What exactly does “marked impairment” mean? According to the AMA’s Guides to the Evaluation of Permanent Impairment, 4th ed., 1993, a person with a marked impairment in daily activities, is a person whose behavioral impairments significantly impede most useful functioning with cleaning, shopping, cooking, riding a bus, paying bills, maintaining a residence, grooming, using a telephone or working.
Aviva refused to accept the conclusion of its own doctors and argued that suffering a single marked impairment was insufficient. It denied further medical and rehabilitation benefits based on an incorrect interpretation of the law.