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American Medical Association assessment of pulmonary dysfunction

American Medical Association assessment of pulmonary dysfunction
Class Class 0 Class 1 Class 2 Class 3 Class 4
Whole person impairment rating (%) 0 2 to 10 11 to 23 24 to 40 45 to 65
Severity grade
Percent impairment   2 4 6 8 10 11 14 17 20 23 24 28 32 36 40 45 50 55 60 65
Grade   A B C D E A B C D E A B C D E A B C D E
History No symptoms currently and/or intermittent dyspnea that does not require treatment Dyspnea controlled with intermittent or continuous treatment or intermittent mild dyspnea despite continuous treatment Constant mild dyspnea despite continuous treatment or intermittent moderate dyspnea despite continuous treatment Constant moderate dyspnea despite continuous treatment or intermittent severe dyspnea despite continuous treatment Constant severe dyspnea despite continuous treatment or intermittent extreme dyspnea despite continuous therapy
Physical findings No current signs of disease Physical findings not present with continuous treatment or intermittent mild physical findings Constant mild physical findings despite continuous treatment or intermittent moderate findings Constant moderate physical findings despite continuous treatment or intermittent severe findings Constant severe physical findings despite continuous treatment or intermittent extreme findings
Objective tests
FVC

≥80% of predicted

and

70 to 79% of predicted

or

60 to 69% of predicted

or

51 to 59% of predicted

or

Below 50% of predicted

or
FEV1

≥80% of predicted

and

65 to 79% of predicted

or

55 to 64% of predicted

or

45 to 54% of predicted

or

Below 45% of predicted

or
FEV1/FVC

FEV1/FVC >LLN or >75% of predicted

and
       
DLCO

DLCO ≥75% of predicted

or

65 to 74% of predicted

or

55 to 64% of predicted

or

45 to 54% of predicted

or

Below 45% of predicted

or
VO2 max

>25 mL/kg/min

or

>7.1 METs

22 to 25 mL/kg/min

or

6.3 to 7.1 METs

18 to 21 mL/kg/min

or

5.1 to 6.2 METs

15 to 17 mL/kg/min

or

4.3 to 5 METs

<15 mL/kg/min

or

<4.3 METs
FVC: forced vital capacity; FEV1: forced expiratory volume in one second; LLN: lower limit of normal; DLCO: diffusion capacity for carbon monoxide; VO2 max: maximum oxygen consumption; METS: metabolic equivalents (multiples of resting oxygen uptake).
Reprinted from AMA's Guides to the Evaluation of Impairment, 6th Edition with the permission of the American Medical Association, Copyright © 2008. All Rights Reserved.
Graphic 94780 Version 3.0

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