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Rating
Impairment for Digital Nerve Lesions - Rating Tip of the Week
Digital nerve lesions require 4 distinct
components of documentation, as explained in
Section 16.3 Sensory Impairment Due to Digital
Nerve Lesions (5th ed., 445 – 450):
| 1. |
Digit involved. |
| 2. |
Length of digit affected. |
| 3. |
Quality of sensory loss in
2-point discrimination. |
| 4. |
Nerves affected (radial and/or
ulnar). |
The method of rating impairment
for this condition is as follows:
| 1. |
Measure sensory loss as total (>15 mm) or
partial (7-15 mm) dependent on results of
two-point discrimination testing. (Note specific
requirements for this testing on page 446) |
| 2. |
Determine distribution of sensory loss as either
longitudinal (one nerve) or transverse (both
nerves). |
| 3. |
Identify level of involvement (i.e. percentage
of digit length). |
| 4. |
Use the above information to apply to Table 16-6
or 16-7 (5th ed., 448) for determining the
impairment. |
Following the above steps will ensure an
accurate impairment rating for this condition.
Common errors we see with these ratings are:
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Rating prior to maximum medical improvement
(nerve lesions may take over a year to improve).
|
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Rating for subjective complaints of decreased
sensation without objective evidence of nerve
injury. |
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Invalid sensory assessment of two-point
discrimination. |
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Rating for digital nerve lesions using Table
16-10 (5th ed., 482). (Page 480 states: 'Sensory
deficits in the digits strictly due to lesions
of digital nerves are evaluated according to
Section 16.3') |
Tip: Total loss of sensory function (i.e. full
length, both sides, and two point discrimination
> 15 mm.) results in 50% digit impairment. You
can easily convert impairments using our free
impairment converter at
www.impairment.com/tools.
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