By Chris E. Wiggins MD
This easy-to-use guide is a timesaving consultant to assigning musculoskeletal impairment rankings for laborers reimbursement, own damage, and incapacity claims. It follows many of the ideas within the American scientific Association's publications to the assessment of everlasting Impairment and offers those guidance in quick-reference tabular layout for busy clinicians. part One summarizes the methods and terminology of impairment score. part comprises score tables for the higher extremity, reduce extremity, backbone, pelvis, dermis, and discomfort. Appendices comprise tables for changing scores from one physique half to a different and mixing a number of accidents.
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Extra resources for A A Concise Guide to Orthopaedic and Musculoskeletal Impairment Ratings
As a final step in any calculation that requires combining impairments, consult = Table 6-2 or Figure 6-1 to ensure that the maximum value is not exceeded. Co= nversion Tables Conversion tables are found in Appendix A. These are essential for converting from one scheduled item Table of Contentso:p 35 36 Table of Contentso:p (injured body part) to another. Su= mmary of Guidelines for Multiple Impairments The following list summarizes the rating guidelines for multiple impairments of the upper extremity.
The Distal to Proximal Rule In evaluating multiple impairments, the evaluation should proceed from distal to proximal. Take, for example, the c= ase of an individual with trauma to one finger and the elbow on the same side. First the impairments to the finger are calculated based on amputation, neurologic impairment, and loss of motion. These three impairments are combined for the digit. That digital impairment is converte= d to the hand, and then to the upper extremity, and then combined with the simil= ar upper extremity impairment calculation for the elbow for a total upper extremity impairment rating.
As always, it is appropriate to extrapolate. For example, complete loss of radial digital nerve sensation in the thumb is 30% permanent partial impairment (<= span class=3DSpellE>ppi) thumb. Partial loss of ulna= r digital nerve sensation in the ring finger is 10% ppi<= /span> ring finger. 36 Table of Contentso:p Table of Contentso:p 37 For conversion to equivalent hand, upper extremity, or whole-person impairments, see the conversion tables in Appendix A. Table 6-3<= /span> indicates= the ratings that are appropriate if there is no recovery of nerve function.