Chapter 15 Upper Limb
Author-Editors of the Musculoskeletal Chapters 15, 16, and 17
Publication Date: September 12, 2024
J. Mark Melhorn, MD, FAAOS, FABOS, FACOEM, FACS, FAAHS, FASSH, FIAIME
Co-chair, AMA Guides Editorial Panel
Clinical Associate Professor, Department of Orthopaedics, University of Kansas School of Medicine – Wichita
The Hand Center at Mid-America Orthopedics
Wichita, KS
Barry Gelinas, MD, DC, FIAIME
Advisor, AMA Guides Editorial Panel
Edmonton, AB, Canada
Subcommittee Upper Limb (Authors)
Barry Gelinas, MD, DC, FIAIME
Advisor, AMA Guides Editorial Panel
Edmonton, AB, Canada
Eric A.K. Mayer MD
North American Spine Society (NASS)
Dell Medical School at the University of Texas
Texas Spine & Scoliosis
Austin, TX
Gary W. Pushkin MD, FAAOS, FIAIME
Cohen & Pushkin MD PA
Baltimore, MD
J. Mark Melhorn, MD, FAAOS, FABOS, FACOEM, FACS, FAAHS, FASSH, FIAIME
Co-chair, AMA Guides Editorial Panel
Clinical Associate Professor, Department of Orthopaedics, University of Kansas School of Medicine – Wichita
The Hand Center at Mid-America Orthopedics
Wichita, KS
Les Kertay PhD, ABPP, FAIME
Ridgeside, TN
Noah Raizman, MD, MFA, FAAOS, FASSH
The Centers for Advanced Orthopaedics
Washington, DC
Steven P. Feinberg, MD, MS, MPH
Adjunct Clinical Professor
Stanford Anesthesiology, Perioperative and Pain Medicine Department
Stanford University - School of Medicine
Stanford, CA
Subcommittee Lower Limb (Authors)
Barry Gelinas, MD, DC, FIAIME
Advisor, AMA Guides Editorial Panel
Edmonton, AB, Canada
Christopher R. Brigham, MD
Hilton Head Island, SC
Charles F. Xeller MD, FIAIME
Houston, TX
Charles N. Brooks, MD
Bellevue, WA
Diana Kraemer, MD, FIAIME
Seattle, WA
Douglas W. Martin, MD, FACOEM, FAAFP, FIAIME
Co-chair, AMA Guides Editorial Panel
CNOS Occupational Medicine
Dakota Dunes, SD
J. Mark Melhorn, MD, FAAOS, FABOS, FACOEM, FACS, FAAHS, FASSH, FIAIME
Co-chair, AMA Guides Editorial Panel
Clinical Associate Professor, Department of Orthopaedics, University of Kansas School of Medicine – Wichita
The Hand Center at Mid-America Orthopedics
Wichita, KS
James Underhill, PsyD, MP, FIAIME
Austin, TX
Naomi Shields, MD, FAAOS
Tru Ortho
San Antonio, TX
Subcommittee Spine & Pelvis (Authors)
Barry Gelinas, MD, DC, FIAIME
Advisor, AMA Guides Editorial Panel
Edmonton, AB, Canada
C. Timothy Floyd, MD
Boise, ID
David Bauer, MD
Orthopedic Independent Medical Exams
Richardson, TX
Eugene J Carragee, MD, FAAOS
Professor, Emeritus
Department of Orthopaedic Surgery
Stanford University School of Medicine
Stanford, CA
Marjorie Eskay-Auerbach, MD, JD
Spine Care and Forensic Medicine, PLLC
Tucson, AZ
J. Mark Melhorn, MD, FAAOS, FABOS, FACOEM, FACS, FAAHS, FASSH, FIAIME
Co-chair, AMA Guides Editorial Panel
Clinical Associate Professor, Department of Orthopaedics, University of Kansas School of Medicine – Wichita
The Hand Center at Mid-America Orthopedics
Wichita, KS
Patrick R. Luers MD
Loudon, TN
Randall D. Lea, MD, MPH
Navarre, FL
Subcommittee International
Charl Els, MBChB, FCPsych[SA], MMedPsych (cum laude), Dip.ABAM, MROCC, DESS, ACBOM, FIAIME
Assistant Registrar: Continuing Competence
College of Physicians and Surgeons of Alberta
Edmonton, Alberta, CAN
(moderator)
Subcommittee PROMs
Dan Bruns, PsyD, FAPA
Health Psychology Associates
Greeley, CO
(moderator)
Alex Bruns, MS
Health Psychology Associates
Greeley, CO
Barry Nierenberg, PhD
College of Psychology, Nova Southeastern University
Miami, FL
Kathryn L. Mueller, MD, MPH
University of Colorado School of Medicine, APA and ACOEM
Aurora, CO
Maija Broox Bruzas, PhD
Health Psychology Associates
Greeley, CO
Stephen R. Gillaspy, PhD
American Psychological Association
Oklahoma City, OK
Ravi Prasad, PhD
University of California, Davis School of Medicine
Sacramento, CA
Robert L. Glueckauf, PhD
Dept. of Behavioral Sciences and Social Medicine
College of Medicine, Florida State University
Tallahassee, FL
AMA Guides Panel Members 2023 - 2024
Douglas W. Martin MD, FACOEM, FAAFP, FIAIME
Co-chair
CNOS Occupational Medicine
Dakota Dunes, SD
J. Mark Melhorn, MD, ,FAAOS, FABOS, FACOEM, FACS, FAAHS, FASSH FIAIME
Co-chair
Clinical Associate Professor, Department of Orthopaedics, University of Kansas School of Medicine – Wichita
The Hand Center at Mid-America Orthopedics
Wichita, KS
Steven P. Feinberg, MD, MS, MPH
Adjunct Clinical Professor
Stanford Anesthesiology, Perioperative and Pain Medicine Department
Stanford University - School of Medicine
Stanford, CA
David Gloss, MD
Charleston Area Medical Center
Charleston, West Virginia
Rita Livingston, MD, MPH
Live-Well Medical Consultants, LLC
Savannah, Georgia
Idalia Massa-Carroll, PhD
Colorado Psychological Services
Arvada, Colorado
E. Kano Mayer, MD
Seton Spine & Scoliosis Center
Austin, Texas
Gayla Poling, PhD
National Institute on Deafness and Other Communication Disorders
Bethesda, Maryland
Jeffrey Keller, MD*
American College of Correctional Physicians
Idaho Falls, Idaho
Marilyn Price, MD
Massachusetts General Hospital
Boston, Massachusetts
Noah Raizman, MD
The Centers for Advanced Orthopaedics
Washington, District of Columbia
Michael Saffir, MD
Orthopaedic Specialty Group
Bethany, Connecticut
Robert Sataloff, MD
Drexel University College of Medicine
Philadelphia, Pennsylvania
Advisors to the AMA Guides Editorial Panel (2023 – 2024)
Hon. Shannon Bishop, JD*
Louisiana Office of Workers' Compensation
Harahan, Louisiana
Christopher R. Brigham, MD, MMS
Brigham and Associates, Inc.
Charleston, South Carolina
Barry Gelinas, MD, DC
International Academy of Independent Medical Evaluators
Edmonton, Alberta
Abbie Hudgens, MPA*
Tennessee Bureau of Workers' Compensation
Nashville, Tennessee
Les Kertay, PhD, ABPP
Axiom Medical Consulting, LLC
Chattanooga, Tennessee
Hon. David Langham, JD
Florida Compensation Claims
Tallahassee, Florida
Robert Snyder, MD
Tennessee Bureau of Workers’ Compensation
Nashville, TN
* Former member, who was active during 2024 content creation
Former Panel Members (2019 – 2022)
Helene Fearon, PT
Fearon Physical Therapy, Inc.
Phoenix, Arizona
Robert Goldberg, DO
Beth Israel Hospital & Medical Center
New York, New York
Lylas Mogk, MD
Henry Ford Health System
Detroit, Michigan
Jan Towers, PhD, RN
Frederick Community Health Care for Homeless Clinic and Federally Qualified Health Center
Biglerville, Pennsylvania
Contributors (Reviewers)
For transparency, accountability and acknowledgement of contributions, reviewer’s names and affiliations are listed below in alphabetical order.
Alexis Rojas, PhD
University of Florida College of Medicine
Jacksonville, FL
Amy Lemley, JD
Foulston Siefkin LLP
Wichita, KS
Annette S. Kluck, PhD
The University of Mississippi
Oxford, MS
Arjena Valis Palacios Reese, MS
Nova Southeastern University
Miami, FL
Arthur E. Rhodes, MD
Devaughn James Injury Lawyers
Wichita, KS
Azadeh Farokhi, MD, MPH, MOH
Washington State Labor & Industries
Tumwater, WA
Barbara Ward-Zimmerman, PhD
Society for Health Psychology
Glastonbury, CT
Barry Gelinas, MD, DC
Advisor, AMA Guides Editorial Panel
Edmonton, CA
Behrooz Broukhim, MD
North Hollywood, CA
Ben Young, MD
Mid-American Orthopedics
Wichita, KS
Bill Townsley II, JD
Flesson, Gooing, Coulson & Kitch LLI
Wichita, KS
Brian Filips, JD
James H. Brown & Associates
Edmonton, Alberta, CAN
Brian S. Wilson, DC, MHA
Director of Medical and Health Services Research, Office of Chief Medical Officer
Ohio Bureau of Workers’ Compensation
Columbus, OH
Bruce Boyer, BA Psy
Western Washington University
Bellingham, WA
Christopher R. Brigham, MD, MMS
Brigham and Associates, Inc.
Charleston, South Carolina
Chris Wong, MD
Orthopaedic Associates of South Broward
Hollywood, CA
Christopher Kauffman, MD
North American Spine Society
Nashville, TN
Clifford K H Lau, MD, FAAOS
Honolulu, HI
D’anna Sydow, MS
Nova Southeastern University
Miami, FL
David Huculak, JD
James H. Brown & Associates
Edmonton, Alberta, CAN
David Hufford, MD
Mid-America Orthopedics
Wichita, KS
David Linklater, MD
WCB Alberta
Edmonton, Alberta, CAN
Descatha Alexis, MD, PhD
Univ Angers Inserm/CHU Angers/Hofstra Northwell
Angers, France
Dong-Sik Park, MD
Korean Academy of Independent Medical Examiners
Seoul, South Korea
Doug Shepherd, MD
Utah Labor Commission Industrial Accidents
Layton, UT
Charl Els, MBChB, FCPsych[SA], MMedPsych(cum laude), Dip.ABAM, MROCC, DESS, ACBOM, FIAIME
Assistant Registrar: Continuing Competence
College of Physicians and Surgeons of Alberta
Edmonton, Alberta, CAN
Edward D. Heath Jr, JD
Law Office of Edward D. Heath, Jr.
Wichita, KS
Emily Jayne Ross, PhD
University of Miami Miller School of Medicine
Miami, FL
Geert Lammens, MD
Geert Lammens Medische Expertises
Ghent, Belgium
Glenn Pfefer MD, FAAOS
Professor Cedars-Sinai, Orthopaedics
Los Angeles, CA
Harold Hoffman, MD
Occupational Medicine, University of Alberta
Edmonton, Alberta, CAN
Harvey Hanel
North Dakota Workforce Safety & Insurance
Bismarck, ND
Ian Blair Fries, MD
Bone, Spine & Hand Surgery, Chartered
Brick, NJ
Jennifer H. Christian, MD, MPH
Alliance for Bridging Health & Work
Wayland, MA
Jessica Flori, PhD
University of Connecticut School of Medicine
Farmington, CT
John Babb, MS
Mid-America Orthopedics
Wichita, KS
John Hopkins, MD, PhD
Preventative Medicine Research Center
Dallas, TX
Jolene F. Rohde
North Dakota Workforce Safety & Insurance
Bismarck, ND
Jon Morgan, DPM
Mid-America Orthopedics
Wichita, KS
Jonathan Voegeli, JD
Slape & Howard, Chtd
Wichita, KS
Jorgia Wilson, MS
Nova Southeastern University
Fort Lauderdale, FL
Joshua Paredes, BS
Florida State University
Tallahassee, FL
Hon. Bruce Moore, JD
Kansas Department of Labor
Division of Workers Compensation
Salina, KS
Julia M. Iannucci, PsyD
Nova Southeastern University
Miami, FL
Justin Strickland, MD
Mid-America Orthopedics
Wichita, KS
Kara Jackson Schroeder, MS
Nova Southeastern University
Miami, FL
Kelly Griffin, MA, MS
Nova Southeastern University
Fort Lauderdale, FL
Lawrence T. Donovan, DO
Naples, FL
Lora L. Black, PhD, MPH
The Ohio State University Wexner Medical Center
Columbus, OH
Mark S. Williams
The Hartford
Portland, ME
Maryana Kravtsenyuk, MD, MSc, FRCPC
University of Toronto, University of Alberta
Northern Ontario School of Medicine
Toronto, ON, CAN
Merita Ismajli Marku, MD
Skopje, North Macedonia
Michel Daigle, MD, FAAOS, FRCS, AOQ, ASSH
St-Bruno, QC, CAN
Michael Snyder, JD
Snider & Seiwert, LLC Law Firm
Wichita, KS
Michelle M. Langer, PhD
Northwestern University
Chicago, IL
Morgan Young, DC
Washington State Department of Labor and Industries
Tacoma, WA
Nan E. Rothrock, PhD
Northwestern University
Chicago, IL
Nina Lucas, MD, CCFP
Halifax, Nova Scotia, CAN
Noelle Mastrili, PhD
Rosalind Franklin University of Medicine and Science
North Chicago, IL
Olivia L. Campbell, PsyD
Spalding University, School of Professional Psychology
Louisville, KY
Pat Do, MD
Mid-America Orthopedics
Wichita, KS
Patrick A. Turner, JD
Devaughn James Injury Lawyers
Wichita, KS
Phil Slape, JD
Slape & Howard, Chtd.
Wichita, KS
Philo F. Willetts, Jr., MD
Westerly, RI
Quentin Durand-Moreau, MD, Med
University of Alberta – Division of Preventative Medicine
Edmonton, Alberta, CAN
Raymond Earl Peeples Jr., MD
Peeples Medical Legal Consulting LLC
Little Rock, AK
Richard Strain, MD
Broward Health Medical Center
Ft. Lauderdale, FL
Ron Wilcox, DC
Morgan Young Washington
Tumwater, WA
Ryan W. Livermore, MD
Mid-America Orthopedics
Wichita, KS
Sang-Gu Lee, MD
Naeun Hospital Spine Center
Korean Academy of Independent Medical Examiners
Seoul, South Korea
Scott S. Porter, PhD
Saible Neuropsychology, LLC
Petersburg, FL
Sebastian Straube, BM BcH, MA (Oxon), DPhil
University of Alberta, Department of Medicine
Edmonton, Alberta, CAN
Shawn Uraine, MD
IAIME
Loma Linda, CA
Stanley G. Andeell, JD
Foulston Siefkin LLP
Wichita, KS
Steven Howell, MD
Kansas Orthopaedic Center
Wichita, KS
Sydney Black, PsyD
Spalding University, School of Professional Psychology, St Elizabeth Physicians
Louisville, KY
Talaib Rajwani, MD, PhD
Edmonton, Alberta, CAN
Tarun Bhargava, MD
Mid-America Orthopedics
Wichita, KS
Timothy E. Doerr, MD
Idaho Medical Exams
Eagle, ID
Tom Mayer, MD
Pride
Dallas, TX
Victoria Cho, MD
WCB Alberta
Edmonton, Alberta, CAN
William J. Sullivan, MD
Aurora, CO
X. J. Ethan Moses, MD, MPH, FACOEM
Colorado Division of Worker’s Compensation
Denver, CO
William Messamore, MD
Kansas Orthopaedic Center
Wichita, KS
Provided Public Comments
Abby Cheng
Adi Renbaum
Amanda Trimpey
American Academy of Physical Medicine and Rehabilitation (AAPM&R)
American Psychological Association
Ashley Maleki
Benjamin Eric Kaplan
Bill Gallagher
Brian M Shelley
Brian Shelley
Caswell Nkuna
Catherine Jeakle Hill
Chaim Rogozinski
Chris Patton
Chris Stewart
Christopher John Standaert
Dan Bruns
David Bauer
Diana Kraemer
Dorian Kenleigh
Elaine Leighton
Emmy Ho
Ernst van den Doel
Eva Pacheco
Frank Salvi
Geert Pieter Lammens
Glen Seidman
Glen Seidman
James B. Talmage (TBWC)
James L. Williams (IAIME)
Jeffrey Scott
Jim Steihl
Joanne Willer
John Hopkins
Jolene Rohde
Jonathan Dunne
Josh Kerr
Kavitha Moturi
Keith L. Blankenship
Kevin Park
Leslie Narramore
Maria Buscemi
Martha Luevano
Matthew Gold
Michael Hisey
Millie Suk
Mohammad Eman
Pam Vanderbilt
Patrick Luers
Patti Vaughn
Prakash Jayabalan
Rahul Bhala
Rebecca Bowen
Richard Rozenswiag
Rick Wickstrom
Salim Esmail
Sarah Cartagena
Stephen Mandel
Steve Johnson
Tiffany Knowlton
Timothy R Lubenow MD
Tom Stanley
Travis Colt
Vikki Stefans
William Brady
William F Hefley, Jr
William Gallagher
Registered Attendees for Public Web Access
Barrie Ross
Barry Markman
Bill Gallagher
Brian M Shelley
Cary Ginter
Chris Voegele
David Bauer
David Hufford
DC Schainholz
Diana Kraemer
Eva Pacheco
Gary Pushkin
James Underhill
John Hopkins
Jolene Rohde
Kathryn Mueller
Manijeh Berenji
Matthew Gold
Naomi Shields
Sanjeev Batra
Sarah White
Tsun Ming Cheng
Non-Registered Attendees for Public Web Access
The panel extends its gratitude to all individuals and organizations who provided comments during the public access period as non-registered attendees.
Table 15-19: DBI Table Digit/Hand Impairment
Table 15-20: DBI Table Wrist Impairment
Table 15-21: DBI Table Elbow Impairment
Table 15-22: DBI Table Shoulder Impairment
Table 15-23f: DBI Table Digital Nerve Sensory Impairment
Table 15-23h: DBI Table Sensory-Only Peripheral Nerve Impairment
Table 15-23i: DBI Table Peripheral Nerve Impairment
Table 15-23j: DBI Table Brachial Plexus Impairment
Table 15-23k: DBI Table Entrapment Neuropathy Impairment
Table 15-23r: DBI Table Thoracic Outlet Syndrome Impairment
Table 15-25: DBI Table Amputation Impairment Upper Limb
Table 15-26: DBI Table Vascular Impairment Upper Limb
Table 15-27: DBI Table Complex Regional Pain Syndrome (CRPS) Impairment
Table 15-19: DBI Table Digit/Hand Impairment
- 15-19-00 Confirmed Diagnosis Corroborated by the Clinical History (Presentation) With No Residual Symptoms
- 15-19-01 Incongruent Clinical Presentation With Residual Symptoms
- 15-19-02 Incongruent Clinical Presentation With Reported Nonspecific Pain (Primary Pain)
- 15-19-03 Soft Tissue Disease or Event Healed Superficial or Minor (ie, abrasion, bite, bruise, burn, contusion, laceration, puncture wound)*
- 15-19-04 Soft Tissue Disease or Event Healed Nonsuperficial
- 15-19-05 Sprain, Strain, Specific Traumatic Event, Tendonitis, Tendinosis, Nonspecific Tendonitis of Digit/Hand
- 15-19-06 Digital Stenosing Tenosynovitis, Trigger Digit
- 15-19-07 Dupuytren's Contracture*
- 15-19-08 Arthritis Posttraumatic Without ROM Loss, Reported by Joint (IP, DIP, PIP, MCP)
- 15-19-09 Instability Thumb IP Joint or Finger DIP Joint (eg, dislocation with residual)
- 15-19-10 Instability Finger PIP Joint (eg, dislocation with residual)
- 15-19-11 Instability Finger MCP Joint (eg, dislocation with residual)
- 15-19-12 Instability Thumb MCP Joint (eg, dislocation with residual)
- 15-19-13 Instability Thumb CMC Joint (eg, dislocation with residual)
- 15-19-14 Flexor Thumb IP Joint With ROM Loss (flexor tendon rupture/laceration)
- 15-19-15 Flexor Thumb MCP Joint With ROM Loss (flexor tendon rupture/laceration)
- 15-19-16 Flexor Finger DIP Joint With ROM Loss (flexor tendon rupture/laceration)
- 15-19-17 Flexor Finger PIP With ROM Loss (flexor tendon rupture/laceration)
- 15-19-18 Flexor Finger MCP With ROM Loss (flexor tendon rupture/laceration)
- 15-19-19 Extensor Thumb IP Joint With ROM Loss (flexor tendon rupture/laceration, posttraumatic tendon adhesions)
- 15-19-20 Extensor Thumb MCP Joint With ROM Loss (extensor tendon rupture/laceration)
- 15-19-21 Extensor Finger DIP Joint With ROM Loss (extensor tendon rupture/laceration)
- 15-19-22 Extensor Finger PIP With ROM Loss (extensor tendon rupture/laceration)
- 15-19-23 Extensor Finger MCP With ROM Loss (extensor tendon rupture/laceration)
- 15-19-24 Joint Stiffness Thumb IP ROM Loss (from posttraumatic tendon adhesions and/or arthritis; arthritis from septic, gouty, rheumatoid, etc; and/or fracture)
- 15-19-25 Joint Stiffness Thumb MCP ROM Loss (from posttraumatic tendon adhesions and/or arthritis; arthritis from septic, gouty, rheumatoid, etc; and/or fracture)
- 15-19-26 Joint Stiffness Thumb CMC ROM Loss (from posttraumatic tendon adhesions and/or arthritis; arthritis from septic, gouty, rheumatoid, etc; and/or fracture)
- 15-19-27 Joint Stiffness Finger DIP ROM Loss (from posttraumatic tendon adhesions and/or arthritis; arthritis from septic, gouty, rheumatoid, etc; and/or fracture)
- 15-19-28 Joint Stiffness Finger PIP ROM Loss (from posttraumatic tendon adhesions and/or arthritis; arthritis from septic, gouty, rheumatoid, etc; and/or fracture)
- 15-19-29 Joint Stiffness Finger MCP ROM Loss (from posttraumatic tendon adhesions and/or arthritis; arthritis from septic, gouty, rheumatoid, etc; and/or fracture)
- 15-19-30 Arthrodesis Thumb IP Joint171,172
- 15-19-31 Arthrodesis Thumb MCP Joint
- 15-19-32 Arthrodesis Thumb CMC Joint
- 15-19-33 Arthrodesis Finger DIP Joint
- 15-19-34 Arthrodesis Finger PIP Joint
- 15-19-35 Arthrodesis Finger MCP Joint
- 15-19-36 Arthroplasty Thumb IP Joint
- 15-19-37 Arthroplasty Thumb MCP Joint
- 15-19-38 Arthroplasty Thumb CMC Joint
- 15-19-39 Arthroplasty Finger DIP Joint*
- 15-19-40 Arthroplasty Finger PIP Joint*
- 15-19-41 Arthroplasty Finger MCP Joint*
- 15-19-42 Fracture Thumb Distal Phalanx*
- 15-19-43 Fracture Thumb Proximal Phalanx*
- 15-19-44 Fracture Thumb Metacarpal*
- 15-19-45 Fracture Thumb Metacarpal Base173 (intraarticular CMC joint)*
- 15-19-46 Fracture Finger Distal Phalanx*174
- 15-19-47 Fracture Finger Middle Phalanx*
- 15-19-48 Fracture Finger Proximal Phalanx*
- 15-19-49 Fracture Finger Metacarpal*175,176
Table 15-20: DBI Table Wrist Impairment
- 15-20-00 Confirmed Diagnosis Corroborated by the Clinical History (Presentation) With No Residual Symptoms
- 15-20-01 Incongruent Clinical Presentation With Residual Symptoms
- 15-20-02 Incongruent Clinical Presentation With Reported Nonspecific Pain (Primary Pain)
- 15-20-03 Soft Tissue Disease or Event Healed Minor (ie, abrasion, bite, bruise, burn, contusion, laceration, puncture wound)*
- 15-20-04 Soft Tissue Disease or Event Healed Nonsuperficial*
- 15-20-05 Wrist Sprain, Strain, Specific Traumatic Event, de Quervain's, Intersection Syndrome, Tendonitis, Tendinosis, Nonspecific Tendonitis of Wrist and/or Forearm177,178
- 15-20-06 Wrist/Forearm Mass or Ganglion Cyst (FCR mass, EDC mass, including recurrent mass, etc)179,180
- 15-20-07 Triangular Fibrocartilage Complex (TFCC) Event181,182
- 15-20-08 Ulnar Impaction
- 15-20-09 Posttraumatic Arthritis Wrist Without ROM Loss
- 15-20-10 Forearm Radial, Ulna, or Both Fracture Without ROM Loss
- 15-20-11 Instability Dorsal Intercalated Segment Instability (DISI) (eg, dislocation, fracture, fracture dislocation, malunion, nonunion with residual)183
- 15-20-12 Instability Volar Intercalated Segment Instability (VISI) (eg, dislocation, fracture, fracture dislocation, malunion, nonunion with residual)183
- 15-20-13 Instability Scapholunate Ligament (eg, dislocation, fracture, fracture dislocation, malunion, nonunion with residual)183-185
- 15-20-14 Instability Peri-Lunate (eg, dislocation with residual)183
- 15-20-15 Instability Carpal Complex (eg, dislocation with residual)183
- 15-20-16 Instability Distal Radioulnar Joint (DRUJ) (eg, dislocation with residual, isolated ulnar head injury, after the Sauvé-Kapandji procedure)183,185,186
- 15-20-17 Ruptured or Laceration Muscle Tendon (Flexor or Extensor) Without ROM Loss
- 15-20-18 Flexor With ROM Loss Wrist (from flexor tendon rupture/laceration
- 15-20-19 Extensor With ROM Loss Wrist (from extensor tendon rupture/laceration)
- 15-20-20 Joint Stiffness Wrist With ROM Loss
- 15-20-21 Avascular Necrosis (AVN) of Lunate (Kienböck's disease with possible dislocation, fracture, fracture dislocation, malunion, nonunion with residual)187,188
- 15-20-22 Arthroplasty Wrist189
- 15-20-23 Arthrodesis Wrist190
Table 15-21: DBI Table Elbow Impairment
- 15-21-00 Confirmed Diagnosis Corroborated by the Clinical History (Presentation) With No Residual Symptoms
- 15-21-01 Incongruent Clinical Presentation With Residual Symptoms
- 15-21-02 Incongruent Clinical Presentation With Reported Nonspecific Pain (Primary Pain)
- 15-21-03 Soft Tissue Disease or Event Healed Minor (ie, abrasion, bite, bruise, burn, contusion, laceration, puncture wound)*
- 15-21-04 Soft Tissue Disease or Event Healed Nonsuperficial*
- 15-21-05 Sprain, Strain, Specific Traumatic Event, Tendonitis, Tendinosis, Nonspecific Tendonitis of Elbow
- 15-21-06 Olecranon Bursitis
- 15-21-07 Epicondylitis Medial or Lateral
- 15-21-08 Distal Biceps Tendon Rupture194,195
- 15-21-09 Instability Elbow Collateral Ligament Event With Medial (Ulnar), Lateral, or Posterolateral196
- 15-21-10 Posttraumatic Elbow Arthritis Without ROM Loss
- 15-21-11 Ruptured or Lacerated Muscle or Tendon Without Limited ROM
- 15-21-12 Joint Stiffness Elbow With ROM Loss (from arthritis or arthrofibrosis [ie, posttraumatic, septic, gouty, rheumatoid], tendon adhesions, fracture [ie, radius, ulnar, distal humerus])
- 15-21-13 Loose Bodies or Osteochondral Lesions (not bone spur)
- 15-21-14 Heterotopic Ossification Elbow Without Limited ROM
- 15-21-15 Arthroplasty Radial Head (isolated)
- 15-21-16 Radial Head Resection*
- 15-21-17 Arthroplasty Total Elbow (total, soft tissue, prosthesis, or Kashiwagi-Outerbridge)*197
- 15-21-18 Arthrodesis Elbow198
- 15-21-19 Fracture Radial Head*199
- 15-21-20 Radial Shaft Fracture Without ROM Loss
- 15-21-21 Ulna Shaft Fracture Without ROM Loss
- 15-21-22 Radial and Ulnar Shaft Fracture Without ROM Loss
Table 15-22: DBI Table Shoulder Impairment
- 15-22-00 Confirmed Diagnosis Corroborated by the Clinical History (Presentation) With No Residual Symptoms
- 15-22-01 Incongruent Clinical Presentation With Residual Symptoms
- 15-22-02 Incongruent Clinical Presentation With Reported Nonspecific Pain (Primary Pain)
- 15-22-03 Soft Tissue Disease or Event Healed Minor (ie, abrasion, bite, bruise, burn, contusion, laceration, puncture wound)*
- 15-22-04 Soft Tissue Disease or Event Healed Nonsuperficial
- 15-22-05 Sprain, Strain, Specific Traumatic Event, Tendonitis, Tendinosis, Nonspecific Tendonitis of Shoulder
- 15-22-06 Shoulder Bursitis or Impingement Syndrome With No ROM Loss or Instability200,201
- 15-22-07 Heterotopic Ossification or Calcific Tendinitis
- 15-22-08 Posttraumatic Shoulder Arthritis Without ROM Loss
- 15-22-09 Partial Rotator Cuff Disease202,203
- 15-22-10 Full Rotator Cuff Disease204-212
- 15-22-11 Labral Lesions and Superior Labrum From Anterior to Posterior (SLAP) Lesions
- 15-22-12 Long Head Biceps (dislocation/subluxation/rupture)
- 15-22-13 AC Joint Separation213,214
- 15-22-14 Instability Unidirectional or Multidirectional, Dislocation, and Hill-Sachs Lesion (subluxation, see shoulder sprain, strain)
- 15-22-15 Instability Multidirectional Bilateral
- 15-22-16 Joint Stiffness Shoulder With ROM Loss (from arthritis [ie, posttraumatic, septic, gouty, rheumatoid], tendon adhesions, fracture [ie, proximal humerus], adhesive capsulitis, frozen shoulder)
- 15-22-17 Loose Bodies or Chondral Lesions (not bone spur)
- 15-22-18 Arthrodesis Shoulder
- 15-22-19 Arthroplasty Shoulder (total shoulder arthroplasty [TSA] or reverse total shoulder arthroplasty [RSA])215,216
- 15-22-20 Arthroplasty Shoulder (resection)217
- 15-22-21 Arthroplasty Shoulder (hemiCAP or resurfacing)218,219
- 15-22-22 Hemiarthroplasty Shoulder220
- 15-22-23 Fracture Humeral Shaft Without ROM Loss
- 15-22-24 Fracture Scapula (body, neck, coracoid process) Without ROM Loss
- 15-22-25 AVN Humeral Head Without ROM Loss
- 15-22-26 Distal Clavicle Resection (Acromioplasty)221,222
Table 15-23f: DBI Table Digital Nerve Sensory Impairment
- 15-23f-00 Confirmed Diagnosis Corroborated by the Clinical History (Presentation) With No Residual Symptoms
- 15-23f-01 Incongruent Clinical Presentation With Residual Symptoms
- 15-23f-02 Incongruent Clinical Presentation With Reported Nonspecific Pain (Primary Pain)
- 15-23f-03 Transverse Digital Nerve Loss Distal to Thumb IP Joint or Distal to Finger PIP Joint
- 15-23f-04 Longitudinal Digital Nerve Loss Distal to Thumb IP Joint or Distal to Finger PIP Joint
- 15-23f-05 Transverse Digital Nerve Loss Distal to Thumb MCP Joint or Distal to Finger MCP Joint
- 15-23f-06 Longitudinal Digital Nerve Loss Distal to Thumb MCP Joint or Distal to Finger MCP Joint
Table 15-23h: DBI Table Sensory-Only Peripheral Nerve Impairment
- 15-23h-00 Confirmed Diagnosis Corroborated by the Clinical History (Presentation) With No Residual Symptoms
- 15-23h-01 Incongruent Clinical Presentation With Residual Symptoms
- 15-23h-02 Incongruent Clinical Presentation With Reported Nonspecific Pain (Primary Pain)
- 15-23h-03 Sensory-Only Peripheral Nerve Impairment (List)
- 15-23h-04 Thumb Sensory-Only Peripheral Loss Resulting in Digit Sensory Loss Below Midforearm
- 15-23h-05 Index/Middle Finger Sensory-Only Peripheral Loss Resulting in Digit Sensory Loss Below Midforearm
- 15-23h-06 Ring/Little Finger Sensory-Only Peripheral Loss Resulting in Digit Sensory Loss Below Midforearm
- 15.23i1 Sensory and Motor Assessment Levels
- 15.23i2 Steps for Peripheral Nerve Injury Rating
- 15.23i3 Steps for Brachial Plexus Injury Rating
- 15.23i4 Cutaneous Innervation of the Upper Limb
- 15.23i5 Motor Innervation of the Upper Limb
DBI Table 15-23i Peripheral Nerve Impairment
- 15-23i-00 Confirm Diagnosis Corroborated by the Clinical History (Presentation) With No Residual Symptoms
- 15-23i-01 Incongruent Clinical Presentation With Residual Symptoms
- 15-23i-02 Incongruent Clinical Presentation With Reported Nonspecific Pain (Primary Pain)
- 15-23i-03 Pectoralis (medial or lateral)
- 15-23i-04 Axillary
- 15-23i-05 Dorsal Scapular
- 15-23i-06 Long Thoracic
- 15-23i-07 Median Above Mid-forearm
- 15-23i-08 Median Anterior Interosseous Branch
- 15-23i-09 Median Below Mid-forearm—Entire Nerve (traditionally palmar digit thumb, middle, and/or radial ring) (Note: Use DBI Table 15-23k for carpal tunnel syndrome entrapment neuropathy)
- 15-23i-10 Musculocutaneous
- 15-23i-11 Radial Upper Arm With Loss of Triceps
- 15-23i-12 Radial Elbow With Sparing of Triceps
- 15-23i-13 Subscapulars (upper and lower)
- 15-23i-14 Suprascapular
- 15-23i-15 Thoracodorsal
- 15-23i-16 Ulnar Above Mid-forearm
- 15-23i-17 Ulnar Below Mid-forearm—Entire Nerve (traditionally palmar digit ulnar ring and little finger) (Note: Use DBI Table 15-23k for cubital tunnel syndrome entrapment neuropathy)
- 15-23i-18 Diabetic Neuropathy
Table 15-23i: DBI Table Peripheral Nerve Impairment
- 15-23j-00 Confirm Diagnosis Corroborated by the Clinical History (Presentation) With No Residual Symptoms
- 15-23j-01 Incongruent Clinical Presentation With Residual Symptoms
- 15-23j-02 Incongruent Clinical Presentation With Reported Nonspecific Pain (Primary Pain)
- 15-23j-03 Brachial Plexus (C5 through T1)
- 15-23j-04 Upper Trunk (C5, C6, Erb-Duchene)
- 15-23j-05 Middle Trunk (C7)
- 15-23j-06 Lower Trunk (C8, T1, Dejerine-Klumpke)
Table 15-23k: DBI Table Entrapment Neuropathy Impairment
- 15-23k-00 Confirm Diagnosis Corroborated by the Clinical History (Presentation) With No Residual Symptoms
- 15-23k-01 Incongruent Clinical Presentation With Residual Symptoms
- 15-23k-02 Incongruent Clinical Presentation With Reported Nonspecific Pain (Primary Pain)
- 15-23k-03 Median Nerve Wrist (carpal tunnel syndrome)
- 15-23k-04 Median Nerve Forearm (anterior interosseous syndrome or pronator syndrome)
- 15-23k-05 Ulnar Nerve Wrist (Guyon's canal syndrome)
- 15-23k-06 Ulnar Nerve Elbow (cubital tunnel syndrome)
- 15-23k-07 Radial Nerve Wrist Forearm (Wartenberg's syndrome)
- 15-23k-08 Radial Nerve Elbow (radial tunnel syndrome or posterior interosseous of proximal forearm syndrome)
Table 15-23r: DBI Table Thoracic Outlet Syndrome Impairment
- 15-23r-00 Confirm Diagnosis Corroborated by the Clinical History (Presentation) With No Residual Symptoms
- 15-23r-01 Incongruent Clinical Presentation With Residual Symptoms
- 15-23r-02 Incongruent Clinical Presentation With Reported Nonspecific Pain (Primary Pain)
- 15-23r-03 Thoracic Outlet Syndrome Neurogenic
- 15-23r-04 Thoracic Outlet Syndrome Vascular (Arterial)
- 15-23r-05 Thoracic Outlet Syndrome Vascular (venous)
Table 15-25: DBI Table Amputation Impairment Upper Limb
- 15.25d Thumb/Finger Amputations: Details and Associated Conditions
- 15.25e Phalange and/or Metacarpal Amputations and Associated Conditions
- 15.25f Carpal-Metacarpal Joint to Shoulder: Details and Associated Conditions
Table 15-26: DBI Table Vascular Impairment Upper Limb
- 15-26-00 Confirm Diagnosis Corroborated by the Clinical History (Presentation) With No Residual Symptoms
- 15-26-01 Incongruent Clinical Presentation With Residual Symptoms
- 15-26-02 Incongruent Clinical Presentation With Reported Nonspecific Pain (Primary Pain)
- 15-26-03 Vascular Condition of Digits/Hand*
- 15-26-04 Vascular Condition of Upper Limb*
Table 15-27: DBI Table Complex Regional Pain Syndrome (CRPS) Impairment
- 15-27-00 Confirm Diagnosis Corroborated by the Clinical History (Presentation) With No Residual Symptoms
- 15-27-01 Incongruent Clinical Presentation With Residual Symptoms
- 15-27-02 Incongruent Clinical Presentation With Reported Nonspecific Pain (Primary Pain)lower
- 15-27-03 Complex Regional Pain Syndrome (CRPS)
Table 15.01g Upper Limb Evaluation Record
Table 15-16 Impairment Values Calculated From Digit Impairments
Table 15-16a Relationship of Impairment of the Digits to Hand
Table 15-16b Relationship of Impairment of the Hand to Upper Limb
Table 15-16c Relationship of Impairment of the Upper Limb to Whole Person
Table 15-16d Combined Values Chart
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