If the patient was previously awarded a SLU based on the earlier guidelines and subsequently sufferers a new injury, the examining physician should evaluate based on the 2018 guidelines to determine the SLU that resulted from the relevant work-related injury as opposed to other causes. To obtain an increase over the SLU previously awarded and based on the earlier guidelines there must be objective medical evidence that the claimant’s anatomical or functional loss (e.g. ROM) has increased since the prior SLU and the evaluation under the 2018 Guidelines results in a higher SLU than the one previously awarded.