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Medical Association Guides to the Evaluation of Permanent Impairment , 5th edition. 4 Using the combined values chart (CVC), as defined by the AMA, AMA Guides to the Evaluation of Permanent Impairment, Sixth Edition, extremity impairment (Use of the Combined Values (5th ed., 604). The values in Table 18.1 (Combined Values. Chart) are derived from the formula where “A” and “B” are the impairment ratings to be combined. The sensory and motor impairments are combined using the Combined Values Chart (5th ed., 604) for the total upper extremity impairment, which is thenAt the intersection of the row and the column is the combined value. larger impairment value must be identified at the side of the chart. The Combined Values Chart is utilized only for combination of whole person impairment ratings, not upper extremity ratings, lower extremity ratings or other I have received nothing of value AMA Guides 5th Edition. ▫ Required to use Guides Convert to whole person. ▫ Combine using combined values chart