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In the Aug. 19, 1961, J.A.M.A. the Committee on Medical Rating of Permanent Impairment of the Ear, Nose, Throat, and Related Structures offers a useful guide for the physician who is called upon to make a report on an individual patient who is applying for disability compensation.
A clear distinction is made between "permanent disability" and "permanent impairment." The former refers to the patient's ability to engage in gainful activity, and is affected by such nonmedical factors as age, sex, education, etc., as well as by the medical impairment. The determination of permanent disability is an administrative (not a medical) decision as to the patient's entitlement.
Permanent impairment can be determined by physicians alone, and evaluates the affect of the patient's illness or injury on his efficiency in the activities of daily living, that is, in self-care, communication, ambulation, and nonspecialized hand activities. Permanent impairment is expressed in percentages,
Rating of Permanent Impairment. Arch Otolaryngol. 1962;75(5):385. doi:10.1001/archotol.1962.00740040396001