RATING FINGER IMMOBILITY THE AMA WAY (2/06)
Rating Finger Immobility is one of the more complex tasks of the new rating schedule. Firstly, it is incumbent upon the physician to provide the appropriate measurements. For the affected fingers, physician is required to provide Flexion & Extension figures at the MP, IP & PIP joints. I won’t address Thumb Immobility, as the complexities of such an analysis are too great for the size of this article. Each motion angle is converted to an impairment percentage per Figures 16-21, 16-23 & 16-25. The percentages within each joint are then added together. The final joint percentages are then combined (page 604) for a final finger percentage. This percentage is then converted to the Hand Impairment level (table 16-1). The respective Hand Impairment figures are then added together. The results are then converted to Upper Extremity & Whole Person Impairment. For example, an injury to the index finger results in the following motion angles. DIP Joint: Flexion - 40 degrees, The DIP Joint figures are referenced per figure 16-21. The pie chart indicates 40 degrees of Flexion takes 15% FI (finger impairment), while the loss of 10 degrees of Extension takes 2% FI. 15% and 2% are added for a figure of 17% FI for the DIP Joint. |
The PIP Joint figures are calculated similarly using figure 16-23. 70 degrees of Flexion equates to 18% FI, while 0 degrees of Extension loss takes 0% FI. The percentages are added for a sum of 18% FI for the PIP Joint. Figure 16-25 is used for the MP Joint. Thus, we have 17% for the DIP Joint, 18% for PIP Joint and 32% for MP Joint. The figures are combined (page 604) for a total of 54% FI. As this is the index finger, 54% is multiplied by .2 (table 16-1) to find the Hand Impairment of 11% HI. 11% if multiplied by .9 to find the Upper Extremity Impairment (table 16-2). The result is 10% UEI. This figure is then multiplied by .6 to find the Whole Person Impairment of 6%. The 6% WPI is then adjusted for Future Earnings Capacity, Age & Occupation. As always, we are available for all your rating needs. |