Common Errors in Spinal Impairment Rating: AMA Guides, Sixth Edition, Definitions of Radiculopathy vs Nonverifiable Radicular Complaints

Abstract

Abstract In assessing spinal impairment, it is imperative to distinguish between limb pain or numbness that might be radicular, but with no objective verification, from symptoms that represent, in fact, true radiculopathy, ie, pain, numbness, or weakness that was related to objective radiculopathy. In the sixth edition of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), this distinction determines what row in the spine tables is used to rate impairment. Failure to discern between nonverifiable radicular complaints and true radiculopathy is a source of frequent errors in spinal impairment rating. True radiculopathy is pain, numbness, and/or weakness from nerve root damage, most commonly from a disc herniation. This article will review how the AMA Guides has dealt with the concept of radiculopathy through the years.