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Impairment evaluations not performed following processes defined in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) will result in erroneous ratings. Common errors in impairment rating (IR) for upper extremity are frequently seen in physician IR reports and independent medical examination reports. Recognizing these errors can result in the prevention and management of these ratings. Common errors include rating impairment using the diagnosis-based approach for more than one diagnosis within a region and making incorrect assessments of motion loss, nerve injuries, entrapment disorders, and complex regional pain syndrome.