Current through Register Vol. 49, No. 13, September 23, 2024
Subpart
1.
Lumbar spine.
The spine rating is inclusive of leg symptoms except for gross
motor weakness, bladder or bowel dysfunction, or sexual dysfunction. Permanent
partial disability of the lumbar spine is a disability of the whole body as
follows:
A. Healed sprain, strain, or
contusion:
(1) Subjective symptoms of pain
not substantiated by objective clinical findings or demonstrable degenerative
changes, 0 percent.
(2) Pain
associated with rigidity (loss of motion or postural abnormality) or chronic
muscle spasm. The chronic muscle spasm or rigidity is substantiated by
objective clinical findings but without associated demonstrable degenerative
changes, 3.5 percent.
(3) Pain
associated with rigidity (loss of motion or postural abnormality) or chronic
muscle spasm. The chronic muscle spasm or rigidity is substantiated by
objective clinical findings and is associated with demonstrable degenerative
changes:
(a) single vertebral level, 7
percent; or
(b) multiple vertebral
levels, 10.5 percent.
(4) Pain associated with rigidity (loss of
motion or postural abnormality) or chronic muscle spasm. The chronic muscle
spasm or rigidity is substantiated by objective clinical findings:
(a) spondylolisthesis grade I, no surgery, 7
percent;
(b) spondylolisthesis
grade II, no surgery, 14 percent; or
(c) spondylolisthesis grade III or IV,
without fusion, 24.5 percent.
B. Herniated intervertebral disc, single
vertebral level:
(1) Condition not surgically
treated:
(a) X-ray or computerized axial
tomography or myelogram specifically positive for herniated disc; excellent
results, with resolution of objective neurologic findings, 9 percent;
(b) back and specific radicular pain present
with objective neurologic findings; and X-ray or computerized axial tomography
or myelogram specifically positive for herniated disc; and no surgery is
performed for treatment, 14 percent;
(2) condition treated by surgery:
(a) surgery or chemonucleolysis with
excellent results such as mild low back pain, no leg pain, and no neurologic
deficit, 9 percent;
(b) surgery or
chemonucleolysis with average results such as mild increase in symptoms with
bending or lifting, and mild to moderate restriction of activities related to
back and leg pain, 11 percent;
(c)
surgery or chemonucleolysis with poor surgical results such as persistent or
increased symptoms with bending or lifting, and major restriction of activities
because of back and leg pain, 13 percent; or
(d) multiple operations on low back with poor
surgical results such as persisting or increased symptoms of back and leg pain,
15 percent;
(3)
recurrent herniated intervertebral disc, occurring to same vertebral level
previously treated with surgery or chemonucleolysis, add five percent to
subitem (2);
(4) herniated
intervertebral disc at a new vertebral level other than the previously treated
herniated intervertebral disc, calculate rating the same as subitems (1) and
(2); or
(5) second herniated disc
at adjacent level treated concurrently, add five percent to subitem (1) or
(2).
C. Spinal stenosis,
central or lateral, proven by computerized axial tomography or myelogram:
(1) mild symptoms such as occasional back
pain with athletic activities or repetitive bending or lifting, leg pain with
radicular symptoms, one vertebral level and no surgery, 14 percent;
or
(2) severe spinal stenosis with
bilateral leg pain requiring decompressive laminectomy, single vertebral level,
with or without surgery (if multiple vertebral levels, add five percent per
vertebral level), 18 percent.
D. Spinal fusion surgery for single vertebral
level with or without laminectomy, 17.5 percent. Add five percent for each
additional vertebral level.
E.
Fractures:
(1) vertebral compression with a
decrease of ten percent or less in vertebral height, one or more vertebral
segments, no fragmentation, no involvement of posterior elements, no nerve root
involvement, 4 percent;
(2)
vertebral compression with a decrease of 25 percent or less in vertebral
height, one or more vertebral segments, no fragmentation, no involvement
posterior elements, no nerve root involvement, 10.5 percent;
(3) vertebral compression fracture, with a
decrease of more than 25 percent in vertebral height, one or more vertebral
segments, no fragmentation, no involvement posterior elements, no nerve root
involvement, 15 percent;
(4)
vertebral fracture with involvement of posterior elements with X-ray evidence
of moderate partial dislocation:
(a) no nerve
root involvement, healed, 10.5 percent;
(b) with persistent radicular pain, 12
percent;
(c) with surgical fusion,
healed, no permanent motor or sensory changes, 14 percent;
(5) severe dislocation:
(a) normal reduction with surgical fusion, 12
percent;
(b) poor reduction with
fusion, persistent radicular pain, 17.5 percent.
Subp. 2.
Cervical
spine.
The spine rating is inclusive of arm symptoms except for gross
motor weakness; sensory loss; and bladder, bowel, or sexual dysfunction.
Bladder, bowel, or sexual dysfunction must be rated as provided in part
5223.0060, subpart 7. Permanent
partial disability of the cervical spine is a disability of the whole body as
follows:
A. Healed sprain, strain, or
contusion:
(1) Subjective symptoms of pain
not substantiated by objective clinical findings or demonstrable degenerative
changes, 0 percent.
(2) Pain
associated with rigidity (loss of motion or postural abnormality) or chronic
muscle spasm. The chronic muscle spasm or rigidity is substantiated by
objective clinical findings but without associated demonstrable degenerative
changes, 3.5 percent.
(3) Pain
associated with rigidity (loss of motion or postural abnormality) or chronic
muscle spasm. The chronic muscle spasm or rigidity is substantiated by
objective clinical findings and is associated with demonstrable degenerative
changes:
(a) single vertebral level, 7
percent; or
(b) multiple vertebral
levels, 10.5 percent.
B. Herniated intervertebral disc, single
vertebral level:
(1) Condition not surgically
treated:
(a) X-ray or computerized axial
tomography or myelogram specifically positive for herniated disc; excellent
results, with resolution of objective neurologic findings, 9 percent.
(b) Neck and specific radicular pain present
with objective neurologic findings; and X-ray or computerized axial tomography
or myelogram specifically positive for herniated disc; and no surgery is
performed for treatment, 14 percent.
(2) Condition treated by surgery:
(a) Surgery with excellent results such as
mild neck pain, no arm pain, and no neurologic deficit, 9 percent.
(b) Surgery with average results such as mild
increase in symptoms with neck motion or lifting, and mild to moderate
restriction of activities related to neck and arm pain, 11 percent.
(c) Surgery with poor surgical results such
as persistent or increased symptoms with neck motion or lifting, and major
restriction of activities because of neck and arm pain, 13 percent.
(d) Multiple operations on neck with poor
surgical results such as persisting or increased symptoms of neck and arm pain,
15 percent.
(3)
Recurrent herniated intervertebral disc, occurring to same vertebral level
previously treated with surgery, add five percent to subitem (2).
(4) Herniated intervertebral disc at a new
vertebral level other than the previously treated herniated intervertebral
disc, calculate rating the same as subitems (1) and (2).
(5) Second herniated disc at adjacent level
treated concurrently, add five percent to subitem (1) or (2).
C. Spinal stenosis, proven by
computerized axial tomography or myelogram.
(1) With myelopathy verified by objective
neurologic findings, no loss of function, 14 percent.
(2) Loss of function: the rate provided in
part
5223.0060, subpart 7.
D. Fusion of a single vertebral
level with or without a laminectomy, 11.5 percent. Add five percent for each
additional vertebral level.
E.
Fracture:
(1) vertebral compression with a
decrease of ten percent or less in vertebral height, one or more vertebral
segments, no fragmentation, no involvement of posterior elements, no nerve root
involvement, loss of motion neck and all planes, approximately 75 percent
normal range of motion neck with pain, 6 percent;
(2) vertebral compression with a decrease of
25 percent or less in vertebral height, one or more vertebral segments, no
fragmentation, no involvement posterior elements, no nerve root involvement,
loss of motion in the neck in all planes, approximately 50 percent normal range
of motion in neck with pain, 14 percent;
(3) vertebral compression with a decrease of
more than 25 percent of vertebral height, one or more vertebral segments, no
fragmentation, no involvement posterior elements, no nerve root involvement,
loss of motion in the neck in all planes, approximately 50 percent normal range
of motion in neck with pain, 19 percent;
(4) vertebral fracture with involvement of
posterior elements with X-ray evidence of moderate partial dislocation:
(a) no nerve root involvement, healed, 10.5
percent;
(b) with persistent pain,
12 percent;
(c) with surgical
fusion, healed, no permanent motor or sensory changes, 14 percent;
(5) severe dislocation:
(a) normal reduction with surgical fusion, 12
percent;
(b) poor reduction with
fusion, persistent radicular pain, 17.5 percent.
Subp. 3.
Thoracic
spine.
The spine rating is inclusive of all symptoms including
radicular gross motor weakness and sensory loss, but excluding spinal cord
injury. Permanent partial disability of the thoracic spine is a disability of
the whole body as follows:
A. Healed
sprain, strain, or contusion:
(1) Subjective
symptoms of pain not substantiated by objective clinical findings or
demonstrable degenerative changes, 0 percent.
(2) Pain associated with chronic muscle
spasm. The chronic muscle spasm is substantiated by objective clinical findings
and is associated with demonstrable degenerative changes, single or multiple
level, 3.5 percent.
B.
Herniated intervertebral disc, symptomatic:
(1) Condition not surgically treated:
(a) X-ray or computerized axial tomography or
myelogram specifically positive for herniated disc; excellent results, with
resolution of objective neurologic findings, 3 percent.
(b) Specific radicular pain present with
objective neurologic findings, and X-ray or computerized axial tomography or
myelogram specifically positive for herniated disc, and no surgery is performed
for treatment, 5 percent.
(2) Condition treated by surgery:
(a) surgery with excellent results such as
mild thoracic pain, no radicular pain, and no neurological deficit, 5
percent;
(b) surgery with poor
surgical results such as persistence of increased symptoms with lifting, and
major restriction of activities, 10 percent.
C. Fractures:
(1) Vertebral compression with a decrease of
ten percent or less in vertebral height, one or more vertebral segments, no
fragmentation, no involvement of posterior elements, no nerve root involvement,
4 percent.
(2) Vertebral
compression with a decrease of 25 percent or less in vertebral height, one or
more vertebral segments, no fragmentation, no involvement posterior elements,
no nerve root involvement, 10.5 percent.
(3) Vertebral compression fracture, with a
decrease of more than 25 percent in vertebral height, one or more vertebral
segments, no fragmentation, no involvement posterior elements, no nerve root
involvement, 15 percent.
(4)
Vertebral fracture with involvement of posterior elements with x-ray evidence
of moderate partial dislocation:
(a) no nerve
root involvement, healed, 10.5 percent;
(b) with persistent pain, with mild motor and
sensory manifestations, 17.5 percent;
(c) with surgical fusion, healed, no
permanent motor or sensory changes, 14 percent.
(5) Severe dislocation, normal reduction with
surgical fusion:
(a) no residual motor or
sensory changes, 12 percent;
(b)
poor reduction with fusion, persistent radicular pain, motor involvement, 17.5
percent.