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Minnesota Administrative Rules

5223.0510 MUSCULOSKELETAL SCHEDULE; KNEE AND LOWER LEG.

Subpart 1.

General.

For permanent partial impairment to the knee and lower leg, 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 leg at the knee under part 5223.0550. 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.

Plateau fracture:

(1)

undisplaced, two percent;

(2)

depressed bone elevated, medial or lateral plateau, and:

(a)

semilunar cartilage intact, seven percent;

(b)

semilunar cartilage excised, partially or completely, nine percent;

(3)

depressed bone elevated, both medial and lateral plateaus, and:

(a)

both semilunar cartilages intact, nine percent;

(b)

one or both semilunar cartilages excised partially or completely, 11 percent.

B.

Supracondylar or intercondylar fracture:

(1)

undisplaced supracondylar or undisplaced intercondylar fracture, two percent;

(2)

undisplaced bicondylar fracture, five percent;

(3)

displaced supracondylar fracture, four percent;

(4)

displaced unicondylar fracture, six percent;

(5)

displaced bicondylar fracture, ten percent.

C.

Patellar shaving, one percent.

D.

Ruptured collateral ligament repaired or unrepaired:

(1)

mild laxity, two percent;

(2)

moderate laxity, four percent.

E.

Repair patellar dislocation, five percent.

F.

Lateral retinacular release, one percent.

G.

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

H.

Nerve entrapment syndrome of the tibial or peroneal nerves at the knee or in the lower leg:

(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, two percent;

(4)

objectively demonstrable motor or sensory loss, the rating is as provided in parts 5223.0420 and 5223.0430.

I.

Nonunion of tibia fracture requiring nonweight bearing orthosis for ambulation, 18 percent.

Subp. 3.

Combinable categories.

A.

Partial or total patellectomy, four percent.

B.

Meniscectomy, or excision of semilunar cartilage in a single knee. If meniscectomy, or excision of semilunar cartilage is performed on both knees, rate each separately and combine the ratings for the overall impairment:

(1)

up to 50 percent of a cartilage removed, two percent;

(2)

more than 50 percent of a cartilage removed, three percent;

(3)

up to 50 percent of both cartilages removed, four percent;

(4)

more than 50 percent of both cartilages removed, six percent;

(5)

for dates of injury on or after August 9, 2010, up to 50 percent of one cartilage and more than 50 percent of the other cartilage removed, five percent.

C.

Arthroplasty:

(1)

unicondylar, seven percent;

(2)

total condylar, eight percent;

(3)

patella replacement, seven percent.

D.

Cruciate ligament laxity:

(1)

anterior:

(a)

mild: positive drawer sign, no pivot shift, three percent;

(b)

severe: positive drawer sign, pivot shift, five percent;

(2)

posterior, five percent.

E.

Posttraumatic varus deformity:

(1)

up to five degrees, zero percent;

(2)

between six degrees and 15 degrees, two percent;

(3)

greater than 15 degrees, four percent.

F.

Posttraumatic valgus deformity:

(1)

up to ten degrees, zero percent;

(2)

between 11 degrees and 20 degrees, two percent;

(3)

greater than 20 degrees, four percent.

G.

Proximal tibial osteotomy, four percent.

H.

Distal femoral osteotomy, four percent.

I.

Fracture or dislocation involving the femur, tibia, or fibula not otherwise ratable under subpart 2 or 3 or part 5223.0500 or 5223.0520, zero percent. For dates of injury on or after August 9, 2010, fracture or dislocation involving the patella not otherwise rated under this subpart, subpart 2, or part 5223.0500 or 5223.0520, zero percent.

Subp. 4.

Categories describing loss of function.

Function of the knee is measured by the available passive range of motion in flexion or extension. Examination with goniometer is performed to determine the limits of passive range.

A.

Extent of range of flexion or extension:

(1)

extension is limited to between zero degrees and nine degrees flexion, that is, there may be a flexion contracture, and flexion is:

(a)

to greater than 120 degrees, zero percent;

(b)

limited to between 91 degrees and 120 degrees, two percent;

(c)

limited to between 51 degrees and 90 degrees, 12 percent;

(d)

limited to between 20 degrees and 50 degrees, 16 percent;

(e)

limited to less than 20 degrees, 20 percent;

(2)

extension is limited to between ten degrees and 20 degrees flexion, that is, there is a flexion contracture, and flexion is:

(a)

to greater than 120 degrees, two percent;

(b)

limited to between 91 degrees and 120 degrees, four percent;

(c)

limited to between 51 degrees and 90 degrees, 14 percent;

(d)

limited to between 20 degrees and 50 degrees, 18 percent;

(e)

limited to less than 20 degrees, 20 percent;

(3)

extension is limited to between 21 degrees and 35 degrees flexion, that is, there is a flexion contracture, and flexion is:

(a)

to greater than 120 degrees, eight percent;

(b)

limited to between 91 degrees and 120 degrees, ten percent;

(c)

limited to between 51 degrees and 90 degrees, 20 percent;

(d)

limited to less than 51 degrees, 24 percent;

(4)

extension is limited to between 36 degrees and 50 degrees flexion, that is, there is a flexion contracture, and flexion is:

(a)

to greater than 120 degrees, 16 percent;

(b)

limited to between 91 degrees and 120 degrees, 18 percent;

(c)

limited to less than 90 degrees, 28 percent;

(5)

extension is limited to between 51 degrees and 90 degrees flexion, that is, there is a flexion contracture, and flexion is:

(a)

to greater than 120 degrees, 26 percent;

(b)

limited to less than 121 degrees, 28 percent;

(6)

extension is limited to greater than 90 degrees flexion, that is, there is a flexion contracture, 36 percent;

(7)

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

(a)

between neutral and 20 degrees, 20 percent;

(b)

between 21 degrees and 50 degrees, 24 percent;

(c)

between 51 degrees and 90 degrees, 28 percent;

(d)

at greater than 90 degrees, 36 percent.

Statutory Authority:

MS s 176.105

History:

17 SR 3364; 35 SR 138

Published Electronically:

August 16, 2010

700 State Office Building, 100 Rev. Dr. Martin Luther King Jr. Blvd., St. Paul, MN 55155 ♦ Phone: (651) 296-2868 ♦ TTY: 1-800-627-3529 ♦ Fax: (651) 296-0569