Current through Register Vol. 63, No. 3, March 1, 2024
(1) Loss of sensation or hypersensitivity in
the leg is not considered disabling except for the plantar surface of the foot
and toes, including the great toe, where it is rated as follows:
(a) Toe (in any toe) Foot partial loss of
sensation or hypersensitivity 5%5% total loss of sensation or
hypersensitivity10%10%
(b) Partial
is part of the toe or foot. Total means the entire toe or foot.
(c) Loss of sensation or hypersensitivity in
the toes in addition to loss of sensation or hypersensitivity in the foot is
rated for the foot only. No additional value is allowed for loss of sensation
or hypersensitivity in the toes.
(d) When there are hypersensitivity and
sensation loss, both conditions are rated.
(2) The following ratings are for length
discrepancies of the injured leg. However, loss of length due to
flexion/extension deformities is excluded. The rating is the same whether the
length change is a result of an injury to the foot or to the upper leg: [Table
not included. See ED. NOTE.]
(3)
Valid instability in the ankle or knee substantiated by clinical findings is
valued based on the ligament demonstrating the laxity, as described in the
table below. The instability value is given even if the ligament itself has not
been injured. [Table not included. See ED. NOTE.]
(a) For ankle joint instability to be rated
as severe there must be a complete disruption of two or more ligaments.
Following are examples of ankle ligaments that may contribute to joint
instability:
(A) The lateral collateral
ligaments including the anterior talofibular, calcaneofibular, talocalcaneal,
posterior talocalcaneal, and the posterior talofibular.
(B) The medial collateral ligaments, or
deltoid ligament, including the tibionavicular, calcaneotibial, anterior
talotibial, and the posterior talotibial.
(b) For knee joint instability the severity
of joint opening is mild at a grade 1 or 1+ (1-5mm), moderate at a grade 2 or
2+ (6-10mm), and severe at a grade 3 or 3+ (>10mm).
(c) Ankle joint instability with additional
anterior or posterior instability receives an additional 10%.
(d) When there is a prosthetic knee
replacement, instability of the knee is not rated unless the severity of the
instability is equivalent to Grade 2 or greater.
(e) Rotary instability in the knee is
included in the impairment value(s) of this section.
(f) Multiple instability values in a single
joint are combined.
(4)
When injury in the ankle or knee/leg results in angulation or malalignment,
impairment values are determined under the following:
(a) Varus deformity greater than 15° of
the knee/leg is rated at 10% of the leg and of the ankle is rated at 10% of the
foot.
(b) Valgus deformity greater
than 20° of the knee/leg is rated at 10% of the leg and of the ankle is
rated at 10% of the foot.
(c)
Tibial shaft fracture resulting in angulation or malalignment (rotational
deformity) affects the function of the entire leg and is rated as follows:
Severity Leg impairment
Mild: 10°- 14° 17%
Moderate: 15°- 19° 26%
Severe: 20°+ 26% plus 1% for each additional degree, to 43%
maximum
(d) Injury resulting
in a rocker bottom deformity of the foot is valued at 14%.
(5) The following values are for surgery of
the toes, foot, or leg:
(a) In the great toe:
[Table not included. See ED. NOTE.]
(b) In the second through fifth toes: [Values
not included. See ED. NOTE.]
(e)
When rating a prosthetic knee replacement, a separate value for meniscectomy(s)
or patellectomy for the same knee is not granted.
(f) A meniscectomy is rated as a complete
loss unless the record indicates that more than the rim of the meniscus
remains.
(6)
Dermatological conditions including burns which are limited to the leg, foot,
or toes are rated based on the body part affected. The percentages indicated in
the classes below are applied to the affected body part(s), e.g., a Class 1
dermatological condition of the foot is 3% of the foot, or a Class 1
dermatological condition of the leg is 3% of the leg. Contact dermatitis is
determined under this section unless it is caused by an allergic systemic
reaction which is also determined under OAR 436-035-0450. Contact dermatitis
for a body part other than the upper or lower extremities is rated under OAR
436-035-0440. Impairments may or may not show signs or symptoms of skin
disorder upon examination but are rated according to the following classes:
(a) Class 1: 3% for the leg, foot, or toe if
treatment results in no more than minimal limitations in the performance of the
activities of daily living (ADL), although exposure to physical or chemical
agents may temporarily increase limitations.
(b) Class 2: 15% for the leg, foot, or toe if
intermittent treatments and prescribed examinations are required, and the
worker has some limitations in the performance of ADL.
(c) Class 3: 38% for the leg, foot, or toe if
regularly prescribed examinations and continuous treatments are required, and
the worker has many limitations in the performance of ADL.
(d) Class 4: 68% for the leg, foot, or toe if
continuous prescribed treatments are required. The treatment may include
periodically having the worker stay home or admitting the worker to a care
facility, and the worker has many limitations in the performance of
ADL.
(e) Class 5: 90% for the leg,
foot, or toe if continuous prescribed treatment is required. The treatment
necessitates having the worker stay home or permanently admitting the worker to
a care facility, and the worker has severe limitations in the performance of
ADL.
(f) Full thickness skin loss
of the heel is valued at 10% of the foot, even when the area is successfully
covered with an appropriate skin graft.
(7) The following ratings are for vascular
dysfunction of the leg. The impairment values are determined according to the
following classifications:
(a) Class 1: 3%
when any of the following exist:
(A) Loss of
pulses in the foot.
(B) Minimal
loss of subcutaneous tissue.
(C)
Calcification of the arteries (as revealed by x-ray).
(D) Transient edema.
(b) Class 2: 15% when any of the following
exist:
(A) Limping due to intermittent
claudication that occurs when walking at least 100 yards.
(B) Vascular damage, as evidenced by a healed
painless stump of a single amputated toe, with evidence of chronic vascular
dysfunction or a healed ulcer.
(C)
Persistent moderate edema which is only partially controlled by support
hose.
(c) Class 3: 35%
when any of the following exist:
(A) Limping
due to intermittent claudication when walking as little as 25 yards and no more
than 100 yards.
(B) Vascular
damage, as evidenced by healed amputation stumps of two or more toes on one
foot, with evidence of chronic vascular dysfunction or persistent superficial
ulcers on one leg.
(C) Obvious
severe edema which is only partially controlled by support hose.
(d) Class 4: 63% when any of the
following exist:
(A) Limping due to
intermittent claudication after walking less than 25 yards.
(B) Intermittent pain in the legs due to
intermittent claudication when at rest.
(C) Vascular damage, as evidenced by
amputation at or above the ankle on one leg, or amputation of two or more toes
on both feet, with evidence of chronic vascular dysfunction or widespread or
deep ulcers on one leg.
(D) Obvious
severe edema which cannot be controlled with support hose.
(e) Class 5: 88% when either of the following
exists:
(A) Constant severe pain due to
claudication at rest.
(B) Vascular
damage, as evidenced by amputations at or above the ankles of both legs, or
amputation of all toes on both feet, with evidence of persistent vascular
dysfunction or of persistent, widespread, or deep ulcerations on both
legs.
(f) If partial
amputation of the lower extremity occurs as a result of vascular dysfunction,
the impairment values are rated separately. The amputation value is then
combined with the impairment value for the vascular dysfunction.
(8) Injuries to unilateral spinal
nerve roots with resultant loss of strength in the leg or foot are rated based
on the specific nerve root supplying (innervating) the weakened muscle(s), as
described in the following table and modified under OAR 436-035-0011(7).
[Values not included. See ED. NOTE.]
(b) Loss
of strength in bilateral extremities results in each extremity being rated
separately.
(9) When a
spinal nerve root or lumbosacral plexus are not injured, valid loss of strength
in the leg or foot is valued as if the peripheral nerve supplying (innervating)
the muscle(s) demonstrating the decreased strength was impaired, as described
in the following table and as modified under OAR 436-035-0011(7). [Values not
included. See ED. NOTE.]
Example 1: A worker suffers a knee injury requiring surgery.
Upon recovery, the attending physician reports 4/5 strength of the quadriceps
femoris. The quadriceps femoris is innervated by the femoral nerve which has a
30% impairment value. 4/5 strength, under OAR 436-035-0011(7), is 20%. Final
impairment is determined by multiplying 30% by 20% for a final value of 6%
impairment of the leg.
Example 2: A worker suffers a laceration of the deep branch of
the common peroneal nerve above mid-shin. Upon recovery, the attending
physician reports 3/5 strength of the calf. The deep common peroneal above
mid-shin has a 28% impairment value. Under OAR 436-035-0011(7), 3/5 strength is
50%. Impairment is determined by multiplying 28% by 50% for a final value of
14% impairment of the foot.
(a) Loss
of strength due to an injury in a single toe receives a value of zero, unless
the strength loss is due to a compensable condition that is proximal to the
digit.
(b) Decreased strength due
to an amputation receives no rating for weakness in addition to that given for
the amputation.
(c) Decreased
strength due to a loss in range of motion receives no rating for weakness in
addition to that given for the loss of range of motion.
(10) For motor loss to any part of a leg
which is due to brain or spinal cord damage, impairment is valued as follows:
(a) Class 1: 23% when the worker can rise to
a standing position and can walk but has difficulty with elevations, grades,
steps, and distances.
(b) Class 2:
48% when the worker can rise to a standing position and can walk with
difficulty but is limited to level surfaces. There is variability as to the
distance the worker can walk.
(c)
Class 3: 76% when the worker can rise to a standing position and can maintain
it with difficulty but cannot walk without assistance.
(d) Class 4: 100% when the worker cannot
stand without a prosthesis, the help of others, or mechanical
support.
(e) When a value is
granted under this section, additional impairment values in the same extremity
are not allowed for strength loss, chronic condition, reduced range of motion,
or limited ability to walk/stand for two hours or less because they have been
included in the impairment values shown in this section.
(f) For bilateral extremity loss, each
extremity is rated separately.
(11) If there is a diagnosis of Grade IV
chondromalacia, extensive arthritis or extensive degenerative joint disease and
one or more of the following are present: secondary strength loss; chronic
effusion; varus or valgus deformity less than that specified in section (4) of
this rule, then one or more of the following rating values apply:
(a) 5% of the foot for the ankle joint;
or
(b) 5% of the leg for the knee
joint.
(12) For a
diagnosis of degenerative joint disease, chondromalacia, or arthritis which
does not meet the criteria noted in section (11) of this rule, the impairment
is determined under the chronic condition rule (OAR 436-035-0019) if the
criteria in that rule is met.
(13)
Other impairment values, e.g., weakness, chronic condition, reduced range of
motion, etc., are combined with the value granted in section (11) of this
rule.
(14) When the worker cannot
be on his or her feet for more than two hours in an 8-hour period, the award is
15% of the leg.
Ratings & Values referenced are available from the
agency.
To view attachments referenced in rule text,
click here to view
rule.
Statutory/Other Authority: ORS
656.726
Statutes/Other Implemented: ORS
656.005,
656.214,
656.268 &
656.726