The Guides started in 1958 with publication by the American Medical Association (AMA) of the article, “A Guide to the Evaluation of Permanent Impairment of the Extremities and Back”; this was followed by additional guides published in the Journal of the American Medical Association. In 1971, a compendium of 13 guides became the First Edition. The Second Edition was published thirteen years later, in 1984, followed by publication of the Third Edition in 1988.
The Third Edition was the first to use the Swanson methodology, which assigned discreet impairment ratings to specific range of motion (ROM) deficits of the upper extremities. Although the Third Edition was replaced two years later by the Third Edition, Revised, which is still used by the State of Colorado for workers compensation cases, the use of ROM “pie charts” to assess impairment from upper-extremity ROM deficits was retained.