Explanation: LOM of the knee is contemplated by the meniscus DCs. Although , refers to “dislocated” cartilage and “locking” of the knee the rating criteria contemplate LOM of the knee through functional impairment with use (namely pain and effusion). , provides for a compensable evaluation for a “symptomatic” knee post removal of the cartilage. states “DC 5259 requires consideration of and because removal of semilunar cartilage may result in complications producing loss of motion.” h. Separate Evaluations, Knee Instability and Meniscus Disabilities Do not assign separate evaluations for subluxation or lateral instability under , and a meniscus disability , or Explanation: The criteria for both of those codes contemplate instability. Dislocation and locking under is consistent with instability. The broad terminology of "symptomatic" under also contemplates instability. Medical EPSS notes that instability is common symptomatology associated with both of these disabilities. i. Separate Evaluations – Genu Recurvatum When evaluating genu recurvatum, which involves hyperextension of the knee beyond 0 degrees of extension, under do not also evaluate separately under , but do evaluate separately under other evaluations if manifestations that are not overlapping, such as limitation of flexion under , are attributed to genu recurvatum, and do not evaluate separately under ; however, if instability is manifested from genu recurvatum at the “moderate” or “severe” level, evaluate under . j. Evaluating Shin Splints Evaluate shin splints analogously with . The table below explains the process and necessary considerations for evaluating shin splints. Step Action 1 Is a chronic disability present? If yes, go to Step 2. If no, deny SC. 2 Determine whether the shin splint disability affects the right, left, or bilateral extremity(ies). Go to Step 3.
caliber of bullet distance from victim organs, bone, blood vessels, and other structures hit. wound which could be sources of infection. fragments from explosive devices Most result in decreased tissue penetration compared to denser bullets. Multiple fragments in a localized area result in tissue disruption affecting a wide area. tears and lacerations Muscles that become isolated from nerve supply by lacerations will be non-functional. Torn muscle fibers heal with very dense scar tissue, but the nerve stimulation will not cross this barrier. Parts of muscle isolated from the nerve will most likely remain non-contractile resulting in a strength deficit proportional to amount of muscle tissue disrupted. Treatment for small tears is symptomatic. Large tears/lacerations may require reconstruction. through and through wound Injuring instrument enters and exits the body. Two wounds result entrance wound, and exit wound. References: For more information on muscle groups (MGs) and corresponding DCs, see anatomical regions of the body, see , and gunshot wounds (GSWs) with pleural cavity involvement, see . b. Standard Muscle Strength Grading System for Examinations Refer to the following table for information about how muscle strength is evaluated on an examination. Numeric Corresponding Strength Assessment Indications on Exam