Criteria: Figure 16-28 Pie Chart of Upper Extremity Motion Impairments Due to Lack of Flexion and Extension (467), Figure 16-31 Pie Chart of Upper Extremity Motion Impairments Due to Abnormal Radial and Ulnar Deviations of the Wrist (467)
Guidance: Often soft tissue injuries do not result in impairment. Section 16.7d Tendinitis (507) states “Several syndromes involving the upper extremity are variously attributed to tendonitis, fasciitis, or epicondylitis Although these conditions may be persistent for some time, they are not given a permanent impairment rating unless there is some other factor that must be considered.” (508) Strength loss has a very limited role in impairment evaluation; the Guides state in Section 16.8 Strength Evaluation: “Decreased strength cannot be rated in the presence of decreased motion, painful conditions, deformities, or absence of parts (eg, thumb amputation) that prevent effective application of maximal force in the region being evaluated.” (508) Most rated conditions are either painful conditions or associated with motion deficits. Wrist motion impairment is assessed as explained in Section 16.4g Wrist Motion Impairment (466-470), and based on Figure 16-28 Pie Chart of Upper Extremity Motion Impairments Due to Lack of Flexion and Extension (467) and Figure 16-31 Pie Chart of Upper Extremity Motion Impairments Due to Abnormal Radial and Ulnar Deviations of the Wrist (467). Impairment values are added. Figure 16-1 Upper Extremity Impairment Evaluation Record (437) should be completed, which provides a mechanism for recording the data needed in impairment evaluation. Measurements are obtained bilaterally and the opposite hand may be used as a baseline, if normal for that individual. Alternative approaches to assessing impairment should also be considered as explained in Section 16.7 Impairment of the Upper Extremity Due to Other Disorders (498-507). Upper extremity impairment is converted to whole person using Table 16-3 Conversion of Impairment of the Upper Extremity to Impairment of the Whole Person (439).
