# Sixth Edition, 2008 Aggregated by Superinsight from public-domain sources, as of 2026-10-21. Domain: ama. --- ## AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition, 2008 {#sixth-2008} *AMA Guides, Sixth Edition (2008)* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition, 2008, published by the American Medical Association, 2007-12-01._ **Jurisdictions that rate under this edition:** Alaska, Kansas, Montana, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee (fixed edition); FECA (federal employees) (ratings on or after 2009-05-01; rater's choice of Fifth or Sixth since 2025). **Rating method:** diagnosis-based impairment grids by region, a default class and grade from the diagnosis, grade adjusted by functional history, physical examination and clinical studies. **Chapters:** - Chapter 1 — Conceptual Foundations and Philosophy - Chapter 2 — Practical Application of the Guides - Chapter 3 — Pain-Related Impairment - Chapter 4 — The Cardiovascular System - Chapter 5 — The Pulmonary System - Chapter 6 — The Digestive System - Chapter 7 — The Urinary and Reproductive Systems - Chapter 8 — The Skin - Chapter 9 — The Hematopoietic System - Chapter 10 — The Endocrine System - Chapter 11 — Ear - Chapter 12 — The Visual System - Chapter 13 — The Central and Peripheral Nervous System - Chapter 14 — Mental and Behavioral Disorders - Chapter 15 — The Upper Extremities - Chapter 16 — The Lower Extremities - Chapter 17 — The Spine and Pelvis 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/9781579478889/9781579478889.xml _Applied in 1,165 published decisions and opinions (ECAB and state courts). Recent: [S.M. Connelly v. Keystone Home Health Service (WCAB), 513 C.D. 2025](https://www.courtlistener.com/opinion/10962894/sm-connelly-v-keystone-home-health-service-wcab/) (2026-08-31) · [Rhodes, Jolicia v. Allstate Insurance Company, 2026 TN WC App. 49](https://www.courtlistener.com/opinion/10960392/rhodes-jolicia-v-allstate-insurance-company/) (2026-08-27) · [ECAB 26-0460](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2026/AUG/26-0460.pdf) (2026-08-26) · [ECAB 26-0350](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2026/JUL/26-0350.pdf) (2026-07-07) · [ECAB 26-0143](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2026/JUN/26-0143.pdf) (2026-06-04)._ --- ## AMA Guides Sixth Edition (2008), Chapter 1 — Conceptual Foundations and Philosophy {#1} *AMA Guides, Sixth Edition (2008), Chapter 1* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition, 2008, published by the American Medical Association; Chapter 1 — Conceptual Foundations and Philosophy._ **Jurisdictions that rate under this edition:** Alaska, Kansas, Montana, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee (fixed edition); FECA (federal employees) (ratings on or after 2009-05-01; rater's choice of Fifth or Sixth since 2025). **Rating method (chapter):** diagnosis-based impairment grids by region, a default class and grade from the diagnosis, grade adjusted by functional history, physical examination and clinical studies. 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/9781579478889/c01.xml _Applied in 8 published decisions and opinions (ECAB and state courts). Recent: [ECAB 19-0090](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2019/May/19-0090.pdf) (2019-05-03) · [ECAB 17-0419](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2018/Aug/17-0419.pdf) (2018-08-08) · [ECAB 17-1341](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2018/Jul/17-1341.pdf) (2018-07-16) · [ECAB 17-0736](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2017/Jul/17-0736.pdf) (2017-07-10) · [ECAB 13-1360](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2013/Dec/13-1360.pdf) (2013-12-20)._ --- ## AMA Guides Sixth Edition (2008), Chapter 2 — Practical Application of the Guides {#2} *AMA Guides, Sixth Edition (2008), Chapter 2* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition, 2008, published by the American Medical Association; Chapter 2 — Practical Application of the Guides._ **Jurisdictions that rate under this edition:** Alaska, Kansas, Montana, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee (fixed edition); FECA (federal employees) (ratings on or after 2009-05-01; rater's choice of Fifth or Sixth since 2025). **Rating method (chapter):** diagnosis-based impairment grids by region, a default class and grade from the diagnosis, grade adjusted by functional history, physical examination and clinical studies. 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/9781579478889/c02.xml _Applied in 28 published decisions and opinions (ECAB and state courts). Recent: [ECAB 25-0622](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2025/NOV/25-0622.pdf) (2025-11-18) · [ECAB 25-0742](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2025/SEP/25-0742.pdf) (2025-09-04) · [ECAB 25-0131](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2025/JUL/25-0131.pdf) (2025-07-25) · [ECAB 25-0272](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2025/MAR/25-0272.pdf) (2025-03-17) · [ECAB 25-0045](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2024/DEC/25-0045.pdf) (2024-12-20)._ --- ## AMA Guides Sixth Edition (2008), Chapter 3 — Pain-Related Impairment {#3} *AMA Guides, Sixth Edition (2008), Chapter 3* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition, 2008, published by the American Medical Association; Chapter 3 — Pain-Related Impairment._ **Jurisdictions that rate under this edition:** Alaska, Kansas, Montana, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee (fixed edition); FECA (federal employees) (ratings on or after 2009-05-01; rater's choice of Fifth or Sixth since 2025). **Rating method (chapter):** diagnosis-based impairment grids by region, a default class and grade from the diagnosis, grade adjusted by functional history, physical examination and clinical studies. 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/9781579478889/c03.xml _Applied in 15 published decisions and opinions (ECAB and state courts). Recent: [ECAB 26-0247](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2026/MAY/26-0247.pdf) (2026-05-01) · [ECAB 21-0303](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2021/JUL/21-0303.pdf) (2021-07-08) · [ECAB 18-1615](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2019/Mar/18-1615.pdf) (2019-03-05) · [ECAB 17-1350](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2018/Dec/17-1350.pdf) (2018-12-12) · [ECAB 17-0197](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2018/May/17-0197.pdf) (2018-05-01)._ --- ## AMA Guides Sixth Edition (2008), Chapter 4 — The Cardiovascular System {#4} *AMA Guides, Sixth Edition (2008), Chapter 4* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition, 2008, published by the American Medical Association; Chapter 4 — The Cardiovascular System._ **Jurisdictions that rate under this edition:** Alaska, Kansas, Montana, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee (fixed edition); FECA (federal employees) (ratings on or after 2009-05-01; rater's choice of Fifth or Sixth since 2025). **Rating method (chapter):** diagnosis-based impairment grids by region, a default class and grade from the diagnosis, grade adjusted by functional history, physical examination and clinical studies. 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/9781579478889/c04.xml _Applied in 13 published decisions and opinions (ECAB and state courts). Recent: [ECAB 25-0181](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2025/FEB/25-0181.pdf) (2025-02-25) · [ECAB 24-0602](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2024/SEP/24-0602.pdf) (2024-09-11) · [ECAB 22-0046](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2023/SEP/22-0046.pdf) (2023-09-13) · [Cain, Sherry v. Volkswagen of America, Inc., 2023 TN WC 23](https://www.courtlistener.com/opinion/9389749/cain-sherry-v-volkswagen-of-america-inc/) (2023-03-31) · [ECAB 17-1350](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2018/Dec/17-1350.pdf) (2018-12-12)._ --- ## AMA Guides Sixth Edition (2008), Chapter 5 — The Pulmonary System {#5} *AMA Guides, Sixth Edition (2008), Chapter 5* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition, 2008, published by the American Medical Association; Chapter 5 — The Pulmonary System._ **Jurisdictions that rate under this edition:** Alaska, Kansas, Montana, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee (fixed edition); FECA (federal employees) (ratings on or after 2009-05-01; rater's choice of Fifth or Sixth since 2025). **Rating method (chapter):** diagnosis-based impairment grids by region, a default class and grade from the diagnosis, grade adjusted by functional history, physical examination and clinical studies. 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/9781579478889/c05.xml _Applied in 37 published decisions and opinions (ECAB and state courts). Recent: [ECAB 25-0785](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2025/NOV/25-0785.pdf) (2025-11-21) · [ECAB 24-0899](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2025/JUN/24-0899.pdf) (2025-06-26) · [ECAB 25-0181](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2025/FEB/25-0181.pdf) (2025-02-25) · [ECAB 24-0940](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2025/FEB/24-0940.pdf) (2025-02-13) · [ECAB 25-0154](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2025/JAN/25-0154.pdf) (2025-01-02)._ --- ## AMA Guides Sixth Edition (2008), Chapter 6 — The Digestive System {#6} *AMA Guides, Sixth Edition (2008), Chapter 6* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition, 2008, published by the American Medical Association; Chapter 6 — The Digestive System._ **Jurisdictions that rate under this edition:** Alaska, Kansas, Montana, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee (fixed edition); FECA (federal employees) (ratings on or after 2009-05-01; rater's choice of Fifth or Sixth since 2025). **Rating method (chapter):** diagnosis-based impairment grids by region, a default class and grade from the diagnosis, grade adjusted by functional history, physical examination and clinical studies. 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/9781579478889/c06.xml _Applied in 9 published decisions and opinions (ECAB and state courts). Recent: [ECAB 21-1192](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2022/MAR/21-1192.pdf) (2022-03-14) · [ECAB 17-1663](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2018/Mar/17-1663.pdf) (2018-03-28) · [ECAB 17-1318](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2017/Oct/17-1318.pdf) (2017-10-11) · [ECAB 17-0515](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2017/Jun/17-0515.pdf) (2017-06-07) · [ECAB 15-0707](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2015/Nov/15-0707.pdf) (2015-11-02)._ --- ## AMA Guides Sixth Edition (2008), Chapter 7 — The Urinary and Reproductive Systems {#7} *AMA Guides, Sixth Edition (2008), Chapter 7* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition, 2008, published by the American Medical Association; Chapter 7 — The Urinary and Reproductive Systems._ **Jurisdictions that rate under this edition:** Alaska, Kansas, Montana, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee (fixed edition); FECA (federal employees) (ratings on or after 2009-05-01; rater's choice of Fifth or Sixth since 2025). **Rating method (chapter):** diagnosis-based impairment grids by region, a default class and grade from the diagnosis, grade adjusted by functional history, physical examination and clinical studies. 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/9781579478889/c07.xml _Applied in 15 published decisions and opinions (ECAB and state courts). Recent: [ECAB 21-0792](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2023/JAN/21-0792.pdf) (2023-01-04) · [ECAB 20-1608](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2022/JAN/20-1608.pdf) (2022-01-20) · [ECAB 17-1182](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2017/Sep/17-1182.pdf) (2017-09-12) · [ECAB 16-0179](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2017/Mar/16-0179.pdf) (2017-03-14) · [ECAB 16-1537](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2017/Feb/16-1537.pdf) (2017-02-07)._ --- ## AMA Guides Sixth Edition (2008), Chapter 8 — The Skin {#8} *AMA Guides, Sixth Edition (2008), Chapter 8* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition, 2008, published by the American Medical Association; Chapter 8 — The Skin._ **Jurisdictions that rate under this edition:** Alaska, Kansas, Montana, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee (fixed edition); FECA (federal employees) (ratings on or after 2009-05-01; rater's choice of Fifth or Sixth since 2025). **Rating method (chapter):** diagnosis-based impairment grids by region, a default class and grade from the diagnosis, grade adjusted by functional history, physical examination and clinical studies. 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/9781579478889/c08.xml _Applied in 12 published decisions and opinions (ECAB and state courts). Recent: [ECAB 25-0678](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2025/AUG/25-0678.pdf) (2025-08-15) · [ECAB 24-0086](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2024/JUN/24-0086.pdf) (2024-06-20) · [ECAB 18-1220](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2019/Feb/18-1220.pdf) (2019-02-05) · [ECAB 18-0300](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2018/Jul/18-0300.pdf) (2018-07-13) · [ECAB 17-1654](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2018/Jan/17-1654.pdf) (2018-01-18)._ --- ## AMA Guides Sixth Edition (2008), Chapter 9 — The Hematopoietic System {#9} *AMA Guides, Sixth Edition (2008), Chapter 9* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition, 2008, published by the American Medical Association; Chapter 9 — The Hematopoietic System._ **Jurisdictions that rate under this edition:** Alaska, Kansas, Montana, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee (fixed edition); FECA (federal employees) (ratings on or after 2009-05-01; rater's choice of Fifth or Sixth since 2025). **Rating method (chapter):** diagnosis-based impairment grids by region, a default class and grade from the diagnosis, grade adjusted by functional history, physical examination and clinical studies. 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/9781579478889/c09.xml _Applied in 6 published decisions and opinions (ECAB and state courts). Recent: [ECAB 25-0699](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2025/SEP/25-0699.pdf) (2025-09-16) · [ECAB 24-0642 Reissue](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2025/JAN/24-0642 Reissue.pdf) (2025-01-31) · [Cain, Sherry v. Volkswagen of America, Inc., 2023 TN WC 23](https://www.courtlistener.com/opinion/9389749/cain-sherry-v-volkswagen-of-america-inc/) (2023-03-31) · [ECAB 14-0333](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2014/Jun/14-0333.pdf) (2014-06-25) · [ECAB 13-1755](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2014/Jan/13-1755.pdf) (2014-01-09)._ --- ## AMA Guides Sixth Edition (2008), Chapter 10 — The Endocrine System {#10} *AMA Guides, Sixth Edition (2008), Chapter 10* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition, 2008, published by the American Medical Association; Chapter 10 — The Endocrine System._ **Jurisdictions that rate under this edition:** Alaska, Kansas, Montana, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee (fixed edition); FECA (federal employees) (ratings on or after 2009-05-01; rater's choice of Fifth or Sixth since 2025). **Rating method (chapter):** diagnosis-based impairment grids by region, a default class and grade from the diagnosis, grade adjusted by functional history, physical examination and clinical studies. 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/9781579478889/c10.xml _Applied in 2 published decisions and opinions (ECAB and state courts). Recent: [ECAB 21-0007](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2021/JUL/21-0007.pdf) (2021-07-30) · [ECAB 17-0197](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2018/May/17-0197.pdf) (2018-05-01)._ --- ## AMA Guides Sixth Edition (2008), Chapter 11 — Ear {#11} *AMA Guides, Sixth Edition (2008), Chapter 11* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition, 2008, published by the American Medical Association; Chapter 11 — Ear._ **Jurisdictions that rate under this edition:** Alaska, Kansas, Montana, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee (fixed edition); FECA (federal employees) (ratings on or after 2009-05-01; rater's choice of Fifth or Sixth since 2025). **Rating method (chapter):** diagnosis-based impairment grids by region, a default class and grade from the diagnosis, grade adjusted by functional history, physical examination and clinical studies. 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/9781579478889/c11.xml _Applied in 27 published decisions and opinions (ECAB and state courts). Recent: [ECAB 26-0447](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2026/AUG/26-0447.pdf) (2026-08-07) · [ECAB 24-0332](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2024/AUG/24-0332.pdf) (2024-08-08) · [ECAB 20-1097](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2020/DEC/20-1097.pdf) (2020-12-18) · [ECAB 19-1226](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2019/Dec/19-1226.pdf) (2019-12-23) · [Ferrell, Michael v. Wade Norris Logging, LLC, 2019 TN WC 44](https://www.courtlistener.com/opinion/4779998/ferrell-michael-v-wade-norris-logging-llc/) (2019-03-13)._ --- ## AMA Guides Sixth Edition (2008), Chapter 12 — The Visual System {#12} *AMA Guides, Sixth Edition (2008), Chapter 12* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition, 2008, published by the American Medical Association; Chapter 12 — The Visual System._ **Jurisdictions that rate under this edition:** Alaska, Kansas, Montana, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee (fixed edition); FECA (federal employees) (ratings on or after 2009-05-01; rater's choice of Fifth or Sixth since 2025). **Rating method (chapter):** diagnosis-based impairment grids by region, a default class and grade from the diagnosis, grade adjusted by functional history, physical examination and clinical studies. 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/9781579478889/c12.xml _Applied in 18 published decisions and opinions (ECAB and state courts). Recent: [ECAB 24-0293](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2024/MAY/24-0293.pdf) (2024-05-09) · [ECAB 22-0197](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2022/JUL/22-0197.pdf) (2022-07-29) · [ECAB 19-0098](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2020/Jan/19-0098.pdf) (2020-01-24) · [ECAB 18-0285](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2019/Sep/18-0285.pdf) (2019-09-26) · [ECAB 18-0975_P](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2019/Jan/18-0975_P.pdf) (2019-01-10)._ --- ## AMA Guides Sixth Edition (2008), Chapter 13 — The Central and Peripheral Nervous System {#13} *AMA Guides, Sixth Edition (2008), Chapter 13* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition, 2008, published by the American Medical Association; Chapter 13 — The Central and Peripheral Nervous System._ **Jurisdictions that rate under this edition:** Alaska, Kansas, Montana, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee (fixed edition); FECA (federal employees) (ratings on or after 2009-05-01; rater's choice of Fifth or Sixth since 2025). **Rating method (chapter):** diagnosis-based impairment grids by region, a default class and grade from the diagnosis, grade adjusted by functional history, physical examination and clinical studies. 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/9781579478889/c13.xml _Applied in 33 published decisions and opinions (ECAB and state courts). Recent: [ECAB 26-0303](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2026/JUN/26-0303.pdf) (2026-06-11) · [ECAB 23-0528](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2026/APR/23-0528.pdf) (2026-04-08) · [ECAB 25-0843](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2025/NOV/25-0843.pdf) (2025-11-24) · [ECAB 24-0855](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2024/NOV/24-0855.pdf) (2024-11-26) · [ECAB 24-0917](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2024/NOV/24-0917.pdf) (2024-11-01)._ --- ## AMA Guides Sixth Edition (2008), Chapter 14 — Mental and Behavioral Disorders {#14} *AMA Guides, Sixth Edition (2008), Chapter 14* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition, 2008, published by the American Medical Association; Chapter 14 — Mental and Behavioral Disorders._ **Jurisdictions that rate under this edition:** Alaska, Kansas, Montana, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee (fixed edition); FECA (federal employees) (ratings on or after 2009-05-01; rater's choice of Fifth or Sixth since 2025). **Rating method (chapter):** diagnosis-based impairment grids by region, a default class and grade from the diagnosis, grade adjusted by functional history, physical examination and clinical studies. 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/9781579478889/c14.xml _Applied in 4 published decisions and opinions (ECAB and state courts). Recent: [ECAB 23-1063](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2024/FEB/23-1063.pdf) (2024-02-09) · [ECAB 14-1147](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2014/Sep/14-1147.pdf) (2014-09-04) · [ECAB 14-0333](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2014/Jun/14-0333.pdf) (2014-06-25) · [ECAB 11-0622](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2011/Oct/11-0622.pdf) (2011-10-07)._ --- ## AMA Guides Sixth Edition (2008), Chapter 15 — The Upper Extremities {#15} *AMA Guides, Sixth Edition (2008), Chapter 15* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition, 2008, published by the American Medical Association; Chapter 15 — The Upper Extremities._ **Jurisdictions that rate under this edition:** Alaska, Kansas, Montana, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee (fixed edition); FECA (federal employees) (ratings on or after 2009-05-01; rater's choice of Fifth or Sixth since 2025). **Rating method (chapter):** diagnosis-based impairment grids by region, a default class and grade from the diagnosis, grade adjusted by functional history, physical examination and clinical studies. 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/9781579478889/c15.xml _Applied in 1,251 published decisions and opinions (ECAB and state courts). Recent: [ECAB 26-0299](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2026/JUL/26-0299.pdf) (2026-07-13) · [ECAB 26-0322](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2026/JUL/26-0322.pdf) (2026-07-01) · [ECAB 26-0166](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2026/JUN/26-0166.pdf) (2026-06-23) · [ECAB 26-0351](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2026/JUN/26-0351.pdf) (2026-06-23) · [ECAB 26-0303](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2026/JUN/26-0303.pdf) (2026-06-11)._ --- ## AMA Guides Sixth Edition (2008), Chapter 16 — The Lower Extremities {#16} *AMA Guides, Sixth Edition (2008), Chapter 16* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition, 2008, published by the American Medical Association; Chapter 16 — The Lower Extremities._ **Jurisdictions that rate under this edition:** Alaska, Kansas, Montana, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee (fixed edition); FECA (federal employees) (ratings on or after 2009-05-01; rater's choice of Fifth or Sixth since 2025). **Rating method (chapter):** diagnosis-based impairment grids by region, a default class and grade from the diagnosis, grade adjusted by functional history, physical examination and clinical studies. 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/9781579478889/c16.xml _Applied in 1,008 published decisions and opinions (ECAB and state courts). Recent: [ECAB 26-0483](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2026/AUG/26-0483.pdf) (2026-08-05) · [ECAB 26-0296](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2026/JUN/26-0296.pdf) (2026-06-09) · [ECAB 26-0332](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2026/JUN/26-0332.pdf) (2026-06-09) · [ECAB 25-0806](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2026/JUN/25-0806.pdf) (2026-06-05) · [ECAB 26-0173](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2026/JUN/26-0173.pdf) (2026-06-04)._ --- ## AMA Guides Sixth Edition (2008), Chapter 17 — The Spine and Pelvis {#17} *AMA Guides, Sixth Edition (2008), Chapter 17* Official source: _AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition, 2008, published by the American Medical Association; Chapter 17 — The Spine and Pelvis._ **Jurisdictions that rate under this edition:** Alaska, Kansas, Montana, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee (fixed edition); FECA (federal employees) (ratings on or after 2009-05-01; rater's choice of Fifth or Sixth since 2025). **Rating method (chapter):** diagnosis-based impairment grids by region, a default class and grade from the diagnosis, grade adjusted by functional history, physical examination and clinical studies. 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/9781579478889/c17.xml _Applied in 255 published decisions and opinions (ECAB and state courts). Recent: [ECAB 26-0104](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2026/APR/26-0104.pdf) (2026-04-16) · [ECAB 26-0094](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2026/MAR/26-0094.pdf) (2026-03-04) · [ECAB 25-0742](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2025/SEP/25-0742.pdf) (2025-09-04) · [ECAB 25-0678](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2025/AUG/25-0678.pdf) (2025-08-15) · [ECAB 25-0628](https://www.dol.gov/sites/dolgov/files/ecab/decisions/2025/AUG/25-0628.pdf) (2025-08-01)._