Title 20: Employees' Benefits
PART 220—DETERMINING DISABILITY
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Appendix 3 to Part 220—Railroad Retirement Board Occupational Disability Standards
1. Introduction
1.01 The Board uses this appendix to adjudicate the occupational disability claims of employees with medical conditions and job titles covered by the Tables in this appendix. The Tables are divided into “Body Parts”, with each Body Part further divided by job title. Under each job title there is a list of impairments and tests with accompanying test results which establish a finding of “D” (disabled). The use of these Tables is a three-step process. In the first step we determine whether the employee's regular railroad occupation is covered by the Tables; next we establish the existence of an impairment covered by the Tables; finally, we reach a disability determination. If we do not find an employee disabled under these Tables, the employee may still be found disabled using Independent Case Evaluation (ICE), as explained in subpart C of this part.
1.02 The Cancer Tables are treated in a different way than other body systems. Different types of cancer and their treatments have different functional impacts. In the Cancer Tables the impact of the impairment is seen as being significant or not significant. Therefore, these tables contain an “S” (significant) which is equivalent to a “D” rating. A detailed explanation of how to use those tables is in that section. The steps to use the remaining Tables are explained below:
2. Confirming the Impairment
2.01 Once we determine that the employee's regular railroad occupation is covered by the Job Titles in the Tables, we must determine the existence of an impairment covered by the Tables. This is done through the use of Confirmatory Tests. These tests can include information from medical records, surgical or operative reports, or specific diagnostic test results. Confirmatory Tests are listed in the initial section regarding each Body Part covered in the Tables. If an impairment cannot be confirmed because of inconsistent medical information, ICE may be required.
2.02 There are two types of Confirmatory Tests as follows.
2.03 “Highly Recommended” Tests—The designation of a confirmatory test as being “highly recommended” means that the test is almost always performed to confirm the existence of the impairment. For many conditions, only one “highly recommended” test finding is suggested to confirm the impairment. However, there may be times when that test is not available or is negative, but other more detailed testing confirms the impairment.
2.04 Example A: To confirm the condition of pulmonary hypertension, the Tables under Body Part C., Cardiac, designate as “highly recommended”: an electrocardiogram which indicates definite right ventricular hypertrophy. However, the impairment may also be confirmed by insertion of a Swan-Ganz catheter into the pulmonary artery and the pulmonary artery pressure measured directly.
2.05 There may be some conditions for which several “highly recommended” tests are suggested to confirm an impairment. In these circumstances, we will use all “highly recommended” tests to establish the existence of the impairment.
2.06 Example B: Under Body Part E., Lumbar Sacral Spine, three highly recommended medical findings are identified for the diagnosis of chronic back pain, not otherwise specified. These findings include:
A. A history of back pain under medical treatment for at least one year, and
B. A history of back pain unresponsive to therapy for at least one year, and
C. A history of back pain with functional limitations for at least one year.
2.07 All three of these criteria must be satisfied to confirm the existence of chronic back pain.
2.08 Sometimes the employee may have undergone detailed testing which is as reliable as one of the “highly recommended” tests listed in the Tables. In cases where an impairment has not been confirmed by one of the designated “highly recommended” tests, the impairment may still be confirmed by “recommended” tests (see below) or by evidence acceptable under section 220.27 of this part.
2.09 Recommended Tests—The designation of a confirmatory test as “recommended” means that the test need not be performed, or be positive, to confirm the impairment. However, a positive test provides significant support for confirming the impairment. If there are no “highly recommended” tests for confirming the impairment, at least one of the “recommended” tests should be positive.
2.10 There are two categories of recommended tests which are described below.
A. Imaging studies—These studies can include MRI, CAT scan, myelogram, or plain film x-rays. For conditions where several of these imaging studies are identified as “recommended” tests, at least one of the test results should be positive and meet the confirmatory test criteria. For some conditions, such as degenerative disc condition, there are several equivalent imaging methods to confirm a diagnosis.
B. Other tests—This category of tests refers to non-imaging studies.
2.11 If there are no “highly recommended” confirmatory tests designated to confirm an impairment and the “recommended” confirmatory tests only include non-imaging procedures, at least one of these tests should be positive to confirm the impairment. The greater the number of tests that are positive, the greater the confidence that the correct diagnosis has been established.
2.12 Example: Under Body Part C., Cardiac, the diagnostic confirmatory tests for ventricular ectopy, a cardiac arrhythmia, include the following “recommended” tests:
A. Medical record review, i.e., a review of the claimant's medical records, or
B. Holter monitoring, or
C. Provocative testing producing a definite arrhythmia.
2.13 In this situation, only one of the “recommended” confirmatory tests need be positive to confirm the impairment. However, the more tests that are positive, the stronger the support for the diagnosis.
2.14 In no circumstance will the Board require that an invasive test be performed to confirm an impairment. Several of the Confirmatory Tests which are described in the Tables are invasive and it is not the intention of the Board to suggest that these be performed. The inclusion of invasive tests in the Tables Confirmatory Tests section is intended to help the Board evaluate the significance of findings from such tests that may have already been performed and which are part of the submitted medical record.
2.15 If an employee's impairment(s) cannot be confirmed by use of the confirmatory tests listed in the Tables, it still may be confirmed by medical evidence described in section 220.27 of this part. However, if a claimant's impairment(s) cannot be confirmed through use of the Tables or under section 220.27, and the medical evidence is complete and in concordance, the claimant will be found not disabled.
3. Disability Determination
3.01 Once the Board determines that the employee's regular railroad occupation is covered by one of the Job Titles in the Tables and that his or her alleged impairment fits into a Body Part covered by the Tables and can be confirmed, we examine the results of any of the disability tests listed under the impairment. If the results from any of these tests indicate a “D” finding, the employee is found disabled. If none of the test results indicate a “D” finding, then the employee's claim is evaluated using ICE.
3.02 Example: A trainman has angina as confirmed by the recommended tests under Body Part A: Cardiac—Angina. An echocardiogram shows that he has poor ejection fraction ≤35%. The employee is rated disabled. If none of the results of the listed disability tests match the results required for a “D” finding, then the employee's claim is evaluated under ICE.
Tables
A. Cancer
B. Endocrine
C. Cardiac
D. Respiratory
E. Lumbar Sacral Spine
F. Cervical Spine
G. Shoulder and Elbow
H. Hand and Arm
I. Hip
J. Knee
K. Ankle and Foot
A. Cancer
Cancer
Cancer conditions can be viewed as belonging to one of three categories.
Category 1: Significant impact on functional capacity or anticipated life span.
Category 2: Intermediate impact on functional capacity; large individual variability.
Category 3: No significant impact on functional capacity or expected life span.
The factors that are considered in developing these categories include the following:
Type of Cancer
The functional impact of different malignancies varies tremendously and each malignancy has to be considered on an individual basis.
Magnitude of Disease
The disability standards are based upon the magnitude or extent of disease. The extent of disease affects both anticipated life span and the functional capacity or work ability of the individual. Localized cancer including cancer “in situ” can frequently be completely cured and not have an impact on functional capacity or life span. In contrast, many cancers that have distant or significant regional spread generally have a poor prognosis. The magnitude or extent of disease is classified into three categories: local, regional and distant.
The criteria which are used to classify a cancer into one of the three categories are based upon the distillation of several staging methods into a single system [Miller, et al. (1992). Cancer Statistics Review, 1973–1989; NIH Publication No. 92–2789].
Effects of Treatment
Although some types of cancer may be potentially curable with radical surgery and/or radiation therapy, the treatment regimen may result in a significant impairment that could affect functional capacity and ability to work. For example, a person with a laryngeal tumor which had spread regionally could be cured by a complete laryngectomy and radiotherapy. However, this treatment could result in a loss of speech and significantly impair the individual's communicative skills or ability to use certain types of respiratory protective equipment.
Prognosis
Some cancers may have minimal impact on a person's functional capacity, but have a very poor prognosis with respect to life expectancy. For example, an individual with early stage brain cancer may be minimally impaired, but have a poor prognosis and minimal potential for surviving longer than two years. Five and two year survival data are presented in the Cancer Disability Guideline Table which follows.
The Cancer Disability Guideline Table provides information concerning the probability of survival for five years for local, regional, and distant disease for each type of malignancy. In addition, two-year survival data are also presented for all disease stages. The five-year survival data are based upon data collected from population-based registries in Connecticut, New Mexico, Utah, Hawaii, Atlanta, Detroit, Seattle and the San Francisco and East Bay area between 1983 and 1987 (Miller, 1992). The two-year data are from a cohort study initially diagnosed in 1988.
Assessment
The malignancies are classified as disabling (Category 1), potentially disabling (Category 2) and non-disabling (Category 3). Category 2 conditions must be evaluated with respect to how the worker's tumor affects the worker's ability to perform the job and an assessment of his life span.
Information concerning the potential impact of the malignancy on a worker's ability to perform a job is identified in the Functional Impact column in the table. All railroad occupations in the Tables are considered together. Functional impacts are classified as significant if the treatment or sequelae from treatment including radiotherapy, chemotherapy and/or surgery is likely to impair the worker from performing the job. If the treatment results in a significant impairment of another organ system, the individual should be evaluated for disability associated with impairment of that body part. For example, a person undergoing an amputation for a bone malignancy would have to be evaluated for an amputation of that body part. For many cancers, it is difficult to make generalizations regarding the level of impairment that will occur after the person has initiated or completed treatment. Nonsignificant impacts include those that are unlikely to have any effect on the individual's work capacity.
---------------------------------------------------------------------------------------------------------------- Disability Functional Cancer type 2-year\1\ 5-year\1\ status\2\ impact\3\----------------------------------------------------------------------------------------------------------------Brain: Local.......................... .................... 26 1 S Regional....................... .................... 27.9 1 S Distant........................ .................... 23.6 1 SFemale Breast: Regional....................... .................... 71.1 2 S Distant........................ .................... 17.8 1 SColon: Local.......................... .................... 91 2 S Regional....................... .................... 60.1 2 S Distant........................ .................... 6 1 SRectal: Local.......................... .................... 84.5 2 S Regional....................... .................... 50.7 2 S Distant........................ .................... 5.3 1 SEsophagus: Local.......................... .................... 18.5 1 S Regional....................... .................... 5.2 1 S Distant........................ .................... 1.8 1 SHodgkin's Disease:\4\ Stage 1........................ .................... 90-95 3 S Stage 2........................ .................... 86 2 S Stage 3........................ .................... <80 2 S Stage 4........................ .................... <80 1 SKidney/Renal Pelvis: Local.......................... .................... 85.4 3 S Regional....................... .................... 56.3 2 S Distant........................ .................... 9 1 SLarynx: Local.......................... .................... 84.2 2 S Regional....................... .................... 52.5 2 S Distant........................ .................... 24 1 SAcute Lymphocytic Leukemia: All............................ .................... 51.1 2 SChronic Lymphocytic Leukemia: All............................ .................... 66.2 2 SAcute Myelogenous Leukemia: All............................ .................... 9.7 1 SChronic Myelogenous Leukemia: All............................ .................... 21.7 1 SLiver/Intrahepatic Bile Duct: Local.......................... .................... 15.1 1 S Regional....................... .................... 5.8 1 S Distant........................ .................... 1.9 1 SLung/Bronchus:\5\ Local.......................... .................... 45.6 2 S Regional....................... .................... 13.1 1 S Distant........................ .................... 1.3 1 SMelanomas of Skin: Regional....................... .................... 53.6 2 S Distant........................ .................... 12.8 1 SOral Cavity/Pharyngeal: Local.......................... .................... 76.2 2 S Regional....................... .................... 40.9 2 S Distant........................ .................... 18.7 1 SPancreas: Local.......................... .................... 6.1 1 S Regional....................... .................... 3.7 1 S Distant........................ .................... 1.4 1 SProstate: Local.......................... .................... 91 3 S Regional....................... .................... 80.4 2 S Distant........................ .................... 28 1 SStomach: Local.......................... .................... 55.4 1 S Regional....................... .................... 17.3 1 S Distant........................ .................... 2.1 1 STesticular: Distant........................ .................... 65.5 1 SThyroid: Regional....................... .................... 93.1 3 S Distant........................ .................... 47.2 1 SBladder: Regional....................... .................... 46 2 S Distant........................ .................... 9.1 1 S----------------------------------------------------------------------------------------------------------------\1\Source of 2 and 5 year survival data: Miller BA et al. Cancer Statistics Review 1973-1989. NIH Publication No. 92-2789.\2\Disability Status:Category 1: Significant impact on functional capacity or life span.Category 2: Intermediate impact.Category 3: No significant impact on functional capacity or life span.\3\Functional Impacts:(S) Significant_significant potential for the effects of treatment (radiotheraphy, chemotherapy. surgery) to affect functional capacity.\4\Hodgkin's disease data presented for each stage derived from American Cancer Society. American Cancer Society Textbook reference for unstaged cancer is derived from Cancer Statistics Review (See 3). In addition to other data, see: American Cancer Society Textbook of Clinical Oncology. Eds: Holleb AI, Fink DJ, Murphy GP, Atlanta: American Cancer Society, Inc. 1991.)\5\Small cell carcinoma is classified as a 1.
B. Endocrine---------------------------------------------------------------------------------------------------------------- Confirmatory test Minimum result Requirements---------------------------------------------------------------------------------------------------------------- BODY PART: ENDOCRINE CONFIRMATORY TESTS----------------------------------------------------------------------------------------------------------------Diabetes, requiring insulin (IDDM): Medical record review.............. Confirmation of condition and Highly recommended. need for insulin use.----------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------- Disability test Test result Disability classification---------------------------------------------------------------------------------------------------------------- BODY PART: ENDOCRINE JOB TITLE: ENGINEER----------------------------------------------------------------------------------------------------------------Diabetes, requiring insulin (IDDM): Medical record review.............. Confirmation of condition and D need for insulin use.----------------------------------------------------------------------------------------------------------------
C. Cardiac---------------------------------------------------------------------------------------------------------------- Confirmatory test Minimum result Requirements---------------------------------------------------------------------------------------------------------------- BODY PART: CARDIAC CONFIRMATORY TESTS----------------------------------------------------------------------------------------------------------------Angina: Medical record review.............. Confirmed history of ischemia Recommended. including copies of electrocardiogram. Stress test........................ Definite ischemia on exercise Recommended. test. Thallium study..................... Definite ischemia with Recommended. exercise.Aortic valve disease: Cardiac catheterization............ Proven and significant....... Recommended. Echocardiogram..................... Significant valve disease.... Recommended.Coronary artery disease: Medical record review.............. Documented ischemia with Recommended. electrocardiogram confirmation. Medical record review.............. Documented myocardial Recommended. infarction. Stress test........................ Positive..................... Recommended. Thallium study..................... Definite ischemia with Recommended. exercise. Angiography........................ Definite occlusion ([le]60%) Recommended. of one vessel.Cardiomyopathy: Echocardiogram..................... Proven ejection fraction Recommended. [le]35%. Catheterization.................... Poor global function and not Recommended. coronary artery disease.Hypertension: Medical record review.............. Documentation of hypertension Highly recommended. for one year. Medical record review.............. Definite diagnosis by Highly recommended. cardiologist or internist. Medical record review.............. Confirmation of medication Highly recommended. use.Arrhythmia: heart block: Medical record review.............. Proven episode with Recommended. electrocardiogram confirmation. Electrocardiogram.................. Documentation of arrhythmia.. Recommended.Mitral valve disease: Cardiac catheterization............ Significant valve disease.... Recommended. Echocardiogram..................... Significant valve disease.... Recommended.Pericardial disease: Medical record review.............. Confirmed by cardiologist or Highly recommended. internist.Pulmonary hypertension: Physical examination............... Increased pulmonic sound or Recommended. pulmonary ejection murmur by cardiologist or internist. Electrocardiogram.................. Definite right ventricular Highly recommended. hypertension.Ventricular ectopy: Medical record review.............. Definite episode within one Recommended. year. Holter monitoring.................. Definite arrhythmia.......... Recommended. Provocative testing................ Positive response............ Recommended.Arrhythmia: supraventricular tachycardia: Medical record review.............. Definite episode within one Recommended. year. Holter monitoring.................. Definite arrhythmia.......... Recommended.Post heart transplant: Medical record review.............. Documented................... Highly recommended.----------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------- Disability test Test result Disability classification---------------------------------------------------------------------------------------------------------------- BODY PART: CARDIAC JOB TITLE: TRAINMAN----------------------------------------------------------------------------------------------------------------Angina: Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]7 METS..... D Medical record review.............. Unstable as diagnosed by D cardiologist. Stress test........................ Documented hypotensive D response. Stress test: significant ST changes Definite ischemia [le]7 METS. DAortic valve disease: Cardiac catheterization............ Aortic gradient 25-50 mm HG.. Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]7 METS..... DCoronary artery disease: Myocardial infarction.............. Multiple infarctions......... D Echocardiogram..................... Confirmed ventricular D aneurysm. Cardiac catheterization............ Aortic gradient 25-50 mm Hg.. D Cardiac catheterization............ Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]7 METS..... D Medical record review.............. Unstable as diagnosed by a D Cardiologist. Stress test........................ Documented hypotensive D response. Stress test........................ Definite ischemia [le] 7 METS D Isotope, e.g., thallium study...... Definite ischemia [le] 7 METS DCardiomyopathy: Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]7 METS..... DHypertension: Medical record review.............. Diastolic [le]120 and D systolic [le]160, 50% of the time and evidence of end organ damage (blood creatinine [le]2; urinary protein [le]\1/2\ gm; or EKG evidence of ischemia).Arrhythmia: heart block: Holter............................. Documented asystole length D [le]1.5-2 seconds. Medical record review.............. Documented syncope with D proven arrhythmia.Mitral valve disease: Cardiac catheterization............ Mitral valve gradient >=5 mm D Hg. Cardiac catheterization............ Mitral regurgitation severe.. D Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]7 METS..... DPericardial disease: Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%.Ventricular ectopy: Medical record review.............. Documented life threatening D arrhythmia. Holter............................. Uncontrolled ventricular D rhythm. Medical record review.............. Documented related syncope... DArrhythmia: supraventricular tachycardia: Medical record review.............. Documented related syncope... DPost heart transplant: Medical record review.............. Post heart transplant........ D---------------------------------------------------------------------------------------------------------------- BODY PART: CARDIAC JOB TITLE: ENGINEER----------------------------------------------------------------------------------------------------------------Angina: Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... D Medical record review.............. Unstable as diagnosed by D cardiologist. Stress test........................ Documented hypotensive D response. Stress test: significant ST changes Definite ischemia [le]5 METS. DAortic valve disease: Cardiac catheterization............ Aortic gradient 25-50 mm HG.. D Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... DCoronary artery disease: Myocardial infarction.............. Multiple infarctions......... D Echocardiogram..................... Confirmed ventricular D aneurysm. Cardiac catheterization............ Aortic gradient 25-50 mm Hg.. D Cardiac catheterization............ Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... D Medical record review.............. Unstable as diagnosed by a D Cardiologist. Stress test........................ Documented hypotensive D response. Stress test........................ Definite ischemia [le]5 METS. D Isotope, e.g., thallium study...... Definite ischemia [le]5 METS. DCardiomyopathy: Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... DHypertension: Medical record review.............. Diastolic [le]120 and D systolic [le]160, 50% of the time and evidence of end organ damage (blood creatinine [le]2; urinary protein [le]\1/2\ gm; or EKG evidence of ischemia).Arrhythmia: heart block: Holter............................. Documented asystole length D [le]1.5-2 seconds. Medical record review.............. Documented syncope with D proven arrhythmia.Mitral valve disease: Cardiac catheterization............ Mitral valve gradient >=10 mm D Hg. Cardiac catheterization............ Mitral regurgitation severe.. D Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... DPericardial disease: Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%.Ventricular ectopy: Medical record review.............. Documented life threatening D arrhythmia. Holter............................. Uncontrolled ventricular D rhythm. Medical record review.............. Documented related syncope... DArrhythmia: supraventricular tachycardia: Medical record review.............. Documented related syncope... DPost heart transplant: Medical record review.............. Post heart transplant........ D---------------------------------------------------------------------------------------------------------------- BODY PART: CARDIAC JOB TITLE: DISPATCHER----------------------------------------------------------------------------------------------------------------Angina: Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... D Medical record review.............. Unstable as diagnosed by D cardiologist. Stress test........................ Documented hypotensive D response. Stress test: significant ST changes Definite ischemia [le]5 METS. DAortic valve disease: Cardiac catheterization............ Aortic gradient 25-50 mm Hg.. D Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... DCoronary artery disease: Myocardial infarction.............. Multiple infarctions......... D Echocardiogram..................... Confirmed ventricular D aneurysm. Cardiac catheterization............ Aortic gradient 25-50 mm Hg.. D Cardiac catheterization............ Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... D Medical record review.............. Unstable as diagnosed by D cardiologist. Stress test........................ Documented hypotensive D response. Stress test........................ Definite ischemia [le]5 METS. D Isotope, e.g., thallium study...... Definite ischemia [le]5 METS. DCardiomyopathy: Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... DHypertension: Medical record review.............. Diastolic [le]120 and D systolic [le]160, 50% of the time and evidence of end organ damage (blood creatinine [le]2; urinary protein [le]\1/2\ gm; or EKG evidence of ischemia).Arrhythmia: heart block: Holter............................. Documented asystole length D [le]1.5-2 seconds. Medical record review.............. Documented syncope with D proven arrhythmia.Mitral valve disease: Cardiac catheterization............ Mitral valve gradient >=10 mm D Hg. Cardiac catheterization............ Mitral regurgitation severe.. D Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... DPericardial disease: Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%.Ventricular ectopy: Medical record review.............. Documented life threatening D arrhythmia. Holter............................. Uncontrolled ventricular D rhythm. Medical record review.............. Documented related syncope... DArrhythmia: supraventricular tachycardia: Medical record review.............. Documented related syncope... DPost heart transplant: Medical record review.............. Post heart transplant........ D---------------------------------------------------------------------------------------------------------------- BODY PART: CARDIAC JOB TITLE: CARMAN----------------------------------------------------------------------------------------------------------------Angina: Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... D Medical record review.............. Unstable as diagnosed by D cardiologist. Stress test........................ Documented hypotensive D response. Stress test: significant ST changes Definite ischemia [le]5 METS. DAortic valve disease: Cardiac catheterization............ Aortic gradient 25-50 mm HG.. Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... DCoronary artery disease: Myocardial infarction.............. Multiple infarctions......... D Echocardiogram..................... Confirmed ventricular D aneurysm. Cardiac catheterization............ Aortic gradient 25-50 mm Hg.. D Cardiac catheterization............ Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... D Medical record review.............. Unstable as diagnosed by a D Cardiologist. Stress test........................ Documented hypotensive D response. Stress test........................ Definite ischemia [le] 5 METS D Isotope, e.g., thallium study...... Definite ischemia [le] 5 METS DCardiomyopathy: Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... DHypertension: Medical record review.............. Diastolic [le]120 and D systolic [le]160, 50% of the time and evidence of end organ damage (blood creatinine [le]2; urinary protein [le]\1/2\ gm; or EKG evidence of ischemia).Arrhythmia: heart block: Holter............................. Documented asystole length D [le]1.5-2 seconds. Medical record review.............. Documented syncope with D proven arrhythmia.Mitral valve disease: Cardiac catheterization............ Mitral valve gradient >=10 mm D Hg. Cardiac catheterization............ Mitral regurgitation severe.. D Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... DPericardial disease: Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%.Ventricular ectopy: Medical record review.............. Documented life threatening D arrhythmia. Holter............................. Uncontrolled ventricular D rhythm. Medical record review.............. Documented related syncope... DArrhythmia: supraventricular tachycardia: Medical record review.............. Documented related syncope... DPost heart transplant: Medical record review.............. Post heart transplant........ D---------------------------------------------------------------------------------------------------------------- BODY PART: CARDIAC JOB TITLE: SIGNALMAN----------------------------------------------------------------------------------------------------------------Angina: Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]7 METS..... D Medical record review.............. Unstable as diagnosed by D cardiologist. Stress test........................ Documented hypotensive D response. Stress test: significant ST changes Definite ischemia [le]7 METS. DAortic valve disease: Cardiac catheterization............ Aortic gradient 25-50 mm HG.. D Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]7 METS..... DCoronary artery disease: Myocardial infarction.............. Multiple infractions......... D Echocardiogram..................... Confirmed ventricular D aneurysm. Cardiac catheterization............ Aortic gradient 25-50 mm Hg.. D Cardiac catheterization............ Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]7 METS..... D Medical record review.............. Unstable as diagnosed by D cardiologist. Stress test........................ Documented hypotensive D response. Stress test........................ Definite ischemia [le]7 METS. D Isotope, e.g., thallium study...... Definite ischemia [le]7 METS. DCardiomyopathy: Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]7 METS..... DHypertension: Medical record review.............. Diastolic [le]120 and D systolic [le]160, 50% of the time and evidence of end organ damage (blood creatinine [le]2; urinary protein [le]\1/2\ gm; or EKG evidence of ischemia).Arrhythmia: heart block Holter............................. Documented asystole length D [le]1.5-2 seconds. Medical record review.............. Documented syncope with D proven arrhythmia.Mitral valve disease: Cardiac catheterization............ Mitral valve gradient >=5 mm D Hg. Cardiac catherization.............. Mitral regurgitation severe.. D Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]7 METS..... DPericardial disease: Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%.Ventricular ectopy: Medical record review.............. Documented life threatening D arrhythmia. Holter............................. Uncontrolled ventricular D rhythm. Medical record review.............. Documented related syncope... DArrhythmia: supraventricular tachycardia: Medical record review.............. Documented related syncope... DPost heart transplant: Medical record review.............. Post heart transplant........ D---------------------------------------------------------------------------------------------------------------- BODY PART: CARDIAC JOB TITLE: TRACKMAN----------------------------------------------------------------------------------------------------------------Angina: Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]7 METS..... D Medical record review.............. Unstable as diagnosed by D cardiologist. Stress test........................ Documented hypotensive D response. Stress test: significant ST changes Definite ischemia [le]7 METS. DAortic valve disease: Cardiac catheterization............ Aortic gradient 25-50 mm HG.. D Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]7 METS..... DCoronary artery disease: Myocardial infarction.............. Multiple infarctions......... D Echocardiogram..................... Confirmed ventricular D aneurysm. Cardiac catheterization............ Aortic gradient 25-50 mm Hg.. D Cardiac catheterization............ Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]7 METS..... D Medical record review.............. Unstable as diagnosed by a D cardiologist. Stress test........................ Documented hypotensive D response. Stress test........................ Definite ischemia [le]7 METS. D Isotope, e.g., thallium study...... Definite ischemia [le]7 METS. DCardiomyopathy: Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]7 METS..... DHypertension: Medical record review.............. Diastolic [le]120 and D systolic [le]160, 50% of the time and evidence of end organ damage (blood creatinine [le]2; urinary protein [le]\1/2\ gm; or EKG evidence of ischemia).Arrhythmia: heart block: Holter............................. Documented asystole length D [le]1.5-2 seconds. Medical record review.............. Documented syncope with D proven arrhythmia.Mitral valve disease: Cardiac catheterization............ Mitral valve gradient >=5 mm D Hg. Cardiac catheterization............ Mitral regurgitation severe.. D Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]7 METS..... DPericardial disease: Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%.Ventricular ectopy: Medical record review.............. Documented life threatening D arrhythmia. Holter............................. Uncontrolled ventricular D rhythm. Medical record review.............. Documented related syncope... DArrhythmia: supraventricular tachycardia: Medical record review.............. Documented related syncope... DPost heart transplant: Medical record review.............. Post heart transplant........ D---------------------------------------------------------------------------------------------------------------- BODY PART: CARDIAC JOB TITLE: MACHINIST----------------------------------------------------------------------------------------------------------------Angina: Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... D Medical record review.............. Unstable as diagnosed by D cardiologist. Stress test........................ Documented hypotensive D response. Stress test: significant ST changes Definite ischemia [le]5 METS. DAortic valve disease: Cardiac catheterization............ Aortic gradient 25-50 mm HG.. Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... DCoronary artery disease: Myocardial infarction.............. Multiple infarctions......... D Echocardiogram..................... Confirmed ventricular D aneurysm. Cardiac catheterization............ Aortic gradient 25-50 mm Hg.. D Cardiac catheterization............ Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... D Medical record review.............. Unstable as diagnosed by a D cardiologist. Stress test........................ Documented hypotensive D response. Stress test........................ Definite ischemia [le]5 METS. D Isotope, e.g., thallium study...... Definite ischemia [le]5 METS. DCardiomyopathy: Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... DHypertension: Medical record review.............. Diastolic [le]120 and D systolic [le]160, 50% of the time and evidence of end organ damage (blood creatinine [le]2; urinary protein [le]\1/2\ gm; or EKG evidence of ischemia).Arrhythmia: heart block: Holter............................. Documented asystole length D [le]1.5-2 seconds. Medical record review.............. Documented syncope with D proven arrhythmia.Mitral valve disease: Cardiac catheterization............ Mitral valve gradient >=10 mm D Hg. Cardiac catheterization............ Mitral regurgitation severe.. D Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... DPericardial disease: Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%.Ventricular ectopy: Medical record review.............. Documented life threatening D arrhythmia. Holter............................. Uncontrolled ventricular D rhythm. Medical record review.............. Documented related syncope... DArrhythmia: supraventricular tachycardia: Medical record review.............. Documented related syncope... DPost heart transplant: Medical record review.............. Post heart transplant........ D---------------------------------------------------------------------------------------------------------------- BODY PART: CARDIAC JOB TITLE: SHOP LABORER----------------------------------------------------------------------------------------------------------------Angina: Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... D Medical record review.............. Unstable as diagnosed by D cardiologist. Stress test........................ Documented hypotensive D response. Stress test: significant ST changes Definite ischemia [le]5 METS. DAortic valve disease: Cardiac catheterization............ Aortic gradient 25-50 mm HG.. Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... DCoronary artery disease: Myocardial infarction.............. Multiple infarctions......... D Echocardiogram..................... Confirmed ventricular D aneurysm. Cardiac catheterization............ Aortic gradient 25-50 mm Hg.. Cardiac catheterization............ Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... D Medical record review.............. Unstable as diagnosed by a D Cardiologist. Stress test........................ Documented hypotensive D response. Stress test........................ Definite ischemia [le]5 METS. D Isotope, e.g., thallium study...... Definite ischemia [le]5 METS. DCardiomyopathy: Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... DHypertension: Medical record review.............. Diastolic [le]120 and D systolic [le]160, 50% of the time and evidence of end organ damage (blood creatinine [le]2; urinary protein [le]\1/2\ gm; or EKG evidence of ischemia).Arrhythmia: heart block: Holter............................. Documented asystole length D [le]1.5-2 seconds. Medical record review.............. Documented syncope with D proven arrhythmia.Mitral valve disease: Cardiac catheterization............ Mitral valve gradient >=10 mm D Hg. Cardiac catheterization............ Mitral regurgitation severe.. D Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... DPericardial disease: Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%.Ventricular ectopy: Medical record review.............. Documented life threatening D arrhythmia. Holter............................. Uncontrolled ventricular D rhythm. Medical record review.............. Documented related syncope... DArrhythmia: supraventricular tachycardia: Medical record review.............. Documented related syncope... DPost heart transplant: Medical record review.............. Post heart transplant........ D---------------------------------------------------------------------------------------------------------------- BODY PART: CARDIAC JOB TITLE: SALES REPRESENTATIVE----------------------------------------------------------------------------------------------------------------Angina: Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... D Medical record review.............. Unstable as diagnosed by D cardiologist. Stress test........................ Documented hypotensive D response. Stress test: significant ST changes Definite ischemia [le]5 METS. DAortic valve disease: Cardiac catheterization............ Aortic gradient 25-50 mm HG.. D Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... DCoronary artery disease: Myocardial infarction.............. Multiple infarctions......... D Echocardiogram..................... Confirmed ventricular D aneurysm. Cardiac catheterization............ Aortic gradient 25-50 mm Hg.. D Cardiac catheterization............ Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... D Medical record review.............. Unstable as diagnosed by a D cardiologist. Stress test........................ Documented hypotensive D response. Stress test........................ Definite ischemia [le]5 METS. D Isotope, e.g., thallium study...... Definite ischemia [le]5 METS. DCardiomyopathy: Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... DHypertension: Medical record review.............. Diastolic [le]120 and D systolic [le]160, 50% of the time and evidence of end organ damage (blood creatinine [le]2; urinary protein [le]\1/2\ gm; or EKG evidence of ischemia).Arrhythmia: heart block: Holter............................. Documented asystole length D [le]1.5-2 seconds. Medical record review.............. Documented syncope with D proven arrhythmia.Mitral valve disease: Cardiac catheterization............ Mitral valve gradient >=10 mm D Hg. Cardiac catheterization............ Mitral regurgitation severe.. D Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... DPericardial disease: Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%.Ventricular ectopy: Medical record review.............. Documented life threatening D arrhythmia. Holter............................. Uncontrolled ventricular D rhythm. Medical record review.............. Documented related syncope... DArrhythmia: supraventricular tachycardia: Medical record review.............. Documented related syncope... DPost heart transplant: Medical record review.............. Post heart transplant........ D---------------------------------------------------------------------------------------------------------------- BODY PART: CARDIAC JOB TITLE: GENERAL OFFICE CLERK----------------------------------------------------------------------------------------------------------------Angina: Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... D Medical record review.............. Unstable as diagnosed by D cardiologist. Stress test........................ Documented hypotensive D response. Stress test: significant ST changes Definite ischemia [le]5 METS. DAortic valve disease: Cardiac catheterization............ Aortic gradient 25-50 mm HG.. D Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... DCoronary artery disease: Myocardial infarction.............. Multiple infarctions......... D Echocardiogram..................... Confirmed ventricular D aneurysm. Cardiac catheterization............ Aortic gradient 25-50 mm Hg.. D Cardiac catheterization............ Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... D Medical record review.............. Unstable as diagnosed by a D Cardiologist. Stress test........................ Documented hypotensive D response. Stress test........................ Definite ischemia [le]5 METS. D Isotope, e.g., thallium study...... Definite ischemia [le]5 METS. DCardiomyopathy: Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... DArrhythmia: heart block: Holter............................. Documented asystole length D [le]1.5-2 seconds. Medical record review.............. Documented syncope with D proven arrhythmia.Mitral valve disease: Cardiac catheterization............ Mitral valve gradient >=10 mm D Hg. Cardiac catheterization............ Mitral regurgitation severe.. D Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%. Stress test........................ Peak exercise [le]5 METS..... DPericardial disease: Cardiac catheterization............ Poor ejection fraction D [le]35%. Echocardiogram..................... Poor ejection fraction D [le]35%.Ventricular ectopy: Medical record review.............. Documented life threatening D arrhythmia. Holter............................. Uncontrolled ventricular D rhythm. Medical record review.............. Documented related syncope... DArrhythmia: supraventricular tachycardia: Medical record review.............. Documented related syncope... DPost heart transplant: Medical record review.............. Post heart transplant........ D----------------------------------------------------------------------------------------------------------------
D. Respiratory---------------------------------------------------------------------------------------------------------------- Confirmatory test Minimum result Requirements---------------------------------------------------------------------------------------------------------------- BODY PART: RESPIRATORY CONFIRMATORY TESTS----------------------------------------------------------------------------------------------------------------Asthma: Spirometry......................... FEV1/FVC ratio diminished.... Recommended. Spirometry......................... [le]15% change with Recommended. administration of bronchodilator. Methacholine challenge test........ Positive: FEV1 decrease Recommended [le]20% at (PC <=8 mg/ml).Bronchiectasis: Medical record review.............. Chronic cough and sputum..... Recommended. Chest X-ray........................ Bronchiectasis demonstrated.. Recommended. Chest CAT scan..................... Bronchiectasis demonstrated.. Recommended.Chronic bronchitis: Medical record review.............. Frequent cough_2 years Highly recommended. duration.Chronic obstructive pulmonary disease: Spirometry......................... FEV1/FVC ratio below 65% when Highly recommended. stable. Spirometry......................... FEV1 below 75% of predicted Highly recommended. when stable.Cor pulmonale: Electrocardiogram.................. Definite right ventricular Recommended. hypertrophy. Echocardiogram..................... Definite right ventricular Recommended. hypertrophy.Pulmonary fibrosis: Lung biopsy........................ Diffuse fibrosis............. Recommended. Chest CAT scan..................... More than minimal fibrosis... Recommended.Lung resection: Medical record review.............. At least one lobe resected... Highly recommended.Pneumothorax: Medical record review.............. Required hospitalization with Highly recommended. chest tube drainage.Restrictive lung disease: Chest X-ray........................ Restrictive lung changes..... Recommended. DLCO............................... Abnormal..................... Highly recommended. Chest CAT scan..................... Restrictive lung changes..... Recommended. Spirometry......................... FVC <75% predicted........ Highly recommended.Silicosis: Medical record review.............. Occupational exposure for at Highly recommended. least 1 year.Tuberculosis: Chest X-ray........................ Evidence of changes Recommended. consistent with tuberculosis infection. Culture............................ Positive..................... Recommended.----------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------- Disability test Test result Disability classification---------------------------------------------------------------------------------------------------------------- BODY PART: RESPIRATORY---------------------------------------------------------------------------------------------------------------- JOB TITLE: TRAINMANAsthma: Spirometry......................... Repeated spirometry FEV1 <40% over a 12 month period.Bronchiectasis: Resting ABG........................ PCO2 arterial [le]50 mm Hg if D stable. Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Chronic bronchitis: Spirometry......................... Repeated spirometry FEV1 D <40% over a 12 month period. Resting ABG........................ PCO2 arterial [le]50 mm Hg if D stable. Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Chronic obstructive pulmonary disease (COPD): Resting ABG........................ PCO2 arterial [le]50 mm Hg if D stable. Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Cor pulmonale: Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Pulmonary fibrosis: Resting ABG........................ PCO2 arterial [le]50 mm Hg if D stable. Electrocardiogram.................. Definite positive right D ventricular hypertrophy. DLCO............................... <45% predicted............ D Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Spirometry......................... FVC <50% predicted........ DLung resection: Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Restrictive lung disease: DLCO............................... <45% predicted............ D Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Spirometry......................... FVC <50% predicted........ D Electrocardiogram.................. efinite positive right D ventricular hypertrophy.Silicosis: Resting ABG........................ PCO2 arterial [le]50 mm Hg If D stable. Electrocardiogram.................. Definite positive right D ventricular hypertrophy.---------------------------------------------------------------------------------------------------------------- BODY PART: RESPIRATORY JOB TITLE: CARMAN----------------------------------------------------------------------------------------------------------------Asthma: Spirometry......................... Repeated spirometry FEV1 D <40% over a 12 month period.Bronchiectasis: Resting ABG........................ PCO2 arterial [le]50 mm Hg if D stable. Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Chronic bronchitis: Spirometry......................... Repeated spirometry FEV1 D <40% over a 12 month period. Resting ABG........................ PCO2 arterial [le]50 mm Hg if D stable. Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Chronic obstructive pulmonary disease (COPD): Resting ABG........................ PCO2 arterial [le]50 mm Hg if D stable. Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Cor pulmonale: Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Pulmonary fibrosis: Resting ABG........................ PCO2 arterial [le]50 mm Hg if D stable. Electrocardiogram.................. Definite positive right D ventricular hypertrophy. DLCO............................... <45% predicted............ D Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Spirometry......................... FVC <50% predicted........ DLung resection: Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Restrictive lung disease: DLCO............................... <45% predicted............ D Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Spirometry......................... FVC <50% predicted........ D Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Silicosis: Resting ABG........................ PCO2 arterial [le]50 mm Hg if D stable. Electrocardiogram.................. Definite positive right D ventricular hypertrophy.---------------------------------------------------------------------------------------------------------------- BODY PART: RESPIRATORY JOB TITLE: SIGNALMAN----------------------------------------------------------------------------------------------------------------Asthma: Spirometry......................... Repeated spirometry FEV1 D <40% over a 12 month period.Bronchiectasis: Resting ABG........................ PCO2 arterial [le]50 mm Hg if D stable. Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Chronic bronchitis: Spirometry......................... Repeated spirometry FEV1 D <40% over a 12 month period. Resting ABG........................ PCO2 arterial [le]50 mm Hg if D stable. Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Chronic obstructive pulmonary disease (COPD): Resting ABG........................ PCO2 arterial [le]50 mm Hg if D stable. Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Cor pulmonale: Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Pulmonary fibrosis: Resting ABG........................ PCO2 arterial [le]50 mm Hg if D stable. DLCO............................... <45% predicted............ D Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Spirometry......................... FVC <50% predicted........ D Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Lung resection: Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Restrictive lung disease: DLCO............................... <45% predicted............ D Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Spirometry......................... FVC <50% predicted........ D Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Silicosis: Resting AGB........................ PCO2 arterial [le]50 mm Hg if D stable. Electrocardiogram.................. Definite positive right D ventricular hypertrophy.---------------------------------------------------------------------------------------------------------------- BODY PART: RESPIRATORY JOB TITLE: TRACKMAN----------------------------------------------------------------------------------------------------------------Asthma: Spirometry......................... Repeated spirometry FEV1 D <40% over a 12 month period.Bronchiectasis: Resting ABG........................ PCO2 arterial [le]50 mm Hg if D stable. Pulmonary exercise test or exercise PO2 [le]5 torr at maximum D ABG. exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Chronic bronchitis: Spirometry......................... Repeated spirometry FEV1 D <40% over a 12 month period. Resting ABG........................ PCO2 arterial [le]50 mm Hg if D stable. Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Chronic obstructive pulmonary disease (COPD): Resting ABG........................ PCO2 arterial [le]50 mm Hg if D stable. Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Cor pulmonale: Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Pulmonary fibrosis: Resting ABG........................ PCO2 arterial [le]50 mm Hg if D stable. Electrocardiogram.................. Definite positive right D ventricular hypertrophy. DLCO............................... <45% predicted............ D Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Spirometry......................... FVC <50% predicted........ DLung resection: Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Restrictive lung disease: DLCO............................... <45% predicted............ D Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Spirometry......................... FVC <50% predicted........ D Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Silicosis: Resting ABG........................ PCO2 arterial [le]50 mm Hg if D stable. Electrocardiogram.................. Definite positive right D ventricular hypertrophy.---------------------------------------------------------------------------------------------------------------- BODY PART: RESPIRATORY JOB TITLE: MACHINIST----------------------------------------------------------------------------------------------------------------Asthma: Spirometry......................... Repeated spirometry FEV1 D <40% over a 12 month period.Bronchiectasis: Resting ABG........................ PCO2 arterial [le]50 mm Hg if D stable. Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Chronic bronchitis: Spirometry......................... Repeated spirometry FEV1 D <40% over a 12 month period. Resting AGB........................ PCO2 arterial [le]50 mm Hg if D stable. Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Chronic obstructive pulmonary disease (COPD): Resting ABG........................ PCO2 arterial [le]50 mm Hg if D stable. Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Cor pulmonale: Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Pulmonary fibrosis: Resting ABG........................ PCO2 arterial [le]50 mm Hg if D stable. Electrocardiogram.................. Definite positive right D ventricular hypertrophy. DLCO............................... <45% predicted............ D Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Spirometry......................... FVC <50% predicted........ DLung resection: Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Restrictive lung disease: DLCO............................... <45% predicted............ D Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Spirometry......................... FVC <50% predicted........ D Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Silicosis: Resting ABG........................ PCO2 arterial [le]50 mm Hg if D stable. Electrocardiogram.................. Definite positive right D ventricular hypertrophy.---------------------------------------------------------------------------------------------------------------- BODY PART: RESPIRATORY JOB TITLE: SHOP LABORER----------------------------------------------------------------------------------------------------------------Asthma: Spirometry......................... Repeated spirometry FEV1 D <40% over a 12 month period.Bronchiectasis: Resting ABG........................ PCO2 arterial [le]50 mm Hg if D stable. Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Chronic bronchitis: Spirometry......................... Repeated spirometry FEV1 D <40% over a 12 month period. Resting ABG........................ PCO2 arterial [le]50 mm Hg if D stable. Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Chronic obstructive pulmonary disease (COPD): Resting ABG........................ PCO2 arterial [le]50 mm Hg if D stable. Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Cor pulmonale: Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Pulmonary fibrosis: Resting ABG........................ PCO2 arterial [le]50 mm Hg if D stable. DLCO............................... <45% predicted............ D Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Spirometry......................... FVC <50% predicted........ D Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Lung resection: Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Restrictive lung disease: DLCO............................... <45% predicted............ D Pulmonary exercise test or exercise PO2 drop [le]5 torr at D ABG. maximum exercise. Pulmonary exercise test............ Maximum VO2 <15 ml/kg..... D Spirometry......................... FVC <50% predicted........ D Electrocardiogram.................. Definite positive right D ventricular hypertrophy.Silicosis: Resting ABG........................ PCO2 arterial [le]50 mm Hg if D stable. Electrocardiogram.................. Definite positive right D ventricular hypertrophy.----------------------------------------------------------------------------------------------------------------
E. Lumbar Sacral Spine---------------------------------------------------------------------------------------------------------------- Confirmatory test Minimum result Requirements---------------------------------------------------------------------------------------------------------------- BODY PART: LS SPINE CONFIRMATORY TESTS----------------------------------------------------------------------------------------------------------------Ankylosing spondylitis: X-ray-lumbar sacral spine.......... Sacroilitis.................. Highly recommended. HLA B27 (blood test)............... Positive HLA B27 (90% case).. Recommended.Backache, unspecified: Medical record review.............. History of back pain under Highly recommended. medical treatment for at least 1 year. Medical record review.............. History of back pain Highly recommended. unresponsive to therapy for at least 1 year. Medical record review.............. History of back pain with Highly recommended. functional limitations for at least 1 year. Chronic back pain, not otherwise specified:. Medical record review.............. History of back pain under Highly recommended. medical treatment for at least 1 year. Medical record review.............. History of back pain Highly recommended. unresponsive to therapy for at least 1 year. Medical record review.............. History of back pain with Highly recommended. functional limitations for at least 1 year. Cauda equina syndrome with bowel or bladder dysfunction:. Magnetic resonance imaging......... Neural impingement of spinal Recommended. nerves below L1. Computerized tomography............ Neural impingement of spinal Recommended. nerves below L1. Cystometrogram..................... Impaired bladder function.... Recommended. Rectal examination................. Diminished rectal sphincter Recommended. tone. Myelogram.......................... Neural impingement of spinal Recommended. nerves below L1.Degeneration of lumbar disc: X-ray lumbar sacral spine.......... Significant degenerative disc Recommended. changes. Computerized tomography............ Significant degenerative disc Recommended. changes. Magnetic resonance imaging......... Significant degenerative disc Recommended. changes. Myelogram.......................... Significant degenerative disc Recommended. changes. Displacement of lumbar disc:....... X-ray-lumbar sacral spine.......... Significant degenerative disc Recommended. changes. Computerized tomography............ Significant degenerative disc Recommended. changes. Magnetic resonance imaging......... Significant degenerative disc Recommended. changes. Myelogram.......................... Significant degenerative disc Recommended. changes. Fracture: vertebral body:.......... Magnetic resonance imaging......... Fracture vertebral body...... Recommended. Computerized tomography............ Fracture vertebral body...... Recommended. X-ray-lumbar sacral spine.......... Fracture vertebral body...... ommended.Fracture: posterior element with spinal canal displacement: Magnetic resonance imaging......... Fracture posterior spinal Recommended. element with displacement of spinal canal. Computerized tomography............ Fracture posterior spinal Recommended. element with displacement of spinal canal. X-ray-lumbar sacral spine.......... Fracture posterior spinal Recommended. element with displacement of spinal canal. Fracture: posterior spinal element with no displacement:. X-ray-lumbar sacral spine.......... Fracture posterior spinal Recommended. element. Magnetic resonance imaging......... Fracture posterior spinal Recommended. element. Computerized tomography............ Fracture posterior spinal Recommended. element.Fracture: spinous process: X-ray-lumbar sacral spine.......... Spinous process fracture..... Recommended. Magnetic resonance imaging......... Spinous process fracture..... Recommended. Computerized tomography............ Spinous process fracture..... Recommended.Fracture: Transverse process: Lumbar sacral spine................ Transverse process fracture.. Recommended. Magnetic resonance imaging......... Transverse process fracture.. Recommended. Computerized tomography............ Transverse process fracture.. Recommended.Intervertebral disc disorder: X-ray-lumbar sacral spine.......... Significant disc degeneration Recommended. Magnetic resonance imaging......... Significant disc degeneration Recommended. Computerized tomography............ Significant disc degeneration Recommended. Myelogram.......................... Significant disc degeneration Recommended.Lumbago: Medical record review: lumbar...... History of back pain under Highly recommended. medical treatment for at least 1 year. Medical record review: lumbar...... History of back pain Highly recommended. unresponsive to therapy for at least 1 year. Medical record review: lumbar...... History of back pain with Highly recommended. functional limitations for at least 1 year.Lumbosacral neuritis: Magnetic resonance imaging......... Evidence of neural Recommended. compression. Electromyography................... Definite denervation......... Recommended. Nerve conduction velocity.......... Definite slowing............. Recommended. Physical examination_atrophy....... Atrophy in affected limb with Recommended. 2 cm difference between limbs. Physical examination: straight leg Positive straight leg raise.. Recommended. raise. Sensory examination................ Loss of sensation in affected Recommended. dermatomes. Medical history.................... History of radicular pain.... Highly recommended. Computerized tomography............ Evidence of neural Recommended. compression.Lumbar spinal stenosis: Computerized tomography............ Significant narrowing: spinal Recommended. cord canal or intervertebral foramen. Magnetic resonance imaging......... Significant narrowing: spinal Recommended. cord canal or intervertebral foramen. Myelogram.......................... Significant narrowing: spinal Recommended. cord canal or intervertebral foramen.Mechanical complication of internal orthopedic device: Medical record review.............. Documentation of failure of Highly recommended. implant following surgical procedure.Osteomalacia: X-ray-lumbar sacral spine.......... Evidence of significant Recommended. osteomalacia. Magnetic resonance imaging......... Evidence of significant Recommended. osteomalacia. Computerized tomography............ Evidence of significant Recommended. osteomalacia.Osteomyelitis, chronic-lumbar: X-ray-lumbar sacral spine.......... Evidence of chronic infection Recommended. Magnetic resonance imaging......... Evidence of chronic infection Recommended. Computerized tomography............ Evidence of chronic infection Recommended.Osteoporosis: Computerized tomography............ Significant bone density loss Recommended. Dual photon absorptiometry......... Significant bone density loss Recommended. X-ray-lumbar sacral spine.......... Significant bone density loss Recommended.Post laminectomy syndrome with radiculopathy: Medical record review: lumbar...... Documented surgical history Highly recommended. of laminectomy. Magnetic resonance imaging......... Evidence of laminectomy...... Recommended. Electromyography................... Definite denervation......... Recommended. Nerve conduction velocity.......... Definite slowing............. Recommended. Physical examination_atrophy....... Atrophy in affected limb with Recommended. 2 cm difference between limbs. Physical examination: straight leg Positive straight leg raise.. Recommended. raise. Sensory examination................ Loss of sensation in affected Recommended. dermatomes. Medical record review: lumbar...... History of radicular pain.... Highly recommended. Computerized tomography............ Evidence of laminectomy...... Recommended. Myelogram.......................... Evidence of laminectomy...... Recommended.Radiculopathy: Magnetic resonance imaging......... Evidence of neural Recommended. compression. Electromyography................... Definite denervation......... Recommended. Nerve conduction velocity.......... Definite slowing............. Recommended. Physical examination_atrophy....... Atrophy in affected limb with Recommended. 2 cm difference between limbs. Physical examination: straight leg Positive straight leg raise.. Recommended. raise. Sensory examination................ Loss of sensation in affected Recommended. dermatomes. Medical record review: lumbar...... History of radicular pain.... Highly recommended. Computerized tomography............ Evidence of neural Recommended. compression. Myelogram.......................... Evidence of neural Recommended. compression.Sciatica: Magnetic resonance imaging......... Evidence of neural Recommended. compression. Electromyography................... Definite denervation......... Recommended. Nerve conduction velocity.......... Definite slowing............. Recommended. Physical examination_atrophy....... Atrophy in affected limb with Recommended. 2 cm difference between limbs. Physical examination: straight leg Positive straight leg raise.. Recommended. raise. Sensory examination................ Loss of sensation in affected Recommended. dermatomes. Medical history.................... History of radicular pain.... Highly recommended. Computerized tomography............ Evidence of neural Recommended. compression. Myelogram.......................... Evidence of neural Recommended. compression.Strains and sprains, unspecified: Medical record review.............. History of back pain under Highly recommended. medical treatment for at least 1 year. Medical record review.............. History of back pain Highly recommended. unresponsive to therapy for at least 1 year. Medical record review.............. History of back pain with Highly recommended. functional limitations for at least 1 year. Medical record review.............. Documented history of strain Highly recommended. and/or sprain.Spondylolisthesis grade 1: X-ray-lumbar sacral spine.......... 1-25% slippage............... Recommended. Computerized tomography............ 1-25% slippage............... Recommended. Magnetic resonance imaging......... 1-25% slippage............... Recommended.Spondylolisthesis grade 2: X-ray-lumbar sacral spine.......... 26-50% slippage.............. Recommended. Computerized tomography............ 26-50% slippage.............. Recommended. Magnetic resonance imaging......... 26-50% slippage.............. Recommended.Spondylolisthesis grade 3: X-ray-lumbar sacral spine.......... 51-75% slippage.............. Recommended. Computerized tomography............ 51-75% slippage.............. Recommended. Magnetic resonance imaging......... 51-75% slippage.............. Recommended.Spondylolisthesis grade 4: X-ray-lumbar sacral spine.......... Complete slippage............ Recommended. Computerized tomography............ Complete slippage............ Recommended. Magnetic resonance imaging......... Complete slippage............ Recommended.Spondylolisthesis-acquired: X-ray-lumbar sacral spine.......... Slippage..................... Recommended. Computerized tomography............ Slippage..................... Recommended. Magnetic resonance imaging......... Slippage..................... Recommended.Spondylolsis: X-ray-lumbar sacral spine.......... Defect_pars interarticularis. Recommended. Computerized tomography............ Defect_pars interarticularis. Recommended. Magnetic resonance imaging......... Defect_pars interarticularis. Recommended.Sprains and strains, sacral: Medical record review: lumbar...... History of back pain under Highly recommended. medical treatment for at least 1 year. Medical record review: lumbar...... History of back pain Highly recommended. unresponsive to therapy for at least 1 year. Medical record review: lumbar...... History of back with Highly recommended. functional limitations for at least 1 year. Medical record review: lumbar...... Documented history of strain Highly recommended. and/or sprain.Sprains and strains, sacroiliac: Medical record review: lumbar...... History of back pain under Highly recommended. medical treatment for at least 1 year. Medical record review: lumbar...... History of back pain Highly recommended. unresponsive to therapy for at least 1 year. Medical record review: lumbar...... History of back pain with Highly recommended. functional limitations for at least 1 year. Medical record review: lumbar...... Documented history of strain Highly recommended. and/or sprain.----------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------- Disability test Test result Disability classification---------------------------------------------------------------------------------------------------------------- BODY PART: LS SPINE JOB TITLE: TRAINMAN----------------------------------------------------------------------------------------------------------------Ankylosing spondylitis: Muscle strength assessment......... Lifting capacity diminished D by 50%.Backache, unspecified: Muscle strength assessment......... Lifting capacity diminished D by 50%.Chronic back pain, not otherwise specified: Muscle strength assessment......... Lifting capacity diminished D by 50%.Cauda equina syndrome with bowel or bladder dysfunction: Computerized tomography............ Disc extrusion with neural D impingement, nerves < L1. Magnetic resonance imaging......... Disc extrusion with neural D impingement, nerves < L1. Physical examination............... Lower extremity weakness..... D Cystometrogram..................... Impaired bladder function.... D Myelogram.......................... Disc extrusion with neural D impingement, nerves <L1. Physical examination: rectal....... Impairment of sphincter tone. D Muscle strength assessment......... Lifting capacity diminished D by 50%.Degeneration of lumbar disc: Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Muscle strength assessment......... Lifting capacity diminished D by 50%.Displacement of lumbar disc: Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture: vertebral body: Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture: posterior spinal element with displacement: Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture: posterior spinal element with no displacement: Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture: spinous process: Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture transverse process: Muscle strength assessment......... Lifting capacity diminished D by 50%.Intervertebral disc disorder: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement.Lumbago: Muscle strength assessment......... Lifting capacity diminished D by 50%.Lumbosacral neuritis: Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Muscle strength assessment......... Lifting capacity diminished D by 50%. Physical examination............... Lower extremity weakness..... DLumbar spinal stenosis: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Significant narrowing of the D spinal canal. Magnetic resonance imaging......... Significant narrowing of the D spinal canal. Myelogram.......................... Significant narrowing of the D spinal canal. Physical examination............... Significant lower extremity D weakness.Mechanical complication of internal orthopedic device: Muscle strength assessment......... Lifting capacity diminished D by 50%. X-ray flexion/extension............ Segmental instability........ DOsteomalacia: Muscle strength assessment......... Lifting capacity diminished D by 50%.Osteomyelitis, chronic-lumbar: Muscle strength assessment......... Lifting capacity diminished D by 50%. Medical record review.............. Frequent flare-ups with D objective findings.Osteoporosis: Muscle strength assessment......... Lifting capacity diminished D by 50%.Post laminectomy syndrome with radiculopathy: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Physical examination............... Significant lower extremity D weakness.Post laminectomy syndrome: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Physical examination............... Significant lower extremity D weakness. X-ray flexion/extension............ Segmental instability........ DRadiculopathy: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Physical examination............... Significant lower extremity D weakness.Sciatica: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Physical examination............... Significant lower extremity D weakness.Strains and sprains, unspecified: Muscle strength assessment......... Lifting capacity diminished D by 50%.Spondylolisthesis grade 1: Muscle strength assessment......... Lifting capacity diminished D by 50%. X-ray flexion/extension............ Segmental instability........ DSpondylolisthesis grade 2: Muscle strength assessment......... Lifting capacity diminished D by 50%.Spondylolisthesis grade 3: Muscle strength assessment......... Lifting capacity diminished D by 50%.Spondylolisthesis grade 4: Muscle strength assessment......... Lifting capacity diminished D by 50%. X-ray flexion/extension............ Segmental instability........ DSpondylolisthesis_acquired: X-ray flexion/extension............ Segmental instability........ DSpondylolysis: X-ray flexion/extension............ Segmental instability........ DSprains and strains, sacral: Muscle strength assessment......... Lifting capacity diminished D by 50%.Sprains and strains, sacroiliac: Muscle strength assessment......... Lifting capacity diminished D by 50%.Vertebral body compression fracture: Muscle strength assessment......... Lifting capacity diminished D by 50%.---------------------------------------------------------------------------------------------------------------- BODY PART: LS SPINE JOB TITLE: ENGINEER----------------------------------------------------------------------------------------------------------------Cauda equina syndrome with bowel or bladder dysfunction: Computerized tomography............ Disc extrusion with neural D impingement, nerves <L1. Magnetic resonance imaging......... Disc extrusion with neural D impingement, nerves <L1. Physical examination............... Lower extremity weakness..... D Cystometrogram..................... Impaired bladder function.... D Myelogram.......................... Disc extrusion with neural D impingement, nerves <L1. Physical examination: rectal....... Impairment of sphincter tone. D---------------------------------------------------------------------------------------------------------------- BODY PART: LS SPINE JOB TITLE: CARMAN----------------------------------------------------------------------------------------------------------------Ankylosing spondylitis: Muscle strength assessment......... Lifting capacity diminished D by 50%.Backache, unspecified: Muscle strength assessment......... Lifting capacity diminished D by 50%.Chronic back pain, not otherwise specified: Muscle strength assessment......... Lifting capacity diminished D by 50%.Cauda equina syndrome with bowel or bladder dysfunction: Computerized tomography............ Disc extrusion with neural D impingement, nerves <L1. Magnetic resonance imaging......... Disc extrusion with neural D impingement, nerves <L1. Physical examination............... Lower extremity weakness..... D Cystometrogram..................... Impaired bladder function.... D Myeolgram.......................... Disc extrusion with neural D impingement, nerves <L1. Physical examination: rectal....... Impairment of sphincter tone. D Muscle strength assessment......... Lifting capacity diminished D by 50%.Degeneration of lumbar disc: Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Muscle strength assessment......... Lifting capacity diminished D by 50%.Displacement of lumbar disc: Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture: vertebral body: Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture: posterior spinal element with displacement: Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture: posterior spinal element with no displacement: Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture: spinous process: Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture transverse process: Muscle strength assessment......... Lifting capacity diminished D by 50%.Intervertebral disc disorder: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement.Lumbago: Muscle strength assessment......... Lifting capacity diminished D by 50%.Lumbosacral neuritis: Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Muscle strength assessment......... Lifting capacity diminished D by 50%. Physical examination............... Lower extremity weakness..... DLumbar spinal stenosis: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Significant narrowing of the D spinal canal. Magnetic resonance imaging......... Significant narrowing of the D spinal canal. Myelogram.......................... Significant narrowing of the D spinal canal. Physical examination............... Significant lower extremity D weakness.Mechanical complication of internal orthopedic device: Muscle strength assessment......... Lifting capacity diminished D by 50%. X-ray flexion/extension............ Segmental instability........ DOsteomalacia: Muscle strength assessment......... Lifting capacity diminished D by 50%.Osteomyelitis, chronic-lumbar: Muscle strength assessment......... Lifting capacity diminished D by 50%. Medical record review.............. Frequent flare-ups with D objective findings.Osteoporosis: Muscle strength assessment......... Lifting capacity diminished D by 50%.Post laminectomy syndrome with radiculopathy: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Physical examination............... Significant lower extremity D weakness.Post laminectomy syndrome: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Physical examination............... Significant lower extremity D weakness. X-ray flexion/extension............ Segmental instability........ DRadiculopathy: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Physical examination............... Significant lower extremity D weakness.Sciatica: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Physical examination............... Significant lower extremity D weakness.Strains and sprains, unspecified: Muscle strength assessment......... Lifting capacity diminished D by 50%.Spondylolisthesis grade 1: Muscle strength assessment......... Lifting capacity diminished D by 50%. X-ray flexion/extension............ Segmental instability........ DSpondylolisthesis grade 2: Muscle strength assessment......... Lifting capacity diminished D by 50%.Spondylolisthesis grade 3: Muscle strength assessment......... Lifting capacity diminshed by D 50%.Spondylolisthesis grade 4: Muscle strength assessment......... Lifting capacity diminished D by 50%. X-ray flexion/extension............ Segmental instability........ DSpondylolisthesis-acquired: X-ray flexion/extension............ Segmental instability........ DSpondylolysis: X-ray flexion/extension............ Segmental instability........ DSprains and strains, sacral: Muscle strength assessment......... Lifting capacity diminshed by D 50%.Sprains and strains, sacroiliac: Muscle strength assessment......... Lifting capacity diminished D by 50%.Vertebral body compression fracture: Muscle strength assessment......... Lifting capacity diminshed by D 50%.---------------------------------------------------------------------------------------------------------------- BODY PART: LS SPINE JOB TITLE: SIGNALMAN----------------------------------------------------------------------------------------------------------------Ankylosing spondylitis: Muscle strength assessment......... Lifting capacity diminished D by 50%.Backache, unspecified: Muscle strength assessment......... Lifting capacity diminished D by 50%.Chronic back pain, not otherwise specified: Muscle strength assessment......... Lifting capacity diminished D by 50%.Cauda equina syndrome with bowel or bladder dysfunction: Computerized tomography............ Disc extrusion with neural D impingement, nerves <L1. Magnetic resonance imaging......... Disc extrusion with neural D impingement, nerves <L1. Physical examination............... Lower extremity weakness..... D Cystometrogram..................... Impaired bladder function.... D Myelogram.......................... Disc extrusion with neural D impingement, nerves <L1. Physical examination: rectal....... Impairment of sphincter tone. D Muscle strength assessment......... Lifting capacity diminished D by 50%.Degeneration of lumbar disc: Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Muscle strength assessment......... Lifting capacity diminished D by 50%.Displacement of lumbar disc: Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture: vertebral body: Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture: posterior spinal element with displacement: Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture: posterior spinal element with no displacement: Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture: spinous process: Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture transverse process: Muscle strength assessment......... Lifting capacity diminished D by 50%.Intervertebral disc disorder: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement.Lumbago: Muscle strength assessment......... Lifting capacity diminished D by 50%.Lumbosacral neuritis: Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Muscle strength assessment......... Lifting capacity diminished D by 50%. Physical examination............... Lower extremity weakness..... DLumbar spinal stenosis: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Significant narrowing of the D spinal canal. Magnetic resonance imaging......... Significant narrowing of the D spinal canal. Myelogram.......................... Significant narrowing of the D spinal canal. Physical examination............... Significant lower extremity D weakness.Mechanical complication of internal orthopedic device: Muscle strength assessment......... Lifting capacity diminished D by 50%. X-ray flexion/extension............ Segmental instability........ DOsteomalacia: Muscle strength assessment......... Lifting capacity diminished D by 50%.Osteomyelitis, chronic-lumbar: Muscle strength assessment......... Lifting capacity diminished D by 50%. Medical record review.............. Frequent flare-ups with D objective findings.Osteoporosis: Muscle strength assessment......... Lifting capacity diminished D by 50%.Post laminectomy syndrome with radiculopathy: Muscle strength assessment......... Lifing capacity diminished by D 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Physical examination............... Significant lower extremity D weakness.Post laminectomy syndrome: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Physical examination............... Significant lower extremity D weakness. X-ray flexion/extension............ Segmental instability........ DRadiculopathy: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Physical examination............... Significant lower extremity D weakness.Sciatica: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Physical examination............... Significant lower extremity D weakness.Strains and sprains, unspecified: Muscle strength assessment......... Lifting capacity diminished D by 50%.Spondylolisthesis grade 1: Muscle strength assessment......... Lifting capacity diminished D by 50%. X-ray flexion/extension............ Segmental instability........ DSpondylolisthesis grade 2: Muscle strength assessment......... Lifting capacity diminished D by 50%.Spondylolisthesis grade 3: Muscle strength assessment......... Lifting capacity diminished D by 50%.Spondylolisthesis grade 4: Muscle strength assessment......... Lifting capacity diminished D by 50%. X-ray flexion/extension............ Segmental instability........ DSpondylolisthesis-acquired: X-ray flexion/extension............ Segmental instability........ DSpondylolysis: X-ray flexion/extension............ Segmental instability........ DSprains and strains, sacral: Muscle strength assessment......... Lifting capacity diminished D by 50%.Sprains and strains, sacroiliac: Muscle strength assessment......... Lifting capacity diminished D by 50%.Vertebral body compression fracture: Muscle strength assessment......... Lifting capacity diminished D by 50%.---------------------------------------------------------------------------------------------------------------- BODY PART: LS SPINE JOB TITLE: TRACKMAN----------------------------------------------------------------------------------------------------------------Ankylosing spondylitis: Muscle strength assessment......... Lifting capacity diminished D by 50%.Backache, unspecified: Muscle strength assessment......... Lifting capacity diminished D by 50%.Chronic back pain, not otherwise specified: Muscle strength assessment......... Lifing capacity diminished by D 50%.Cauda equina syndrome with bowel or bladder dysfunction: Computerized tomography............ Disc extrusion with neural D impingement, nerves <L1. Magnetic resonance imaging......... Disc extrusion with neural D impingement, nerves <L1. Physical examination............... Lower extremity weakness..... D Cystometrogram..................... Impaired bladder function.... D Myelogram.......................... Disc extrusion with neural D impingement, nerves <L1. Physical examination: rectal....... Impairment of sphincter tone. D Muscle strength assessment......... Lifting capacity diminished D by 50%.Degeneration of lumbar disc: Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Muscle strength assessment......... Lifting capacity diminished D by 50%.Displacement of lumbar disc: Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture: vertebral body: Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture: posterior spinal element with displacement: Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture: posterior spinal element with no displacement: Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture: spinous process: Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture transverse process: Muscle strength assessment......... Lifting capacity diminished D by 50%.Intervertebral disc disorder: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement.Lumbago: Muscle strength assessment......... Lifting capacity diminished D by 50%.Lumbosacral neuritis: Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Muscle strength assessment......... Lifting capacity diminished D by 50%. Physical examination............... Lower extremity weakness..... DLumbar spinal stenosis: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Significant narrowing of the D spinal canal. Magnetic resonance imaging......... Significant narrowing of the D spinal canal. Myelogram.......................... Significant narrowing of the D spinal canal. Physcial examination............... Significant lower extremity D weakness.Mechanical complication of internal orthopedic device: Muscle strength assessment......... Lifting capacity diminished D by 50%. X-ray flexion/extension............ Segmental instability........ DOsteomalacia: Muscle strength assessment......... Lifting capacity diminished D by 50%.Osteomyelitis, chronic-lumbar: Muscle strength assessment......... Lifting capacity diminished D by 50%. Medical record review.............. Frequent flare-ups with D objective findings.Osteoporosis: Muscle strength assessment......... Lifting capacity diminished D by 50%.Post laminectomy syndrome with radiculopathy: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Physical examination............... Significant lower extremity D weakness.Post laminectomy syndrome: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Physical examination............... Significant lower extremity D weakness. X-ray flexion/extension............ Segmental instability........ DRadiculopathy: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Physical examination............... Significant lower extremity D weakness.Sciatica: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Physical examination............... Significant lower extremity D weakness.Strains and sprains, unspecified: Muscle strength assessment......... Lifting capacity diminished D by 50%.Spondylolisthesis grade 1: Muscle strength assessment......... Lifting capacity diminished D by 50%. X-ray flexion/extension............ Segmental instability........ DSpondylolisthesis grade 2: Muscle strength assessment......... Lifting capacity diminished D by 50%.Spondylolisthesis grade 3: Muscle strength assessment......... Lifting capacity diminished D by 50%.Spondylolisthesis grade 4: Muscle strength assessment......... Lifting capacity diminished D by 50%. X-ray flexion/extension............ Segmental instability........ DSpondylolisthesis-acquired: X-ray flexion/extension............ Segmental instability........ DSpondylolysis: X-ray flexion/extension............ Segmental instability........ DSprains and strains, sacral: Muscle strength assessment......... Lifting capacity diminished D by 50%.Sprains and strains, sacroiliac: Muscle strength assessment......... Lifting capacity diminished D by 50%.Vetebral body compression fracture: Muscle strength assessment......... Lifting capacity diminished .......................................... by 50%.---------------------------------------------------------------------------------------------------------------- BODY PART: LS SPINE JOB TITLE: MACHINIST----------------------------------------------------------------------------------------------------------------Ankylosing spondylitis: Muscle strength assessment......... Lifting capacity diminished D by 50%.Backache, unspecified: Muscle strength assessment......... Lifting capacity diminished D by 50%.Chronic back pain, not otherwise specified: Muscle strength assessment......... Lifting capacity diminished D by 50%.Cauda equina syndrome with bowel or bladder dysfunction: Computerized tomography............ Disc extrusion with neural D impingement, nerves <L1. Magnetic resonance imaging......... Disc extrusion with neural D impingement, nerves <L1. Physical examination............... Lower extremity weakness..... D Cystometrogram..................... Impaired bladder function.... D Myelogram.......................... Disc extrusion with neural D impingement, nerves <L1. Physical examination: rectal....... Impairment of sphincter tone. D Muscle strength assessment......... Lifting capacity diminished D by 50%.Degeneration of lumbar disc: Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Muscle strength assessment......... Lifting capacity diminished D by 50%.Displacement of lumbar disc: Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture: vertebral body: Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture: posterior spinal element with displacement: Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture: posterior spinal element with no displacement: Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture: spinous process: Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture transverse process: Muscle strength assessment......... Lifting capacity diminished D by 50%.Intervertebral disc disorder: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement.Lumbago: Muscle strength assessment......... Lifting capacity diminished D by 50%.Lumbosacral neuritis: Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Muscle strength assessment......... Lifting capacity diminished D by 50%. Physical examination............... Lower extremity weakness..... DLumbar spinal stenosis: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Significant narrowing of the D spinal canal. Magnetic resonance imaging......... Significant narrowing of the D spinal canal. Myelogram.......................... Significant narrowing of the D spinal canal. Physical examination............... Significant lower extremity D weakness.Mechanical complication of internal orthopedic device: Muscle strength assessment......... Lifting capacity diminished D by 50%. X-ray flexion/extension............ Segmental instability........ DOsteomalacia: Muscle strength assessment......... Lifting capacity diminished D by 50%.Osteomyelitis, chronic-lumbar: Muscle strength assessment......... Lifting capacity diminished D by 50%. Medical record review.............. Frequent flare-ups with D objective findings.Osteoporosis: Muscle strength assessment......... Lifting capacity diminished D by 50%.Post laminectomy syndrome with radiculopathy: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Physical examination............... Significant lower extremity D weakness.Post laminectomy syndrome: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Physical examination............... Significant lower extremity D weakness. X-ray flexion/extension............ Segmental instability........ DRadiculopathy: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Physical examination............... Significant lower extremity D weakness.Sciatica: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Physical examination............... Significant lower extremity D weakness.Strains and sprains, unspecified: Muscle strength assessment......... Lifting capacity diminished D by 50%.Spondylolisthesis grade I: Muscle strength assessment......... Lifting capacity diminished D by 50%. X-ray flexion/extension............ Segmental instability........ DSpondylolisthesis grade 2: Muscle strength assessment......... Lifting capacity diminished D by 50%.Spondylolisthesis grade 3: Muscle strength assessment......... Lifting capacity diminished D by 50%.Spondylolisthesis grade 4: Muscle strength assessment......... Lifting capacity diminished D by 50%. X-ray flexion/extension............ Segmental instability........ DSpondylolisthesis-acquired: X-ray flexion/extension............ Segmental instability........ DSpondylolysis: X-ray flexion/extension............ Segmental instability........ DSprains and strains, sacral: Muscle strength assessment......... Lifting capacity diminished D by 50%.Sprains and strains, sacroiliac: Muscle strength assessment......... Lifting capacity diminished D by 50%.Vertebral body compression fracture: Muscle strength assessment......... Lifting capacity diminished D by 50%.---------------------------------------------------------------------------------------------------------------- BODY PART: LS SPINE JOB TITLE: SHOP LABORER----------------------------------------------------------------------------------------------------------------Ankylosing spondylitis: Muscle strength assessment......... Lifting capacity diminished D by 50%.Backache, unspecified: Muscle strength assessment......... Lifting capacity diminished D by 50%.Chronic back pain, not otherwise specified: Muscle strength assessment......... Lifting capacity diminished D by 50%.Cauda equina syndrome with bowel or bladder dysfunction: Computerized tomography............ Disc extrusion with neural D impingement, nerves <L1. Magnetic resonance imaging......... Disc extrusion with neural D impingement, nerves <L1. Physical examination............... Lower extremity weakness..... D Cystometrogram..................... Impaired bladder function.... D Myelogram.......................... Disc extrusion with neural D impingement, nerves <L1. Physical examination: rectal....... Impairment of sphincter tone. D Muscle strength assessment......... Lifting capacity diminished D by 50%.Degeneration of lumbar disc: Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Muscle strength assessment......... Lifting capacity diminished D by 50%.Displacement of lumber disc: Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture: vertebral body: Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture: posterior spinal element with displacement: Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture: posterior spinal element with no displacement: Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture: spinous process: Muscle strength assessment......... Lifting capacity diminished D by 50%.Fracture transverse process: Muscle strength assessment......... Lifting capacity diminished D by 50%.Intervertebral disc disorder: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement.Lumbago: Muscle strength assessment......... Lifting capacity diminished D by 50%.Lumbosacral neuritis: Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Muscle strength assessment......... Lifting capacity diminished D by 50%. Physical examination............... Lower extremity weakness..... DLumbar spinal stenosis: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Significant narrowing of the D spinal canal. Magnetic resonance imaging......... Significant narrowing of the D spinal canal. Myelogram.......................... Significant narrowing of the D spinal canal. Physical examination............... Significant lower extremity D weakness.Mechanical complication of internal orthopedic device: Muscle strength assessment......... Lifting capacity diminished D by 50%. X-ray flexion/extension............ Segmental instability........ DOsteomalacia: Muscle strength assessment......... Lifting capacity diminished D by 50%.Osteomyelitis, chronic-lumbar: Muscle strength assessment......... Lifting capacity diminished D by 50%. Medical record review.............. Frequent flare-ups with D objective findings.Osteoporosis: Muscle strength assessment......... Lifting capacity diminished D by 50%.Post laminectomy syndrome with radiculopathy: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Physical examination............... Significant lower extremity D weakness.Post laminectomy syndrome: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Physical examination............... Significant lower extremity D weakness. X-ray flexion/extension............ Segmental instability........ DRadiculopathy: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Physical examination............... Significant lower extremity D weakness.Sciatica: Muscle strength assessment......... Lifting capacity diminished D by 50%. Computerized tomography............ Disc extrusion with neural D impingement. Magnetic resonance imaging......... Disc extrusion with neural D impingement. Myelogram.......................... Disc extrusion with neural D impingement. Physical examination............... Significant lower extremity D weakness.Strains and sprains, unspecified: Muscle strength assessment......... Lifting capacity diminished D by 50%.Spondylolisthesis grade 1: Muscle strength assessment......... Lifting capacity diminished D by 50%. X-ray flexion/extension............ Segmental instability........ DSpondylolisthesis grade 2: Muscle strength assessment......... Lifting capacity diminished D by 50%.Spondylolisthesis grade 3: Muscle strength assessment......... Lifting capacity diminished D by 50%.Spondylolisthesis grade 4: Muscle strength assessment......... Lifting capacity diminished D by 50%. X-ray flexion/extension............ Segmental instability........ DSpondylolisthesis-acquired: X-ray flexion/extension............ Segmental instability........ DSpondylolysis: X-ray flexion/extension............ Segmental instability........ DSprains and strains, sacral: Muscle strength assessment......... Lifting capacity diminished D by 50%.Sprains and strains, sacroiliac: Muscle strength assessment......... Lifting capacity diminished D by 50%.Vertebral body compression fracture: Muscle strength assessment......... Lifting capacity diminished D by 50%.----------------------------------------------------------------------------------------------------------------
F. Cervical Spine---------------------------------------------------------------------------------------------------------------- Confirmatory test Minimum result Requirements---------------------------------------------------------------------------------------------------------------- BODY PART: CE SPINE CONFIRMATORY TESTS----------------------------------------------------------------------------------------------------------------Cervical disc disease with myelopathy: Physical examination: cervical..... Evidence of myelopathy....... Highly recommended. Myelogram.......................... Evidence of neurogenic Recommended. compression. Computerized axial tomography...... Evidence of neurogenic Recommended. compression. Magnetic resonance imaging......... Evidence of neurogenic Recommended. compression.Chronic herniated disc: X-ray: cervical spine.............. Evidence of significant disc Recommended. degeneration. Myelogram.......................... Evidence of significant disc Recommended. degeneration. Computerized axial tomography...... Evidence of significant disc Recommended. degeneration. Magnetic resonance imaging......... Evidence of significant disc Recommended. degeneration.Cervical spondylolysis: X-ray: cervical spine.............. Evidence of significant disc Recommended. degeneration. Computerized axial tomography...... Evidence of significant disc Recommended. degeneration. Magnetic resonance imaging......... Evidence of significant disc Recommended. degeneration.Cervical intervertebral disc degeneration: X-ray: cervical spine.............. Evidence of significant disc Recommended. degeneration. Myelogram.......................... Evidence of significant disc Recommended. degeneration. Magnetic resonance imaging......... Evidence of significant disc Recommended. degeneration.Fracture: posterior element with spinal canal displacement: X-ray: cervical spine.............. Fractured posterior element Recommended. with canal displacement. Computerized axial tomography...... Fractured posterior element Recommended. with canal displacement. Magnetic resonance imaging......... Fractured posterior element Recommended. with canal displacement.Fracture: transverse, spinous or posterior process: X-ray: cervical spine.............. Fracture of relevant part.... Recommended. Computerized axial tomography...... Fracture of relevant part.... Recommended. Magnetic resonance imaging......... Fracture of relevant part.... Recommended.Osteoarthritis, cervical: X-ray: cervical spine.............. Evidence of extensive disc Recommended. degeneration. Computerized axial tomography...... Evidence of extensive disc Recommended. degeneration. Magnetic resonance imaging......... Evidence of extensive disc Recommended. degeneration.Post laminectomy syndrome: Medical records: cervical.......... Confirmed surgical history... Highly recommended. Medical records: cervical.......... Continued pain post-surgery.. Highly recommended.Radiculopathy: Medical records: cervical.......... History of radicular pain.... Highly recommended. Physical examination: arm.......... Loss of reflexes in affected Recommended. dermatomes. Physical examination: arm.......... Evidence of atrophy [le]2 cm. Recommended. Electromyography................... Definite denervation in Recommended. muscle of affected nerve root. Myelogram.......................... Evidence of neurogenic Recommended. compression. Magnetic resonance imaging......... Compression of spinal nerves. Recommended. Computerized axial tomography...... Compression of spinal nerves. Recommended.Rheumatoid arthritis, cervical: Rheumatoid factor (blood test)..... Titer of rheumatoid factor... Recommended. X-ray: cervical spine.............. Rheumatoid changes of spine.. Highly recommended. Medical records review: cervical... Confirmation by Highly recommended. rheumatologist or internist.Spondylogenic compression of spinal cord: Physical examination: cervical..... Evidence of myelopathy....... Highly recommended. Computerized axial tomography...... Evidence of neurogenic Recommended. compression. Magnetic resonance imaging......... Evidence of neurogenic Recommended. compression. Myelogram.......................... Evidence of neurogenic Recommended. compression.----------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------- Disability test Test result Disability classification---------------------------------------------------------------------------------------------------------------- BODY PART: CE SPINE JOB TITLE: TRAINMAN----------------------------------------------------------------------------------------------------------------Cervical disc disease with myelopathy: Computerized axial tomography...... Significant spinal cord D pressure. Magnetic resonance imaging......... Significant spinal cord D pressure. Myelogram.......................... Significant spinal cord D pressure. Cystometrogram..................... Impaired bladder function.... D Physical examination: rectal....... Impairment of sphincter tone. .......................................... Physical examination: lower limb... Lower extremity weakness or D significant spasticity. Physical examination............... Multi-level neurologic D compromise.Chronic herniated disc: Physical examination............... Multi-level neurologic D compromise.Cervical spondylolysis: Physical examination............... Multi-level neurologic D compromise.Cervical intervertebral disc degeneration: Physical examination............... Multi-level neurologic D compromise.Fracture: posterior element with spinal canal displacement: Physical examination............... Multi-level neurologic D compromise.Post laminectomy syndrome: Physical examination............... Multi-level neurologic D compromise.Cervical radiculopathy: Physical examination............... Multi-level neurologic D compromise.Spondylogenic compression of spinal cord: Computerized axial tomography...... Significant spinal cord D pressure. Magnetic resonance imaging......... Significant spinal cord D pressure. Cystometrogram..................... Impaired bladder function.... D Myelogram.......................... Significant spinal cord D pressure. Physical examination: rectal....... Impairment of sphincter tone. D Physical examination............... Multi-level neurologic D compromise. Physical examination: lower limb... Lower extremity weakness or D significant spasticity.---------------------------------------------------------------------------------------------------------------- BODY PART: CE SPINE JOB TITLE: ENGINEER----------------------------------------------------------------------------------------------------------------Cervical disc disease with myelopathy: Computerized axial tomography...... Significant spinal cord D pressure. Magnetic resonance imaging......... Significant spinal cord D pressure. Myelogram.......................... Significant spinal cord D pressure. Cystometrogram..................... Impaired bladder function.... D Physical examination: rectal....... Impairment of sphincter tone. D Physical examination: lower limb... Lower extremity weakness or D significant spasticity. Physical examination............... Multi-level neurologic D compromise.Chronic herniated disc: Physical examination............... Multi-level neurologic D compromise.Cervical spondylolysis: Physical examination............... Multi-level neurologic D compromise.Cervical intervertebral disc degeneration: Physical examination............... Multi-level neurologic D compromise.Fracture: posterior element with spinal canal displacement: Physical examination............... Multi-level neurologic D compromise.Post laminectomy syndrome: Physical examination............... Multi-level neurologic D compromise.Cervical radiculopathy: Physical examination:.............. Multi-level neurologic D compromise.Spondylogenic compression of spinal cord: Computerized axial tomography...... Significant spinal cord D pressure. Magnetic resonance imaging......... Significant spinal cord D pressure. Cystometrogram..................... Impaired bladder function.... D Myelogram.......................... Significant spinal cord D pressure. Physical examination: rectal....... Impairment of sphincter tone. D Physical examination............... Multi-level neurologic D compromise. Physical examination: lower limb... Lower extremity weakness or D significant spasticity.---------------------------------------------------------------------------------------------------------------- BODY PART: CE SPINE JOB TITLE: DISPATCHER----------------------------------------------------------------------------------------------------------------Cervical disc disease with myelopathy: Cystometrogram..................... Impaired bladder function.... D Physical examination: rectal....... Impairment of sphincter tone. DSpondylogenic compression of spinal cord: Cystometrogram..................... Impaired bladder function.... D Physical examination: rectal....... Impairment of sphincter tone. D---------------------------------------------------------------------------------------------------------------- BODY PART: CE SPINE JOB TITLE: CARMAN----------------------------------------------------------------------------------------------------------------Cervical disc disease with myelopathy: Computerized axial tomography...... Significant spinal cord D pressure. Magnetic resonance imaging......... Significant spinal cord D pressure. Myelogram.......................... Significant spinal cord D pressure. Cystometrogram..................... Impaired bladder function.... D Physical examination: rectal....... Impairment of sphincter tone. D Physical examination: lower limb... Lower extremity weakness or D significant spasticity. Physical examination............... Multi-level neurologic D compromise.Chronic herniated disc: Physical examination............... Multi-level neurologic D compromise.Cervical spondylolysis: Physical examination............... Multi-level neurologic D compromise.Cervical intervertebral disc degeneration: Physical examination............... Multi-level neurologic D compromise.Fracture: posterior element with spinal canal displacement: Physical examination............... Multi-level neurologic D compromise.Post laminectomy syndrome: Physical examination............... Multi-level neurologic D compromise.Cervical radiculopathy: Physical examination............... Multi-level neurologic D compromise.Spondylogenic compression of spinal cord: Computerized axial tomography...... Significant spinal cord D pressure. Magnetic resonance imaging......... Significant spinal cord D pressure. Cystometrogram..................... Impaired bladder function.... D Myelogram.......................... Significant spinal cord D pressure. Physical examination: rectal....... Impairment of sphincter tone. D Physical examination............... Multi-level neurologic D compromise. Physical examination: lower limb... Lower extremity weakness or D significant spasticity.---------------------------------------------------------------------------------------------------------------- BODY PART; CE SPINE JOB TITLE: SIGNALMAN----------------------------------------------------------------------------------------------------------------Cervical disc disease with myelopathy: Computerized axial tomography...... Significant spinal cord D pressure. Magnetic resonance imaging......... Significant spinal cord D pressure. Myelogram.......................... Significant spinal cord D pressure. Cystometrogram..................... Impaired bladder function.... D Physical examination: rectal....... Impairment of sphincter tone. D Physical examination: lower limb... Lower extremity weakness or D significant spasticity. Physical examination............... Multi-level neurologic D compromise.Chronic herniated disc: Physical examination............... Multi-level neurologic D compromise.Cervical spondylolysis: Physical examination............... Multi-level neurologic D compromise.Cervical intervertebral disc degeneration: Physical examination............... Multi-level neurologic D compromise.Fracture: posterior element with spinal canal displacement: Physical examination............... Multi-level neurologic D compromise.Post laminectomy syndrome: Physical examination............... Multi-level neurologic D compromise.Cervical radiculopathy: Physical examination............... Multi-level neurologic D compromise.Spondylogenic compression of spinal cord: Computerized axial tomography...... Significant spinal cord D pressure. Magnetic resonance imaging......... Significant spinal cord D pressure. Cystometrogram..................... Impaired bladder function.... D Myelogram.......................... Significant spinal cord D pressure. Physical examination: rectal....... Impairment of sphincter tone. D Physical examination............... Multi-level neurologic D compromise. Physical examination: lower limb... Lower extremity weakness or D significant spasticity.---------------------------------------------------------------------------------------------------------------- BODY PART: CE SPINE JOB TITLE: TRACKMAN----------------------------------------------------------------------------------------------------------------Cervical disc disease with myelopathy: Computerized axial tomography...... Significant spinal cord D pressure. Magnetic resonance imaging......... Significant spinal cord D pressure. Myelogram.......................... Significant spinal cord D pressure. Cystometrogram..................... Impaired bladder function.... D Physical examination: rectal....... Impairment of sphincter tone. D Physical examination: lower limb... Lower extremity weakness or D significant spasticity. Physical examination............... Multi-level neurologic D compromise.Chronic herniated disc: Physical examination............... Multi-level neurologic D compromise.Cervical spondyloysis: Physical examination............... Multi-level neurologic D compromise.Cervical intervertebral disc degeneration: Physical examination............... Multi-level neurologic D compromise.Fracture: posterior element with spinal canal displacement: Physical examination............... Multi-level neurologic D compromise.Post laminectomy syndrome: Physical examination............... Multi-level neurologic D compromise.Cervical radiculopathy: Physical examination............... Multi-level neurologic D compromise.Spondylogenic compression of spinal cord: Computerized axial tomography...... Significant spinal cord D pressure. Magnetic resonance imaging......... Significant spinal cord D pressure. Cystometrogram..................... Impaired bladder function.... D Myelogram.......................... Significant spinal cord D pressure. Physical examination: rectal....... Impairment of sphincter tone. D Physical examination............... Multi-level neurologic D compromise. Physical examination: lower limb... Lower extremity weakness or D significant spasticity.---------------------------------------------------------------------------------------------------------------- BODY PART: CE SPINE JOB TITLE: MACHINIST----------------------------------------------------------------------------------------------------------------Cervical disc disease with myelopathy: Computerized axial tomography...... Significant spinal cord D pressure. Magnetic resonance imaging......... Significant spinal cord D pressure. Myelogram.......................... Significant spinal cord D pressure. Cystometrogram..................... Impaired bladder function.... D Physical examination: rectal....... Impairment of sphincter tone. D Physical examination: lower limb... Lower extremity weakness or D significant spasticity. Physical examination............... Multi-level neurologic D compromise.Chronic herniated disc: Physical examination............... Multi-level neurologic D compromise.Cervical spondylolysis: Physical examination............... Multi-level neurologic D compromise.Cervical intervertebral disc degeneration: Physical examination............... Multi-level neurologic D compromise.Fracture: posterior element with spinal canal displacement: Physical examination............... Multi-level neurologic D compromise.Post laminectomy syndrome: Physical examination............... Multi-level neurologic D compromise.Cervical radiculopathy: Physical examination............... Multi-level neurologic D compromise.Spondylogenic compression of spinal cord: Computerized axial tomography...... Significant spinal cord D pressure. Magnetic resonance imaging......... Significant spinal cord D pressure. Cystometrogram..................... Impaired bladder function.... D Myelogram.......................... Significant spinal cord D pressure. Physical examination: rectal....... Impairment of sphincter tone. D Physical examination............... Multi-level neurologic D compromise. Physical examination: lower limb... Lower extremity weakness or D significant spasticity.---------------------------------------------------------------------------------------------------------------- BODY PART: CE SPINE JOB TITLE: SHOP LABORER----------------------------------------------------------------------------------------------------------------Cervical disc disease with myelopathy: Computerized axial tomography...... Significant spinal cord D pressure. Magnetic resonance imaging......... Significant spinal cord D pressure. Myelogram.......................... Significant spinal cord D pressure. Cystometrogram..................... Impaired bladder function.... D Physical examination: rectal....... Impairment of sphincter tone. D Physical examination: lower limb... Lower extremity weakness or D significant spasticity. Physical examination............... Multi-level neurologic D compromise.Chronic herniated disc: Physical examination............... Multi-level neurologic D compromise.Cervical spondylolysis: Physical examination............... Multi-level neurologic D compromise.Cervical intervertebral disc degeneration: Physical examination............... Multi-level neurologic D compromise.Fracture: posterior element with spinal canal displacement: Physical examination............... Multi-level neurologic D compromise.Post laminectomy syndrome: Physical examination............... Multi-level neurologic D compromise.Cervical radiculopathy: Physical examination............... Multi-level neurologic D compromise.Spondylogenic compression of spinal cord: Computerized axial tomography...... Significant spinal cord D pressure. Magnetic resonance imaging......... Significant spinal cord D pressure. Cystometrogram..................... Impaired bladder function.... D Myelogram.......................... Significant spinal cord D pressure. Physical examination: rectal....... Impairment of sphincter tone. D Physical examination............... Multi-level neurologic D compromise. Physical examination: lower limb... Lower extremity weakness or D significant spasticity.---------------------------------------------------------------------------------------------------------------- BODY PART: CE SPINE JOB TITLE: SALES REPRESENTATIVE----------------------------------------------------------------------------------------------------------------Cervical disc disease with myelopathy: Cystometrogram..................... Impaired bladder function.... D Physical examination: rectal....... Impairment of sphincter tone. DSpondylogenic compression of spinal cord: Cystometrogram..................... Impaired bladder function.... D Physical examination: rectal....... Impairment of sphincter tone. D---------------------------------------------------------------------------------------------------------------- BODY PART: CE SPINE JOB TITLE: GENERAL OFFICE CLERK----------------------------------------------------------------------------------------------------------------Cervical disc disease with myelopathy: Cystometrogram..................... Impaired bladder function.... D Physical examination: rectal....... Impairment of sphincter tone. DSpondylogenic compression of spinal cord: Cystometrogram..................... Impaired bladder function.... D Physical examination: rectal....... Impairment of sphincter tone. D----------------------------------------------------------------------------------------------------------------
G. Shoulder and Elbow---------------------------------------------------------------------------------------------------------------- Confirmatory test Minimum result Requirements.---------------------------------------------------------------------------------------------------------------- BODY PART: SHOULDER AND ELBOW CONFIRMATORY TESTS----------------------------------------------------------------------------------------------------------------Arthritis, acromioclavicular: X-ray: shoulder.................... Significant degenerative Recommended. changes of joint. Computerized tomography............ Significant degenerative Recommended. changes of joint. Magnetic resonance imaging......... Significant degenerative Recommended. changes of joint.Arthritis, glenohumeral: X-ray: shoulder.................... Significant degenerative Recommended. changes of joint. Computerized tomography............ Significant degenerative Recommended. changes of joint. Magnetic resonance imaging......... Significant degenerative Recommended. changes of joint.Rotator cuff tear: Computerized tomography............ Tear of rotator cuff......... Recommended. Magnetic resonance imaging......... Tear of rotator cuff......... Recommended.Medical diagnosis leading to a permanent functional limitation of the elbow: Medical record review.............. Condition with permanent Highly recommended. functional limitation. X-ray: elbow....................... Imaging confirmation of Recommended. functional diagnosis. Magnetic resonance imaging......... Imaging confirmation of Recommended. functional diagnosis.----------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------- Disability test Test result Disability classification---------------------------------------------------------------------------------------------------------------- BODY PART: SHOULDER AND ELBOW JOB TITLE: TRAINMAN----------------------------------------------------------------------------------------------------------------Arthritis, acromioclavicular: Physical examination_range of <40 degrees flexion....... D motion. Physical examination_range of <40 degrees abduction..... D motion.Arthritis, glenohumeral: Physical examination_range of <40 degrees flexion....... D motion. Physical examination_range of <40 degrees abduction..... D motion.Rotator cuff tear: Physical examination_range of <40 degrees flexion....... D motion. Physical examination_range of <40 degrees abduction..... D motion.Permanent functional limitation, elbow: Physical examination............... [le]40 degrees deviation..... D Physical examination_range of Flexion limit to 60 degrees.. D motion.---------------------------------------------------------------------------------------------------------------- BODY PART: SHOULDER AND ELBOW JOB TITLE: ENGINEER----------------------------------------------------------------------------------------------------------------Arthritis, acromioclavicular: Physical examination_range of <40 degrees flexion....... D motion. Physical examination_range of <40 degrees abduction..... D motion.Arthritis, glenohumeral: Physical examination_range of <40 degrees flexion....... D motion. Physical examination_range of <40 degrees abduction..... D motion.Rotator cuff tear: Physical examination_range of <40 degrees flexion....... D motion. Physical examination_range of <40 degrees abduction..... D moiton.Permanent functional limitation, elbow: Physical examination............... [le]40 degrees deviation..... D Physical examination_range of Flexion limit to 60 degrees.. D motion.---------------------------------------------------------------------------------------------------------------- BODY PART: SHOULDER AND ELBOW JOB TITLE: CARMAN----------------------------------------------------------------------------------------------------------------Arthritis, acromioclavicular: Physical examination_range of <40 degrees flexion....... D motion. Physical examination_range of <40 degrees abduction..... D motion.Arthritis, glenohumeral: Physical examination_range of <40 degrees flexion....... D motion. Physical examination_range of <40 degrees abduction..... D motion.Rotator cuff tear: Physical examination_range of <40 degrees flexion....... D motion. Physical examination_range of <40 degrees abduction..... D motion.Permanent functional limitation, elbow: Physical examination............... [le]40 degrees deviation..... D Physical examination_range of Flexion limit to 60 degrees.. D motion.---------------------------------------------------------------------------------------------------------------- BODY PART: SHOULDER AND ELBOW JOB TITLE: SIGNALMAN----------------------------------------------------------------------------------------------------------------Arthritis, acromioclavicular: Physical examination_range of <40 degrees flexion....... D motion. Physical examination_range of <40 degrees abduction..... D motion.Arthritis, glenohumeral: Physical examination_range of <40 degrees flexion....... D motion. Physical examination_range of <40 degrees abduction..... D motion.Rotator cuff tear: Physical examination_range of <40 degrees flexion....... D motion. Physical examination_range of <40 degrees abduction..... D motion.Permanent functional limitation, elbow: Physical examination............... [le]40 degrees deviation..... D Physical examination_range of Flexion limit to 60 degrees.. D motion.---------------------------------------------------------------------------------------------------------------- BODY PART: SHOULDER AND ELBOW JOB TITLE: TRACKMAN----------------------------------------------------------------------------------------------------------------Arthritis, acromioclavicular: Physical examination_range of <40 degrees flexion....... D motion. Physical examination_range of <40 degrees abduction..... D motion.Arthritis, glenohumeral: Physical examination_range of <40 degrees flexion....... D motion. Physical examination_range of <40 degrees abduction..... D motion.Rotator cuff tear: Physical examination_range of <40 degrees flexion....... D motion. Physical examination_range of <40 degrees abduction..... D motion.Permanent functional limitation, elbow: Physical examination............... [le]40 degrees deviation..... D Physical examination_range of Flexion limit to 60 degrees.. D motion.---------------------------------------------------------------------------------------------------------------- BODY PART: SHOULDER AND ELBOW JOB TITLE: MACHINIST----------------------------------------------------------------------------------------------------------------Arthritis, acromioclavicular: Physical examination_range of <40 degrees flexion....... D motion. Physical examination_range of <40 degrees abduction..... D motion.Arthritis, glenohumeral: Physical examination_range of <40 degrees flexion....... D motion. Physical examination_range of <40 degrees abduction..... D motion.Rotator cuff tear: Physical examination_range of <40 degrees flexion....... D motion. Physical examination_range of <40 degrees abduction..... D motion.Permanent functional limitation, elbow: Physical examination............... [le]40 degrees deviation..... D Physical examination_range of Flexion limit to 60 degrees.. D motion.---------------------------------------------------------------------------------------------------------------- BODY PART: SHOULDER AND ELBOW JOB TITLE: SHOP LABORER----------------------------------------------------------------------------------------------------------------Arthritis, acromioclavicular: Physical examination_range of <40 degrees flexion....... D motion. Physical examination_range of <40 degrees abduction..... D motion.Arthritis, glenohumeral: Physical examination_range of <40 degrees flexion....... D motion. Physical examination_range of <40 degrees abduction..... D motion.Rotator cuff tear: Physical examination_range of <40 degrees flexion....... D motion. Physical examination_range of <40 degrees abduction..... D motion.Permanent functional limitation, elbow: Physical examination............... [le]40 degrees deviation..... D Physical examination_range of Flexion limit to 60 degrees.. D motion.----------------------------------------------------------------------------------------------------------------
H. Hand and Arm---------------------------------------------------------------------------------------------------------------- Confirmatory test Minimum result Requirements---------------------------------------------------------------------------------------------------------------- BODY PART: HAND AND ARM CONFIRMATORY TESTS----------------------------------------------------------------------------------------------------------------Carpal tunnel syndrome: Medical record review.............. Pain, paresthesia and Highly recommended. weakness in distribution median nerve. Nerve conduction testing........... Definite median nerve Highly recommended. conduction slowing at wrist. Electromyography................... Denervation in severe cases.. Recommended.Fracture: wrist: X-ray: wrist....................... Evidence of fracture......... Highly recommended.Hand: permanent functional limitation: Medical record review.............. Documentation of medical Highly recommended. condition for permanent limitation. Physical examination............... Definite reproducible Highly recommended. evidence of limitation. Imaging study (e.g. X-ray, CAT, Positive confirmation of Highly recommended. MRI). underlying condition.Rheumatoid arthritis: hand: Rheumatoid factor.................. Titer of rheumatoid factor... Recommended. Medical record review.............. History of objective findings Highly recommended. including serological studies. X-ray: hand........................ Characteristic rheumatoid Highly recommended. changes.Tenosynovitis: Medical record review.............. History of chronic Highly recommended. tenosynovitis and objective findings. Physical examination............... Definite evidence of Highly recommended. tenosynovitis.Thumb: Permanent functional limitation: Medical record review.............. Documentation of medical Highly recommended. condition for permanent limitation. Physical examination............... Definite reproducible Highly recommended. evidence of limitation. Imaging study (X-ray, CAT, MRI).... Positive confirmation of Highly recommended. underlying condition.Wrist: Permanent functional limitation: Medical record review.............. Documentation of medical Highly recommended. condition for permanent limitation. Physical examination............... Definite reproducible Highly recommended. evidence of limitation. Imaging study (e.g. X-ray, CAT, Positive confirmation of Highly recommended. MRI). underlying condition.----------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------- Disability test Test result Disability classification---------------------------------------------------------------------------------------------------------------- BODY PART: HAND AND ARM JOB TITLE: TRAINMAN----------------------------------------------------------------------------------------------------------------Fracture, wrist: Physical examination_range of Extension_limit to 30 degrees D motion. Physical examination_range of Flexion_limit to 30 degrees.. D motion. Physical examination_range of Ankylosis: [le]20 degrees D motion. from neutral.Rheumatoid arthritis hand: Physical examination............... Significant deformity........ D Medical record review.............. Significant flare-ups, under D treatment with rheumatologist. Medical record review.............. Extensive medication use, D under treatment with rheumatologist.Thumb: permanent functional limitation: Adduction of thumb................. Loss [le]4 cm................ D Ankylosis: degree from neutral..... <20 degrees extension..... D Ankylosis: degree from neutral..... <40 degrees flexion....... D Loss of extension or flexion....... MCP or PIP: maximum flexion D <40 degrees. Opposition......................... Loss [le]4 cm................ D Wrist: permanent functional limitation:. Physical examination_range of Extension_limit to 30 degrees D motion. Physical examination_range of Flexion_limit to 30 degrees.. D motion. Physical examination_range of Ankylosis: [le]20 degrees D motion. from neutral.---------------------------------------------------------------------------------------------------------------- BODY PART: HAND AND ARM JOB TITLE ENGINEER----------------------------------------------------------------------------------------------------------------Fracture, wrist: Physical examination_range of Extension-limit to 30 degrees D motion. Physical examination_range of Flexion-limit to 30 degrees.. D motion. Physical examination_range of Ankylosis: [le]20 degrees D motion. from neutral.Rheumatoid arthritis hand: Physical examination............... Significant deformity........ D Medical record review.............. Significant flare-ups, under D treatment with rheumatologist. Medical record review.............. Extensive medication use, D under treatment with rheumatologist.Thumb: permanent functional limitation: Adduction of thumb................. Loss [le]4 cm................ D Ankylosis: degree from neutral..... <20 degrees extension..... D Ankylosis: degree from neutral..... <40 degrees flexion....... D Loss of extension or flexion....... MCP or PIP: maximum flexion D <40 degrees. Opposition......................... Loss [le]4 cm................ DWrist: permanent functional limitation: Physical examination_range of Extension_limit to 30 degrees D motion. Physical examination_range of Flexion_limit to 30 degrees.. D motion. Physical examination_range of Ankylosis: [le]20 degrees D motion. from neutral.---------------------------------------------------------------------------------------------------------------- BODY PART: HAND AND ARM JOB TITLE: DISPATCHER----------------------------------------------------------------------------------------------------------------Fracture, wrist: Physical examination_range of Extension_limit to 30 degrees D motion. Physical examination_range of Flexion_limit to 30 degrees.. D motion. Physical examination_range of Ankylosis: [le]20 degrees D motion. from neutral.Rheumatoid arthritis hand: Physical examination............... Significant deformity........ D Medical record review.............. Significant flare-ups, under D treatment with rheumatologist. Medical record review.............. Extensive medication use, D under treatment with rheumatologist.Thumb: permanent functional limitation: Adduction of thumb................. Loss [le]4 cm................ D Ankylosis: degree from neutral..... <20 degrees extension..... D Ankylosis: degree from neutral..... <40 degrees flexion....... D Loss of extension or flexion....... MCP or PIP: maximum flexion D <40 degrees. Opposition......................... Loss [le]4 cm................ DWrist: permanent functional limitation: Physical examination_range of Extension_limit to 30 degrees D motion. Physical examination_range of Flexion_limit to 30 degrees.. D motion. Physical examination_range of Ankylosis: [le]20 degrees D motion. from neutral.---------------------------------------------------------------------------------------------------------------- BODY PART: HAND AND ARM JOB TITLE: CARMAN----------------------------------------------------------------------------------------------------------------Fracture, wrist: Physical examination_range of Extension_limit to 30 degrees D motion. Physical examination_range of Flexion_limit to 30 degrees.. D motion. Physical examination_range of Ankylosis: [le]20 degrees D motion. from neutral.Rheumatoid arthritis hand: Physical examination............... Significant deformity........ D Medical record review.............. Significant flare-ups, under D treatment with rheumatologist. Medical record review.............. Extensive medication use, D under treatment with rheumatologist.Thumb: permanent functional limitation: Adduction of thumb:................ Loss [le]4 cm................ D Ankylosis: degree from neutral..... <20 degrees extension..... D Ankylosis: degree from neutral..... <40 degrees flexion....... D Loss of extension or flexion....... MCP of PIP: maximum flexion D <40 degrees. Opposition......................... Loss [le]4 cm................ DWrist: permanent functional limitation: Physical examination_range of Extension_limit to 30 degrees D motion. Physical examination_range of Flexion_limit to 30 degrees.. D motion. Physical examination_range of Ankylosis: [le]20 degrees D motion. from neutral.---------------------------------------------------------------------------------------------------------------- BODY PART: HAND AND ARM JOB TITLE: SIGNALMAN----------------------------------------------------------------------------------------------------------------Fracture, wrist: Physical examination_range of Extension_limit to 30 degrees D motion. Physical examination_range of Flexion_limit to 30 degrees.. D motion. Physical examination_range of Ankylosis: [le]20 degrees D motion. from neutral.Rheumatoid arthritis hand: Physical examination............... Significant deformity........ D Medical record review.............. Significant flare-ups, under D treatment with rheumatologist. Medical record review.............. Extensive medication use, D under treatment with rheumatologist.Thumb: permanent functional limitation: Adduction of thumb................. Loss [le]4 cm................ D Ankylosis: degree from neutral..... <20 degrees extension..... D Ankylosis: degree from neutral..... <40 degrees flexion....... D Loss of extension or flexion....... MCP or PIP: maximum flexion D <40 degrees. Opposition......................... Loss [le]4 cm................ DWrist: permanent functional limitation: Physical examination_range of Extension_limit to 30 degrees D motion. Physical examination_range of Flexion_limit to 30 degrees.. D motion. Physical examination_range of Ankylosis: [le]20 degrees D motion. from neutral.---------------------------------------------------------------------------------------------------------------- BODY PART: HAND AND ARM JOB TITLE: TRACKMAN----------------------------------------------------------------------------------------------------------------Fracture, wrist: Physical examination_range of Extension_limit to 30 degrees D motion. Physical examination_range of Flexion_limit to 30 degrees.. D motion. Physical examination_range of Ankylosis: [le]20 degrees D motion. from neutral.Rheumatoid arthritis hand: Physical examination............... Significant deformity........ D Medical record review.............. Significant flare-ups, under D treatment with rheumatologist. Medical record review.............. Extensive medication use, D under treatment with rheumatologist.Thumb: permanent functional limitation: Adduction of thumb................. Loss [le]4 cm................ D Ankylosis: degree from neutral..... <20 degrees extension..... D Ankylosis: degree from neutral..... <40 degrees flexion....... D Loss of extension or flexion....... MCP or PIP: maximum flexion D <40 degrees. Opposition......................... Loss [le]4 cm................ DWrist: permanent functional limitation: Physical examination_range of Extension_limit to 30 degrees D motion. Physical examination_range of Flexion_limit to 30 degrees.. D motion. Physical examination_range of Ankylosis: [le]20 degrees D motion. from neutral.---------------------------------------------------------------------------------------------------------------- BODY PART: HAND AND ARM JOB TITLE: MACHINIST----------------------------------------------------------------------------------------------------------------Fracture, wrist: Physical examination_range of Extension_limit to 30 degrees D motion. Physical examination_range of Flexion_limit to 30 degrees.. D motion. Physical examination_range of Ankylosis: [le]20 degrees D motion. from neutral.Rheumatoid arthritis hand: Physical examination............... Significant deformity........ D Medical record review.............. Significant flare-ups, under D treatment with rheumatologist. Medical record review.............. Extensive medication use, D under treatment with rheumatologist.Thumb: permanent functional limitation: Adduction of thumb................. Loss [le]4 cm................ D Ankylosis: degree from neutral..... <20 degrees extension..... D Ankylosis: degree from neutral..... <40 degrees flexion....... D Loss of extension or flexion....... MCP or PIP: maximum flexion D <40 degrees. Opposition......................... Loss [le]4 cm................ DWrist: permanent functional limitation: Physical examination_range of Extension_limit to 30 degrees D motion. Physical examination_range of Flexion_limit to 30 degrees.. D motion. Physical examination_range of Ankylosis: [le]20 degrees D motion. from neutral.---------------------------------------------------------------------------------------------------------------- BODY PART: HAND AND ARM JOB TITLE: SHOP LABORER----------------------------------------------------------------------------------------------------------------Fracture, wrist: Physical examination_range of Extension_limit to 30 degrees D motion. Physical examination_range of Flexion_limit to 30 degrees.. D motion. Physical examination_range of Ankylosis: [le]20 degrees D motion. from neutral.Rheumatoid arthritis hand: Physical examination............... Significant deformity........ D Medical record review.............. Significant flare-ups, under D treatment with rheumatologist. Medical record review.............. Extensive medication use, D under treatment with rheumatologist.Thumb: permanent functional limitation: Adduction of thumb................. Loss [le]4 cm................ D Ankylosis: degree from neutral..... <20 degrees extension..... D Ankylosis: degree from neutral..... <40 degrees flexion....... D Loss of extension or flexion....... MCP or PIP: maximum flexion D <40 degrees. Opposition......................... Loss [le]4 cm................ DWrist: permanent functional limitation: Physical examination_range of Extension_limit to 30 degrees D motion. Physical examination_range of Flexion_limit to 30 degrees.. D motion. Physical examination_range of Ankylosis: [le]20 degrees D motion. from neutral.---------------------------------------------------------------------------------------------------------------- BODY PART: HAND AND ARM JOB TITLE: SALES REPRESENTATIVE----------------------------------------------------------------------------------------------------------------Fracture, wrist: Physical examination_range of Extension_limit to 30 degrees D motion. Physical examination_range of Flexion_limit to 30 degrees.. D motion. Physical examination_range of Ankylosis: [le]20 degrees D motion. from neutral.Rheumatoid arthritis hand: Physical examination............... Significant deformity........ D Medical record review.............. Significant flare-ups, under D treatment with rheumatologist. Medical record review.............. Extensive medication use, D under treatment with rheumatologist.Thumb: permanent functional limitation: Adduction of thumb................. Loss [le]4 cm................ D Ankylosis: degree from neutral..... <20 degrees extension..... D Ankylosis: degree from neutral..... <40 degrees flexion....... D Loss of extension or flexion....... MCP or PIP: maximum flexion D <40 degrees. Opposition......................... Loss [le]4 cm................ DWrist: permanent functional limitation: Physical examination_range of Extension_limit to 30 degrees D motion. Physical examination_range of Flexion_limit to 30 degrees.. D motion. Physical examination_range of Ankylosis: [le]20 degrees D motion. from neutral.---------------------------------------------------------------------------------------------------------------- BODY PART: HAND AND ARM JOB TITLE: GENERAL OFFICE CLERK----------------------------------------------------------------------------------------------------------------Fracture, wrist: Physical examination_range of Extension_limit to 30 degrees D motion. Physical examination_range of Flexion_limit to 30 degrees.. D motion. Physical examination_range of Ankylosis: [le]20 degrees D motion. from neutral.Rheumatoid arthritis hand: Physical examination............... Significant deformity........ D Medical record review.............. Significant flare-ups, under D treatment with rheumatologist. Medical record review.............. Extensive medication use, D under treatment with rheumatologist.Thumb: permanent functional limitation: Adduction of thumb................. Loss [le]4 cm................ D Ankylosis: degree from neutral..... <20 degree extension...... D Ankylosis: degree from neutral..... <40 degree flexion........ D Loss of extension or flexion....... MCP or PIP: maximum flexion D <40 degrees. Opposition......................... Loss [le]4 cm................ DWrist: permanent functional limitation: Physical examination_range of Extension_limit to 30 degrees D motion. Physical examination_range of Flexion_limit to 30 degrees.. D motion. Physical examination_range of Ankylosis: [le]20 degrees D motion. from neutral.----------------------------------------------------------------------------------------------------------------
I. Hip---------------------------------------------------------------------------------------------------------------- Confirmatory test Minimum result Requirements---------------------------------------------------------------------------------------------------------------- BODY PART: HIP CONFIRMATORY TESTS----------------------------------------------------------------------------------------------------------------Ankylosis, hip: X-ray: hip......................... Extreme joint destruction.... Highly Recommended. Physical examination_range of No mobility.................. Highly Recommended. motion.Osteoarthritis, hip: X-ray: hip......................... <4 mm joint space, or Recommended. other positive evidence. Magnetic resonance imaging......... <4 mm joint space, or Recommended. other positive evidence. Computerized axial tomography...... <4 mm joint space, or Recommended. other positive evidence.Osteomyelitis, hip: X-ray: hip......................... Evidence of chronic infection Recommended. Computerized axial tomography...... Evidence of chronic infection Recommended.Paget's disease: X-ray: hip......................... Osteolytic or blastic lesions Highly Recommended. Alkaline phosphatase............... Increased up to 50 times..... Highly Recommended.Hip replacement surgery: X-ray: hip......................... Evidence of artificial hip... Recommended. Medical record review.............. Documentation of prior hip Recommended. replacement.----------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------- Disability test Test result Disability classification---------------------------------------------------------------------------------------------------------------- BODY PART: HIP JOB TITLE: TRAINMAN----------------------------------------------------------------------------------------------------------------Ankylosis, hip: Physical examination_range of Ankylosis 5 degrees or D motion. [le]flexion. Physical examination_range of Ankylosis internal rotation D motion. [le]5 degrees. Physical examination_range of Ankylosis external rotation D motion. [le]10 degrees. Physical examination_range of Ankylosis in abduction [le]5 D motion. degrees. Physical examination_range of Ankylosis in adduction [le]5 D motion. degrees.Osteoarthritis, hip: X-ray: hip......................... 0 mm cartilage interval...... D Physical examination_range of 30 degrees flexion D motion. contracture. Physical examination_range of <50 degrees flexion....... D motion. Physical examination_range of <5 degrees abduction...... D motion.Osteomyelitis, chronic hip: X-ray: hip......................... Significant joint destruction D Physical examination_range of 30 degrees flexion D motion. contracture. Physical examination_range of <50 degrees flexion....... D motion. Physical examination_range of <5 degrees abduction...... D motion. Medical record review.............. Documented occurrence of D recurring infections with treatment.Paget's disease: X-ray: hip......................... Significant joint destruction D Physical examination_range of 30 degrees flexion D motion. contracture. Physical examination_range of <50 degrees flexion....... D motion. Physical examination_range of <5 degrees abduction...... D motion.Hip replacement surgery: X-ray: hip......................... Evidence of artificial hip D joint. Medical record review.............. Documentation of prior hip D replacement.---------------------------------------------------------------------------------------------------------------- BODY PART: HIP JOB TITLE: ENGINEER----------------------------------------------------------------------------------------------------------------Ankylosis, hip: Physical examination_range of Ankylosis 5 degrees or D motion. [le]flexion. Physical examination_range of Ankylosis internal rotation D motion. [le]5 degrees. Physical examination_range of Ankylosis external rotation D motion. [le]10 degrees. Physical examination_range of Ankylosis in abduction [le]5 D motion. degrees. Physical examination_range of Ankylosis in adduction [le]5 D motion. degrees.Osteoarthritis, hip: X-ray: hip......................... 0 mm cartilage interval...... D Physical examination_range of 30 degrees flexion D motion. contracture. Physical examination_range of <50 degrees flexion....... D motion. Physical examination_range of <5 degrees abduction...... D motion.Osteomyelitis, chronic hip: X-ray: hip......................... Signficant joint destruction. D Physical examination_range of 30 degrees flexion D motion. contracture. Physical examination_range of <50 degrees flexion....... D motion. Physical examination_range of <5 degrees abduction...... D motion. Medical record review.............. Documented occurrence of D recurring infections with treatment.Paget's disease: X-ray: hip......................... Significant joint destruction D Physical examination_range of 30 degrees flexion D motion. contracture. Physical examination_range of <50 degrees flexion....... D motion. Physical examination_range of <5 degrees abduction...... D motion.Hip replacement surgery: X-ray: hip......................... Evidence of artificial hip D joint. Medical record review.............. Documentation of prior hip D replacement.---------------------------------------------------------------------------------------------------------------- BODY PART: HIP JOB TITLE: CARMAN----------------------------------------------------------------------------------------------------------------Ankylosis, hip: Physical examination_range of Ankylosis 5 degrees or D motion. [le]flexion. Physical examination_range of Ankylosis internal rotation D motion. [le]5 degrees. Physical examination_range of Ankylosis external rotation D motion. [le]10 degrees. Physical examination_range of Ankylosis in abduction [le]5 D motion. degrees. Physical examination_range of Ankylosis in adduction [le]5 D motion. degrees.Osteoarthritis, hip: X-ray: hip......................... 0 mm cartilage interval...... D Physical examination_range of 30 degrees flexion D motion. contracture. Physical examination_range of <50 degrees flexion....... D motion. Physical examination_range of <5 degrees abduction...... D motion.Osteomyelitis, chronic hip: X-ray: hip......................... Significant joint destruction D Physical examination_range of 30 degrees flexion D motion. contracture. Physical examination_range of <50 degrees flexion....... D motion. Physical examination_range of <5 degrees abduction...... D motion. Medical record review.............. Documented occurrence of D recurring infections with treatment.Paget's disease: X-ray: hip......................... Significant joint destruction D Physical examination_range of 30 degrees flexion D motion. contracture. Physical examination_range of <50 degrees flexion....... D motion. Physical examination_range of <5 degrees abduction...... D motion.Hip replacement surgery: X-ray: hip......................... Evidence of artificial hip D joint. Medical record review.............. Documentation of prior hip D replacement.---------------------------------------------------------------------------------------------------------------- BODY PART: HIP JOB TITLE: SIGNALMAN----------------------------------------------------------------------------------------------------------------Ankylosis, hip: Physical examination_range of Ankylosis 5 degrees or D motion. [le]flexion. Physical examination_range of Ankylosis internal rotation D motion. [le]5 degrees. Physical examination_range of Ankylosis external rotation D motion. [le]10 degrees. Physical examination_range of Ankylosis in abduction [le]5 D motion. degrees. Physical examination_range of Ankylosis in adduction [le]5 D motion. degrees.Osteoarthritis, hip: X-ray: hip......................... 0 mm cartilage interval...... D Physical examination_range of 30 degrees flexion D motion. contracture. Physical examination_range of <50 degrees flexion....... D motion. Physical examination_range of <5 degrees abduction...... D motion.Osteomyelitis, chronic hip: X-ray: hip......................... Significant joint destruction D Physical examination_range of 30 degrees flexion D motion. contracture. Physical examination_range of <50 degrees flexion....... D motion. Physical examination_range of <5 degrees abduction...... D motion. Medical record review.............. Documented occurrence of D recurring infections with treatment.Paget's disease: X-ray: hip......................... Significant joint destruction D Physical examination_range of 30 degrees flexion D motion. contracture. Physical examination_range of <50 degrees flexion....... D motion. Physical examination_range of <5 degrees abduction...... D motion.Hip replacement surgery: X-ray: hip......................... Evidence of artificial hip D joint. Medical record review.............. Documentation of prior hip D replacement.---------------------------------------------------------------------------------------------------------------- BODY PART: HIP JOB TITLE: TRACKMAN----------------------------------------------------------------------------------------------------------------Ankylosis, hip: Physical examination_range of Ankylosis 5 degrees or D motion. [le]flexion. Physical examination_range of Ankylosis internal rotation D motion. [le]5 degrees. Physical examination_range of Ankylosis external rotation D motion. [le]10 degrees. Physical examination_range of Ankylosis in abduction [le]5 D motion. degrees. Physical examination_range of Ankylosis in adduction [le]5 D motion. degrees.Osteoarthritis, hip: X-ray: hip......................... 0 mm cartilage interval...... D Physical examination_range of 30 degrees flexion D motion. contracture. Physical examination_range of <50 degrees flexion....... D motion. Physical examination_range of <5 degrees abduction...... D motion.Osteomyelitis, chronic hip: X-ray: hip......................... Significant joint destruction D Physical examination_range of 30 degrees flexion D motion. contracture. Physical examination_range of <50 degrees flexion....... D motion. Physical examination_range of <5 degrees abduction...... D motion. Medical record review.............. Documented occurrence of D recurring infections with treatment.Paget's disease: X-ray: hip......................... Significant joint destruction D Physical examination_range of 30 degrees flexion D motion. contracture. Physical examination_range of <50 degrees flexion....... D motion. Physical examination_range of <5 degrees abduction...... D motion.Hip replacement surgery: X-ray: hip......................... Evidence of artificial hip D joint. Medical record review.............. Documentation of prior hip D replacement.---------------------------------------------------------------------------------------------------------------- BODY PART: HIP JOB TITLE: MACHINIST----------------------------------------------------------------------------------------------------------------Ankylosis, hip: Physical examination_range of Ankylosis 5 degrees or D motion. [le]flexion. Physical examination_range of Ankylosis internal rotation D motion. [le]5 degrees. Physical examination_range of Ankylosis external rotation D motion. [le]10 degrees. Physical examination_range of Ankylosis in abduction [le]5 D motion. degrees. Physical examination_range of Ankylosis in adduction [le]5 D motion. degrees.Osteoarthritis, hip: X-ray: hip......................... 0 mm cartilage interval...... D Physical examination_range of 30 degrees flexion D motion. contracture. Physical examination_range of <50 degrees flexion....... D motion. Physical examination_range of <5 degrees abduction...... D motion.Osteomyelitis, chronic hip: X-ray: hip......................... Significant joint destruction D Physical examination_range of 30 degrees flexion D motion. contracture. Physical examination_range of <50 degrees flexion....... D motion. Physical examination_range of <5 degrees abduction...... D motion. Medical record review.............. Documented occurrence of D recurring infections with treatment.Paget's disease: X-ray: hip......................... Significant joint destruction D Physical examination_range of 30 degrees flexion D motion. contracture. Physical examination_range of <50 degrees flexion....... D motion. Physical examination_range of <5 degrees abudction...... D motion.Hip replacement surgery: X-ray: hip......................... Evidence of artificial hip D joint. Medical record review.............. Documentation of prior hip D replacement.---------------------------------------------------------------------------------------------------------------- BODY PART: HIP JOB TITLE: SHOP LABORER----------------------------------------------------------------------------------------------------------------Ankylosis, hip: Physical examination_range of Ankylosis 5 degrees of D motion. [le]flexion. Physical examination_range of Ankylosis internal rotation D motion. [le]5 degrees. Physical examination_range of Ankylosis external rotation D motion. [le]10 degrees. Physical examination_range of Ankylosis in abduction [le]5 D motion. degrees. Physical examination_range of Ankylosis in adduction [le]5 D motion. degrees.Osteoarthritis, hip: X-ray: hip......................... 0 mm cartilage interval...... D Physical examination_range of 30 degrees flexion D motion. contracture. Physical examination_range of <50 degrees flexion....... D motion. Physical examination_range of <5 degrees abduction...... D motion.Osteomyelitis, chronic hip: X-ray: hip......................... Significant joint destruction D Physical examination_range of 30 degrees flexion D motion. contracture. Physical examination_range of <50 degrees flexion....... D motion. Physical examination_range of <5 degrees abduction...... D motion. Medical record review.............. Documented occurrence of D recurring infections with treatment.Paget's disease: X-ray; hip......................... Significant joint destruction D Physical examination_range of 30 degrees flexion D motion. contracture. Physical examination_range of <50 degrees flexion....... D motion. Physical examination_range of <5 degrees abduction...... D motion.Hip replacement surgery: X-ray: hip......................... Evidence of artificial hip D joint. Medical record review.............. Documentation of prior hip D replacement.----------------------------------------------------------------------------------------------------------------
J. Knee---------------------------------------------------------------------------------------------------------------- Confirmatory test Minimum result Requirements---------------------------------------------------------------------------------------------------------------- BODY PART: KNEE CONFIRMATORY TESTS----------------------------------------------------------------------------------------------------------------Arthritis: knee: X-ray: knee........................ Evidence of significant Recommended. degenerative changes.Collateral ligament tear with laxity: Physical examination: knee......... Evidence of ligamentous Highly Recommended. laxity. Magnetic resonance imaging......... Evidence of ligamentous tear. Recommended.Cruciate and collateral ligament tear with laxity: Magnetic resonance imaging......... Tear of both ligaments....... Recommended. Physical examination............... Evidence of ligamentous Highly Recommended. laxity. Medical record review.............. Documentation of tear by Recommended. arthroscopy.Cruciate ligament tear with laxity: Physical examination: knee......... Evidence of ligamentous Highly Recommended. laxity. Magnetic resonance imaging......... Evidence of cruciate tear.... Recommended. Medical record review.............. Documentation of tear by Recommended. arthroscopy.Intercondylar fracture: X-ray: knee........................ Evidence of fracture......... Highly Recommended.Osteomyelitis: knee: Medical record review.............. Documented history of Highly Recommended. osteomyelitis requiring treatment. X-ray: knee........................ Evidence of chronic infection Recommended. Computerized tomography............ Evidence of chronic infection Recommended. Magnetic resonance imaging......... Evidence of chronic infection Recommended.Osteonecrosis: X-ray: knee........................ Necrosis of femoral condyle Recommended. or tibial plateau. Computerized tomography............ Necrosis of femoral condyle Recommended. or tibial plateau. Magnetic resonance imaging......... Necrosis of femoral condyle Recommended. or tibial plateau.Patellofemoral arthritis: X-ray: knee........................ Evidence of arthritis........ Recommended. Magnetic resonance imaging......... Evidence of arthritis........ Recommended. Physical examination............... Crepitation with movement.... Highly Recommended.Patellar fracture nonunion with displacement: X-ray: knee........................ Nonunion and displacement.... Recommended. Magnetic resonance imaging......... Nonunion and displacement.... Recommended. Computerized tomography............ Nonunion and displacement.... Recommended.Plateau fracture: X-ray: knee........................ Evidence of fracture......... Recommended. Computerized tomography............ Evidence of fracture......... Recommended. Magnetic resonance imaging......... Evidence of fracture......... Recommended.Meniscectomy_medial or lateral: Medical record review.............. History of surgery........... Highly Recommended.Patellectomy: Physical examination: knee......... Absent patella............... Highly Recommended.Patellar_subluxation_recurrent: Medical record review.............. History of recurrent Highly Recommended. subluxation.Supracondylar fracture: X-ray: knee........................ Evidence of fracture......... Recommended. Magnetic resonance imaging......... Evidence of fracture......... Recommended. Computerized tomography............ Evidence of fracture......... Recommended.Total knee replacement: X-ray: knee........................ Presence of replacement knee. Recommended. Medical record review.............. Documented surgical history.. Recommended.Tibial shaft fracture: X-ray: leg......................... Fracture of shaft............ Recommended. Magnetic resonance imaging......... Evidence of fracture......... Recommended. Computerized tomography............ Evidence of fracture......... Recommended.----------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------- Disability test Test result Disability classification---------------------------------------------------------------------------------------------------------------- BODY PART: KNEE JOB TITLE: TRAINMAN----------------------------------------------------------------------------------------------------------------Arthritis knee: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D X-ray knee......................... 0-1 mm cartilage interval D with degenerative change.Meniscectomy, medial or lateral: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le]degrees).Collateral ligament tear with laxity: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Cruciate and collateral ligament tear: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Cruciate ligament tear with laxity: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Intercondylar fracture: Post fracture angulation........... [le]20 degrees angulation.... D Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Osteomyelitis, chronic knee: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D Medical record review.............. Frequent episodes of D infection requiring treatment. X-ray knee......................... 0-1 mm cartilage interval D with degenerative change.Osteonecrosis: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D X-ray knee......................... 0-1 mm cartilage interval D with degenerative change.Patellofemoral arthritis: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D X-ray knee: patello femoral joint.. 0 mm cartilage interval with D degenerative change.Patellar fracture nonunion with displacement: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). X-ray knee......................... Nonunion and [le]3 mm D displacement.Plateau fracture: Post fracture angulation........... [le]20 degrees angulation.... D Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Patellectomy: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Patellar, subluxation, recurrent: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Supracondylar fracture: Post fracture angulation........... [le]20 degrees angulation.... D Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Tibial shaft fracture: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Post fracture angulation........... [le]20 degrees malalignment.. D---------------------------------------------------------------------------------------------------------------- BODY PART: KNEE JOB TITLE: ENGINEER----------------------------------------------------------------------------------------------------------------Arthritis knee: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D X-ray knee......................... 0-1 mm cartilage interval D with degenerative change.Meniscectomy, medial or lateral: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Collateral ligament tear with laxity: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Cruciate and collateral ligament tear: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Cruciate ligament tear with laxity: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Intercondylar fracture: Post fracture angulation........... [le]20 degrees angulation.... D Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Osteomyelitis, chronic knee: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D Medical record review.............. Frequent episodes of D infection requiring treatment. X-ray knee......................... 0-1 mm cartilage interval D with degenerative change.Osteonecrosis: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D X-ray knee......................... 0-1 mm cartilage interval D with degenerative change.Patellofemoral arthritis: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D X-ray knee: patello femoral joint.. 0 mm cartilage interval with D degenerative change.Patellar fracture nonunion with displacement: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). X-ray knee......................... Nonunion and [le]3 mm D displacement.Plateau fracture: Post fracture angulation........... [le]20 degrees angulation.... D Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Patellectomy: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Patellar, subluxation, recurrent: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Supracondylar fracture: Post fracture angulation........... [le]20 degrees angulation.... D Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Tibial shaft fracture: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Post fracture angulation........... [le]20 degrees malalignment.. D---------------------------------------------------------------------------------------------------------------- BODY PART: KNEE JOB TITLE: CARMAN----------------------------------------------------------------------------------------------------------------Arthritis knee: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D X-ray knee......................... 0-1 mm cartilage interval D with degenerative change.Meniscectomy, medial or lateral: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Collateral ligament tear with laxity: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Cruciate and collateral ligament tear:. Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Cruciate ligament tear with laxity: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Intercondylar fracture: Post fracture angulation........... [le]20 degrees angulation.... D Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Osteomyelitis, chronic knee: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D Medical record review.............. Frequent episodes of D infection requiring treatment. X-ray knee......................... 0-1 mm cartilage interval D with degenerative change.Osteonecrosis: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D X-ray knee......................... 0-1 mm cartilage interval D with degenerative change.Patellofemoral arthritis: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D X-ray knee: patello femoral joint.. 0 mm cartilage interval with D degenerative change.Patellar fracture nonunion with displacement: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). X-ray knee......................... Nonunion and [le]3 mm D displacement.Plateau fracture: Post fracture angulation........... [le]20 degrees angulation.... D Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Patellectomy: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Patellar, subluxation, recurrent: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Supracondylar fracture: Post fracture angulation........... [le]20 degrees angulation.... D Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Tibial shaft fracture: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Post fracture angulation........... [le]20 degrees malalignment.. D---------------------------------------------------------------------------------------------------------------- BODY PART: KNEE JOB TITLE: SIGNALMAN----------------------------------------------------------------------------------------------------------------Arthritis knee: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D X-ray knee......................... 0-1 mm cartilage interval D with degenerative change.Meniscectomy, medial or lateral: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Collateral ligament tear with laxity: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Cruciate and collateral ligament tear: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Cruciate ligament tear with laxity: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Intercondylar fracture: Post fracture angulation........... [le]20 degrees angulation.... D Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Osteomyelitis, chronic knee: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D Medical record review.............. Frequent episodes of D infection requiring treatment. X-ray knee......................... 0-1 mm cartilage interval D with degenerative change.Osteonecrosis: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D X-ray knee......................... 0-1 mm cartilage interval D with degenerative change.Patellofemoral arthritis: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D X-ray knee: patello femoral joint.. 0 mm cartilage interval with D degenerative change.Patellar fracture nonunion with displacement: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). X-ray knee......................... Nonunion and [le]3 mm D displacement.Plateau fracture: Post fracture angulation........... [le]20 degrees angulation.... D Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Patellectomy: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Patellar, subluxation, recurrent: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Supracondylar fracture: Post fracture angulation........... [le]20 degrees angulation.... D Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Tibial shaft fracture: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Post fracture angulation........... [le]20 degrees malalignment.. D---------------------------------------------------------------------------------------------------------------- BODY PART: KNEE JOB TITLE: TRACKMAN----------------------------------------------------------------------------------------------------------------Arthritis knee: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D X-ray knee......................... 0-1 mm cartilage interval D with degenerative change.Meniscectomy, medial or lateral: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Collateral ligament tear with laxity: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Cruciate and collateral ligament tear: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Cruciate ligament tear with laxity: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Intercondylar fracture: Post fracture angulation........... [le]20 degree angulation..... D Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Osteomyelitis, chronic knee: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D Medical record review.............. Frequent episodes of D infection requiring treatment. X-ray knee......................... 0-1 mm cartilage interval D with degenerative change.Osteonecrosis: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D X-ray knee......................... 0-1 mm cartilage interval D with degenerative change.Patellofemoral arthritis: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D X-ray knee: patello femoral joint.. 0 mm cartilage interval with D degenerative change.Patellar fracture nonunion with displacement: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). X-ray knee......................... Nonunion and [le]3 mm D displacement.Plateau fracture: Post fracture angulation........... [le]20 degrees angulation.... D Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Patellectomy: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Patellar, subluxation, recurrent: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Supracondylar fracture: Post fracture angulation........... [le]20 degrees angulation.... D Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Tibial shaft fracture: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Post fracture angulation........... [le]20 degrees malalignment.. D---------------------------------------------------------------------------------------------------------------- BODY PART: KNEE JOB TITLE: MACHINIST----------------------------------------------------------------------------------------------------------------Arthritis knee: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D X-ray knee......................... 0-1 mm cartilage interval D with degenerative change.Meniscectomy, medial or lateral: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Collateral ligament tear with laxity: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Cruciate and collateral ligament tear: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Cruciate ligament tear with laxity: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Intercondylar fracture: Post fracture angulation........... [le]20 degrees angulation.... D Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Osteomyelitis, chronic knee: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D Medical record review.............. Frequent episodes of D infection requiring treatment. X-ray knee......................... 0-1 mm cartilage interval D with degenerative change.Osteonecrosis: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D X-ray knee......................... 0-1 mm cartilage interval D with degenerative change.Patellofemoral arthritis: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D X-ray knee......................... 0 mm cartilage interval with D degenerative change.Patellar fracture nonunion with displacement: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). X-ray knee......................... Nonunion and [le]3 mm D displacement.Plateau fracture: Post fracture angulation........... [le]20 degrees angulation.... D Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Patellectomy: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Patellar, subluxation, recurrent: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Supracondylar fracture: Post fracture angulation........... [le]20 degrees angulation.... D Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Tibial shaft fracture: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Post fracture angulation........... [le]20 degrees malalignment.. D---------------------------------------------------------------------------------------------------------------- BODY PART: KNEE JOB TITLE: SHOP LABORER----------------------------------------------------------------------------------------------------------------Arthritis knee: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D X-ray knee......................... 0-1 mm cartilage interval D with degenerative change.Meniscectomy, medial or lateral: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Collateral ligament tear with laxity: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Cruciate and collateral ligament tear: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Cruciate ligament tear with laxity: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Intercondylar fracture: Post fracture angulation........... [le]20 degrees angulation.... D Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Osteomyelitis, chronic knee: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D Medical record review.............. Frequent episodes of D infection requiring treatment. X-ray knee......................... 0-1 mm cartilage interval D with degenerative change.Osteonecrosis: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D X-ray knee......................... 0-1 mm cartilage interval D with degenerative change.Patellofemoral arthritis: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Physical examination............... Valgus deformity, 16-20 D degrees. Physical examination............... Varus deformity, 8-12 degrees D X-ray knee: patellofemoral joint... 0 mm cartilage interval with D degenerative change.Patellar fracture nonunion with displacement: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). X-ray knee......................... Nonunion and [le]3 mm D displacement.Plateau fracture: Post fracture angulation........... [le]20 degrees angulation.... D Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Patellectomy: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Patellar, subluxation, recurrent: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Supracondylar fracture: Post fracture angulation........... [le]20 degrees angulation.... D Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees).Tibial shaft fracture: Physical examination_range of Range of motion: flexion D motion. <60 degrees. Physical examination_range of Flexion contracture (20 or D motion. [le] degrees). Post fracture angulation........... [le]20 degrees malalignment.. D----------------------------------------------------------------------------------------------------------------
K. Ankle and Foot---------------------------------------------------------------------------------------------------------------- Confirmatory test Minimum result Requirements---------------------------------------------------------------------------------------------------------------- BODY PART: ANKLE AND FOOT CONFIRMATORY TESTS----------------------------------------------------------------------------------------------------------------Ankle fracture: Medical record review.............. Documented history of ankle Recommended. fracture. X-ray: ankle....................... Ankle fracture............... Highly recommended.Ankylosis, ankle: X-ray: ankle....................... Extensive joint destruction.. Highly recommended. Physical examination............... No mobility.................. Highly recommended.Arthritis, subtalar joint: X-ray: ankle....................... Evidence of significant Highly recommended. arthritis: subtalar joint.Arthritis, talonavicular joint: X-ray: ankle....................... Significant arthritis: Highly recommended. talonavicular joint.Achilles tendon rupture: Medical record review.............. Documentation of achilles Highly recommended. tendon rupture. Physical examination............... Rupture of achilles tendon... Highly recommended.Arthritis, ankle: X-ray: ankle....................... Significant arthritis........ Highly recommended.Hindfoot fracture: X-ray: foot and ankle.............. Documentation of fracture.... Highly recommended.Rheumatoid arthritis, foot: Medical History.................... Documented history of Highly recommended. condition. X-ray: foot........................ Significant arthritis........ Highly recommended.----------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------- Disability test Test result Disability classification---------------------------------------------------------------------------------------------------------------- BODY PART: ANKLE AND FOOT JOB TITLE: TRAINMAN----------------------------------------------------------------------------------------------------------------Ankle fracture: X-ray: ankle....................... Displaced intra-articular D fracture. Physical examination............... Varus deformity [le]15 D degrees. Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees.Ankylosis, ankle: Physical examination_range of Ankylosis in 20 degree or D motion. [le] dorsiflexion. Physical examination_range of Ankylosis in 20 degree D motion. plantar flexion. Physical examination_range of Ankylosis in int or ext D motion. malrotation [le]15 degrees. Physical examination_range of Ankylosis in varus 10 or more D motion. degrees. Physical examination_range of Ankylosis in valgus 10 or D motion. more degrees.Arthritis, subtalar joint (hindfoot): X-ray: ankle_subtalar joint........ Subtalar joint space 0 mm.... D Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees. Physical examination............... Varus deformity [le]15 D degrees.Arthritis, talonavicular joint (hindfoot): Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees. X-ray: ankle_talonavicular joint... Talonavicular joint space 0 D mm. Physical examination............... Varus deformity [le]15 D degrees.Achilles tendon rupture: Physical examination_range of Plantar flexion capability, D motion. <5 degrees. Physical examination_range of Plantar flexion contracture, D motion. 20 degrees.Arthritis, ankle: X-ray: ankle....................... 0 mm......................... D Physical examination_range of Plantar flexion capability, D motion. <5 degrees. Physical examination_range of Plantar flexion contracture, D motion. 20 degrees. Physical examination............... Varus deformity [le]15 D degrees.Hindfoot fracture: X-ray: foot........................ Calcaneal fracture with D Boehler angle <95 degrees. X-ray: foot........................ Subtalar fracture with D Boehler angle <95 degrees. Physical examination............... Varus angulation [le]20 D degrees (hindfoot). Physical examination............... Valgus angulation [le]20 D degrees (hindfoot).Rheumatoid arthritis, foot: X-ray: foot........................ Significant degeneration..... D Medical record review.............. Chronic flare-up with D treatment.---------------------------------------------------------------------------------------------------------------- BODY PART: ANKLE AND FOOT JOB TITLE: ENGINEER----------------------------------------------------------------------------------------------------------------Ankle fracture: X-ray: ankle....................... Displaced intra-articular D fracture. Physical examination............... Varus deformity [le]15 D degrees. Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees.Ankylosis, ankle: Physical examination_range of Ankylosis in 20 degree or D motion. [le] dorsiflexion. Physical examination_range of Ankylosis in 20 degree D motion. plantar flexion. Physical examination_range of Ankylosis in int or ext D motion. malrotation [le]15 degrees. Physical examination_range of Ankylosis in varus 10 or more D motion. degrees. Physical examination_range of Ankylosis in valgus 10 or D motion. more degrees.Arthritis, subtalar joint (hindfoot): X-ray: ankle_subtalar joint........ Subtalar joint space 0 mm.... D Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees. Physical examination............... Varus deformity [le]15 D degrees.Arthritis, talonavicular joint (hindfoot): Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees. X-ray ankle_talonavicular joint.... Talonavicular joint space 0 D mm. Physical examination............... Varus deformity [le]15 D degrees.Achilles tendon rupture: Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees.Arthritis, ankle: X-ray: ankle....................... 0 mm......................... D Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees. Physical examination............... Varus deformity [le]15 D degrees.Hindfoot fracture: X-ray: foot........................ Calcaneal fracture with D Boehler angle <95 degrees. X-ray: foot........................ Subtalar fracture with D Boehler angle <95 degrees. Physical examination............... Varus angulation [le]20 D degrees (hindfoot). Physical examination............... Valgus angulation [le]20 D degrees (hindfoot).Rheumatoid arthritis, foot: X-ray: foot........................ Significant degeneration..... D Medical record review.............. Chronic flare-up with D treatment.---------------------------------------------------------------------------------------------------------------- BODY PART: ANKLE AND FOOT JOB TITLE: DISPATCHER----------------------------------------------------------------------------------------------------------------Achilles tendon rupture: Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees.Arthritis, ankle: X-ray: ankle....................... 0 mm......................... D Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees. Physical examination............... Varus deformity [le]15 D degrees.Hindfoot fracture: X-ray: foot........................ Calcaneal fracture with D Boehler angle <95 degrees. X-ray: foot........................ Subtalar fracture with D Boehler angle <95 degrees. Physical examination............... Varus angulation [le]20 D degrees (hindfoot). Physical examination............... Valgus angulation [le]20 D degrees (hindfoot).Rheumatoid arthritis, foot: X-ray: foot........................ Significant degeneration..... D Medical record review.............. Chronic flare-up with D treatment.---------------------------------------------------------------------------------------------------------------- BODY PART: ANKLE AND FOOT JOB TITLE: CARMAN----------------------------------------------------------------------------------------------------------------Ankle fracture: X-ray: ankle....................... Displaced intra-articular D fracture. Physical examination............... Varus deformity [le]15 D degrees. Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees.Ankylosis, ankle: Physical examination_range of Ankylosis in 20 degree or D motion. [le] dorisiflexion. Physical examination_range of Ankylosis in 20 degree D motion. plantar flexion. Physical examination_range of Ankylois in int or ext D motion. malrotation [le]15 degrees. Physical examination_range of Ankylosis in varus 10 or more D motion. degrees. Physical examination_range of Ankylosis in valgus 10 or D motion. more degrees.Arthritis, subtalar joint (hindfoot): X-ray: ankle_subtalar joint........ Subtalar joint space 0 mm.... D Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees. Physical examination............... Varus deformity [le]15 D degrees.Arthritis, talonavicular joint (hindfoot): Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees. X-ray: ankle_talonavicular joint... Talonavicular joint space 0 0 mm. Physical examination............... Varus deformity [le]15 D degrees.Achilles tendon rupture: Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees.Arthritis, ankle: X-ray: ankle....................... 0 mm......................... D Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees. Physical examination............... Varus deformity [le]15 D degrees.Hindfoot fracture: X-ray: foot........................ Calcaneal fracture with D Boehler angle <95 degrees. X-ray: foot........................ Subtalar fracture with D Boehler angle <95 degrees. Physical examination............... Varus angulation [le]20 D degrees (hindfoot). Physical examination............... Valgus angulation [le]20 D degrees (hindfoot).Rheumatoid arthritis, foot: X-ray: foot........................ Significant degeneration..... D Medical record review.............. Chronic flare_up with D treatment.---------------------------------------------------------------------------------------------------------------- BODY PART: ANKLE AND FOOT JOB TITLE: SIGNALMAN----------------------------------------------------------------------------------------------------------------Ankle fracture: X-ray: ankle....................... Displaced intra-articular D fracture. Physical examination............... Varus deformity [le]15 D degrees. Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees.Ankylosis, ankle: Physical examination_range of Ankylosis in 20 degree or D motion. [le] dorsiflexion. Physical examination_range of Ankylosis in 20 degree D motion. plantar flexion. Physical examination_range of Ankylosis in int or ext D motion. malrotation [le]15 degrees. Physical examination_range of Ankylosis in varus 10 or more D motion. degrees. Physical examination_range of Ankylosis in valgus 10 or D motion. more degrees.Arthritis, subtalar joint (hindfoot): X-ray: ankle_subtalar joint........ Subtalar joint space 0 mm.... D Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees. Physical examination............... Varus deformity [le]15 D degrees.Arthritis, talonavicular joint (hindfoot): Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees. X-ray: ankle_talonavicular joint... Talonavicular joint space 0 D mm. Physical examination............... Varus deformity [le]15 D degrees.Achilles tendon rupture: Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees.Arthritis, ankle: X-ray: ankle....................... 0 mm......................... D Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees. Physical examination............... Varus deformity [le]15 D degrees.Hindfoot fracture: X-ray: foot........................ Calcaneal fracture with D Boehler angle <95 degrees. X-ray: foot........................ Subtalar fracture with D Boehler angle <95 degrees. Physical examination............... Varus angulation [le]20 D degrees (hindfoot). Physical examination............... Valgus angulation [le]20 D degrees (hindfoot).Rheumatoid arthritis, foot: X-ray: foot........................ Significant degeneration..... D Medical record review.............. Chronic flare-up with D treatment.---------------------------------------------------------------------------------------------------------------- BODY PART: ANKLE AND FOOT JOB TITLE: TRACKMAN----------------------------------------------------------------------------------------------------------------Ankle fracture: X-ray: ankle....................... Displaced intra-articular D fracture. Physical examination_range of Varus deformity [le]15 D motion. degrees. Physical examinaton_range of motion Plantar flexion capability D [le]5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees.Ankylosis, ankle: Physical examination_range of Ankylosis in 20 degree or D motion. [le] dorsiflexion. Physical examination_range of Ankylosis in 20 degree D motion. plantar flexion. Physical examination_range of Ankylosis in int or ext D motion. malrotation [le]15 degrees. Physical examination_range of Ankylosis in varus 10 or more D motion. degrees. Physical examination_range of Ankylosis in valgus 10 or D motion. more degrees.Arthritis, subtalar joint (hindfoot): X-ray: ankle_subtalar joint........ Subtalar joint space 0 mm.... D Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees. Physical examination............... Varus deformity [le]15 D degrees.Arthritis, talonavicular joint (hindfoot): Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees. X-ray: angle_talonavicular joint... Talonavicular joint space 0 D mm. Physical examination............... Varus deformity [le]15 D degrees.Achilles tendon rupture: Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees.Arthritis, ankle: X-ray: ankle....................... 0 mm......................... D Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination............... Varus deformity [le]15 D degrees.Hindfoot fracture: X-ray: foot........................ Calcaneal fracture with D Boehler angle <95 degrees. X-ray: foot........................ Subtalar fracture with D Boehler angle <95 degrees. Physical examination............... Varus angulation [le]20 D degrees (hindfoot). Physical examination............... Valgus angulation [le]20 D degrees (hindfoot).Rheumatoid arthritis, foot: X-ray: foot........................ Significant degeneration..... D Medical record review.............. Chronic flare-up with D treatment.---------------------------------------------------------------------------------------------------------------- BODY PART: ANKLE AND FOOT JOB TITLE: MACHINIST----------------------------------------------------------------------------------------------------------------Ankle fracture: X-ray: ankle....................... Displaced intra-articular D fracture. Physical examination............... Varus deformity [le]15 D degrees. Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees.Ankylosis, ankle: Physical examination_range of Ankylosis in 20 degree or D motion. [le] dorsiflexion. Physical examination_range of Ankylosis in 20 degree D motion. plantar flexion. Physical examination_range of Ankylosis in int or ext D motion. malrotation [le]15 degrees. Physical examination_range of Ankylosis in varus 10 or more D motion. degrees. Physical examination_range of Ankylosis in valgus 10 or D motion. more degrees.Arthritis, subtalar joint (hindfoot): X-ray: ankle_subtalar joint........ Subtalar joint space 0 mm.... D Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees. Physical examination............... Varus deformity [le]15 D degrees.Arthritis, talonavicular joint (hindfoot): Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees. X-ray: ankle_talonavicular joint... Talonavicular joint space 0 D mm. Physical examination............... Varus deformity [le]15 D degrees.Achilles tendon rupture: Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees.Arthritis, ankle: X-ray: ankle....................... 0 mm......................... D Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees. Physical examination............... Varus deformity [le]15 D degrees.Hindfoot fracture: X-ray: foot........................ Calcaneal fracture with D Boehler angle <95 degrees. X-ray: foot........................ Subtalar fracture with D Boehler angle <95 degrees. Physical examination............... Varus angulation [le]20 D degrees (hindfoot). Physical examination............... Valgus angulation [le]20 D degrees (hindfoot).Rheumatoid arthritis, foot: X-ray: foot........................ Significant degeneration..... D Medical record review.............. Chronic flare-up with D treatment.---------------------------------------------------------------------------------------------------------------- BODY PART: ANKLE AND FOOT JOB TITLE: SHOP LABORER----------------------------------------------------------------------------------------------------------------Ankle fracture: X-ray: ankle....................... Displaced intra-articular D fracture. Physical examination............... Varus deformity [le]15 D degrees. Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees.Ankylosis, ankle: Physical examination_range of Ankylosis in 20 degree or D motion. [le] dorsiflexion. Physical examination_range of Ankylosis in 20 degree D motion. plantar flexion. Physical examination_range of Ankylosis in int or ext D motion. malrotation [le]15 degrees. Physical examination_range of Ankylosis in varus 10 or more D motion. degrees. Physical examination_range of Ankylosis in valgus 10 or D motion. more degrees.Arthritis, subtalar joint (hindfoot): X-ray: ankle_subtalar joint........ Subtalar joint space 0 mm.... D Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees. Physical examination............... Varus deformity [le]15 D degrees.Arthritis, talonavicular joint (hindfoot): Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees. X-ray: ankle_talonavicular joint... Talonavicular joint space 0 D mm. Physical examination............... Varus deformity [le]15 D degrees.Achilles tendon rupture: Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees.Arthritis, ankle: X-ray: ankle....................... 0 mm......................... D Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees. Physical examination............... Varus deformity [le]15 D degrees.Hindfoot fracture: X-ray: foot........................ Calcaneal fracture with D Boehler angle <95 degrees. X-ray: foot........................ Subtalar fracture with D Boehler angle <95 degrees. Physical examination............... Varus angulation [le]20 D degrees (hindfoot). Physical examination............... Valgus angulation [le]20 D degrees (hindfoot).Rheumatoid arthritis, foot: X-ray: foot........................ Significant degeneration..... D Medical record review.............. Chronic flare-up with D treatment.----------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------- Disability test Test result Disability classification---------------------------------------------------------------------------------------------------------------- BODY PART: ANKLE AND FOOT JOB TITLE: SALES REPRESENTATIVES----------------------------------------------------------------------------------------------------------------Achilles tendon rupture: Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees.Arthritis, ankle: X-ray: ankle....................... 0 mm......................... D Physical examination_range of Plantar flexion capability D motion. <5 degrees. Physical examination_range of Plantar flexion contracture D motion. 20 degrees. Physical examination............... Varus deformity [le]15 D degrees.Hindfoot fracture: X-ray: foot........................ Calcaneal fracture with D Boehler angle <95 degrees. X-ray: foot........................ Subtalar fracture with D Boehler angle <95 degrees. Physical examination............... Varus angulation [le]20 D degrees (hindfoot). Physical examination............... Valgus angulation [le]20 D degrees (hindfoot).Rheumatoid arthritis, foot: X-ray: foot........................ Significant degeneration..... D Medical record review.............. Chronic flare-up with D treatment.----------------------------------------------------------------------------------------------------------------
