Abstract: This article discusses the physician’s role in impairment rating as well as providing a historical perspective of the impairment rating guidelines. Philosophical and historical concepts of impairment rating systems are covered. Basic rules of impairment rating are explored with emphasis on the AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition. Two case studies are discussed, with the rating of a neurological disorder discussed from both a plaintiff and defense attorney’s perspective. An overall legal perspective as it applies to impairment ratings is discussed as well as specific discussions surrounding the plaintiff and defense attempt to manipulate the impairment rating in an impairment rating environment. This article helps the health care provider understand not only the impairment rating process, but delves into the motivations of attorneys, which can help the practitioner prepare for testimony in controverted cases.
