AMA Guides

The AMA Guides to the Evaluation of Permanent Impairment (Guides) is the most widely used basis for determining impairment. They are widely used in workers’ compensation, Longshore and Harbor Workers Act, automobile casualty and personal injury cases to quantify permanent losses associated with injury or illness. The current standard is the Sixth Edition, published in 2008.1 Certain states make use of earlier editions, most commonly the Fifth Edition.

Understanding Key Terms

Impairment is “a significant deviation, loss, or loss of use of any body structure or function in an individual with a health condition, disorder, or disease”). Impairment differs from the concept of disability, which is “an umbrella term for activity limitations and/or participation restrictions in an individual with a health condition, disorder, or disease.” Impairment evaluation refers to the “acquisition, recording, and reporting of medical evidence, using a standard method such as described in the Guides to determine permanent impairment associated with a physical or mental condition.” The result is an impairment rating which is a “consensus-derived percentage estimate of loss of activity, which reflects severity of impairment for a given health condition, and the degree of associated limitations in terms of Activities of Daily Living (ADLs).” (Guides, Sixth Edition, Glossary)


1. Dr. Brigham served as Senior Contributing Editor of the Sixth Edition of the AMA Guides.

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