To compute permanent impairment ratings, physicians first conduct specialized tests on affected individuals to determine the extent of physical incapacity and then assign ratings based on the results and on the outcome of overall physical and mental exams, notes Nolo. In making these determinations, physicians rely on certain state regulations that assign specific ratings to each type of injury.
Some jurisdictions combine separate injury assignations into a composite measure, referred to as the whole person impairment rating, which is designed to evaluate injuries that affect the entire body and compute their impact on future earnings, reports Nolo.
The majority of states use the American Medical Association’s Guides to the Evaluation of Permanent Impairment to appraise permanent impairment, explains Nolo. Oregon, Minnesota, New York, Florida and Utah, among other states, rely on an alternative set of self-developed guidelines that are analogous to the recommendations in AMA’s publication.
In contrast, states such as New Jersey, South Carolina, Virginia, Michigan and Missouri lack specific regulations on the process, while jurisdictions like California use hybrid approaches that combine recommendations from the AMA publication with state-specific guidelines, according to Nolo.
In general, physicians commence the processes of determining the nature and extent of permanent impairment after the injured party attains maximum medical improvement, which is the point at which the injured party’s recovery shows no indication of improving in the near future, reports the U.S. National Library of Medicine.