Impairment Ratings for Posttraumatic Headache
Article first published online: 19 MAY 2005
Headache: The Journal of Head and Face Pain
Volume 33, Issue 7, pages 359–364, August 1993
How to Cite
Packard, R. C. and Ham, L. P. (1993), Impairment Ratings for Posttraumatic Headache. Headache: The Journal of Head and Face Pain, 33: 359–364. doi: 10.1111/j.1526-4610.1993.hed3307359.x
- Issue published online: 19 MAY 2005
- Article first published online: 19 MAY 2005
- Accepted for publication: March 14, 1993
- Cited By
- posttraumatic headach
No standardized criteria are available for establishing impairment ratings for pain or posttraumatic headache. The AMA Guides to the Evaluation of Permanent Impairment, 3rd Edition, 1988, defines impairment as “the loss of use of, or derangement of any body part, system or function.” Headaches may be classified under episodic neurological disorders and impairment based loosely on frequency, severity and duration of attacks and how activities of daily living are affected. Other systems base ratings by physical findings or diagnosis.
Criteria for posttraumatic headache are proposed in the form of a mnemonic: I M P A I R M E N T. Intensity, Medication use, Physical signs/symptoms, Adjustment, Incapacitation, Recreation, Miscellaneous activity of daily living, Employment, Number (frequency), Time (duration of attacks). Each are scored from 0 to 2 points. There are three physician modifiers, scored from 0 to -4 points: Motivation for treatment, Overexaggeration or overconcern, Degree of legal interest. Case examples will illustrate how impairment ratings are determined, along with further details on scoring. Proposed criteria for posttraumatic headache impairment are understandable, easy to utilize and reproducible.