Impairment Rating Letter Template: A Comprehensive Guide

Introduction: Quantifying Permanent Loss

An Impairment Rating Letter is a definitive medical opinion that translates a patient's physical damage into a number—a percentage of Whole Person Impairment (WPI). This document is the linchpin of disability settlements, providing an objective basis for financial compensation after an injury has stabilized (reached MMI).

Why This Letter is Crucial

It serves as the objective currency in medical-legal negotiations:

• For Patients: validates the permanent nature of their injury and secures fair benefits.
• For Insurers: Provides a standardized, defensible metric for closing claims.
• For Attorneys: Is the key piece of evidence used to argue for appropriate settlement values.
• For Physicians: Allows them to communicate complex medical outcomes in a universally understood legal format.

Key Components of an Impairment Rating Letter

To be legally sound, the letter must include:

• MMI Declaration: Confirmation that the patient's condition is stable.
• History & Exam: Specific clinical findings (e.g., "Range of motion in left shoulder is limited to 90 degrees flexion") supporting the rating.
• Methodology: Explicit citation of the guidelines used (e.g., "AMA Guides, 6th Edition, Chapter 15").
• Calculation: Step-by-step math showing how the WPI was derived from specific organ/body part impairments.
• Functional Implications: Narrative on how this impairment affects daily life or work capacity.

Complete Impairment Rating Template Example

PERMANENT IMPAIRMENT RATING REPORT

Date: [Today's Date]
To: [Claims Administrator/Attorney]
Patient: [Patient Name] | DOB: [DOB] | Claim #: [Claim Number]
Date of Injury: [DOI]

Subject: Final Impairment Rating Evaluation

1. Maximum Medical Improvement (MMI):
I have evaluated the patient and determined they reached MMI on [Date].

2. Clinical Summary:
Patient presented with [Injury]. Despite [Treatment: Surgery/PT], they retain [Specific Deficit: e.g., 20% loss of grip strength].

3. Impairment Rating Calculation:
Based on the AMA Guides to the Evaluation of Permanent Impairment, 6th Edition:

*   Region: Upper Extremity
*   Diagnosis: Distal Radius Fracture
*   Class: 1 (Mild problem)
*   Grade Modifications:
    *   Functional History: Grade 1
    *   Physical Exam: Grade 1
    *   Clinical Studies: Grade 1
*   Upper Extremity Impairment (UEI): 6%
*   Whole Person Impairment (WPI): 4% (Converted from UEI)

4. Final Rating:
4% Whole Person Impairment

5. Functional Limitations:
Patient should avoid heavy lifting (>20lbs) with the right arm.

I declare that this report is true and correct to the best of my knowledge and follows the principles of the AMA Guides.

Sincerely,

[Physician Signature]
[Physician Name, MD, CIME]

Automating Impairment Ratings with HealOS

Calculating ratings is complex and prone to error. HealOS AI agents simplify the process:

• AI Medical Scribe: Captures precise range-of-motion measurements and sensory deficits during the exam.
• Clinical Documentation Agent: Automatically structures the exam data into the specific format required by the AMA Guides.
• EHR Interoperability Agent: Pulls critical diagnostic reports (MRI/EMG) directly into the calculator to substantiate the rating.

Automated Workflow Diagram (Mermaid)

graph TD
    A[Patient Reaches MMI] --> B[Physician Conducts Exam];
    B --> C[HealOS Scribe Records Measurements];
    C --> D[HealOS Agent Retrieves Diagnostic Reports];
    D --> E[Physician Applies AMA Guidelines];
    E --> F[HealOS Generates Draft Rating Letter];
    F --> G[Physician Reviews & Finalizes];
    G --> H[Final Report Sent to Payor/Legal];

Frequently Asked Questions (FAQs)

Accurate Ratings, Simplified by HealOS

Ensure your impairment ratings are accurate, compliant, and defensible. Let HealOS AI agents handle the heavy lifting of documentation and data synthesis.

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Example Letter Template