Post-traumatic stress disorder, chronic
ICD-10 Code: F43.12 · Body Part: Head/Brain (TBI)
QME Evaluation Process
Psychiatric interview, CAPS-5 or PCL-5, functional assessment including occupational impact. Chapter 14 psychiatric impairment. Higher ratings for treatment-resistant chronic PTSD.
Typical Impairment Rating
20-50% WPI for chronic PTSD
AMA Guides Edition
5th Edition
Common Treatments
Related Conditions
Body Part Guide
Head/Brain (TBI) Evaluation Guide
Impairment rating methods, common conditions, and QME evaluation protocols
QME Specialties for Post-traumatic stress disorder, chronic
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What is Post-traumatic stress disorder, chronic (F43.12)?
Post-traumatic stress disorder, chronic is an ICD-10 diagnosis code (F43.12) classified under Psychiatric conditions. It affects the Head/Brain (TBI) and is commonly encountered in California workers' compensation claims. QME physicians evaluate this condition using AMA Guides 5th Edition protocols.
How is F43.12 rated for impairment?
The typical whole person impairment (WPI) range for Post-traumatic stress disorder, chronic is 20-50% WPI for chronic PTSD. The exact rating depends on clinical findings, imaging, and the evaluation method (DRE or ROM) chosen by the QME physician per AMA Guides 5th Edition.
What is the QME evaluation process for F43.12?
Psychiatric interview, CAPS-5 or PCL-5, functional assessment including occupational impact. Chapter 14 psychiatric impairment. Higher ratings for treatment-resistant chronic PTSD.
What treatments are common for Post-traumatic stress disorder, chronic?
Common treatments for Post-traumatic stress disorder, chronic include Cognitive processing therapy, EMDR, SSRI/SNRI medication, Group therapy, Ketamine-assisted therapy. Treatment appropriateness and outcomes are considered during the QME evaluation when determining permanent and stationary status and apportionment.