Anatomical vs Functional Impairment

In the area of personal injury, some of the most important factors in determining a person’s employability and wage earning capacity are the medical condition(s) and any related limitations he or she may have as a result of the injury. Physicians many times are asked to opine as to an anatomical impairment rating which can be defined as:

“a consensus-derived percentage estimate of loss of activity reflecting severity for a given health condition, and the degree of associated limitations in terms of activities of daily living “. The rating system and process are based on The AMA Guides to the Evaluation of Permanent Impairment. The rating of percent of anatomical impairment may be an important factor from a claims perspective and monetary award associated with such; however, from a vocational rehabilitation perspective, it is more important to determine the functional impairment and any corresponding physical/psychological restrictions.

For example, a psychologist and a concert pianist both sustain an amputation to the nondominant little finger. Under the AMA Guides, both have the same “impairment”, 100% of the digit, 10% of the hand, 9% of the upper extremity or 5% of the whole person. However, from a functional standpoint, more probably that not, the psychologist would not sustain any loss of earning capacity whereas the pianist would be totally disabled from that occupation with potential loss of earning capacity.

For a vocational expert, the more important information as it relates to employability and wage earning capacity is the functional capacity/limitations associated with the injury or illness, not the anatomical impairment rating.

We at Stokes and Associates, Inc. have developed a “Physical Capacities Work Restriction” form to assist in obtaining this necessary information from medical providers. To request a complimentary copy of this form to provide to physicians or other medical specialists, please contact David Barrett at or 504-454-5009.

We offer complimentary consultations concerning "hypothetical matters" To strategize with one of our vocational experts at Stokes & Associates, please call David Barrett at 504-454-5009 or email

Larry S. Stokes, Ph.D.
Aaron Wolfson, Ph.D.
Todd Capielano, M.Ed., LRC, CRC, LPC, CLCP