Criteria: If surgery: Table 16-34 Upper Extremity Joint Impairment Due to Loss of Grip or Pinch Strength (509)
Guidance: Epicondylitis is not usually considered a permanent impairment. Most episodes of lateral epicondylitis are not permanent. Those that have ongoing symptoms typically relate to problems with tendinitis. 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.” Unless there has been surgery, it would not be appropriate to rate by strength loss since the Guides state “decreased strength cannot be rated in the presence of decreased motion, painful conditions.” (508) If an individual has had tendon rupture or has undergone surgical release of the flexor or extensor origins of the epicondyles, there may be some permanent weakness of grip as result of the tendon rupture or the surgery. In this case, impairment can be given on the basis of weakness of grip strength according to Section 16.8b (508-509) with the use of Table 16-34 Upper Extremity Joint Impairment Due to Loss of Grip or Pinch Strength (509).
