Assessing Disability from Occupational Asthma

A Perspective on the AMA Guides

¹ The Department of Medicine, Occupational Medicine Branch, Pulmonary Division, University of California, Los Angeles.

In summary, the AMA Guides treat occupational asthma as a special case or subset of respiratory impairment assessment, but do not develop an entirely separate evaluative process. The Guides provide a clear criterion for determining if asthma is actually present and also indicate a mechanism to categorize the physiologic impairment due to the asthma. The Guides are also eminently practical, and it should be possible for most evaluating physicians to comply with the recommended evaluative procedures. Furthermore, the Guides provide a clear and externally verifiable mechanism for testing.

The simplicity, practicality, clarity, and continuity with past guides do, however, carry a price. There are many unresolved questions, as I have discussed. It is therefore likely that in the future, the Guides will again be revised as more information is gained and as additional evaluative procedures become more generally available.