Impairment Ratings & IMEs
AMA Guides ratings, second opinions and independent evaluations
Overview
Impairment Ratings & IMEs for federal and state claims
A rating that cites the wrong edition of the AMA Guides gets challenged. We rate to the standard the governing jurisdiction actually adopted and show the measurement behind each figure.
An impairment rating is a legal document written in clinical language. It gets challenged on three things: whether maximum medical improvement was actually reached, whether the correct edition of the AMA Guides was applied, and whether the measurements behind the percentage are shown and reproducible.
We address all three explicitly on the face of the report. The edition applied is named. MMI is justified rather than assumed. Each figure traces back to a stated measurement, so a reviewer can follow the arithmetic instead of taking the conclusion on faith.
Second opinions and independent evaluations are handled as separate engagements from treatment, with the referral question answered directly — and answered the same way regardless of who paid for the examination.
Scope of service
What's included
- Permanent partial impairment ratings under the applicable AMA Guides edition
- Maximum medical improvement determinations
- Second opinion examinations
- Independent medical evaluations
- Narrative reports written for the claim file and hearing record
- Records review with a written opinion where no examination is needed
Report types
- Permanent partial impairment rating
- Maximum medical improvement determination
- Second opinion examination on treatment or causation
- Independent medical evaluation
- Records-only review with written opinion
- Apportionment opinion where a pre-existing condition is at issue
- Work-capacity opinion for permanent restriction questions
Questions a report can answer
- Has the worker reached maximum medical improvement?
- What is the permanent impairment percentage, and by which edition?
- Is the diagnosis causally related to the described work event?
- Is proposed additional treatment reasonable and necessary?
- What permanent restrictions, if any, remain?
- How much of the impairment predates this claim?
How it works
From referral to closure
1. Referral question in writing
We ask for the specific questions to be answered and the jurisdiction, because the standard applied depends on both.
2. Records review before the exam
Prior imaging, operative reports, therapy measurements and earlier ratings are reviewed first so the examination tests the actual dispute.
3. Examination and measurement
Motion, strength and neurologic findings are measured and recorded numerically, with reproducibility noted.
4. Rating to the adopted edition
The applicable AMA Guides edition for the governing jurisdiction is named in the report, and each component figure is tied to its measurement.
5. Narrative written for the file
The report answers the referral question in plain terms, then shows the clinical basis — usable by an adjuster, an examiner or a hearing record.
6. Clarification if challenged
Where a figure is disputed, we provide written clarification tied to the same measurements rather than a revised conclusion.
Documentation you receive
- Narrative report naming the AMA Guides edition applied
- MMI determination with the reasoning stated
- Numeric measurements supporting each impairment component
- Direct answers to each referral question asked
- Apportionment discussion where pre-existing findings exist
- Permanent restriction set where residuals remain
Why safety managers and TPAs use us
- Ratings that hold up because the arithmetic is visible
- The correct edition for Missouri, Kansas or federal claims
- Reports that answer the question actually asked
- Records-only reviews where an examination is not warranted
- A clear MMI date so a file can finally be valued
Federal and state rules
Missouri ratings follow the edition of the AMA Guides applied under Missouri DWC practice; Kansas ratings follow the edition adopted by Kansas statute. Federal ratings follow OWCP's stated standard. Under the Federal Employees' Compensation Act, an injured federal employee chooses their own initial treating physician. Nothing on this page should be read as an agency directing an employee's choice of provider.
Questions
Impairment Ratings & IMEs: frequently asked questions
By location
Impairment Ratings & IMEs near you
Impairment Ratings & IMEs in Kansas City, MO
Impairment ratings are where Kansas City files most often stall. Dr. Pearson is a certified 6th Edition rater, and ratings are written with the findings, methodology and tables shown — so the number is traceable rather than asserted.
Kansas City detailsImpairment Ratings & IMEs in St. Louis, MO
Missouri permanent partial disability findings and federal schedule award ratings are not the same exercise, and a rating written for the wrong system gets challenged. Our ratings show the measurements, the edition and the tables used, so the conclusion can be checked line by line.
St. Louis details