An impairment is permanent when it has reached MMI.
no longer refers to a change by more than 3%, since it is notpossible to accurately assess a 3% change in an impairment.
refers to a range or zone that represents healthy functioning andvaries with age, gender, and other factors, such as environmental conditions(
, p 2).
is defined from either an individual or a population perspective,depending on the preinjury information that is available and the physician’sclinical judgment concerning the best estimate of normal.
may be determined by means other than studies of representativepopulations carried out with valid measures.
may also be deter-mined by a comparison with a preinjury or preillness state or a complemen-tary body part (eg, right and left legs).Impairment ratings or percentages are consensus-derived estimates thatreflect both the severity of the condition and the degree to which the impair-ment decreases an individual’s ability to perform ADL(work is excluded)(
, p 4).Whole person impairment percentages estimate the impact of the impair-ment on the individual’s overall ability to perform ADL.A0% impairment rating indicates that an impairment may be present, butthat impairment does not impact the ability to perform ADL. This situationis considered to be a “nonratable impairment.”Updated statistics regarding the growing use of the
: 40 of 51 jurisdictions use the
in workers’compensation cases by statute,by regulations, or by administrative/legal practice.
is an alteration of an individual’s capacity to meet personal,social, or occupational demands or statutory or regulatory requirementsbecause of an impairment (
, p 8).Impairments can but do not necessarily lead to functional limitationsor disability.Functional limitations or disability can both lead to further impairment.
Philosophy, Purpose, and Appropriate Use of the
C h a p t e r 1