Criteria: Table 15-2 Digit Regional Grid: Upper Extremity Impairments (391-394), Table 15-3 Wrist Regional Grid: Upper Extremity Impairments (395-397), Table 15-6 Adjustment Grid: Summary (406), Table 15-7 Functional History Adjustment: Upper Extremities (406), Table 15-8 Physical Examination Adjustment: Upper Extremities (408), Table 15-9 Clinical Studies Adjustment: Upper Extremities (410-411).
Accurately define diagnosis, and assess history, physical examination findings, and clinical studies, as explained in Section 15-1 (385-386). Impairment is based on Diagnosis-Based Impairment (DBI). Diagnosis is specified under the Category of “Muscle / Tendon”. Determine if most appropriate to rate as digit (Table 15-2, 392) or wrist (Table 15-3, 395). If no significant objective findings, will be Class 0. Class 1 assignment may be given for persistent symptoms (“once in an individual’s lifetime”). Impairment values are converted from UEI to WPI using Table 15-11 (420). Note revisions provided in “Corrections and Clarifications” (AMA Press, August 2008) on page 18 to Table 15-7 Functional History Adjustment and modifications to Section 15.3b explaining that if a physical finding is used to determine class placement that specific finding should not be considered again for adjustment. Rate only for the most significant causally-related diagnosis for each digit or the wrist. Assure accuracy of adjustment factors, net adjustment calculation, and grade modification. In rare case, if significant, consistent motion impairment deficits that result in greater impairment rate via Range of Motion. Figure 15-2 (388) summarizes findings.
