Improving the validity of the impairment evaluation process: A proposed theoretical framework

The American Medical Association's Guides to the Evaluation of Permanent Im pairment is the most widely used set of procedures for rating permanent med ical impairment. Al though the Guides authors intend that the impairment ra tings not be used for disability determination, the ratings are routinely u sed in benefit entitlement systems for work disability This has created pro blems with the validity of the Guides because the validity of a measure is affected by the context within which the measure is used. To maintain wide acceptance of the Guides, its authors need to address this problem, One app roach that Mle recommend is to adopt a model of work disability to specific the context of the Guides so that the level of measurement of each chapter can be Explicated. This will retain the validity of inferences from the me asures and integrate with developing systems that determine work disability .