Here are more impairment rating guidelines for physicians to use in North Carolina work injury cases. The guidelines are meant to be a starting point. Doctors should also factor into their impairment ratings the oral examination, functional tests, diagnostic tests, and the prognosis for the injured worker.<\/p>\n
For a deeper understanding of why the impairment ratings can impact directly the amount of benefits you deserve, watch this video by attorney Joe Miller<\/a>. He has been a tough advocate for injured workers for over 25 years. His counsel includes working with workers and doctors to fight for the right rating for each worker\u2019s unique set of physical problems.<\/p>\n Many of the decision points for doctors are medical terms of art. A few that can help guide the discussion are:<\/strong> The upper extremities means the thumbs, fingers, hands, wrist, elbows, shoulders, and the arms. Doctors should use the follow guidelines to decide if the digit, hand or arm should be rated:<\/strong> Elbow<\/strong> A slight variance in an impairment rating can be a huge difference in a worker\u2019s wallet, particularly if the injured worker has returned to alternate employment and is earning the same as pre-injury. To help you get the right rating, it is crucial that speak with a knowledgeable North Carolina injury lawyer who understands the complex medical jargon and who has worked with work injury doctors. For help now, call North Carolina Workers\u2019 Compensation<\/a> attorney Joe Miller today at 888-694-1671<\/a>. You can also fill out his contact form.<\/p>\n","protected":false},"excerpt":{"rendered":" Here are more impairment rating guidelines for physicians to use in North Carolina work injury cases. The guidelines are meant to be a starting point. Doctors should also factor into their impairment ratings the oral examination, functional tests, diagnostic tests, and the prognosis for the injured worker. For a deeper understanding of why the impairment … <\/p>\nUpper Extremities<\/h2>\n
\n\u2022 Ankylosis is stiffness of the joint(s) due to abnormal adhesion and joint bone rigidity.
\n\u2022 Arthroplasty is an orthopedic surgical procedure performed to help restore function of the joints.<\/p>\n
\n\u2022 If damage is limited to the digits (fingers) distal to the metacarpophalangeal joint, then the digit itself should be rated.
\n\u2022 If there is anatomical damage proximal to the metacarpophalangeal joint, a rating for the hand should be given, including any consideration for the digit as a percentage of the hand.
\n\u2022 If anatomical damage includes an area proximal to the elbow joint, the disability rating should be for the arm and include any percentage which would have otherwise been credited for the hand or digits.
\n“ANKYLOSIS” AND “LIMITED MOTION WITH PAIN.”<\/strong>
\nFingers<\/strong>
\n\u2022 Ankylosis of distal IP joint (in optimum position) = 35% of digit
\n\u2022 Ankylosis of proximal IP joint (in optimum position) = 50% of digit
\n\u2022 Ankylosis of metacarpal-phalangeal joint (in optimum position) = 45% of digit
\n\u2022 Any of the above in malposition = up to 100% of digit
\nWrist<\/strong>
\n\u2022 Ankylosis in optimum position = 35% of “hand”
\n\u2022 Ankylosis in malposition = up to 100% of “hand”
\no Limited motion, mild = up to 10% of hand
\no moderate = up to 20% of hand
\no severe = up to 25% of hand<\/p>\n
\n\u2022 Ankylosis in optimum position = 50% of arm
\n\u2022 Ankylosis in malposition = up to 90% (Straightened position not as disabling as marked flexion).
\n\u2022 Limited motion and pain
\no Flexion and extension (accounts for 60% of elbow function)
\n\uf0a7 20\u00ba motion in middle range = 35% of “arm” (80 to 100%)
\n\uf0a7 40\u00ba motion in middle range = 30% of “arm” (70 to 100%)
\n\uf0a7 120\u00ba motion in middle range = 5% of “arm” (45 to 160%)
\no Pronation and Supination account for 40% of elbow function
\n\uf0a7 Total loss in neutral position = 25% of hand
\n\uf0a7 20\u00ba motion each way from neutral 20% of hand
\n\uf0a7 60\u00ba motion each way from neural 5% of hand
\n\uf0a7 Arthroplasty of elbow using prosthesis = 40% of arm
\nShoulder
\n\u2022 Ankylosis in optimum position = 50% of “arm”
\n\u2022 Ankylosis in malposition = up to 80% of “arm”
\n\u2022 Resection end of clavicle (distal to coranoid and trapezoid ligaments) = 5% plus limitation
\nFRACTURES<\/strong>
\n\u2022 Fingers and Metacarpals. Mal-alignment, shortening, stiffening, etc., rated according to function of finger. Express as “percent of digit” if loss is distal to MP joint; otherwise, as “percent of hand,” calculated from the sum of each involved digit, reduced to its known percent of hand.
\n\u2022 Carpals: Rated according to function of wrist.
\n\u2022 Forearm fractures
\no Mal-alignment. Rated primarily on limited motion in wrist joint. Add for angulation, shortening, weakness, etc. Express as “percent of hand.” Occasionally the elbow must also be rated for loss of motion, expressed in “percent of the arm” and the total impairment calculated from the sum of the parts reduced to their relative percent of the whole.
\no Excision of fractured radial head. Full motion with no pain = 10% of arm. Otherwise rate on basis of loss of motion and pain in elbow and wrist.
\no Excision of distal end of ulna. Rated on basis of adjacent joint function with minimum loss of 10% of hand
\n\u2022 Fractures of humerus
\no Mal-alignment. Rated primarily on basis of limited motion and pain in shoulder and elbow joints, and expressed in “percent of arm.” Add for angulation, shortening, weaknesses, etc., not reflected in loss of joint function.
\n\u2022 Fractures of shoulder girdle. Rated according to function of shoulder joint. Add for pain and weakness in non-union.
\n\u2022 Fracture into a joint. In general, add 10% if minimal displacement, and more if joint surface is irregular. Any time a joint is entered surgically for repair or excision of a part, the minimum impairment is to be 10%
\nLACERATION OF THE HAND (TENDON, NERVE, JOINT, ETC.)<\/strong>
\n\u2022 Loss of sensation (complete and noticeable) (exclusive of tendon damage)
\no \u00bd of distal phalanx = 25% of digit
\no \u00bd of finger = 100% of digit
\n\u2022 Division of flexor sublimis with full extension of finger
\no Tendon only = 10% of digit
\n\u2022 Division of flexor profundus
\no Tendon only = 75% of digit
\n\u2022 Division of both profundus and sublimis tendons.= 90% of digit
\n\u2022 Arthrodesis of distal IP joint = 35% of joint
\n\u2022 Arthrodesis of proximal IP joint = 50% of digit
\n\u2022 Arthrodesis of MP joint = 45% of digit
\n\u2022 Above ratings are for arthrodesis in optimum position. Add for malposition.
\n\u2022 “Contractures” of joints or “limited motion and pain.” Impairment determined on basis of severity as compared to arthrodesis of the joint.
\n PERIPHERAL NERVE INJURIES:<\/strong>
\n(Rated on basis of loss in the “hand.” If lesion is high and involves structures above biceps insertion, then loss is rated on the “arm.”)
\n\u2022 Ulnar nerve injury
\no Complete motor and sensory = 60% of “hand”
\no Complete motor and partial sensory = 50% of “hand”
\no Motor only = 40% of “hand”
\n\u2022 Median nerve injury
\no Complete motor and sensory = 90% of “hand”
\no Complete motor and partial sensory = 60% of “hand”
\no Motor only to thumb = 35% of “hand”
\n\u2022 Radial nerve injury
\no Motor and sensory = 75% of “hand”
\n\u2022 Above estimates are given prior to any reconstruction and may be reduced considerably by reconstructive surgery.
\n\u2022 If contracture has occurred in the digits, additional impairment should be added.<\/p>\nSpeak with an Experienced North Carolina Workers Compensation Attorney Today<\/h2>\n