with objective findings or bodily dysfunction. The article includes several special determinations under FECA, including loss of body parts, loss of hearing or vision, loss of function of bodily organs, lung impairment, and impairments in other organs.
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2. Rating Spinal Stenosis: AMA Guides Sixth Edition Case Example

   Marjorie Eskay-Auerbach

   Pages 12–13

   DOI: 10.1001/amaguidesnewsletters.2010.SepOct02

   Abstract

   Spinal stenosis refers to narrowing of the spinal canal that may result in compression of the spinal cord, or cauda equina. The most common type of spinal stenosis is degenerative stenosis associated with the natural process of aging. In the lumbar spine, the narrowing may result in compression of spinal nerve roots, causing a constellation of symptoms that may include lower pack pain, neurogenic claudication, and lower extremity pain. This case illustrates the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition process of assessing impairment for spinal stenosis. The case involves a 54-year-old male truck driver whose lumbar spine was injured when he unloaded and lifted a tire; he underwent lumbar decompression at L3-4 and L4-5, and fourteen months after surgery was evaluated as being at maximum medical improvement, was able to walk, and could void spontaneously. In a one-page final medical report, the patient's physician hand wrote a note assigning 29% whole person impairment without a medical rationale to support the rating. The author of this case example first notes that the medical reporting does not support placing this patient in class 4, and the examinee's condition is most consistent with a class 1 rating for spinal stenosis. Using Section 17.3, Adjustment Grids and Grade Modifiers: Non-Key Factors, an evaluator would conclude a grade B, 6% whole person impairment for the lumbar spine.
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3. Upper Extremities Workbook Question

   Pages 14–14

   DOI: 10.1001/amaguidesnewsletters.2010.SepOct03