AMA Guides, Impairment Ratings, and Alabama Work Injuries

What the AMA Guides are used for

Doctors may use the AMA Guides to the Evaluation of Permanent Impairment to assign a permanent impairment rating. Injured workers may also hear this described loosely as the AMA guidelines. The official AMA Guides Digital resource is available from the American Medical Association. That rating may become part of an Alabama workers' compensation case.

Open AMA Guides Digital

Impairment is not the same as disability

An impairment rating is a medical percentage. Disability in a serious work injury case may also involve what the worker can actually do, whether the old job is still possible, whether permanent restrictions exist, whether an FCE limits the worker, and whether age, education, and work history make new employment realistic.

Why a low rating can still require review

A worker may receive a low impairment rating and still have major return-to-work problems. Examples include a heavy labor job, permanent lifting restrictions, failed light duty, denied treatment, a poor job market for the worker's background, or Social Security Disability concerns. The rating matters, but it should be read with the entire record.

Red flags involving impairment ratings

• The worker is placed at MMI but still cannot do the old job.
• The rating is low, but restrictions are severe.
• The FCE conflicts with the rating or the job demands.
• The worker is being pushed to settle before future medical care is understood.
• The worker is also applying for Social Security Disability.

Read the red flag library