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Last Modified on Apr 29, 2026
The current American Medical Association (AMA) Guides, 6th edition, were published in late 2007. There has not been a new edition since then, although minor updates are frequently made, affecting definitions, examination processes, and other finer details of the Guides. It’s important to understand the AMA Guides to the Evaluation of Permanent Impairment, because almost every medical assessor uses them to evaluate a patient’s level of injury for workers’ comp.
Categories of the Body
The AMA Guides separate parts of the body to better evaluate injuries and their impact on the whole of a person’s health and daily life. There is a guide for each section of the body, such as the upper body, lower body, spine, and hip, the sight system, and other parts.
These are then broken down into subsections to deal with specific parts, such as arms, elbows, wrists, hands, and fingers. These external parts are classified under the upper body guide. Each subpart, such as a hand, deals with parts of fingers that have been injured, or toes on a foot.
The ICF Model for Evaluations
When this edition was published, the International Classification of Function, Disability, and Health (ICF) was included to regulate how evaluations would be done. This includes the disability reviews, which are conducted for most people who claim disability. It aimed to also give consistency among all medical reviewers.
The ICF provides a method of interviewing the patient to determine the severity of an injury and the impact it has on one’s lifestyle and working capabilities:
- Impairments and their relation to significant loss of activity and bodily functions
- Activity, or lack of, and the ability of a patient to conduct daily activities, such as walking around the home, managing cooking capabilities, cleaning, or other typically normal activities
- Social participation or engagement, including factors like living with others or living alone, and engaging in social events such as family get-togethers
- Changes in body functions, including the ease of going to the bathroom, digesting food and liquids properly, and the ability to engage in self-care
- Body structure, or the changes in the structure of the body, and not being able to move in certain ways anymore
As of 2024, updates to the AMA guidelines no longer use “mild,” “moderate,” or “severe” to grade the severity of an injury. Instead, the Guides offer a more descriptive and reliable definition to assess injuries and illnesses.
Scheduled Impairments
Scheduled impairments are applied to specific body parts that affect the worker’s ability to return to work. The evaluating medical provider assesses the severity of the impairment and assigns a percentage to that impairment.
A higher impairment award would go to the worker who is unable to return to the work he did previously, due to partial or total loss of a body part. A lower percentage and impairment rating would be given when injuries are less limiting. The analysis combines the percentage impairment given to multiple portions of the body.
Unscheduled Impairments
There can be impairments to two or more parts of the body that are in different evaluation categories. There can also be one main category defined in the initial report, with a second one in a different part of the body, which becomes an unscheduled impairment rating.
In some cases, where the AMA Guide does not give a satisfactory method of evaluation, the injury can be made an unscheduled impairment. When this is the case, your jurisdiction can affect how your impairment is rated and how your workers’ compensation is paid. Arizona has the state code A.R.S. §23-1065(B), which specifically deals with unscheduled impairments.
Total Disability or Permanent Impairment
In extreme cases of disability or permanent impairment, for which there might also be an award provided, aside from the monthly benefit, those injuries are:
- Loss of use or separation of both hands
- Loss of use or separation of both feet
- Loss of separation of one hand and foot
- Brain injury resulting in a lack of comprehension, cognitive awareness, or decision-making process
- Injury to the spine, possibly resulting in permanent and total paralysis of significant parts of the body (legs, arms, torso, etc.).
FAQs About Evaluation of Permanent Impairment
How Do You Determine Permanent Impairment?
How permanent impairment is determined depends on your jurisdiction, although many states use the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment. Medical professionals use this guide to assess the severity of an injury or illness, the systems of the body it affects, and whether that injury or illness is expected to affect someone for the rest of their life or not.
What Is the AMA Impairment Analysis?
The AMA Guides impairment analysis is used by medical professionals to assess and measure the impact of an injury or illness that causes a long-term or permanent disability. This includes the loss of a limb, loss of another body part, or loss or damage to a functional system of the body. This analysis is meant to standardize how disability is assessed for legal cases, insurance claims, and workers’ compensation claims.
What Are the Most Recent AMA Guidelines?
The most recent AMA Guidelines as of 2026 are the Sixth Edition, with minor updates made in late 2025. The 2025 updates made changes to evaluating and other standards for the pulmonary system, as well as limited changes to the hearing and tinnitus sections.
Larger changes were made in the 2024 updates, which improved the analysis of impairment methods by providing more reliable and less vague guidelines. The 2024 update also included more diagnoses.
What Is the AMA Guideline for Whole Person Impairment?
Whole-person impairment under AMA Guidelines is how an injury or illness affects a whole person. It considers all the long-term limitations of the injury or illness, and combines each separate percentage impairment into a full rating of the person’s total impairment. This is how it is defined under the Office of Workers’ Compensation Programs.
Hire a Workers’ Compensation Lawyer at Arizona Injury Law Group
There were 59,600 nonfatal occupational illnesses and injuries in private industries in Arizona in 2024. Although the AMA Guides are important for evaluating medical providers and have an impact on your injury rating, it’s also important to know that Arizona has its own statutory determinations for parietal and total disability. These laws impact how much and how long employees are paid in workers’ compensation claim benefits.
When you hire a workers’ compensation lawyer, you should reach out to the Board-Certified Workers’ Compensation Law Specialists at Arizona Injury Law Group. We can help you file your claim with the Industrial Commission of Arizona (ICA). The ICA has an office in Tucson and in Phoenix.
Our team has almost 70 years of combined experience working solely in workers’ compensation law, and we can give you the support you need to obtain the compensation you deserve.
