Medico-Legal Services

Impairment & Disability Ratings

AMA Guides-based permanent impairment assessments

Fellowship-trained orthopedic spine surgeon
Active clinical spine practice
Objective, evidence-based opinions
AMA Guides methodology
Deposition and trial-ready

What You Receive

Permanent impairment rating using AMA Guides 5th Edition
Detailed explanation of rating methodology and calculations
Range of motion measurements and DRE/ROM determination
Assessment of neurological deficits
Work restrictions and functional limitations
Comparison to previous ratings (if applicable)
Supporting documentation and measurement records

Process & Timeline

1

Submit Records

Send medical records and case details

2

Evaluation

Thorough review and examination

3

Report Delivery

Comprehensive written opinion, typically 2-3 weeks

Who This Service Is For

Workers' compensation carriers determining benefits
Personal injury attorneys quantifying damages
Social Security disability evaluators
Long-term disability insurance carriers
Administrative law judges requiring objective assessments

Understanding AMA Guides 5th Edition

The AMA Guides to the Evaluation of Permanent Impairment, 5th Edition, is the standard reference used in most workers' compensation jurisdictions for rating permanent impairment.

Key Components of Spine Impairment Rating

  • Diagnosis-Related Estimate (DRE): Categories I through V based on severity of pathology and surgical intervention
  • Range of Motion (ROM): Measured in degrees for each plane of motion when DRE doesn't apply
  • Radiculopathy: Additional impairment for nerve root compression with objective findings
  • Neurological deficits: Motor, sensory, or reflex loss adds to overall rating

Common Impairment Ranges

  • Simple discectomy (successful): Typically 5-8% whole person impairment
  • Single-level fusion: Typically 10-13% whole person impairment
  • Multi-level fusion: 15-25% depending on levels and neurological involvement
  • With radiculopathy: Additional 5-10% depending on severity

These are general ranges; actual ratings depend on specific clinical findings and methodology used.

What Is Evaluated

Neutral, Defensible Opinions

Evidence-Based Methodology: All opinions are grounded in objective clinical findings, peer-reviewed literature, and established medical guidelines—not advocacy.

Equal Treatment: Whether representing plaintiff or defense, each case receives the same rigorous, unbiased analysis focused solely on the medical facts.

Deposition-Ready: Reports are written to withstand scrutiny, with clear rationale and supporting medical evidence for every conclusion.

Records Needed

  • Complete medical records documenting the condition
  • All spine imaging (MRI, CT, X-rays) with radiology reports
  • Surgical reports if applicable
  • Physical therapy records showing functional limitations
  • Previous impairment ratings (for comparison)
  • Job description and physical demands analysis
  • FCE (Functional Capacity Evaluation) if performed

Submit a Case

We respond to all inquiries within 24 business hours.

Credentials

  • Board-certified, ABOS
  • FAAOS designation
  • Cleveland Clinic Fellowship
  • Licensed: OH, KY, MI, CA

Submit Your Case Inquiry

Get an objective, evidence-based medical opinion within 2-3 weeks

Professional Affiliations

AAOS • NASS • AMA • Cleveland Clinic • University of Chicago • UCLA • OHSU