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5223.0540 MUSCULOSKELETAL SCHEDULE; AMPUTATIONS OF UPPER EXTREMITY.

Subpart 1.

Amputations.

Permanent partial impairment due to amputation of upper extremities is a disability of the whole body as follows:

A.

amputation of the upper extremity at the shoulder, including removal of the ipsilateral scapula, clavicle, and muscles of the upper extremity attaching to the chest, 70 percent;

B.

disarticulation, as defined in part 5223.0310, subpart 21, at shoulder joint, 60 percent;

C.

amputation of arm above deltoid insertion, 60 percent;

D.

amputation of arm between deltoid insertion and elbow joint, 57 percent;

E.

disarticulation at elbow joint, 57 percent;

F.

amputation of forearm below elbow but proximal to insertion of biceps tendon, 57 percent;

G.

amputation of forearm below elbow joint distal to insertion of biceps tendon, 54 percent;

H.

disarticulation at wrist joint, 54 percent;

I.

midcarpal or midmetacarpal amputation of hand, 54 percent;

J.

amputation of multiple digits, add as described in part 5223.0300, subpart 3, item F, the ratings obtained for the specific abnormalities in items K to O;

K.

amputation of thumb:

(1)

at metacarpophalangeal joint or with resection of metacarpal bone, 22 percent;

(2)

through proximal phalanx, 16 percent;

(3)

at interphalangeal joint to middle of distal phalanx, 11 percent;

(4)

distal to middle of distal phalanx, 6.5 percent;

(5)

isolated soft tissue loss of the end of the digit greater than one centimeter, five percent;

L.

amputation of index finger:

(1)

at metacarpophalangeal joint or with resection of metacarpal bone or through proximal phalanx, 11 percent;

(2)

at proximal interphalangeal joint or through middle phalanx, nine percent;

(3)

at distal interphalangeal joint to middle of distal phalanx, five percent;

(4)

distal to middle of distal phalanx, 2.5 percent;

(5)

isolated soft tissue loss of the end of the digit greater than one centimeter, 2.5 percent;

M.

amputation of middle finger:

(1)

at metacarpophalangeal joint or with resection of metacarpal bone or through proximal phalanx, 11 percent;

(2)

at proximal interphalangeal joint or through middle phalanx, nine percent;

(3)

at distal interphalangeal joint to middle of distal phalanx, five percent;

(4)

distal to middle of distal phalanx, 2.5 percent;

(5)

isolated soft tissue loss of the end of the digit greater than one centimeter, 2.5 percent;

N.

amputation of ring finger:

(1)

at metacarpophalangeal joint or with resection of metacarpal bone or through proximal phalanx, 5.5 percent; for dates of injury on or after August 9, 2010, at metacarpophalangeal joint or with resection of metacarpal bone or through proximal phalanx, five percent;

(2)

at proximal interphalangeal joint or through middle phalanx, four percent;

(3)

at distal interphalangeal joint to middle of distal phalanx, 2.5 percent;

(4)

distal to middle of distal phalanx, one percent;

(5)

isolated soft tissue loss of the end of the digit greater than one centimeter, one percent;

O.

amputation of little finger:

(1)

at metacarpophalangeal joint or with resection of metacarpal bone or through proximal phalanx, 5.5 percent; for dates of injury on or after August 9, 2010, at metacarpophalangeal joint or with resection of metacarpal bone or through proximal phalanx, five percent;

(2)

at proximal interphalangeal joint or through middle phalanx, four percent;

(3)

at distal interphalangeal joint to middle of distal phalanx, 2.5 percent;

(4)

distal to middle of distal phalanx, one percent;

(5)

isolated soft tissue loss of the end of the digit greater than one centimeter, one 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