Document ID: chunk:federal_register_of_legislation:F2016L01332:reg:81:p1
Version: federal_register_of_legislation:F2016L01332
Segment Type: reg
Provision Reference: reg 81 (pt 1/6)
Character Range: 140894–143488

81

Step 1: Calculate the functional impairment due to restriction of range of movement of the spine as a result of accepted conditions.

 Table 3.3.1 is to be applied to rate spinal function. It is based on range of movement of the spine. Two ratings may be given from this table -- one for the cervical spine and one for the thoraco-lumbar spine. Only one rating is to be given for the cervical spine for any condition or combination of conditions which contribute to the loss of range of movement of the cervical spine. Only one rating is to be given for the thoraco-lumbar spine for any condition or combination of conditions which contribute to the loss of range of movement of the thoraco-lumbar spine.

 It is not practicable to measure range of movement of the thoracic spine independently of that of the lumbar spine. If only the thoracic spine is to be rated, all movements are to be measured, but emphasis is given to rotation. If only the lumbar spine is to be rated, all movements are to be measured, but emphasis is given to forward flexion. However, even if conditions of both the thoracic and lumbar spine are to be assessed, only one rating is to be made from the thoraco-lumbar spine column of Table 3.3.1.

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

 The loss of range of movement will usually be provided as a fractional loss of range of movement and such data can be used directly in Table 3.3.1. However, sometimes, the measured movements of the affected part of the spine will be available in degrees. In such a case the measured movement is to be compared with the average range of movement of the normal spine to obtain the fractional loss of range of movement.

 The average ranges of movement of the normal spine may be obtained from Table 3.5.1 in Part 3.5. These values are to be used in arriving at the fractional loss of range of movement when the actual movements of the spine are known in degrees.

 If a functional impairment rating obtained from Table 3.3.1 has been contributed to by any non-accepted conditions, then that rating is to be moderated by applying Chapter 19 (Partially Contributing Impairment).

 Step 2: (Omit this step if you are not assessing an impairment of the thoraco­ lumbar spine.) Determine the impairment rating applicable to the thoraco- lumbar spine by applying Table 3.3.2.

 Table 3.3.2 is to be applied to assess functional loss of the thoraco-lumbar spine that is not adequately measured by loss of range of movement.  Ratings obtained from Table 3.3.2 are