Criteria: Table 16-3 Knee Regional Grid (LEI) (509-511), Table 16-5 Adjustment Grid: Summary (515), Table 16-6 Functional History Adjustment – Lower Extremities (516), Table 16-7 Physical Examination Adjustment – Lower Extremities (517), Table 16-8 Clinical Studies Adjustment – Lower Extremities (519-520).
Accurately define diagnosis, and assess history, physical examination findings, and clinical studies, as explained in Section 16.1(494-496). Impairment is based on Diagnosis-Based Impairment (DBI). Diagnosis of “contusion” may be used in Table 16-3 (509) or alternatively rate under arthritis (711) if significant ratable arthritis is present. Impairment values are converted from LEI to WPI using Table 16-10 (530-531). Assure accuracy of adjustment factors, net adjustment calculation, and grade modification. Note revisions provided in “Corrections and Clarifications” (AMA Press, August 2008) on page 25 to Functional History Grade modifiers, on page 26 explaining that within a region the single most clinically accurate and causally related impairment should be used, and on page 27 that if a physical finding is used for class placement that specific finding should not be used to select a grade modifier. If significant, consistent motion impairment deficits result in greater impairment than DBI rate via Range of Motion. Figure 16-2 (498) summarizes findings.
