Document ID: chunk:federal_register_of_legislation:F2016L01332:reg:73:p1
Version: federal_register_of_legislation:F2016L01332
Segment Type: reg
Provision Reference: reg 73 (pt 1/6)
Character Range: 118525–121116

73

Step 1: Establish which joints in the lower limbs, if any, have some restriction of movement as a result of accepted conditions affecting the lower limbs.

 For the purposes of assessment under this Guide the major joints of the lower limbs are the hip, the knee and the ankle.

 In addition, the joints of the toes are also to be considered. However, only one rating is to be given for the total effect of restrictions in all joints of the toes of one foot considered together.

 Conditions such as chondromalacia patellae and torn medial meniscus may affect the range of movement of the knee. A condition such as fractured neck of femur will be likely to affect the range of movement of the hip. In cases of a fracture, the ranges of movements of the joints both proximal to and distal to the fracture site should generally be considered as joints the range of movement of which may be affected. The closer a fracture site is to a joint, the more likely it is that it will have some effect on the range of movement of that joint.

 Hence, it must be determined which, if any, of both right and left:

 + hip;
+ knee;
+ ankle; and
+ toes;

 potentially have loss of range of movement due to accepted conditions.

 Certain vascular conditions or neurological conditions of the lower limb, such as muscle weakness, tremor, apraxia, or loss of co-ordination may have an effect on the function of the lower limb without restricting the range of movement of any joint of the limbs.  The assessment of such conditions is made in Step 4 of this Part.

 Step 2: Calculate the functional impairment due to restriction of the range of movement of joints in the lower limbs as a result of accepted conditions of the lower limbs.

 Single functional impairment ratings may be obtained for each of the following eight joints or sets of joints based on restriction of range of movement due to accepted conditions:

 + Right hip;          + Left hip;
+ Right knee;       + Left knee;
+ Right ankle;      + Left ankle; and
+ Right toes;        + Left toes.

These impairment ratings are obtained by applying Table 3.2.1. Such functional impairment ratings are referred to as the functional impairment rating of the relevant lower limbs based on restriction or range of movement of the right or left hip, knee, ankle, or toes respectively.

    The loss of range of movement is to be estimated to the nearest quarter of the normal range of movement.

    The range of movement relevant to assessment under this Guide is the active range of movement of the joint, that is the range through