# Impairment Rating Record Review — AMA Guides > Record review for permanent impairment ratings across states. AMA Guides 4th, 5th and 6th edition findings, Texas DWC-069 and New York SLU, cited. Canonical page: https://medrecords.ai/solutions/impairment-rating-record-review/ --- [Home](https://medrecords.ai/) ›[Solutions](https://medrecords.ai/solutions/) ›[Workers' Compensation](https://medrecords.ai/solutions/workers-comp/) ›Impairment Rating Record Review IMPAIRMENT RATING RECORD REVIEW ## Sixth edition, fifth edition, fourth edition — or New York's own guidelines. Impairment rating record review reads a workers' comp file against the rating standard that applies at the state line: AMA Guides 6th edition in roughly eighteen states and FECA, 5th in California, 4th in Texas, and New York's own Schedule Loss of Use tables. We read the file once and return what each guide asks for. [Test a file ](https://medrecords.ai/test-a-file/?src=impairment-rating-record-review) [Book a demo](https://medrecords.ai/demo/?src=impairment-rating-record-review) Click any row → the source page it cites Rating file · Case #IME-4812 read Adams, Timothy · right knee · rating file 342 pp / 2 packets received logged 11 duplicate pages removed free p.140 — wrong patient quarantined Pages 342 Packets 2 Cited 100% ### One injury. Four rulebooks. We do not build for a case type until we can name the standard that defines a correct output and the person who grades the file against it. Permanent impairment has both. It just has four of the first one, and which applies depends on where the injury happened. That fragmentation is the reason the read is worth building. A single generic summary is wrong in three jurisdictions out of four; a read that knows which edition is in play is not. The rulebook and the referee The rulebook - **AMA Guides 6th edition** — roughly 18 states, plus FECA and DBA hearing loss claims - **California** — AMA Guides 5th edition under Labor Code §4660, with Almaraz/Guzman as the rebuttal path - **Texas** — AMA Guides 4th edition, frozen, reported on Form DWC-069 by the Designated Doctor - **New York** — its own 2018 Schedule Loss of Use Guidelines and Form C-4.3, explicitly not the AMA Guides The referee - The state workers' comp judge or appeals board, which accepts or rejects the rating - The opposing party, which buys a rebuttal IME when the number moves money - In Texas, the Designated Doctor's opinion carries presumptive weight, rebuttable only by a preponderance of the evidence Impairment rating and IME reports average roughly $900 each, across an estimated 440,000 reports a year Flat 10¢/page here, duplicates free Rating file · Case #IME-4812 cited 100% Production342 pp / 2 packets · 11 deduplicatedlogged Range of motion7 visits, improving since 4/02trended Therapy flowsheetsHandwritten, faxed, off-axisdegraded Page 140Belongs to a different patientquarantined Every line cited · no rating assigned What the file actually looks like ### 300 to 1,200 pages. The rating turns on a few dozen. A permanent impairment file runs 300 to 1,200 pages, about 750 in the middle, and it almost never arrives as one production. The treating chart comes from one system, the surgical records from another, the therapy notes from a third, and the carrier sends whatever it already had on file. Some of it is a clean PDF export. Much of it is a fax of a scan, a handwritten therapy flowsheet with the goniometer readings in the margin, or the same operative report filed three times under three different cover sheets. The measurements the tables need are in there. Finding all of them is the work. We estimate roughly 440,000 impairment rating reports a year across the US system, working down from about 4.5 million workers' comp claims to some 900,000 indemnity claims, of which around 35% reach maximum medical improvement with a rating, plus about 40% again in rebuttal IMEs. Every one of those is a file somebody reads end to end before a number can be defended. What we'd build with you ### A co-build, not a signup. We do not ship one impairment rating template and hope it survives contact with Texas. The read gets built against a real file from your practice, in the jurisdiction you actually work in, and you see the output before anyone commits to anything. The line we do not cross is the same one in every jurisdiction: the platform organizes, cites, and surfaces the record evidence. The evaluator forms the opinion, assigns the percentage, and signs the report. Nearby in the same lane: [California QME record review](https://medrecords.ai/solutions/california-qme-record-review/) and [statement of accepted facts](https://medrecords.ai/solutions/statement-of-accepted-facts/) . 01 #### Send one real file One impairment rating file, from whatever state it came from, in whatever shape it arrived in. Three hundred pages or twelve hundred, degraded scans and handwriting included. In the demo case, 342 pages across 2 packets. 02 #### We return the read The record read end to end and page-cited: range of motion entries, treatment course, documented restrictions, and the dates the edition in play turns on. No rating, no opinion, no signature. 03 #### We scope the build If the read lands, we scope a repeatable version for your jurisdiction mix: 6th edition, 5th under §4660, 4th on the DWC-069, New York's SLU tables, or some combination of them. 04 #### You run it Your evaluator reads the citations, applies the tables, and signs the report. The platform never assigns an impairment percentage, never rates a claim, and never decides what a rating is worth. Why Medrecords AI ### The rules the platform never breaks. EVERY LINE CITED CASE #IME-4812 · ADAMS, T.342 pp 2/14 — ER visit, right knee p.4 4/18 — arthroscopic surgery p.61 p.140 — wrong patient quarantined Medrecords AI Read every page · cite every line #### HIPAA, under a signed BAA Every file is handled under our Business Associate Agreement, from the first byte. #### Never trains a model Your records are never used to train any AI model — ours or anyone else's. #### Every line cited If we can't cite it, we don't say it. Every sentence links to its source page. #### Deleted after delivery Files are deleted 30 days after delivery, with a full audit log of every access. Powered by the platform ### Four capabilities behind every rating read. Impairment rating record review is one deliverable of the same platform that reads, sorts, and cites the whole record. [ #### Pain & Range of Motion Analysis Goniometer readings, pain scores, and functional measures pulled out of the therapy notes wherever they were written down, handwriting included. IN ACTION · every ROM entry across 342 pp, each cited ](https://medrecords.ai/product/pain-range-of-motion-analysis/) [ #### Work Limitation Extraction Every documented restriction, lifting limit, and duty modification lifted out of the chart with the date it was imposed and the page it sits on. IN ACTION · restriction lines → one dated, cited list ](https://medrecords.ai/product/work-limitation-extraction/) [ #### Condition Progression Tracking The same measure plotted across every visit, so the plateau that supports maximum medical improvement is visible rather than argued from memory. IN ACTION · 7 visits, improving since 4/02 ](https://medrecords.ai/product/condition-progression-tracking/) [ #### Custom Report Builder One template per jurisdiction, so a DWC-069 file and a New York C-4.3 file come back in the shape each one is filed in. IN ACTION · 38 template fields filled, each cited ](https://medrecords.ai/product/custom-report-builder/) FAQ ### Impairment rating record review, answered. Whichever one your jurisdiction actually uses. Roughly eighteen states, plus FECA and DBA hearing loss claims, run on the AMA Guides 6th edition. California uses the 5th under Labor Code §4660, with Almaraz/Guzman available as a rebuttal path. Texas is frozen on the 4th. New York uses its own 2018 Schedule Loss of Use Guidelines instead of the Guides. You name the jurisdiction; the read surfaces what that edition's tables ask about. No. The Designated Doctor assigns the rating and signs the DWC-069. We read the underlying records and return the measurements, dates, and treatment history the 4th edition tables call for, each cited to its source page. In Texas the Designated Doctor's opinion carries presumptive weight, rebuttable only by a preponderance of the evidence, so the physician's own review is the part that has to hold up. No, and that is exactly the problem. New York's 2018 SLU Guidelines and Form C-4.3 are explicitly not the AMA Guides, so a read built for the 6th edition returns findings the C-4.3 never asks for. A New York file gets read against what the SLU tables actually require instead. No. We do not calculate a whole person impairment percentage, combine values, or apportion. We extract and cite the record evidence a rating physician needs in front of them: range of motion entries, diagnosis-based findings, the treatment course, and documented restrictions. The physician does the calculation, forms the opinion, and signs the report. On the record side, yes. We read the same file the original rating was built from and page-cite what is in it, including the material the first report left unaddressed. Whether the rating is wrong, and whether it is worth rebutting before a judge or appeals board, is the reviewing physician's and the party's call, not ours. ### Send one file. We'll tell you what we can read. No obligation. If the case type is buildable we'll scope it; if it isn't, we'll say so. [Test a file ](https://medrecords.ai/test-a-file/?src=impairment-rating-record-review) [Book a demo](https://medrecords.ai/demo/?src=impairment-rating-record-review) [All workers' compensation record review →](https://medrecords.ai/solutions/workers-comp/) [See every case type we process →](https://medrecords.ai/solutions/case-types/)