Current through Register Vol. 49, No. 13, September 23, 2024
Subpart 1.
General.
For permanent partial impairment to the cervical spine,
disability of the whole body is as provided in subparts
2 to
5. The impairing condition in
the cervical spine resulting from an injury may be rated only under one
category of subpart
2,
3, or
4. Categories from more than
one category in subpart
2,
3, or
4 cannot be used in rating
the impairing condition resulting from a single injury. Categories in subparts
2 to
4 may not be combined or
added together in rating the extent of impairment due to a single injury except
as specifically provided. Categories in other subparts may be combined with the
rating under subpart
3 or
4 as specifically provided in
this part.
If any injury has resulted in mutually exclusive impairing
conditions in other areas of the spine, such as thoracic spine or lumbar spine,
the mutually exclusive impairing conditions must be rated separately and all
impairments shall be combined as described in part
5223.0300, subpart
3, item E.
A. Permanent partial impairment due to injury
of the spinal cord is as provided in part
5223.0360, subpart 6, and may be
combined with ratings under subpart
2.
B. Permanent partial impairment due to injury
of the nerve roots is as provided in parts
5223.0400 and
5223.0410 and may be combined with
ratings under this part if the nerve injury results in complete loss, as
defined in part
5223.0410, subpart
1, item A. If the loss is
less than complete, the ratings under this part are inclusive of any injury to
the nerve.
C. Permanent partial
impairment due to bladder dysfunction is as provided in part
5223.0600, subpart
3, and may be combined with
ratings under this part.
D.
Permanent partial impairment due to sexual dysfunction is as provided in part
5223.0600, subparts 6 and 9, and
may be combined with ratings under this part.
E. Permanent partial impairment due to anal
dysfunction is as provided in part
5223.0590, subpart
4, and may be combined with
ratings under this part.
Subp.
2.
Fractures.
A.
Compression fracture of vertebral body, with no involvement of posterior
elements, one or more vertebral bodies is rated by the greatest loss of
vertebral height among the involved segments:
(1) decrease of no more than ten percent in
vertebral height in any vertebral segment, zero percent;
(2) decrease of greater than ten percent but
less than or equal to 25 percent in vertebral height in at least one vertebral
segment, six percent;
(3) decrease
in vertebral height is greater than 25 percent but less than or equal to 50
percent in at least one vertebral segment, 14 percent;
(4) decrease of greater than 50 percent in
vertebral height in at least one vertebral segment, 19 percent.
B. Vertebral fractures involving
posterior elements and X-ray evidence of dislocation regardless of vertebral
compression of any degree:
(1) normal
reduction and no surgery required, 10.5 percent;
(2) surgery performed and normal reduction
achieved, 14 percent;
(3) no
surgery performed and reduction not normal, 15 percent;
(4) surgery performed with poor reduction, 19
percent.
C. Any other
documented acute fracture other than as specified in item A or B, four
percent.
D. For fractures of
multiple vertebral levels, add three percent, regardless of the number of
levels involved, to whichever of item A, B, or C is otherwise
applicable.
Subp. 3.
Cervical pain syndrome.
A.
Symptoms of pain or stiffness in the region of the cervical spine not
substantiated by persistent objective clinical findings, regardless of
radiographic findings, zero percent.
B. Symptoms of pain or stiffness in the
region of the cervical spine, substantiated by persistent objective clinical
findings, that is, involuntary muscle tightness in the paracervical muscle or
decreased passive range of motion in the cervical spine, but no radiographic
abnormality, 3.5 percent.
C.
Symptoms of pain or stiffness in the region of the cervical spine,
substantiated by persistent objective clinical findings, that is, involuntary
muscle tightness in the paracervical muscle or decreased passive range of
motion in the cervical spine, and with any radiographic, myelographic, CT scan,
or MRI scan abnormality not specifically addressed elsewhere in this part:
(1) single vertebral level, seven
percent;
(2) multiple vertebral
levels, ten percent.
Subp.
4.
Radicular syndromes.
A. Radicular pain or paresthesia, as defined
in part
5223.0310, subpart 44, with or
without cervical pain syndrome, not substantiated by persistent objective
clinical findings, regardless of radiographic findings, zero percent.
B. Radicular pain or paresthesia, with or
without cervical pain syndrome, with persistent objective clinical findings
confined to the region of the cervical spine, that is, involuntary muscle
tightness in the paracervical muscle or decreased passive range of motion in
the cervical spine, but no radiographic findings, 3.5 percent.
C. Radicular pain or paresthesia, with or
without cervical pain syndrome, with persistent objective clinical findings
confined to the region of the cervical spine, that is, involuntary muscle
tightness in the paracervical muscle or decreased passive range of motion in
the cervical spine, and with any radiographic, myelographic, CT scan, or MRI
scan abnormality not specifically addressed elsewhere in this part:
(1) single vertebral level, seven
percent;
(2) multiple vertebral
levels, ten percent;
(3) if a
surgery at one level, other than fusion, is performed as part of the treatment,
ten percent;
(4) if a surgery at
more than one level, other than a fusion, is performed as part of the
treatment, 13 percent.
D. Radicular pain or paresthesia, with or
without cervical pain syndrome, and with objective radicular findings, that is,
hyporeflexia or EMG abnormality or nerve root specific muscle weakness in the
upper extremity, on examination and myelographic, CT scan, or MRI scan evidence
of intervertebral disc bulging, protrusion, or herniation that impinges on a
cervical nerve root, and the medical imaging findings correlate anatomically
with the findings on neurologic examination, nine percent with the addition of
as many of subitems (1) to (4) as apply, but each may be used only once:
(1) if chronic radicular pain or paresthesia
persist despite treatment, add three percent;
(2) if a surgery other than a fusion
performed as part of the treatment, add two percent, if surgery included a
fusion, the rating is as provided in subpart
5;
(3) for additional surgery, other than a
fusion, regardless of the number of additional surgeries, add two percent, if
the additional surgery included a fusion, the rating is as provided in subpart
5;
(4) additional concurrent lesion on
contralateral side at the same level or on either side at any other level which
meets all of the criteria of this item or item E, add nine percent.
E. Radicular pain or paresthesia,
with or without cervical pain syndrome, and with objective radicular findings,
that is, reflex changes or EMG abnormality or nerve root specific muscle
weakness in the upper extremity, or myelopathic findings on examination and
myelographic, CT scan, or MRI scan evidence of spinal stenosis, as defined in
part
5223.0310, subpart 47, that
impinges on a cervical nerve root or spinal cord and the medical imaging
findings correlate with the findings on neurological examination, ten percent
with the addition of as many of subitems (1) to (4) as apply, but each may be
used only once:
(1) if chronic radicular pain
or paresthesia, or myelopathic symptoms persist despite treatment, add three
percent;
(2) if a surgery other
than a fusion performed as part of the treatment, add five percent, if surgery
included a fusion, the rating is as provided in subpart
5. For dates of injury on or
after August 9, 2010, for the first surgery performed as part of the treatment,
regardless of the type of surgery, add five percent; if surgery included a
fusion, also add the rating as provided in subpart
5;
(3) for additional surgery, other than a
fusion, regardless of the number of additional surgeries, add three percent, if
the additional surgery included a fusion, the rating is as provided in subpart
5. For dates of injury on or
after August 9, 2010, for additional surgery, regardless of the number of
additional surgeries, add three percent. If any of the additional surgeries
included a fusion, also add the rating as provided in subpart
5;
(4) additional concurrent lesion on
contralateral side at same level or at either side at other level which meets
all of the criteria of this item or item D, add nine percent.
Subp. 5.
Fusion.
A. Fusion, as defined in
part
5223.0310, subpart 29, at one
level performed as part or all of the surgical treatment of a cervical pain or
radicular syndrome, add 2.5 percent to the otherwise appropriate category in
subpart
3 or
4.
B. Fusion at multiple levels performed as
part or all of the surgical treatment of a cervical pain or radicular syndrome,
add five percent to the otherwise appropriate category in subpart
3 or
4.