Mental and Behavioral Disorders Impairment Rating
Chapter 14 of the AMA Guides to the Evaluation of Permanent Impairment, 6th Edition covers impairment to the whole person specifically focusing on Mental and Behavioral Disorders. As an expansion of the 5th Edition, there are three rating scales listed in the 6th Edition: Brief Psychiatric Rating Scale, Global Assessment of Functioning Scale, and Psychiatric Impairment Rating Scale. Psychiatric impairment is based on Axis I diagnoses only. While other medical conditions are not considered with these instruments, physical limitations are important for determining the complete picture of a person’s impairment. Simple computer versions of these scales can be downloaded for your use. These programs produce files with a TXT extension. They cannot be run from CD-ROM, but work very well on memory sticks on a MicroSoft Computer. When the results are obtained from each program, Right Click on the text, Select All, the Right Click, and Copy to a report or text file if you want to directly include the results in an Attachment to a report. Programs updated 12/12/2010.
Impairment Rating Scales
Brief Psychiatric Rating ScaleOverall and Gorham describe the BPRS. It measures major psychiatric and non-psychotic symptoms in patients with major psychiatric illnesses. It can be applied to adults in either inpatient or outpatient settings. It has demonstrated excellent reliability in clinical trials. Updated 2/20/2011 to provide an additional measure of the whole person using the perecent of total possible points.
Global Assessment of Functioning ScaleThe GAF is a rating on Axis V of the DSM-IV-TR. This 100-point rating scale indicates overall symptoms, occupational functioning, and social functioning. Although it has 100 points, it actually represents a scale of 10 values. The GAF has shown satisfactory inter-rater reliability.
Psychiatric Impairment Rating ScaleDeveloped by the New South Wales Motor Accidents Authority in Australia, the PIRS has thankfully modified for use in the AMA Guides. There are 6 functional impairment scales focusing on the domains of life. Emphasis of the scale is on role function and impairment. Updated 2/20/2011 to include the orginal scoring used by insurance companies in addition to the scoring method from the AMA Guides. The percent of total possible points has also been added to allow for better comparisons between scales.