Effects of Medication and Impairment Rating

How the AMA Guides 5th Edition approaches impairment is complex, and accurate impairment ratings are tricky as a result.

For example, many medical providers don’t realize that the effects that medication has on an injured worker can actually change the worker’s impairment rating. This is defined on page 600 of the AMA Guides.

With page after page of definitions and tables, little details like these can easily be glossed over. We designed RateFast so that you don’t need to spend your time reading and re-reading the Guides. If you use RateFast to write your California PR-4 reports, then our software will prompt you with easy-to-answer questions about the effects that medication has on your patient.

But it’s still important to understand how the effects of mediation impact a worker’s whole person impairment. Here are a few key facts:

  1. “Effects of medication” are defined on page 600 of the AMA Guides, 5th Edition: “Medications may impact the individual signs, symptoms, and ability to function.”
  2. If an injured worker is affected by the medication he or she takes for the work-related injury, then the physician may choose to increase the impairment by small amount—between 1% and 3%. (Frustratingly, the AMA Guides do not give specific instructions on how to do this.)

So imagine that your patient has reached MMI for an injury to the low back. Let’s say that she is assigned a DRE category II and given a 5% WPI.

Now, imagine that the muscle relaxant she has been prescribed causes excessive drowsiness and limits her ability to drive. Is she eligible for an increased whole person impairment rating? Yes. The muscle relaxant has affected her life by limiting her ability to drive.

The moral of the story: if you’re a medical provider, make sure to ask your patients if their medications cause any side effect. It could make a real change in their impairment rating.

If you need help remembering to ask if medications are affecting your patients symptoms, try RateFast today for free. This question is built into our patient history questionnaire and our impairment calculations.