Minnesota Administrative Rules
Agency 151 - Labor and Industry Department
Chapter 5223 - DISABILITY SCHEDULES
Part 5223.0110 - MUSCULOSKELETAL SCHEDULE; SHOULDER
Universal Citation: MN Rules 5223.0110
Current through Register Vol. 48, No. 39, March 25, 2024
Subpart 1. General.
For permanent partial disability to the shoulder, disability of the whole body is as in subparts 2 and 3.
Subp. 2. Range of motion.
A. Total ankylosis in optimum position,
abduction 60 degrees, flexion ten degrees, rotation, neutral position, 30
percent;
B. Total ankylosis in
mal-position, grade upward to 50 percent;
C. Mild limitation of motion: no abduction
beyond 90 degrees, rotation no more than 40 degrees with full flexion and
extension, 3 percent;
D. Moderate
limitation of motion: no abduction beyond 60 degrees, rotation no more than 20
degrees, with flexion and extension limited to 30 degrees, 12
percent;
E. Severe limitation of
motion: no abduction beyond 25 degrees, rotation no more than ten degrees,
flexion and extension limited to 20 degrees, 30 percent.
Subp. 3. Procedures or conditions.
A. Acromio clavicular
separation of the following severity:
(1)
grade 1, 0 percent;
(2) grade 2, 3
percent;
(3) grade 3, 6
percent.
B. Anterior or
posterior shoulder dislocation, no surgery, single episode, 3
percent.
C. Recurrent dislocation,
at least three times in six months, 10 percent.
D. Repair recurrent shoulder dislocation:
(1) no loss of motion, 6 percent;
(2) if mild limitation of motion, 9
percent;
(3) if moderate or severe
limitation of motion, rate as in subpart
2, items D and E.
E. Resection distal end of
clavicle, 3 percent.
F. Humeral
shaft fracture, normal range of motion both joints, 0 percent.
G. Humeral shaft fracture, open reduction,
mild restriction of shoulder and elbow motion, 6 percent. For moderate or
severe limitation of motion, rate as in subpart
2, items D and E.
H. Surgical neck fracture, healed, no loss of
motion, 0 percent; if loss of motion, rate as in subpart
2.
I. Greater tuberosity fracture, normal range
of motion, 0 percent. If loss of motion, rate as in subpart
2.
Statutory Authority: MS s 176.105
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