Under the AMA Guides (5th Edition), a worker cannot obtain a rateable whole person impairment for pulmonary hypertension without a PAP assessment of 40 mm Hg or higher on echocardiogram or right heart catheterisation. Clinical judgment alone, including evidence of breathlessness and functional limitation, is insufficient to establish a rateable impairment in the absence of objective PAP evidence meeting this threshold. The reference to 'any degree of pulmonary hypertension' in classes 3 and 4 of Table 4-6 means any degree from mild (40 mm Hg) upwards, not any clinical evidence of pulmonary hypertension regardless of PAP reading. There is a confirmed error in class 3 of Table 4-6: it should refer to moderate pulmonary hypertension (PAP 51-75 mm Hg), not PAP > 75 mm Hg.
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