Current through Register Vol. 49, No. 13, September 23, 2024
Subpart 1.
General.
For permanent partial impairment to vision from any cause,
disability of the whole body is as provided in subparts
2 and
3. Permanent partial
disability due to cosmetic disfigurement is as provided in part
5223.0650 and may be combined with
ratings under this part as described in part
5223.0300, subpart
3, item E. Permanent partial
disability due to impairment of the jaw and facial bones is as provided in part
5223.0320, subpart 6, and may be
combined with ratings under this part as described in part
5223.0300, subpart
3, item E.
Subp. 2.
Complete loss of
vision.
A. Complete loss of vision in
both eyes, 85 percent.
B. Complete
loss of vision in one eye:
(1) if vision in
the other eye is completely normal in regard to acuity, motility, and visual
field, 24 percent; or
(2) if vision
in the other eye is not completely normal, rate as provided in subpart
3.
C. Enucleation:
(1) unilateral:
(a) if vision in the other eye is completely
normal in regard to acuity, motility, and visual field, 24 percent;
or
(b) if vision in the other eye
is not completely normal, rate as provided in subpart
3;
(2) bilateral, 85 percent.
D. In all other cases of loss of
vision, the rating is as provided in subpart
3.
Subp. 3.
Incomplete loss of
vision.
A. Disability shall not be
determined until all medically acceptable attempts to correct the defect have
been made. Before the final examination on which disability must be determined,
at least six months shall elapse after all visible inflammation has
disappeared. In cases of disturbance of extrinsic ocular muscles, optic nerve
atrophy, injury of the retina, sympathetic ophthalmia, and traumatic cataract,
at least 12 months shall elapse before the final examination is made. Testing
shall be conducted with corrective lenses applied, unless indicated otherwise
in this part.
B. The primary
coordinate factors of vision are central visual acuity, visual field
efficiency, and ocular motility.
(1) The
maximum limit for each coordinate function is established in units (a) to (c).
(a) The maximum limit of central visual
acuity is the ability to recognize letters or characters which subtend an angle
of five minutes, each unit part of which subtends a one-minute angle at the
distance viewed. A 20/20 Snellen rating is 100 percent maximum central visual
acuity for distance vision. A 14/14 Snellen rating is 100 percent maximum
central visual acuity for near vision, as defined in part
5223.0310, subpart 38.
(b) The maximum visual field is 500 degrees.
It is the sum of the degrees in the eight principal meridians from the point of
fixation to the outermost limits of visual perception. One hundred percent
visual field efficiency is the visual field that extends from the point of
fixation 85 degrees temporally, 85 degrees down temporally, 65 degrees direct
down, 50 degrees down nasally, 60 degrees nasally, 55 degrees up nasally, 45
degrees direct up, and 55 degrees up temporally.
(c) Maximum ocular motility is present if
there is absence of diplopia in all parts of the field of binocular fixation,
and if normal binocular motor coordination is present.
(2) The minimum limit for each coordinate
function is established in units (a) to (c).
(a) The minimum limit of central visual
acuity is a 20/800 Snellen rating for distance vision and a 14/140 Snellen
rating for near vision.
(b) The
minimum limit for field vision is established as a concentric central
contraction of the visual field to five degrees.
(c) The minimum limit for ocular motility is
established by the presence of diplopia in all parts of the field of binocular
fixation or by absence of binocular motor coordination.
C. The measurement of the
coordinate factors of vision shall be performed as specified in subitems (1) to
(3).
(1) Central visual acuity shall be
measured in a 20/20 Snellen rating for distance vision and a 14/14 Snellen
rating for near vision, with each eye being measured separately, with
correction. Test illumination shall be at least five foot-candles.
(a) Using the corrected near vision and the
corrected far vision for an eye, refer to the table for loss of central vision,
as defined in part
5223.0310, subpart 54, and locate
the appropriate percentage of loss using the upper figure of the two provided.
This is the percentage loss of central vision for that eye.
(b) In cases with aphakia, or pseudophakia as
defined in part
5223.0310, subpart 42, proceed as
in unit (a), but use the lower figure of the two provided in the table. This is
the percentage loss of central vision corrected for aphakia or pseudophakia for
that eye.
(2) For each
eye, the extent of the field of vision shall be determined by perimetric test
methods. The result shall be plotted on the visual field chart as defined in
part
5223.0310, subpart 60.
(a) The amount of radial contraction in the
eight principal meridians shall be determined. The sum of the degrees of field
vision lost on these meridians, divided by 500, is the visual field loss of one
eye, expressed as a percentage. If the eye has a concentric central contraction
of the field to a diameter of five degrees, the visual loss is 100
percent.
(b) If the impairment of
field is irregular and not fairly disclosed by the eight radii, the
determination shall be based on a number of radii greater than eight and the
divisor in unit (a) shall be changed accordingly.
(c) If there is a loss of a quadrant or a
half-field, the degrees of field vision lost in each included meridian are
added to one-half the sum of the two boundary meridians.
(3) Ocular motility shall be measured in all
parts of the motor field with any useful correction applied.
(a) All directions of gaze shall be tested
with use of a test light and without the addition of colored lenses or
correcting prisms. The extent of diplopia is determined on the perimeter at 330
millimeters or on a tangent screen at a distance of one meter from the
eye.
(b) Plot the test results on a
motility chart, as defined in part
5223.0310, subpart 37.
(c) Determine the percentage loss of ocular
motility from the motility chart by adding the percentages for loss of ocular
motility due to diplopia in the meridian of maximum impairment on the motility
charts. This percentage is assigned to the injured eye or, if both eyes are
injured, to the eye with the greatest impairment of central visual acuity and
field vision. The eye with the greatest impairment means the eye for which the
loss of central vision and visual field is the greatest. For the purpose of
calculation, a value of zero percent is deemed to be one percent. For the other
eye, the percentage loss of ocular motility is zero.
D. The visual impairment of one
eye is the combination of the percentage losses of central vision acuity,
visual field, and ocular motility as described in part
5223.0300, subpart
3, item E. This combination
is calculated by combining the loss of vision and the loss of visual field for
each eye. The combined loss for the eye with the larger combined loss is
combined with the loss of ocular motility.
Impairment of the eye shall be increased by adding two
percent for each of the following conditions which are present due to the
injury:
(1) loss of color
vision;
(2) loss of adaptation to
light and dark;
(3)
metamorphopsia;
(4) entropion or
ectropion uncorrected by surgery;
(5) lagophthalmos;
(6) epiphora;
(7) muscle disturbances such as ocular tics
not included under diplopia;
(8)
for dates of injury on or after August 9, 2010, corneal transplant.
E. The procedure for determining
whole body disability due to vision loss is described in subitems (1) to (5).
The better eye has the lower percentage impairment. The poorer eye has the
greater percentage impairment.
(1) Multiply
the percentage impairment of the better eye by three.
(2) Add the percentage impairment of the
poorer eye to the product obtained in subitem (1).
(3) Divide the sum obtained in subitem (2) by
four.
(4) The quotient obtained in
subitem (3) is the percentage impairment of the visual system. Fractions shall
be rounded to the nearest whole number percentage by rounding up from the
midpoint and rounding down from below the midpoint.
(5) The percentage impairment of the visual
system is translated to the percentage disability of the whole body by Table 3.
Table 3
Eye Schedule
Impairment of Visual System, Percent |
Disability of Whole Body, Percent |
Impairment of Visual System, Percent |
Disability of Whole Body, Percent |
0 |
0 |
45 |
42 |
1 |
1 |
46 |
43 |
2 |
2 |
47 |
44 |
3 |
3 |
48 |
45 |
4 |
4 |
49 |
46 |
5 |
5 |
50 |
47 |
6 |
6 |
51 |
48 |
7 |
7 |
52 |
49 |
8 |
8 |
53 |
50 |
9 |
8 |
54 |
51 |
10 |
9 |
55 |
52 |
11 |
10 |
56 |
53 |
12 |
11 |
57 |
54 |
13 |
12 |
58 |
55 |
14 |
13 |
59 |
56 |
15 |
14 |
60 |
57 |
16 |
15 |
61 |
58 |
17 |
16 |
62 |
59 |
18 |
17 |
63 |
59 |
19 |
18 |
64 |
60 |
20 |
19 |
65 |
61 |
21 |
20 |
66 |
62 |
22 |
21 |
67 |
63 |
23 |
22 |
68 |
64 |
24 |
23 |
69 |
65 |
25 |
24 |
70 |
66 |
26 |
25 |
71 |
67 |
27 |
25 |
72 |
68 |
28 |
26 |
73 |
69 |
29 |
27 |
74 |
70 |
30 |
28 |
75 |
71 |
31 |
29 |
76 |
72 |
32 |
30 |
77 |
73 |
33 |
31 |
78 |
74 |
34 |
32 |
79 |
75 |
35 |
33 |
80 |
76 |
36 |
34 |
81 |
76 |
37 |
35 |
82 |
77 |
38 |
36 |
83 |
78 |
39 |
37 |
84 |
79 |
40 |
38 |
85 |
80 |
41 |
39 |
86 |
81 |
42 |
40 |
87 |
82 |
43 |
41 |
88 |
83 |
44 |
42 |
89 |
84 |
|
|
90-100 |
85 |
Subp. 4.
Extraocular muscle.
Impairment of extraocular muscle is ratable only under
subpart
3.
Subp. 5.
Ocular adnexa.
Impairment of the eyelid, eyelashes, conjunctiva, lacrimal
duct, or lacrimal gland are ratable only under subpart
3 or part
5223.0650, subpart
2.