Medical Provider

Impairment Rating Information

 Tips and Guidelines

• Permanent Impairment Rating Guidelines - Rule 12

• Impairment Rating Tips - Desk Aid #11  (PDF)  (MS Word)

• Bibliography of references consulted for 6/06 revision of Impairment Rating Tips

• Level II Curriculum

• Range of Motion Measurements

• Invasive Treatment Procedures/Impairment Rating:  Issued 10/2003

Apportionment

• Apportionment of Spinal Conditions Worksheet - Desk Aid #10  (PDF) (MS Word)

• Spinal Apportionment Case Example

Forms and Worksheets

• AMA Guides 3rd Edition (revised) Range of Motion worksheets (used with permission of the AMA)
   

• Lower Extremity Worksheet  (PDF)  (MS Word)

• Mental Impairment Rating Worksheet (WC-M3-Psych)  (PDF)  (MS Word)

• Guidelines for Assessing Elements Under the Mental Impairment Rating Worksheet "Areas of Function"

• Vision Impairment Rating Worksheet  (PDF)  (MS Word)

• Hearing Impairment Rating Worksheet  (PDF)  (MS Word)

• IME Physician's Summary Sheet  (PDF)  (MS Word)

 

Return to Quick List

Return to Home Page