Comparative Analysis of Upper Limb Impairment Rating Processes in the AMA Guides Sixth Edition 2024 vs 2008: Impact on Stakeholders

J Occup Environ Med. 2024 Jul 8. doi: 10.1097/JOM.0000000000003186. Online ahead of print.

Abstract

Objective: To evaluate how upper limb impairment ratings are affected by updates to the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) Sixth Edition 2024 compared with the AMA Guides Sixth Edition 2008, and to investigate potential correlations with judicial, legislative, and economic factors.

Methods: Two expert evaluators reviewed 31 upper limb clinical vignettes from the 2008 and 2024 versions. The impairment ratings for each version were compared.

Results: After following the impairment ratings steps in each version, the results for 2024 showed no significant differences when compared with the impairment ratings generated using 2008 methods (Cohen's Kappa = 1.00).

Conclusions: The updated AMA Guides Sixth Edition 2024 with improved, transparent processes and enhanced diagnosis-based impairment tables provides efficiency while retaining the accuracy, validity, and reliability of past versions of the AMA Guides.