AMA Guides® Newsletter - Issue Archive

Articles

1. Post-Operative Backs: Common Impairment Rating Scenarios (Part II)

   James B. Talmage

   Pages 1–3

   DOI: 10.1001/amaguidesnewsletters.1997.SepOct01

   Abstract

   This article continues the discussion from the previous issue regarding common impairment rating scenarios for individuals who have had back surgery: Scenario 6) What is the impairment rating for an individual who has had a spinal fusion operation? 7) What is the impairment rating for an individual who has pre-existing spondylolisthesis, has a back strain injury, and undergoes a spinal fusion operation? 8) What is the impairment rating of an individual with spinal fracture(s) who has been treated by spinal fusion? 9) What about surgical complications? The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) notes that, following the Injury Model, surgery to treat an impairment does not modify the original impairment estimate. Major postoperative complications such as myocardial infarction and deep venous thrombosis are covered by most workers’ compensation systems; thus they should be rated, and the rating should be combined with the rating for the injury. The article discusses ratings for arachnoiditis; discitis; bowel, bladder, and sexual impairment; pseudarthrosis following attempted fusion; and chronic pain syndrome (note that it is never appropriate to rate an individual for both a spinal injury and chronic pain syndrome). The AMA Guides recognizes that rating spinal impairment is challenging and may change over time.
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2. Erratum

   Pages 2–2

   DOI: 10.1001/amaguidesnewsletters.1997.SepOct02

   Abstract

   This tutorial will help clinicians understand the components of a hearing impairment assessment and rating it in accordance with the AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, particularly Chapter 9. A hearing impairment evaluation is derived from a pure-tone audiogram and is always based on the functioning of both ears, even if hearing loss is apparent in only one ear. Hearing can be temporarily impaired by recent exposure to loud noise, and an audiogram should be conducted only after an extended period of rest (eg, 12 to 14 hours) after any exposure to loud noises. Audiometers must be properly calibrated and typically measure the decibel loss at 500, 1000, 20000, and 3000 Hz (the test frequencies), the frequencies that represent everyday auditory stimuli. The following steps can be used to determine hearing impairment: 1) test each ear separately using the test frequencies; 2) total the hearing threshold decibel levels of the test frequencies for each ear to determine the decibel sum of hearing threshold levels; 3) use Table 1 to determine a monaural hearing impairment based on the totals calculated in step 2; 4) use Table 2 to calculate the binaural hearing impairment; 5) use Table 3 to convert the binaural hearing loss impairment to whole person impairment. Examples demonstrate the steps and calculations.
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3. Impairment Questions and Answers

   William S. Shaw

   Pages 3–3

   DOI: 10.1001/amaguidesnewsletters.1997.SepOct03

4. Impairment Tutorial: Rating Hearing Loss Impairment

   William S. Shaw

   Pages 4–4

   DOI: 10.1001/amaguidesnewsletters.1997.SepOct04

5. Tools and Resources: Impairment and Disability Web Sites

   Pages 5–6

   DOI: 10.1001/amaguidesnewsletters.1997.SepOct05

6. Literature Review

   James B. Talmage

   Pages 7–7

   DOI: 10.1001/amaguidesnewsletters.1997.SepOct06