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This is the Epworth Sleepiness Scale The Patient must fill this form out on the 3rd visit to the office if… the Symptoms form has boxes checked indicating a sleep disruption, fatigue, tiredness, dozing, etc.
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2. Here is how you know when to use the Epworth Scale See where the Symptoms form has boxes checked indicating Sleepiness, Sleep Disruption, Very Tired, and Dozing During the Day. Any one of these will cause you to use the Epworth Form to evaluate the patient’s sleeping problem.

3. The AMA Guides to the Evaluation of Permanent Impairments, 5th Edition (used by Colossus) says: “A score of 10/24 on the Epworth sleepiness scale is equal to excessive sleepiness, or a class 2 impairment.” Class 2 Sleep Impairment is 10% to 29% Whole Person

4. Have the patient fill this out on day 3 if there are symptoms of sleep disruption Repeat at every re-exam, including the final exam so long as the patient does not score Zero

5. In Summary…
The Epworth Form is filled out Day 3 initially, at re-exams & at final exam.
There will be 3 to 6 of these when you are ready to write the narrative report.
If the scores 5 or more on the final exam, have an MD give an impairment rating for sleep disorder.

6. The End