# Fourth Edition, 1993 Aggregated by Superinsight from public-domain sources, as of 2026-10-21. Domain: ama. --- ## AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, 1993 {#fourth} *AMA Guides, Fourth Edition (1993)* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, 1993, published by the American Medical Association, 1993-01-01._ **Jurisdictions that rate under this edition:** Alabama, Arkansas, Maine, Maryland, Texas, West Virginia (fixed edition). **Rating method:** impairment of the organ system or region by the chapter's criteria, expressed as whole person impairment and combined with the combined values chart; spine by the injury model or the range of motion model. **Chapters:** - Chapter 1 — Impairment Evaluation - Chapter 2 — Records and Reports - Chapter 3 — The Musculoskeletal System - Chapter 4 — The Nervous System - Chapter 5 — The Respiratory System - Chapter 6 — The Cardiovascular System - Chapter 7 — The Hematopoietic System - Chapter 8 — The Visual System - Chapter 9 — Ear - Chapter 10 — The Digestive System - Chapter 11 — The Urinary and Reproductive Systems - Chapter 12 — The Endocrine System - Chapter 13 — The Skin - Chapter 14 — Mental and Behavioral Disorders - Chapter 15 — Pain The edition's text, tables and values are published by the American Medical Association and are not reproduced here. Read the edition on the publisher's platform: https://ama-guides.ama-assn.org/display/book/9780899705538/9780899705538.xml _Applied in 173 published decisions and opinions (ECAB and state courts). Recent: [Sicilia, V. v. API Roofers Adv. Program (WCAB), 14 MAP 2023](https://www.courtlistener.com/opinion/10005448/sicilia-v-v-api-roofers-adv-program-wcab/) (2024-07-17) · [Logan-Mingo Area Mental Health, Inc. v. David M. Lester, 22-0275](https://www.courtlistener.com/opinion/9523257/logan-mingo-area-mental-health-inc-v-david-m-lester/) (2024-06-10) · [S. Conrad v. DOT (WCAB), 557 C.D. 2022](https://www.courtlistener.com/opinion/9478254/s-conrad-v-dot-wcab/) (2024-02-26) · [Weaver v. Unified Government of Wyandotte County, 125592](https://www.courtlistener.com/opinion/9441881/weaver-v-unified-government-of-wyandotte-county/) (2023-11-17) · [Teresa Gosling v. Lifepoint Hospitals, Inc., 22-0248](https://www.courtlistener.com/opinion/9434114/teresa-gosling-v-lifepoint-hospitals-inc/) (2023-10-19)._ --- ## AMA Guides Fourth Edition (1993), Chapter 1 — Impairment Evaluation {#1} *AMA Guides, Fourth Edition (1993), Chapter 1* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, 1993, published by the American Medical Association; Chapter 1 — Impairment Evaluation._ **Jurisdictions that rate under this edition:** Alabama, Arkansas, Maine, Maryland, Texas, West Virginia (fixed edition). **Rating method (chapter):** impairment of the organ system or region by the chapter's criteria, expressed as whole person impairment and combined with the combined values chart; spine by the injury model or the range of motion model. The chapter's text, tables and values are published by the American Medical Association and are not reproduced here. Read the chapter on the publisher's platform: https://ama-guides.ama-assn.org/display/book/9780899705538/c01.xml _Applied in 2 published decisions and opinions (ECAB and state courts). Recent: [ECAB 09-0144](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2009/Sep/09-0144.pdf) (2009-09-08) · [George Humfleet Mobile Homes v. Christman, 125 S.W.3d 288](https://www.courtlistener.com/opinion/1384890/george-humfleet-mobile-homes-v-christman/) (2004-01-22)._ --- ## AMA Guides Fourth Edition (1993), Chapter 2 — Records and Reports {#2} *AMA Guides, Fourth Edition (1993), Chapter 2* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, 1993, published by the American Medical Association; Chapter 2 — Records and Reports._ **Jurisdictions that rate under this edition:** Alabama, Arkansas, Maine, Maryland, Texas, West Virginia (fixed edition). **Rating method (chapter):** impairment of the organ system or region by the chapter's criteria, expressed as whole person impairment and combined with the combined values chart; spine by the injury model or the range of motion model. The chapter's text, tables and values are published by the American Medical Association and are not reproduced here. Read the chapter on the publisher's platform: https://ama-guides.ama-assn.org/display/book/9780899705538/c02.xml _Applied in 1 published decision or opinion (ECAB and state courts). Recent: [State ex rel. Harris v. Indus. Comm., 2022 Ohio 3149](https://www.courtlistener.com/opinion/7914184/state-ex-rel-harris-v-indus-comm/) (2022-09-08)._ --- ## AMA Guides Fourth Edition (1993), Chapter 3 — The Musculoskeletal System {#3} *AMA Guides, Fourth Edition (1993), Chapter 3* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, 1993, published by the American Medical Association; Chapter 3 — The Musculoskeletal System._ **Jurisdictions that rate under this edition:** Alabama, Arkansas, Maine, Maryland, Texas, West Virginia (fixed edition). **Rating method (chapter):** impairment of the organ system or region by the chapter's criteria, expressed as whole person impairment and combined with the combined values chart; spine by the injury model or the range of motion model. The chapter's text, tables and values are published by the American Medical Association and are not reproduced here. Read the chapter on the publisher's platform: https://ama-guides.ama-assn.org/display/book/9780899705538/c03.xml _Applied in 6 published decisions and opinions (ECAB and state courts). Recent: [Teresa Gosling v. Lifepoint Hospitals, Inc., 22-0248](https://www.courtlistener.com/opinion/9434114/teresa-gosling-v-lifepoint-hospitals-inc/) (2023-10-19) · [State ex rel. Bowman v. Indus. Comm., 2020 Ohio 5343](https://www.courtlistener.com/opinion/4832925/state-ex-rel-bowman-v-indus-comm/) (2020-11-19) · [ECAB 14-1592](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2014/Nov/14-1592.pdf) (2014-11-10) · [Smart v. Department of Public Safety, 959 A.2d 756](https://www.courtlistener.com/opinion/5143818/smart-v-department-of-public-safety/) (2008-11-20) · [Harvey v. H.C. Price Co., 2008 ME 161](https://www.courtlistener.com/opinion/2066743/harvey-v-hc-price-co/) (2008-10-21)._ --- ## AMA Guides Fourth Edition (1993), Chapter 4 — The Nervous System {#4} *AMA Guides, Fourth Edition (1993), Chapter 4* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, 1993, published by the American Medical Association; Chapter 4 — The Nervous System._ **Jurisdictions that rate under this edition:** Alabama, Arkansas, Maine, Maryland, Texas, West Virginia (fixed edition). **Rating method (chapter):** impairment of the organ system or region by the chapter's criteria, expressed as whole person impairment and combined with the combined values chart; spine by the injury model or the range of motion model. The chapter's text, tables and values are published by the American Medical Association and are not reproduced here. Read the chapter on the publisher's platform: https://ama-guides.ama-assn.org/display/book/9780899705538/c04.xml --- ## AMA Guides Fourth Edition (1993), Chapter 5 — The Respiratory System {#5} *AMA Guides, Fourth Edition (1993), Chapter 5* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, 1993, published by the American Medical Association; Chapter 5 — The Respiratory System._ **Jurisdictions that rate under this edition:** Alabama, Arkansas, Maine, Maryland, Texas, West Virginia (fixed edition). **Rating method (chapter):** impairment of the organ system or region by the chapter's criteria, expressed as whole person impairment and combined with the combined values chart; spine by the injury model or the range of motion model. The chapter's text, tables and values are published by the American Medical Association and are not reproduced here. Read the chapter on the publisher's platform: https://ama-guides.ama-assn.org/display/book/9780899705538/c05.xml _Applied in 1 published decision or opinion (ECAB and state courts). Recent: [Dillard's, Inc. v. Johnson, 374 S.W.3d 92](https://www.courtlistener.com/opinion/5282378/dillards-inc-v-johnson/) (2010-02-11)._ --- ## AMA Guides Fourth Edition (1993), Chapter 6 — The Cardiovascular System {#6} *AMA Guides, Fourth Edition (1993), Chapter 6* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, 1993, published by the American Medical Association; Chapter 6 — The Cardiovascular System._ **Jurisdictions that rate under this edition:** Alabama, Arkansas, Maine, Maryland, Texas, West Virginia (fixed edition). **Rating method (chapter):** impairment of the organ system or region by the chapter's criteria, expressed as whole person impairment and combined with the combined values chart; spine by the injury model or the range of motion model. The chapter's text, tables and values are published by the American Medical Association and are not reproduced here. Read the chapter on the publisher's platform: https://ama-guides.ama-assn.org/display/book/9780899705538/c06.xml _Applied in 2 published decisions and opinions (ECAB and state courts). Recent: [ECAB 10-2168](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2011/Jul/10-2168.pdf) (2011-07-18) · [Cabatbat v. County of Hawai'i, Department of Water Supply, 78 P.3d 756](https://www.courtlistener.com/opinion/2549587/cabatbat-v-county-of-hawaii-department-of-water-supply/) (2003-12-08)._ --- ## AMA Guides Fourth Edition (1993), Chapter 7 — The Hematopoietic System {#7} *AMA Guides, Fourth Edition (1993), Chapter 7* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, 1993, published by the American Medical Association; Chapter 7 — The Hematopoietic System._ **Jurisdictions that rate under this edition:** Alabama, Arkansas, Maine, Maryland, Texas, West Virginia (fixed edition). **Rating method (chapter):** impairment of the organ system or region by the chapter's criteria, expressed as whole person impairment and combined with the combined values chart; spine by the injury model or the range of motion model. The chapter's text, tables and values are published by the American Medical Association and are not reproduced here. Read the chapter on the publisher's platform: https://ama-guides.ama-assn.org/display/book/9780899705538/c07.xml --- ## AMA Guides Fourth Edition (1993), Chapter 8 — The Visual System {#8} *AMA Guides, Fourth Edition (1993), Chapter 8* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, 1993, published by the American Medical Association; Chapter 8 — The Visual System._ **Jurisdictions that rate under this edition:** Alabama, Arkansas, Maine, Maryland, Texas, West Virginia (fixed edition). **Rating method (chapter):** impairment of the organ system or region by the chapter's criteria, expressed as whole person impairment and combined with the combined values chart; spine by the injury model or the range of motion model. The chapter's text, tables and values are published by the American Medical Association and are not reproduced here. Read the chapter on the publisher's platform: https://ama-guides.ama-assn.org/display/book/9780899705538/c08.xml _Applied in 2 published decisions and opinions (ECAB and state courts). Recent: [State Ex Rel. Walker v. Songer Constr. Corp, 07ap-83 (12-18-2007), 2007 Ohio 6786](https://www.courtlistener.com/opinion/4000287/state-ex-rel-walker-v-songer-constr-corp-07ap-83-12-18-2007/) (2007-12-18) · [Bridges v. Liberty Insurance Co. of Hartford, 101 S.W.3d 64](https://www.courtlistener.com/opinion/1634482/bridges-v-liberty-insurance-co-of-hartford/) (2000-11-03)._ --- ## AMA Guides Fourth Edition (1993), Chapter 9 — Ear {#9} *AMA Guides, Fourth Edition (1993), Chapter 9* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, 1993, published by the American Medical Association; Chapter 9 — Ear._ **Jurisdictions that rate under this edition:** Alabama, Arkansas, Maine, Maryland, Texas, West Virginia (fixed edition). **Rating method (chapter):** impairment of the organ system or region by the chapter's criteria, expressed as whole person impairment and combined with the combined values chart; spine by the injury model or the range of motion model. The chapter's text, tables and values are published by the American Medical Association and are not reproduced here. Read the chapter on the publisher's platform: https://ama-guides.ama-assn.org/display/book/9780899705538/c09.xml --- ## AMA Guides Fourth Edition (1993), Chapter 10 — The Digestive System {#10} *AMA Guides, Fourth Edition (1993), Chapter 10* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, 1993, published by the American Medical Association; Chapter 10 — The Digestive System._ **Jurisdictions that rate under this edition:** Alabama, Arkansas, Maine, Maryland, Texas, West Virginia (fixed edition). **Rating method (chapter):** impairment of the organ system or region by the chapter's criteria, expressed as whole person impairment and combined with the combined values chart; spine by the injury model or the range of motion model. The chapter's text, tables and values are published by the American Medical Association and are not reproduced here. Read the chapter on the publisher's platform: https://ama-guides.ama-assn.org/display/book/9780899705538/c10.xml _Applied in 2 published decisions and opinions (ECAB and state courts). Recent: [State Ex Rel. Walker v. Songer Constr. Corp, 07ap-83 (12-18-2007), 2007 Ohio 6786](https://www.courtlistener.com/opinion/4000287/state-ex-rel-walker-v-songer-constr-corp-07ap-83-12-18-2007/) (2007-12-18) · [Bridges v. Liberty Insurance Co. of Hartford, 101 S.W.3d 64](https://www.courtlistener.com/opinion/1634482/bridges-v-liberty-insurance-co-of-hartford/) (2000-11-03)._ --- ## AMA Guides Fourth Edition (1993), Chapter 11 — The Urinary and Reproductive Systems {#11} *AMA Guides, Fourth Edition (1993), Chapter 11* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, 1993, published by the American Medical Association; Chapter 11 — The Urinary and Reproductive Systems._ **Jurisdictions that rate under this edition:** Alabama, Arkansas, Maine, Maryland, Texas, West Virginia (fixed edition). **Rating method (chapter):** impairment of the organ system or region by the chapter's criteria, expressed as whole person impairment and combined with the combined values chart; spine by the injury model or the range of motion model. The chapter's text, tables and values are published by the American Medical Association and are not reproduced here. Read the chapter on the publisher's platform: https://ama-guides.ama-assn.org/display/book/9780899705538/c11.xml _Applied in 1 published decision or opinion (ECAB and state courts). Recent: [State Ex Rel. Walker v. Songer Constr. Corp, 07ap-83 (12-18-2007), 2007 Ohio 6786](https://www.courtlistener.com/opinion/4000287/state-ex-rel-walker-v-songer-constr-corp-07ap-83-12-18-2007/) (2007-12-18)._ --- ## AMA Guides Fourth Edition (1993), Chapter 12 — The Endocrine System {#12} *AMA Guides, Fourth Edition (1993), Chapter 12* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, 1993, published by the American Medical Association; Chapter 12 — The Endocrine System._ **Jurisdictions that rate under this edition:** Alabama, Arkansas, Maine, Maryland, Texas, West Virginia (fixed edition). **Rating method (chapter):** impairment of the organ system or region by the chapter's criteria, expressed as whole person impairment and combined with the combined values chart; spine by the injury model or the range of motion model. The chapter's text, tables and values are published by the American Medical Association and are not reproduced here. Read the chapter on the publisher's platform: https://ama-guides.ama-assn.org/display/book/9780899705538/c12.xml _Applied in 1 published decision or opinion (ECAB and state courts). Recent: [Beets v. Metropolitan Life Insurance Co., 1999 OK 15](https://www.courtlistener.com/opinion/1291837/beets-v-metropolitan-life-insurance-co/) (2011-01-10)._ --- ## AMA Guides Fourth Edition (1993), Chapter 13 — The Skin {#13} *AMA Guides, Fourth Edition (1993), Chapter 13* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, 1993, published by the American Medical Association; Chapter 13 — The Skin._ **Jurisdictions that rate under this edition:** Alabama, Arkansas, Maine, Maryland, Texas, West Virginia (fixed edition). **Rating method (chapter):** impairment of the organ system or region by the chapter's criteria, expressed as whole person impairment and combined with the combined values chart; spine by the injury model or the range of motion model. The chapter's text, tables and values are published by the American Medical Association and are not reproduced here. Read the chapter on the publisher's platform: https://ama-guides.ama-assn.org/display/book/9780899705538/c13.xml _Applied in 1 published decision or opinion (ECAB and state courts). Recent: [Dillard's, Inc. v. Johnson, 374 S.W.3d 92](https://www.courtlistener.com/opinion/5282378/dillards-inc-v-johnson/) (2010-02-11)._ --- ## AMA Guides Fourth Edition (1993), Chapter 14 — Mental and Behavioral Disorders {#14} *AMA Guides, Fourth Edition (1993), Chapter 14* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, 1993, published by the American Medical Association; Chapter 14 — Mental and Behavioral Disorders._ **Jurisdictions that rate under this edition:** Alabama, Arkansas, Maine, Maryland, Texas, West Virginia (fixed edition). **Rating method (chapter):** impairment of the organ system or region by the chapter's criteria, expressed as whole person impairment and combined with the combined values chart; spine by the injury model or the range of motion model. The chapter's text, tables and values are published by the American Medical Association and are not reproduced here. Read the chapter on the publisher's platform: https://ama-guides.ama-assn.org/display/book/9780899705538/c14.xml --- ## AMA Guides Fourth Edition (1993), Chapter 15 — Pain {#15} *AMA Guides, Fourth Edition (1993), Chapter 15* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, 1993, published by the American Medical Association; Chapter 15 — Pain._ **Jurisdictions that rate under this edition:** Alabama, Arkansas, Maine, Maryland, Texas, West Virginia (fixed edition). **Rating method (chapter):** impairment of the organ system or region by the chapter's criteria, expressed as whole person impairment and combined with the combined values chart; spine by the injury model or the range of motion model. The chapter's text, tables and values are published by the American Medical Association and are not reproduced here. Read the chapter on the publisher's platform: https://ama-guides.ama-assn.org/display/book/9780899705538/c15.xml _Applied in 21 published decisions and opinions (ECAB and state courts). Recent: [ECAB 21-0798](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2023/JAN/21-0798.pdf) (2023-01-31) · [ECAB 22-0977](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2022/OCT/22-0977.pdf) (2022-10-31) · [Pardo v. United Parcel Service, 422 P.3d 1185](https://www.courtlistener.com/opinion/4503199/pardo-v-united-parcel-service/) (2018-06-01) · [ECAB 17-1360](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2018/Jan/17-1360.pdf) (2018-01-10) · [ECAB 17-0914](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2017/Oct/17-0914.pdf) (2017-10-11)._