Minnesota Administrative Rules

5223.0470 MUSCULOSKELETAL SCHEDULE; WRIST.

Subpart 1.

General.

For permanent partial impairment to the wrist, disability of the whole body is as provided in subparts 2 to 4. The percent of whole body disability under this part may not exceed the percent of whole body disability for amputation of the arm at the wrist under part 5223.0540. Each mutually exclusive impairing condition must be rated separately and the ratings must be combined as described in part 5223.0300, subpart 3, item E.

If an impairing condition is represented by a category designated as exclusive under subpart 2, it must be rated by that category only and that rating may not be combined with a rating under any other category of this part for that impairing condition.

If an impairing condition is represented by a category designated as combinable under subpart 3, it must be rated under that category and under the appropriate categories describing loss of function under subpart 4. The ratings obtained must be combined as described in part 5223.0300, subpart 3, item E.

If an impairing condition is not represented by a category designated either exclusive or combinable, it must be rated only under the appropriate categories describing loss of function under subpart 4.

Subp. 2.

Exclusive categories.

A.

Painful organic syndrome, as defined in part 5223.0310, subpart 40, including tendonitis syndrome and de Quervain syndrome, not elsewhere specified, and substantiated by appropriate, consistent, and reproducible clinical findings which results in persistent limitation of active range of motion but no limitation of passive range of motion, zero percent.

B.

Nerve entrapment syndrome of the ulnar, radial, or median nerve at the wrist:

(1)

resolved with treatment, zero percent;

(2)

pain and paresthesia recurring or persisting despite treatment, but not substantiated by persistent findings on electrodiagnostic testing, zero percent;

(3)

pain and paresthesia persisting despite treatment or recurring and persisting despite treatment and substantiated by persistent findings on electrodiagnostic testing, three percent;

(4)

objectively demonstrable motor or sensory loss, the rating is as provided in parts 5223.0400 and 5223.0410.

Subp. 3.

Combinable categories.

A.

Arthroplasty:

(1)

total wrist, 18 percent;

(2)

ulnar head, five percent;

(3)

proximal carpal row, nine percent;

(4)

single carpal bone resection except resection of the pisiform or hook of the hamate, six percent;

(5)

excision of the pisiform or the hook of the hamate, two percent.

B.

Carpal instability, as defined in part 5223.0310, subpart 12, based on appropriate clinical, laboratory, and medical imaging findings:

(1)

confirmed by clinical examination only, four percent;

(2)

confirmed by both clinical examination and medical imaging study, seven percent;

(3)

confirmed by both clinical examination and medical imaging study which also demonstrates degenerative arthritis, 11 percent.

C.

Fracture or dislocation involving radius, ulna, carpal bone not otherwise ratable under subpart 2 or 3 or part 5223.0460, zero percent.

Subp. 4.

Categories describing loss of function.

Function at the wrist is measured by the available passive range of motion at the wrist.

The passive range of motion is measured in two arcs: flexion or extension and deviation. Examination with goniometer is performed to determine the limits of passive range of motion in each arc. If there is impairment in more than one arc, the ratings for each arc are added to determine the overall disability for loss of motion.

A.

Extent of range of flexion or extension:

(1)

extension is greater than 45 degrees and flexion is:

(a)

to greater than 45 degrees, zero percent;

(b)

to between 31 degrees and 45 degrees, 2.5 percent;

(c)

to between zero degrees and 30 degrees, five percent;

(d)

limited to between one degree and 30 degrees extension, that is, there is an extension contracture, ten percent;

(e)

limited to greater than 30 degrees extension, that is, there is an extension contracture, 25 percent;

(2)

extension is limited to between 31 degrees and 45 degrees and flexion is:

(a)

to greater than 45 degrees, 2.5 percent;

(b)

to between 31 degrees and 45 degrees, five percent;

(c)

to between zero degrees and 30 degrees, 7.5 percent;

(d)

limited to between one degree and 30 degrees extension, that is, there is an extension contracture, 12.5 percent;

(e)

limited to greater than 30 degrees extension, that is, there is an extension contracture, 25 percent;

(3)

extension is limited to between one degree and 30 degrees and flexion is:

(a)

to greater than 45 degrees, five percent;

(b)

to between 31 degrees and 45 degrees, 7.5 percent;

(c)

to between zero degrees and 30 degrees, ten percent;

(d)

to between one degree and 30 degrees extension, that is, there is an extension contracture, 15 percent;

(4)

extension is limited to between zero degrees and 30 degrees flexion, that is, there is a flexion contracture, and flexion is:

(a)

to greater than 45 degrees, ten percent;

(b)

to between 31 degrees and 45 degrees, 12.5 percent;

(c)

to less than 30 degrees, 15 percent;

(5)

extension is limited to greater than 30 degrees flexion, that is, there is a flexion contracture, 25 percent;

(6)

ankylosis, as defined in part 5223.0310, subpart 7, in flexion or extension occurs:

(a)

at greater than 30 degrees of extension, 25 percent;

(b)

between 30 degrees of extension and five degrees of flexion, 15 percent;

(c)

between six degrees of flexion and 30 degrees of flexion, 20 percent;

(d)

at greater than 30 degrees of flexion, 25 percent.

B.

Extent of range of deviation:

(1)

ulnar deviation is greater than 15 degrees and radial deviation is:

(a)

to greater than zero degrees, zero percent;

(b)

limited to between zero degrees and 15 degrees ulnar deviation, that is, there is an ulnar deviation contracture, two percent;

(c)

limited to greater than 15 degrees ulnar deviation, that is, there is an ulnar deviation contracture, five percent;

(2)

ulnar deviation is limited to between zero degrees and 15 degrees and radial deviation is:

(a)

to greater than zero degrees, two percent;

(b)

to between zero degrees and 15 degrees ulnar deviation, that is, there is an ulnar deviation contracture, four percent;

(3)

ulnar deviation is limited to greater than zero degrees radial deviation, that is, there is a radial deviation contracture, five percent;

(4)

ankylosis, as defined in part 5223.0310, subpart 7, in deviation occurs:

(a)

in radial deviation, five percent;

(b)

between zero degrees of ulnar deviation and 15 degrees of ulnar deviation, two percent;

(c)

at greater than 15 degrees of ulnar deviation, five percent.

Statutory Authority:

MS s 176.105

History:

17 SR 3364

Published Electronically:

August 16, 2010