Current through Register Vol. 49, No. 13, September 23, 2024
Subpart
1.
General.
For permanent partial impairment of the central nervous
system the percentage of disability of the whole body is as provided in
subparts
2 to
7.
Subp. 2.
Trigeminal nerve.
For permanent partial impairment of the trigeminal nerve, the
percent of disability is provided in items A to J:
A. partial unilateral sensory loss, three
percent;
B. complete unilateral
sensory loss, ten percent;
C.
partial bilateral sensory loss, ten percent;
D. complete bilateral sensory loss, 25
percent;
E. intractable trigeminal
neuralgia, as defined in part
5223.0310, subpart 57, 20
percent;
F. atypical facial
neuralgia, five percent;
G. partial
unilateral motor loss:
(1) less than 25
percent of function lost, zero percent;
(2) 25 to 75 percent of function lost, two
percent;
H. complete
unilateral motor loss, more than 75 percent of function lost, five
percent;
I. partial bilateral motor
loss:
(1) less than 25 percent of function
lost, zero percent;
(2) 25 to 75
percent of overall function lost, ten percent;
J. complete bilateral motor loss, more than
75 percent of overall function lost, 30 percent.
Subp. 3.
Taste or smell.
For permanent partial impairment of taste or smell, the
percent of disability is provided in items A and B:
A. total loss of taste, one
percent;
B. total loss of smell,
one percent.
Subp. 4.
Facial nerve.
For injuries to the lower motor neuron, rate each side
independently, then add the ratings for the overall impairment:
A. partial unilateral motor loss, 25 to 75
percent of function lost, three percent;
B. unilateral motor loss, more than 75
percent of function lost:
(1) able to close
the eye without assistance, seven percent;
(2) unable to close the eye without
assistance, ten percent.
Subp. 5.
Dysequilibrium or
vertigo.
Signs or symptoms of dysequilibrium, as defined in part
5223.0310, subpart 23, or vertigo,
as defined in part
5223.0310, subpart 59, are present
and persistent despite therapy, and there is anatomic loss or alteration or
objectively measurable neurologic deficit in the vestibular mechanism, ocular
mechanism, proprioceptive sense organs, spinal cord, brain stem, cerebellum, or
cerebral cortex of a type known to cause dysequilibrium or vertigo:
A. can live independently without supervision
or assistance but with restrictions on working at exposed heights, walking on
scaffolding or girders, and activities such as riding a bicycle, ten
percent;
B. can live independently
without supervision or assistance but with restrictions preventing the
operation of any motor vehicle, 20 percent;
C. able to perform self cares, as defined in
part
5223.0310, subpart 45,
independently but requires adaptive equipment for ambulation as defined in part
5223.0310, subpart
6, and is not capable of
operating any motor vehicle, 40 percent;
D. requires some assistance with self cares
and a wheelchair or human assistance with ambulation, 75 percent;
E. unable to perform self cares and dependent
even with wheelchair locomotion, 95 percent.
Subp. 6.
Spinal cord.
To rate under this subpart, determine the impairment to the
central nervous system, peripheral nervous system, respiratory system, urinary
bladder, anus, penis, and any other members as provided in items A to G. The
ratings obtained are then combined for the final rating as described in part
5223.0300, subpart
3, item E:
A. central nervous system ataxia, movement
disorder, tremor, or spasticity as provided in subpart
7, item E;
B. the extremities as provided in parts
5223.0400 to
5223.0430;
C. the respiratory system as provided in part
5223.0560;
D. the urinary bladder as provided in part
5223.0600, subpart
4;
E. the anus as provided in part
5223.0590, subpart
4;
F. the penis as provided in part
5223.0600, subpart
6, or the vagina or vulva as
provided in part
5223.0600, subpart 9;
G. any other members as provided in the
appropriate parts of this schedule.
Subp. 7.
Brain dysfunction.
Signs or symptoms of organic brain dysfunction due to illness
or injury must be present and persistent with anatomic loss or alteration, or
objectively measurable neurologic deficit. A rating under this part is the
combination as described in part
5223.0300, subpart
3, item E, of the ratings
assigned by items A to I.
A.
Communications disturbances, expressive:
(1)
mild disturbance of expressive language ability not significantly impairing
ability to be understood, such as mild word-finding difficulties, mild degree
of paraphasia, ten percent;
(2)
unintelligible oral language, but still capable of functional communication
with the use of additional methods such as gestures, facial expression,
writing, word board, or alphabet board, 35 percent;
(3) unable to produce any functional
communication, 70 percent.
B. Communication disturbances, receptive:
(1) unable to comprehend oral speech without
the addition of visual cues such as gestures, facial expressions, or written
material, 35 percent;
(2) some
ability to comprehend communication is present, but significant impairment even
with use of visual cues such as gestures, facial expressions, and written
material, 60 percent;
(3) no
evidence of functional comprehension of language, 95 percent.
C. Disturbances of consciousness
or complex integrated cerebral function disturbances must be determined by
medical observation, and in the case of complex integrated cerebral function,
supported by psychometric testing. Functional overlay or primary psychiatric
disturbances shall not be rated under this part. Disturbances of complex
integrated cerebral function include defects in orientation, ability to
abstract or understand concepts, memory, judgment, ability to initiate and
perform planned activity, and acceptable social behavior. Disturbances of
consciousness include lethargy, clouding of consciousness, delirium, stupor,
and coma:
(1) mild impairment of complex
integrated cerebral function is demonstrated by psychometric testing but able
to live independently, ten percent;
(2) mild impairment of complex integrated
cerebral function is demonstrated by psychometric testing and able to live
independently but requiring supervision with executive function, as defined in
part
5223.0310, subpart 25, 20
percent;
(3) moderate impairment of
complex integrated cerebral function is demonstrated by psychometric testing or
there is a mild clouding of consciousness and able to perform all activities of
daily living, as defined in part
5223.0310, subpart
5, independently but
requiring some supervision on a daily basis, 40 percent;
(4) moderately severe impairment of complex
integrated cerebral function is demonstrated by psychometric testing or there
is a moderate clouding of consciousness or persistent lethargy as defined in
part 5223.0311, subpart 38, and requires supervision for activities of daily
living, as defined in part
5223.0310, subpart
5, 75 percent;
(5) severe impairment of complex integrated
cerebral function is demonstrated by psychometric testing or there is delirium
as defined in part
5223.0310, subpart 19, and
requires assistance as well as supervision in activities of daily living, 95
percent;
(6) stupor, as defined in
part
5223.0310, subpart 53; coma, as
defined in part
5223.0310, subpart 16; or
persistent vegetative state, 99 percent.
D. Emotional disturbances and personality
changes must be substantiated by medical observation and supported by
psychometric testing. These disturbances may include irritability, outbursts of
rage or aggression, absence of normal emotional response, inappropriate
euphoria, depression, abnormal emotional interaction with others, involuntary
laughing and crying, akinetic mutism, and uncontrollable fluctuation of
emotional state. Primary psychiatric disturbances, including functional
overlay, shall not be rated under this part:
(1) intermittent emotional disturbances
requiring intervention by a caregiver are only present under stressful
situations such as losing one's job, getting a divorce, or a death in the
family, ten percent;
(2) mild
emotional disturbance is present at all times but can live independently and
relate to others, 20 percent;
(3)
moderate emotional disturbance is present at all times and can live
independently but requires some supervision on a daily basis, 40
percent;
(4) moderate to severe
emotional disturbances are present at all times, and requires sheltering with
some supervision of all activities, 75 percent;
(5) severe degree of emotional disturbance is
present at all times and is confined to continuous supervision and protective
care, 95 percent.
E.
Ataxia, movement disorder including tremor, or spasticity:
(1) in the upper extremity:
(a) performance on the nine hole peg test
better, that is, faster, than the tenth percentile of the age-sex specific
normative value in both arms, zero percent;
(b) performance on the nine hole peg test
worse, that is, slower, than the tenth percentile of the age-sex specific
normative value in one arm, ten percent;
(c) performance on the nine hole peg test
worse, that is, slower, than the tenth percentile of the age-sex specific
normative value in both arms, 40 percent;
(d) requires some assistance with activities
of daily living, as defined in part
5223.0310, subpart
5, 75 percent;
(e) unable to perform activities of daily
living, 95 percent;
(2)
the tenth percentile of the age-sex specific normative value, in seconds, of
the nine hold peg test is:
(a) at less than 25
years of age:
i. for a male: right hand -
18.5; left hand - 19.6;
ii. for a
female: right hand - 18.5; left hand - 20.3;
(b) at 25 to 29 years of age:
i. for a male: right hand - 18.7; left hand -
19.7;
ii. for a female: right hand
- 18.6; left hand - 19.9;
(c) at 30 to 34 years of age:
i. for a male: right hand - 20.9; left hand -
21.5;
ii. for a female: right hand
- 18.7; left hand - 20.4;
(d) at 35 to 39 years of age:
i. for a male: right hand - 21.0; left hand -
23.9;
ii. for a female: right hand
- 18.4; left hand - 19.9;
(e) at 40 to 44 years of age;
i. for a male: right hand - 20.5; left hand -
21.5;
ii. for a female: right hand
- 19.5; left hand - 22.2;
(f) at 45 to 49 years of age:
i. for a male: right hand - 21.7; left hand -
24.1;
ii. for a female: right hand
- 19.9; left hand - 20.8;
(g) at 50 to 54 years of age:
i. for a male: right hand - 21.5; left hand -
23.6;
ii. for a female: right hand
- 21.2; left hand - 23.9;
(h) at 55 to 59 years of age:
i. for a male: right hand - 22.5; left hand -
25.1;
ii. for a female: right hand
- 21.2; left hand - 22.3;
(i) at 60 to 64 years of age:
i. for a male: right hand - 23.6; left hand -
24.2;
ii. for a female: right hand
- 21.0; left hand - 23.4;
(j) at 65 to 69 years of age:
i. for a male: right hand - 24.4; left hand -
27.4;
ii. for a female: right hand
- 22.4; left hand - 24.9;
(k) at 70 to 74 years of age:
i. for a male: right hand - 26.2; left hand -
28.8;
ii. for a female: right hand
- 23.7; left hand - 25.5;
(l) at greater than 74 years of age:
i. for a male: right hand - 28.0; left hand -
32.5;
ii. for a female: right hand
- 25.2; left hand - 30.1;
(3) in the lower extremity:
(a) normal tandem gait, as defined in part
5223.0310, subpart 55, zero
percent;
(b) abnormal tandem gait
and with restriction on working on exposed heights and walking on scaffolding
or girders, ten percent;
(c) unable
to walk on level ground without adaptive equipment for ambulation, as defined
in part
5223.0310, subpart
6, 40 percent;
(d) unable to walk and must use a wheelchair,
75 percent;
(e) abnormal sitting
balance impairs use of the upper extremities so unable to perform any
activities of daily living, as defined in part
5223.0310, subpart
5, 95 percent.
F. Impairments of
respiration, urinary bladder function, anorectal function, or sexual function,
the rating is as provided in parts
5223.0560 to
5223.0600.
G. Episodic neurologic disorders, that is,
syncope, epilepsy, or convulsive disorders:
(1) able to live independently without
supervision or assistance but with restrictions preventing the operation of
motor vehicles or dangerous machinery and working on exposed heights, 20
percent;
(2) able to live
independently but having three or more seizures per 12-month period despite
adequate treatment and with restrictions preventing the operation of motor
vehicles or dangerous machinery and working on exposed heights, 30
percent;
(3) able to perform all
self cares, as defined in part
5223.0310, subpart 45,
independently, but some supervision is required, 40 percent;
(4) requires some assistance with self care,
supervision is required, and some protective care is required, 75
percent;
(5) unable to perform any
self cares, constant supervision and constant protective care is required, and
confinement to home or domicile is necessary, 95 percent.
H. Recurring vascular headaches characterized
as throbbing in nature, accompanied by nausea and vomiting, and associated with
an inability to perform activities of daily living, as defined in part
5223.0310, subpart
5, in excess of 12 hours, two
percent.
I. Motor or sensory
impairments, the rating is as provided in parts
5223.0400 to
5223.0430.