436-035-0230 Other Lower Extremity Findings (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) [See attached table.] (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: [See attached table.] (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. [See attached table.] (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: [See attached table.] (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: [See attached table.] (b) In the second through fifth toes: [See attached table.] (c) Foot surgery [See attached table.] (d) Leg surgery [See attached table.] (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). (a) [See attached table.] (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). [See attached table.] (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 their feet for more than two hours in an 8-hour period, the award is 15% of the leg. [ED. NOTE: To view attachments referenced in rule text, click here to view rule.] Statutory/Other Authority: ORS 656.726 Statutes/Other Implemented: ORS 656.726, ORS 656.005, ORS 656.214 & ORS 656.268 History: WCD 8-2022, amend filed 11/08/2022, effective 12/04/2022 WCD 8-2012, f. 11-26-12, cert. ef. 1-1-13 WCD 2-2010, f. 5-5-10, cert. ef. 6-1-10 WCD 8-2005, f. 12-6-05, cert. ef. 1-1-06 WCD 9-2004, f. 10-26-04, cert. ef. 1-1-05 WCD 2-2003, f. 1-15-03, cert. ef. 2-1-03 WCD 6-1998, f. 5-13-98, cert. ef. 7-1-98 WCD 1-1997, f. 1-9-97, cert. ef. 2-15-97 WCD 3-1996, f. 1-29-96, cert. ef. 2-17-96 WCD 15-1992, f. 11-20-92, cert. ef. 11-27-92 WCD 10-1992(Temp), f. & cert. ef. 6-1-92 WCD 6-1992, f. 2-14-92, cert. ef. 3-13-92 WCD 2-1991, f. 3-26-91, cert. ef. 4-1-91 WCD 7-1988, f. 12-21-88, cert. ef. 1-1-89, Renumbered from 436-030-0340 WCD 2-1988, f. 6-3-88, cert. ef. 7-1-88 WCD 5-1981, f. 12-30-81, cert. ef. 1-1-82, Renumbered from 436-065-0532 WCD 4-1980, f. 3-20-80, cert. ef. 4-1-80