disability impairment rating

Welcome to Disability Impairment Rating. This four-hour program gives California QMEs a practical method for rating permanent impairment under Chapters 15 through 18 of the AMA Guides, Fifth Edition.

The course begins with the spine. It then addresses the upper extremities and lower extremities. The final session explains when Chapter 18 permits an additional rating for pain. Each session shows how to connect the medical findings to the selected method and final whole person impairment.

PART 1 SPINE IMPAIRMENT RATINGS

Chapter 15 explains the DRE and ROM methods. The session addresses nonvitrifiable radicular complaints, DRE categories, motion segment integrity, valid motion measurements, conversion, and report documentation.

PART 2 UPPER EXTREMITY IMPAIRMENT RATINGS

Chapter 16 explains how to rate the shoulder, arm, wrist, hand, and fingers. The session covers motion, nerve loss, amputation, circulation, strength, diagnosis-based methods, conversion, and duplicate ratings.

PART 3 LOWER EXTREMITY IMPAIRMENT RATINGS

Chapter 17 explains how to rate the hip, knee, leg, ankle, foot, and toes. The session reviews the thirteen methods, regional conversion, combination rules, and the need to avoid a second rating for the same loss.

PART 4 PAIN RELATED IMPAIRMENT

Chapter 18 explains when pain may support an additional rating. The session addresses activities of daily living, recognized pain syndromes, behavioral factors, the 3 percent WPI limit, and the report explanation.

•  Choose the correct method for the body region and condition.
• Document the objective findings that support the method.
• Calculate and convert regional impairment values in the correct order.
• Apply the rules that govern combination and duplicate ratings.
• Explain when Chapter 18 does or does not support an additional rating.

•  Credit  -  4 hours of California QME continuing education 
• Format - Online and Self - paced
• Audience  - California QMEs who seek reappointment credit.
• Provider - EZ Continuing Education. org DWC Provider No. 1280.
• Instructor - Perry Carpenter, DC., DC QME 
• Assessment - 20 questions; 16 Correct answer required. 
• Contact - (800) 676-8127 | sportsdc@aol.com

 Watch all four sessions. Review the course materials. Complete the examination with a score of at least 16 correct answers. Submit the required completion information to receive credit and a certificate.

 An impairment rating affects the value and direction of a workers’ compensation case. The parties need more than a percentage. They need a rating that follows the AMA Guides and rests upon positive objective findings. They also need an explanation that allows another reader to reproduce the calculation.

This four-hour program shows California QMEs how to rate the spine, upper extremities, lower extremities, and pain under Chapters 15 through 18 of the AMA Guides, Fifth Edition. Each session applies the same basic process. The QME selects the correct method, documents the findings, uses the correct tables, converts the regional values, and explains the final whole person impairment.

The program satisfies four hours of continuing education for QMEs who seek reappointment under 8 CCR section 55.1(b)(5), subject to DWC approval.

PART 1 SPINE IMPAIRMENT RATINGS

Chapter 15 explains the DRE and ROM methods. The session addresses nonvitrifiable radicular complaints, DRE categories, motion segment integrity, valid motion measurements, conversion, and report documentation.

PART 2 UPPER EXTREMITY IMPAIRMENT RATINGS

Chapter 16 explains how to rate the shoulder, arm, wrist, hand, and fingers. The session covers motion, nerve loss, amputation, circulation, strength, diagnosis-based methods, conversion, and duplicate ratings.

PART 3 LOWER EXTREMITY IMPAIRMENT RATINGS

Chapter 17 explains how to rate the hip, knee, leg, ankle, foot, and toes. The session reviews the thirteen methods, regional conversion, combination rules, and the need to avoid a second rating for the same loss.

PART 4 PAIN RELATED IMPAIRMENT

Chapter 18 explains when pain may support an additional rating. The session addresses activities of daily living, recognized pain syndromes, behavioral factors, the 3 percent WPI limit, and the report explanation.

• Select the correct rating method for a condition of the spine or an extremity.
• Identify the positive objective findings that support the selected method.
• Use the correct tables and conversion sequence to calculate whole person impairment.
• Avoid duplicate ratings for the same functional loss.
• Decide when Chapter 18 permits an additional rating for pain.
• Show each calculation and explain the medical basis for the final rating.

• Four hours of video instruction.
• Four coordinated PowerPoint presentations.
• Downloadable course materials and references.
• A 20-question examination.
• Four hours of QME continuing education credit after successful completion and DWC approval.

 This program is designed for California QMEs of every specialty who evaluate permanent impairment. It gives newer QMEs a clear method. It also helps experienced QMEs review difficult rating choices and strengthen the explanations in their reports.

 Perry J. Carpenter, D.C., QME, is a veteran California Qualified Medical Evaluator and a long-time provider of continuing education for QMEs. He teaches the rating process through practical examples that physicians can use in their next evaluation.

 A reproducible impairment rating begins with the correct method and positive objective findings. This four-part program shows QMEs how to rate the spine, upper extremities, lower extremities, and pain under Chapters 15 through 18 of the AMA Guides.

By Perry J. Carpenter, D.C., QME

An impairment percentage carries little value unless the medical evidence supports it. The QME must choose the correct chapter and method. The examination must document the findings that support that choice. The report must then show the tables, conversions, and calculations that produce the final whole person impairment.

Disability Impairment Rating is a four-hour course for California QMEs. The program provides a practical overview of Chapters 15 through 18 of the AMA Guides, Fifth Edition. Each hour addresses a different part of the rating process.

Part 1 addresses the spine under Chapter 15. The session explains when the QME should use the DRE method or the ROM method. It gives special attention to nonverifiable radicular complaints, which arise far more often than objective radiculopathy in QME practice.

Part 2 addresses the upper extremities under Chapter 16. The session follows the examination from the shoulder to the hand. It explains the major rating methods and the conversion from a digit, hand, or upper extremity value to whole person impairment.

Part 3 addresses the lower extremities under Chapter 17. The session reviews the thirteen available methods. It explains how the QME selects the most specific method, converts regional values, combines separate losses, and avoids a second rating for the same impairment.

Part 4 addresses pain under Chapter 18. The session explains when the conventional rating already accounts for pain. It also explains when additional functional loss may support an increase of up to 3 percent WPI. 

The QME must identify the loss and explain the medical reasoning.

Together, the four sessions provide one clear process. The QME selects the method, records the findings, completes the calculation, and explains the result. This approach produces an accurate rating that another reader can understand and reproduce.