Impairment Ratings and Injury Documentation After a Car Accident
An impairment rating is a percentage describing lasting loss of function after an injury, assigned once you have healed as much as you are expected to. At Back in Motion in St. Augustine, Dr. Colby Caltrider is a Certified Impairment Rater under the AMA Guides 6th edition, and documents every accident case from first exam to final report.
What an impairment rating is
An impairment rating is a percentage that describes lasting loss of function. It is assigned once a patient has reached maximum medical improvement (MMI), the point where you are not expected to get meaningfully better with more treatment. Rating before MMI would be guessing.
The rating follows the American Medical Association’s Guides to the Evaluation of Permanent Impairment, 6th edition. The Guides give a standard method so two trained raters looking at the same patient should land in the same place.
Who can assign one
Dr. Colby is a Certified Impairment Rater through the International Academy of Independent Medical Examiners (IAIME), using the AMA Guides 6th edition. His training included work with Dr. Chris Brigham, senior contributing editor of the AMA Guides 6th edition. Few chiropractors hold this certification.
When a rating is done and what the exam involves
Near the end of care, once you have plateaued, Dr. Colby performs a final exam: range of motion, neurologic testing, a review of your imaging (including any AOMSI findings) and your history. He applies the AMA Guides method and records the rating and how he reached it in your final report.
TODO PETE Confirm with client whether they rate workers' compensation cases. Note: Florida workers' comp uses its own Uniform Permanent Impairment Rating Schedule, not the AMA 6th, so wording for WC must be checked.
What we document
Strong records protect your claim. This is what every accident patient at Back in Motion gets.
Initial exam summary
A dated record of your first visit: history, orthopedic and neurologic tests, and clinical findings.
X-ray report
The Davis cervical series read by a radiologist trained in AOMSI and ligament laxity, with translation measured to the nearest 0.1 mm.
Per-visit notes
Every visit documented, so the record shows what was treated and how you progressed.
Final report
Diagnosis, course of care, outcome, and when appropriate, a permanent impairment rating under the AMA Guides 6th edition.
More on the Davis series and AOMSI on our auto accident and whiplash page.
What is considered a permanent impairment in Florida?
For car accident cases, Florida law lets an injured person recover pain-and-suffering damages only if the injury includes a significant and permanent loss of an important bodily function, a permanent injury within a reasonable degree of medical probability, significant and permanent scarring or disfigurement, or death. Whether an injury is permanent is a medical opinion, documented in your records.
That four-part list is the “tort threshold” in Florida Statute 627.737(2) (Fla. Stat. 627.737). An impairment rating is one way a qualified provider documents permanent injury, using a standard method instead of a guess.
What is a 20% impairment rating?
A 20% rating means the rater found a lasting loss of function equal to 20 percent of the whole person, using the method in the AMA Guides. It is not a pain score or a percentage of a settlement. It describes how much function has been permanently lost once you have healed as much as you are expected to.
Spine ratings after soft-tissue injuries are often in the single digits. Higher ratings usually reflect more serious findings, such as nerve loss or documented ligament instability. Your rating depends on your exam and imaging, not on what anyone would like it to be.
What is the purpose of a letter of protection?
A letter of protection (LOP) is a letter from your attorney to a medical provider promising that your treatment bills will be paid from any settlement or judgment in your case. It lets you keep getting care while the case is open, instead of paying up front.
If your case does not result in a recovery, you may still owe the bill. Ask your attorney how your LOP works.
TODO PETE Confirm with client that they accept letters of protection before publishing this.
Are letters of protection legal in Florida?
Yes. Letters of protection are commonly used in Florida personal injury cases. Florida changed some rules about how LOP medical bills are disclosed and used as evidence in 2023, so your attorney should explain how they apply to your case. This is not legal advice.
Can a chiropractor write reports for my case?
Yes. Dr. Colby documents every accident patient’s exam, imaging and progress, and writes a final report. As a Certified Impairment Rater under the AMA Guides 6th edition, he can also provide a permanent impairment rating when one is appropriate.
Working with Back in Motion
We work with personal injury attorneys across St. Johns County and Northeast Florida. Your client gets prompt care and clear records; you get documentation that holds up.
- Records requests: send a signed authorization through our contact page.
- Report format: initial exam summary, AOMSI radiology report, per-visit notes and final narrative report with impairment rating when appropriate.
- Turnaround: TODO PETE confirm typical turnaround time for records and final reports.
- Letters of protection: TODO PETE confirm accepted.
TODO PETE Ask client which law firms they already work with (for internal use, not to publish without permission).
Other things people ask
What happens after an impairment rating?
The rating goes into your final report and records, which can be sent to your attorney or insurer. From there, it is part of your claim. You may continue care as needed; reaching maximum medical improvement does not mean you have to stop treatment.
What is a good impairment rating?
There is no good or bad rating. An accurate rating is the goal: one that matches your exam, imaging and history and follows the AMA Guides method, so it holds up to review.
Is my settlement offer fair?
We do not give settlement advice. That is a question for your attorney, who knows your case and Florida law. Our job is to treat you and document your injuries accurately.
This page is general information, not legal advice. Speak with a Florida personal injury attorney about your case.
Dr. Colby Caltrider, D.C.
Palmer College graduate · OwnerDr. Colby is a Certified Impairment Rater through the International Academy of Independent Medical Examiners, using the AMA Guides 6th edition. Few chiropractors hold this certification.
When someone walks in here in pain, my job isn't to sell them a package. My job is to figure out what's going on and get them moving again. That's it.
Hurt in an accident?
Get examined, treated and documented from day one. If you have an attorney, we coordinate with them.