Disorders of the liver disease may be associated with permanent impairment. Criteria for the impairment have been published by the American Medical Association (AMA).
Parameters:
(1) signs and symptoms of liver disease
(2) nutrition and strength
(3) laboratory findings
(4) central nervous system changes
Signs and symptoms:
(1) history of alcohol abuse
(2) history of viral hepatitis
(3) family history of liver disease
(4) history of ulcerative colitis
(5) history of exposure to hepatotoxic drugs or chemicals
(6) history of multiple transfusions
(7) jaundice
(8) ascites and edema
(9) pruritis
(10) limited physical activity
(11) cutaneous and ocular signs of chronic liver disease
(12) Keyser-Fleischer rings in the eyes
(13) skin hyperpigmentation
(14) xanthomas
(15) gastrointestinal bleeding
(16) encephalopathy
Signs and Symptoms |
Nutrition and Strength |
Laboratory Findings |
CNS Changes |
Impairment Whole Person |
no liver symptoms; no history of ascites, jaundice or bleeding varices within past 3 years |
good |
minimal disturbance hepatocellular function or bilirubin metabolism |
none |
0 - 14% |
no liver symptoms; no history of ascites, jaundice or bleeding varices within past 3 years |
good |
moderate disturbance hepatocellular function |
none |
15 – 29% |
progressive chronic disease; evidence of jaundice, bleeding varices in past year |
fair, may be affected |
moderate to severe disturbance hepatocellular function; increase serum bilirubin |
intermittent hepatic encephalopathy |
30 – 49% |
progressive chronic disease; current ascites, jaundice or bleeding varices |
poor |
severe disturbance hepatocellular function; increased serum bilirubin |
persistent hepatic encephalopathy |
50 – 95% |
Specialty: Sports Medicine & Rehabilitation, Gastroenterology