Criteria: Table 13-4 Criteria for Rating Impairment Due to Sleep and Arousal Disorders (317).
Guidance: The sleep disorder must be supported by formal studies in a sleep laboratory. Based on interference in daytime alertness and the impact on activities of daily living. Table 13-4 Criteria for Rating Impairment Due to Sleep and Arousal Disorders (317) provides for assignment to four classes of impairment. Reduced daytime alertness is required for impairment rating. If the individual can perform most activities of daily living the assignment is Class 1 (1% to 9% whole person permanent impairment) and if there is interference with some activities of daily living the assignment is Class 2 (10% to 29% whole person permanent impairment). The clinician can evaluate sleepiness with the Epworth Sleepiness Scale, which assesses the likelihood of dozing (never = 0, 1 = slight chance, 2 = moderate chance, and 3 = high chance) in eight different situations: sitting and reading, watching television, sitting in a public place, riding as a passenger for an hour, taking an afternoon nap, sitting and talking to someone, sitting after a nonalcohol lunch, and stopped in traffic in a car. A score of 10/24 is equal to excessive sleepiness, or class 2 impairment. Clinical judgment is required to place the individual within a range.
