Current through Register Vol. 49, No. 13, September 23, 2024
Subpart
1.
Complete loss of vision.
For complete loss of vision in both eyes, disability of the
whole body is 85 percent. For complete loss of vision in one eye, disability of
the whole body is 24 percent. In determining the degree of vision impairment
and of whole body disability, subparts
2 to
6 shall be used.
Subp. 2.
Examination.
Disability shall not be determined until all medically
acceptable attempts to correct the defect have been made. Prior to the final
examination on which disability is to 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.
Subp. 3.
Maximum and minimum
limits of primary coordinate factors of vision.
The primary coordinate factors of vision are central visual
acuity, visual field efficiency, and ocular motility.
A. The maximum limit for each coordinate
function is established in subitems (1) to (3):
(1) 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 or A.M.A. chart is 100 percent (maximum)
central visual acuity for distance vision. 14/14 A.M.A. card is 100 percent
(maximum) central visual acuity for near vision.
(2) The maximum visual field is defined as
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 and defines
the area in which a three millimeter white target is visible at 33 centimeters.
One hundred percent visual field efficiency is that visual field which extends
from the point of fixation outward 85 degrees, down 65 degrees, down and in 50
degrees, inward 60 degrees, in and up 55 degrees, upward 45 degrees, and up and
out 55 degrees.
(3) 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.
B. The minimum
limit for each coordinate function is established in subitems (1) to (3):
(1) The minimum limit of central visual
acuity is:
(a) for distance vision, 20/800
Snellen or A.M.A. chart; and
(b)
for near vision, 14/560 A.M.A. card.
(2) The minimum limit for field vision is
established as a concentric central contraction of the visual field to five
degrees. Five degrees of contraction of the visual field reduces the visual
efficiency of the eye to zero.
(3)
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. The minimum limit is 50 percent ocular motility
efficiency.
Subp.
4.
Measurement of coordinate factors of vision and
computation of partial loss.
A.
Central visual acuity shall be measured both for distance vision and for near
vision, each eye being measured separately, both with and without correction. A
Snellen or A.M.A. chart shall be used for distance vision and an A.M.A. card
shall be used for near vision. Illumination shall be at least five footcandles.
(1) Table 1 shows the percentage of visual
efficiency corresponding to the notations for distance vision and for near
vision. For test readings between those listed on the chart, round up from the
midpoint to the nearest reading, and round down from below the midpoint.
Where distance vision is less than 20/200 and the A.M.A. chart
is used, readings are at ten feet. The test reading is translated to the
corresponding distance reading in Table 1 by multiplying both the numerator and
the denominator of the test reading by two.
Table 1
Central Visual Acuity
| A.M.A. Chart or Snellen Reading for Distance |
A.M.A. Card Reading for Near |
Percentage of Central Visual Acuity Efficiency |
| 20/20 |
14/14 |
100.00 |
| 20/25 |
14/17.5 |
95.7 |
| 20/25.7 |
..... |
95.0 |
| 20/30 |
14/21 |
91.5 |
| 20/32.1 |
..... |
90.0 |
| 20/35 |
14/24.5 |
87.5 |
| 20/38.4 |
..... |
85.0 |
| 20/40 |
14/28 |
83.6 |
| 20/44.9 |
14/31.5 |
80.0 |
| 20/50 |
14/35 |
76.5 |
| 20/52.1 |
.... |
75.0 |
| 20/60 |
14/42 |
69.9 |
| 20/60.2 |
..... |
70.0 |
| 20/68.2 |
..... |
65.0 |
| 20/70 |
14/49 |
64.0 |
| 20/77.5 |
..... |
60.0 |
| 20/80 |
14/56 |
58.5 |
| 20/86.8 |
..... |
55.0 |
| 20/90 |
14/63 |
53.4 |
| 20/97.5 |
..... |
50.0 |
| 20/100 |
14/70 |
48.9 |
| 20/109.4 |
..... |
45.0 |
| 20/120 |
14/84 |
40.9 |
| ..... |
14/89 |
38.4 |
| 20/122.5 |
..... |
40.0 |
| 20/137.3 |
..... |
35.0 |
| 20/140 |
14/98 |
34.2 |
| 20/155 |
..... |
30.0 |
| 20/160 |
14/112 |
28.6 |
| 20/175 |
..... |
25.0 |
| 20/180 |
14/126 |
23.9 |
| 20/200 |
14/140 |
20.0 |
| 20/220 |
14/154 |
16.7 |
| 20/240 |
14/168 |
14.0 |
| .... |
14/178 |
12.3 |
| 20/260 |
14/182 |
11.7 |
| 20/280 |
14/196 |
9.7 |
| 20/300 |
14/210 |
8.2 |
| 20/320 |
14/224 |
6.8 |
| 20/340 |
14/238 |
5.7 |
| 20/360 |
14/252 |
4.8 |
| 20/380 |
14/266 |
4.0 |
| 20/400 |
14/280 |
3.3 |
| 20/450 |
14/315 |
2.1 |
| 20/500 |
14/350 |
1.4 |
| 20/600 |
14/420 |
0.6 |
| 20/700 |
14/490 |
0.3 |
| 20/800 |
14/560 |
0.1 |
(2)
The percentage of central visual acuity efficiency of the eye for distance
vision is that percentage in Table 1 which corresponds to the test reading for
distance vision for that eye.
(3)
The percentage of central visual acuity efficiency of the eye for near vision
is that percentage in Table 1 which corresponds to the test reading for near
vision for that eye.
(4) The
percentage of central visual acuity efficiency of the eye in question is
determined as follows:
(a) Multiply by two
the value determined for corrected near vision in subitem (3).
(b) Add the product obtained in unit (a) to
the value determined for corrected distance vision in subitem (2).
(c) Divide the sum obtained in unit (b) by
three.
The following is an example of this calculation. If the central
visual acuity efficiency for distance is 70 percent, and that for near is 25
percent, the percentage of central visual acuity efficiency for the eye
is:
|
70% + (2 x 25) / 3 |
= 40% central visual acuity efficiency |
(5) For traumatic aphakia, the corrected
central visual acuity efficiency of the eye is 50 percent of the central visual
acuity efficiency determined in subitem (4). This subitem shall not apply if an
adjustment for glasses or contact lenses pursuant to subpart
5, item B, subitem (2) or (3)
results in a lower visual efficiency than would be given by application of this
subitem.
(6) For traumatic
pseudophakia, the corrected central visual acuity efficiency of the eye is 80
percent of the central visual acuity efficiency determined in subitem (4). This
subitem shall not apply if an adjustment for glasses or contact lenses pursuant
to subpart
5, item B, subitem (2) or (3)
results in a lower visual efficiency than would be given by application of this
subitem.
B. For each
eye, the extent of the field of vision shall be determined by perimetric test
methods. A three millimeter white disk which subtends a 0.5-degree angle under
illumination of not less than seven footcandles shall be used. For aphakia, a
six millimeter white disk shall be used. The result shall be plotted on the
visual field chart as illustrated in the A.M.A. Guides, page 144.
(1) The amount of radial contraction in the
eight principal meridians shall be determined. The sum of the degrees of field
vision remaining on these meridians, divided by 500, is the visual field
efficiency 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
efficiency is zero.
(2) When 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 subitem (1) shall be changed accordingly.
(3) Where there is a loss of a quadrant or a
half-field, the degrees of field vision remaining in each meridian are added to
one-half the sum of the two boundary meridians.
C. Ocular motility shall be measured in all
parts of the motor field with any useful correction applied.
(1) 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.
(2) Plot the test results on a
motility chart as illustrated in the A.M.A. Guides, page 147.
(3) Determine the percentage loss of ocular
motility from the motility chart. 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 product of central visual acuity efficiency and
visual field efficiency is the least. 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.
(4) The percentage loss of ocular motility is
subtracted from 100 percent to obtain the ocular motility efficiency. The
minimum ocular motility efficiency of one eye is 50 percent.
Subp. 5.
Visual
efficiency.
The visual efficiency of one eye is the product of the
efficiency values of central visual acuity, of visual field, and of ocular
motility. For the purpose of this calculation, these values shall be expressed
as decimals and not as percentages; a value of zero percent is deemed to be one
percent.
A. For example, if central
visual acuity efficiency is 50 percent, visual field efficiency is 80 percent,
and ocular motility efficiency is 100 percent, the visual efficiency of the eye
is .50 times .80 times 1.00, equals 40 percent. If ocular motility efficiency
is changed to 50 percent, the visual efficiency is .50 times .80 times .50,
equals 20 percent.
B. Visual
efficiency shall be adjusted as set in this item. Visual efficiency may not be
less than zero percent. No adjustment for glasses or contacts shall be made in
cases of aphakia or pseudophakia where the central visual efficiency was
adjusted pursuant to subpart
4, item A, subitem (5) or
(6).
(1) Visual efficiency shall be decreased
by subtracting two percent for any of the following conditions which are
present due to the injury: loss of color vision; loss of adaptation to light
and dark; metamorphosis; entropion or ectropion uncorrected by surgery;
lagophthalmos; epiphora; and muscle disturbances such as ocular ticks not
included under diplopia.
(2) If
glasses are required as a result of the injury, or if as a result of the injury
the refractive error increases by at least one diopeter of sphere or of
cylinder or of both, subtract five percent from the visual efficiency. Where
the glasses contain prisms, subtract six percent.
(3) If a noncosmetic contact lens is required
in one or both eyes as a result of the injury, subtract seven percent from the
visual efficiency.
Subp.
6.
Procedure for determining whole body disability due to
vision loss.
For each eye, subtract the percentage of visual efficiency
determined in subpart
5 from 100 percent. The
difference is the percentage impairment of each eye. The better eye has the
lower percentage impairment. The poorer eye has the greater percentage
impairment.
A. Multiply the percentage
impairment of the better eye by three.
B. Add the percentage impairment of the
poorer eye to the product obtained in item A.
C. Divide the sum obtained in item B by
four.
D. The quotient obtained in
item C is the percentage impairment of the visual system. Fractions shall be
rounded to the nearest whole number percentage as provided in subpart
4, item A, subitem
(1).
E. The percentage impairment
of the visual system is translated to the percentage disability of the whole
body by Table 2.
Table 2
Eye Schedule
| Impairment of Visual System, Percent |
Disability of Whole Body, Percent |
| 0 |
0 |
| 1 |
1 |
| 2 |
2 |
| 3 |
3 |
| 4 |
4 |
| 5 |
5 |
| 6 |
6 |
| 7 |
7 |
| 8 |
8 |
| 9 |
8 |
| 10 |
9 |
| 11 |
10 |
| 12 |
11 |
| 13 |
12 |
| 14 |
13 |
| 15 |
14 |
| 16 |
15 |
| 17 |
16 |
| 18 |
17 |
| 19 |
18 |
| 20 |
19 |
| 21 |
20 |
| 22 |
21 |
| 23 |
22 |
| 24 |
23 |
| 25 |
24 |
| 26 |
25 |
| 27 |
25 |
| 28 |
26 |
| 29 |
27 |
| 30 |
28 |
| 31 |
29 |
| 32 |
30 |
| 33 |
31 |
| 34 |
32 |
| 35 |
33 |
| 36 |
34 |
| 37 |
35 |
| 38 |
36 |
| 39 |
37 |
| 40 |
38 |
| 41 |
39 |
| 42 |
40 |
| 43 |
41 |
| 44 |
42 |
| 45 |
42 |
| 46 |
43 |
| 47 |
44 |
| 48 |
45 |
| 49 |
46 |
| 50 |
47 |
| 51 |
48 |
| 52 |
49 |
| 53 |
50 |
| 54 |
51 |
| 55 |
52 |
| 56 |
53 |
| 57 |
54 |
| 58 |
55 |
| 59 |
56 |
| 60 |
57 |
| 61 |
58 |
| 62 |
59 |
| 63 |
59 |
| 64 |
60 |
| 65 |
61 |
| 66 |
62 |
| 67 |
63 |
| 68 |
64 |
| 69 |
65 |
| 70 |
66 |
| 71 |
67 |
| 72 |
68 |
| 73 |
69 |
| 74 |
70 |
| 75 |
71 |
| 76 |
72 |
| 77 |
73 |
| 78 |
74 |
| 79 |
75 |
| 80 |
76 |
| 81 |
76 |
| 82 |
77 |
| 83 |
78 |
| 84 |
79 |
| 85 |
80 |
| 86 |
81 |
| 87 |
82 |
| 88 |
83 |
| 89 |
84 |
| 90 - 100 |
85 |
Statutory Authority: MS s
176.105
