IMPAIRMENT RATING REPORT

Lower Extremity Range of Motion Impairments

Lower extremity range of motion was evaluated following AMA Guides protocol using a goniometer or similar device for measurements. A minimum of three measurements were taken following adequate warmup. Measurements that failed reproducibility (precision) guidelines as specified in the Guides are not considered when calculating impairment as they may indicate a lack of optimum effort by the subject during examination.

Left Side

Left ankle plantar flexion maximum motion of 6° = 21% left foot (Table 17-11, p. 537)

Left ankle extension maximum motion of 5° = 10% left foot (Table 17-11, p. 537)

Left great toe extension maximum motion of 9° = 7% left foot (Table 17-14, p. 537)

Left second toe extension maximum motion of 5° = 3% left foot (Table 17-14, p. 537)

Left third toe extension maximum motion of 5° = 3% left foot (Table 17-14, p. 537)

Left fourth toe extension maximum motion of 5° = 3% left foot (Table 17-14, p. 537)

Left fifth toe extension maximum motion of 5° = 3% left foot (Table 17-14, p. 537)

Lower Extremity Range of Motion Summary

Range of motion impairments within the same joint (i.e. hip, knee, etc.) are added. The sum is then later combined with other impairments in the same body region.

Left ankle ROM summary: 21% + 10% = 31% left foot

Lower Extremity Impairments

Muscle atrophy was observed in subject's left calf. Impairment is based on the difference in circumference between the left and right calf as measured at the same level on both sides. The difference in circumference between the two sides is 1.0 cm. Based on Table 17-6, p. 530, the impairment is 3% left lower extremity region.

Foot Summary

Left great toe ROM summary: 7% left foot

Left lesser toes: 3% + 3% + 3% + 3% = 12% left foot. According to the footnote for Table 17-14 on page 537, the maximum impairment for two or more lesser toes of one foot is 7% foot (equivalent to 2% whole person). Impairment for the lesser toes is therefore capped at 7% left foot.

Left foot summary: 31% ⊕ 7% ⊕ 7% = 40% left foot

Left foot conversion: 40% left foot = 28% left lower extremity (Table 17-2a, p. 527)

Summaries and Conversions

Conversions from upper extremity and lower extremity to whole person are based on Table 16-2 (p. 439) and Table 17-3 (p. 527) respectively.

Left lower extremity summary: 28% left lower extremity

28% left lower extremity = 11% whole person

Whole person impairment (WPI) summary: 11% whole person

The above figures can be found in the American Medical Association's Guides to the Evaluation of Permanent Impairment, Fifth Edition, 2001.