How to Calculate an Impairment Rating for a Skin Condition

Does Impairment Rating Get Under Your Skin?

Today we Chapter 8 in the AMA Guides 5th Edition: “The Skin.” Specifically, we want to make sure that you place a skin condition in the appropriate class for impairment rating.

The rating table, found on page 178 of the Guides, represents the rating strategy for the entire “Skin” chapter. The rating method is a class based rating system comprised of 5 classes. The whole person impairment range for the chapter is 0-95%.

The rating method in this chapter is primarily driven by the impact of the skin condition on activities of daily living (ADL;Table 1-2 Page 4).

Inventory the Activities of Daily Living!

Initial classification of the skin condition is based on determining how many ADLs (activities of daily living) are “limited.” The ADLs that are considered to be limited by the industrial injury or condition are then grouped into the following categories:

  1. No (none)
  2. Few
  3. Many
  4. Most

Classes 3 and 4 are differentiated by “intermittent confinement at home or domicile.”


When creating or reviewing an impairment rating for the injured employee’s skin, make certain the ADLs have been properly reviewed. It is necessary that those ADLs used to classify the rating category clearly are indicated as “limited.” When “Many” ADLs are reported as “limited,” a statement should be included if the condition results in the individual being confined to his or her home.

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