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Combined
Values - Rating Tip of the Week
This week's tip is on "Combined Values". Most
values in the Guides are combined, not added. A
few points:
The "Philosophy and Use of the Combined Values
Chart" is presented in Section 1.4 on pages 9
and 10, and the Combined Values Chart appears on
pages 604 through 606 (follow the directions).
This philosophy is such that a region or part of
body should never exceed the maximum value for
the region or part of body. (ie. There can never
be a person with greater than 100% WPI).
The March/April 2002 issue of the Guides
Newsletter featured an article on "Combining
Values" explaining the rationale and practical
aspects.
Most impairments are combined, with the notable
exception of: 1) range of motion deficits at the
same joint, 2) range of motion deficits of the
thumb, 3) total hand impairment (eg, hand
impairment contributed to by each digit), and 4)
rating hip or knee replacement results.
Chapter 16, The Upper Extremities, on page 438
advises "If three or more values are to be
combined, the two lowest values are first
selected and their combined value is found. The
combined value and the third value are then
combined to give the total value." (However, in
California, per the Permanent Disability Rating
Schedule, the two largest numbers are first
combined.)
A common error with bilateral upper extremity
impairment is combining at the upper extremity
level. First, combine upper extremity
impairments on one side and then convert to
whole person. The whole person impairments from
both sides are then combined.
In California, per the directives of the
Permanent Disability Rating Schedule, specific
impairments are converted to whole person for
"adjustments" prior to combining the resultant
disability rating.
At www.impairment.com/tools there is a tool that
will combine up to 3 values (easier than
referencing the Combined Values Chart)
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