Regulators To Discuss Impact Of AMA Guides To The Evaluation Of Permanent Impairment

Editors Note: Watch for the WorkersCompensation.com CompTalk! Radio Program featuring Dr. Chris Brigham speaking extensively on the new AMA Guides. The first of a two part series will be released on January 3, 2008.

Madison, WI  (CompNewsNetwork) - Rating the severity of permanent injury has been an arbitrary and contentious process in many workers' compensation systems.  Over the years, jurisdictions have searched for a more consistent, objective, and fair way to measure severity of permanent impairment from occupational injury. With the release of the American Medical Association's Guides to the Evaluation of Permanent Impairment, 6th Edition, many jurisdictional agencies are looking to reevaluate their current method of impairment rating.

To foster a better understanding of the new AMA Guides and facilitate administrative and legislative decisions about their use, the IAIABC is hosting a regulatory seminar on the AMA guides.  It will take place on February 7 & 8, 2008 in Orlando, Florida.  The goal is to educate administrators, regulators, and other workers' compensation professionals on the difficulties and current resources available to perform permanent impairment ratings.

Alan McClain, CEO of the Arkansas Workers' Compensation Commission, oversees one of the many agencies that dictates use of the 4th Edition.  He wonders, though, whether Arkansas should "trade up" and notes, "Arkansas would like our ratings to be more consistent with current publications but have heard negative things about the 5th Edition and are hoping the 6th Edition might be worth recommending to our legislature."

Thirty-five jurisdictions in the U.S. and several in Canada and other countries have statutory provisions that require the use of the American Medical Association's Guides to the Evaluation of Permanent Impairment.  According to a report released by Dr. Chris Brigham of Brigham & Associates, 11 states currently use the AMA 4th Edition, 21 the AMA 5th Edition, and 3 specify the AMA Guides in some other way.  Several states require the use of the most current Edition and therefore will make use of the 6th Edition in 2008.  View the complete report at: http://www.impairment.com/Use_of_A MA_Guides.htm. 

The AMA Guides have often been criticized for their complexity and lack of direction on how to produce objective and accurate ratings of loss to bodily function. Prior Editions used different approaches for different body systems and regions, therefore some chapters were more problematic.  The upper extremities chapter, for example, draws more fire than low back ratings. 

To help reduce disputes, some states have embraced "home grown" rating laws that stress objectivity and leave little room for dispute in many types of scheduled ratings.  Utah and Wisconsin are two such states with relatively few disputes involving permanent injury rating. "Physicians are comfortable with the straightforward process defined by Utah law.  The range of disagreement for most ratings is narrow," contends Dr. Alan Colledge, Medical Director for the Utah Workers' Compensation Commission and a leading critic of the AMA Guides.

 Senior Contributing Editor to the 6th Edition, Dr. Chris Brigham, has a positive outlook for the reception of the 6th Edition.  He notes, "The goal was to provide an impairment rating system which is authoritative, fair and equitable to all parties. Although the process is staff far from perfect, the intention is to simplify the rating process and to improve the reliability of ratings."

Administrators may still be leery. "Adopting a new Edition could be problematic if it increases system costs dramatically or ratings arbitrarily," worries Paul Dionne, CEO of the Maine Workers' Compensation Commission.

The IAIABC regulatory seminar will critically evaluate the effect the new guide may have on the consistency, accuracy, and supportability of the impairment rating process.  Panel discussions will also give attendees an opportunity for extended dialogue on the potential benefits and significant criticisms of the AMA's Guides to the Evaluation of Permanent Impairment, 6th Edition.  The important discussion created at this workshop may be a small step forward in finding a more streamlined, fair, and clear process to rate and award benefits for permanent impairment.

To learn more about the Regulatory Seminar visit the IAIABC website at: http://www.iaiabc.org/events/impairme nt2008/

The International Association of Industrial Accident Boards and Commissions is a not-for-profit association representing most of the government agencies charged with the administration of workers' compensation systems throughout the United States, Canada, and other nations and territories.  Its mission is to advance the administration of workers' compensation systems throughout the world through education, research, and information sharing.  It is governed by an Executive Committee of jurisdictional agency leaders and maintains a staff headquarters in Madison, Wisconsin, USA.