AMA Guides® Newsletter - Issue Archive

Articles

1. COVID-19: Achieving Maximum Medical Improvement and Assessing Permanent Impairment

   James B. Talmage, Mark H. Hyman, Christopher R. Brigham, Sarah H. Gulick, Leslie Burton

   Pages 3–12

   DOI: 10.1001/amaguidesnewsletters.2021.MarApr01

   Abstract

   Patients with coronavirus disease 2019 (COVID-19) may have persistent symptoms beyond the normally expected illness resolution. This disease was not diagnosed before late 2019, and therefore, we have more limited experience in understanding all of its outcomes. Thus, clinical, functional, and permanent impairment assessment is challenging. Symptoms including fatigue, dyspnea, and cognitive difficulties have been referred to as “post-acute COVID,” “long COVID,” or “long haulers.”

   Patients who present for assessment of causation, maximum medical improvement (MMI), and permanent impairment can be challenging. For some examinees, after 6 to 12 months without outgoing improvement and with appropriate investigation, treatment, and rehabilitation, the examinee can be considered at MMI. However, because this disorder is new and appropriate treatment may be unclear, the time to achieve MMI is less certain. Physicians may use approaches in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), to help define MMI. As science evolves, so will our understanding of how to evaluate chronic problems associated with COVID-19.
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2. Rating Peripheral Nerves of the Lower Extremities Using the AMA Guides, Sixth Edition

   James B. Talmage, Jay Blaisdell, Christopher R. Brigham

   Pages 13–17

   DOI: 10.1001/amaguidesnewsletters.2021.MarApr02

   Abstract

   Nerve lesions caused by traumatic events to the lower extremity's peripheral nerves are rated using Section 16.4 of the sixth edition of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides). Results from sensory and motor nerve tests are used to assign the impairment class within Table 16-12, Peripheral Nerve Impairment (6th ed, 534). The default rating may be modified with the functional history and clinical studies modifiers, but not the physical examination modifier, because it is used to assign the impairment class and define the degree of neurologic severity. Impairment for both sensory and motor deficits are assigned and then combined at the lower extremity level.
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3. Q&A: Rating an Adductor Longus Tendon Tear

   Charles N. Brooks, Christopher R. Brigham, James B. Talmage

   Pages 18–19

   DOI: 10.1001/amaguidesnewsletters.2021.MarApr03