AMA Criteria for Permanent Impairment Associated with Intestinal Hernias

Hernias may be associated with permanent impairment. Criteria for the impairment have been published by the American Medical Association (AMA).

Parameters:

(1) palpable defect in supporting structures of the abdominal wall

(2) protrusion at site of defect

(3) signs and symptoms; impact on activities of daily living (ADL)

Signs and symptoms:

(1) discomfort

(2) pain associated with postural changes

(3) limitation in physical activity

(4) limitation on lifting

(5) abdominal protrusion or swelling

Palpable Defect	Protrusion Through Defect	Symptoms	Impairment Whole Person
present	slight protrusion; readily reducible	occasional mild discomfort; no or minimal limits on ADL	0 - 9%
present	frequent or persistent protrusion; can be produced by increasing abdominal pressure; manually reducible	frequent discomfort; unable to do heavy lifting; may be limited in some ADL	10 – 19%
present	persistent, irreducible or irreparable protrusion	limitations in several ADL	20 - 30%

where:

• Incarceration of the hernia would result in severe impairment.

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