Chapter 1: Philosophy, Purpose, and Appropriate Use of the Guides
Tables
Table 1-1: Definitions and interpretations of Impairment and Disability
Table 1-2: Activities of Daily Living Commonly Measured in Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) Scales
Table 1-3: Scales for Measurement of Instrumental Activities of Daily Living (IADL) and Activities of Daily Living (ADL)

Chapter 2: Practical Application of the Guides
Tables
[There are no tables in this chapter.]

Chapter 3: The Cardiovascular System: Heart and Aorta
Tables
Table 3-1: NYHA Functional Classification of Cardiac Disease
Table 3-2: Relationship of METs and Functional Class According to 5 Treadmill Protocols
Table 3-3: Energy Expenditure in METs During Bicycle Ergometry
Table 3-4: Severity of Valve Stenosis
Table 3-5: Criteria for Rating Permanent Impairment due to Valvular Heart Disease
Table 3-6a: Criteria for Rating Impairment due to Coronary Artery Disease
Table 3-6b: Maximal and 90%% of Maximal Achievable Heart Rate, by Age and Sex [same content as Table 3-7]
Table 3-7: Maximal and 90%% of Maximal Achievable Heart Rate, by Age and Sex [same content as Table 3-6b]
Table 3-8: Criteria for Rating Permanent Impairment due to Congenital Heart Disease
Table 3-9: Criteria for Rating Impairment due to Cardiomyopathies
Table 3-10: Criteria for Rating Permanent Impairment Due to Pericardial Heart Disease
Table 3-11: Criteria for Rating Permanent Impairment due to Arrhythmias
Table 3-12: Cardiac Impairment Evaluation Summary

Chapter 4: The Cardiovascular System: Systemic and Pulmonary Arteries
Tables
Table 4-1: Classification of Hypertension in Adults
Table 4-2: Criteria for Rating Permanent Impairment Due to Hypertensive Cardiovascular Disease
Table 4-3: Criteria for Rating Permanent Impairment Due to Diseases of the Aorta
Table 4-4: Criteria for Rating Permanent Impairment to the Upper Extremity Due to Peripheral Vascular Disease
Table 4-5: Criteria for Rating Permanent Impairment of the Lower Extremity Due to Peripheral Vascular Disease
Table 4-6: Criteria for Rating Permanent Due to Pulmonary Hypertension
Table 4-7: Cardiac Impairment Evaluation Summary

Chapter 5: The Respiratory System
Tables
Table 5-1: Impairment Classification of Dyspnea
Table 5-2a: Predicted Normal Forced Vital Capacity (FVC) in Liters for Men (BTPS)
Table 5-2b: Predicted Lower Limit of Normal Forced Vital Capacity (FVC) for Men
Table 5-3a: Predicted Normal Forced Vital Capacity (FVC) in Liters for Women (BTPS)
Table 5-3b: Predicted Lower Limit of Normal Forced Vital Capacity (FVC) for Women
Table 5-4a: Predicted Normal Forced Expiratory Volume in the First Second (FEV₁) in Liters for Men
Table 5-4b: Predicted Lower Limit of Normal Forced Expiratory Volume in the First Second (FEV₁) for Men
Table 5-5a: Predicted Normal Forced Expiratory Volume in the First Second (FEV₁) in Liters for Women
Table 5-5b: Predicted Lower Limit of Normal Forced Expiratory Volume in the First Second (FEV₁) for Women
Table 5-6a: Predicted Normal Diffusing Capacity for Carbon Monoxide (Dco) for Men (STPD)
Table 5-6b: Predicted Lower Limit of Normal Diffusing Capacity for Carbon Monoxide (Dco) for Men
Table 5-7b: Predicted Lower Limit of Normal Diffusing Capacity for Carbon Monoxide (Dco) for Women
Table 5-8: Impairment Classification for Prolonged Physical Work Intensity by Oxygen Consumption
Table 5-9: Impairment Classification for Asthma Severity
Table 5-10: Impairment Rating for Asthma
Table 5-11: Scale for Judging Capabilities of Subjects With Cancer
Table 5-12: Impairment Classification for Respiratory Disorders, Using Pulmonary Function and Exercise Test Results
Table 5-13: Respiratory Impairment Evaluation Summary

Chapter 6: The Digestive Tract
Tables
Table 6-1: Desirable Weights for Men by Height and Body Build
Table 6-2: Desirable Weights for Women by Height and Body Build
Table 6-3: Methodology for Determining the Grade in an Impairment Class
Table 6-4: Criteria for Rating Permanent Impairment due to Upper Digestive Tract (Esophagus, Stomach and Duodenum, Small Intestine, and Pancreas) Disease
Table 6-5: Criteria for Rating Permanent Impairment due to Colonic and Rectal Disorders
Table 6-6: Criteria for Rating Permanent Impairment due to Anal Disease
Table 6-7: Impairments From Surgically Created Stomas
Table 6-8: Criteria for Rating Permanent Impairment due to Liver Disease
Table 6-9: Criteria for Rating Permanent Impairment due to Biliary Tract Disease
Table 6-10: Criteria for Rating Permanent Impairment due to Herniation
Table 6-11: Digestive System Impairment Evaluation Summary

Chapter 7: The Urinary and Reproductive Systems
Tables
Table 7-1: Criteria for Rating Permanent Impairment due to Upper Urinary Tract Disease
Table 7-2: Criteria for Rating Permanent Impairment due to Urinary Diversion Disorders
Table 7-3: Criteria for Rating Permanent Impairment due to Bladder Disease
Table 7-4: Criteria for Rating Permanent Impairment due to Urethral Disease
Table 7-5: Criteria for Rating Permanent Impairment due to Penile Disease
Table 7-6: Criteria for Rating Permanent Impairment due to Scrotal Disease
Table 7-7: Criteria for Rating Impairment due to Testicular, Epidydimal, and Spermatic Cord Disease
Table 7-8: Criteria for Rating Impairment due to Seminal Vesicle Disease
Table 7-9: Criteria for Rating Permanent Impairment due to Vulval and Vaginal Disease
Table 7-10: Criteria for Rating Permanent Impairment due to Cervical and Uterine Disease
Table 7-11: Criteria for Rating Permanent Impairment due to Fallopian Tube and Ovarian Disease
Table 7-12: Urinary and Reproductive Systems Impairment Evaluation Summary

Chapter 8: The Skin
Tables
Table 8-1: Structure, Functions, and Disorders of the Skin
Table 8-2: Criteria for Rating Permanent Impairment due to Skin Disorders
Table 8-3: Skin Impairment Evaluation Summary

Chapter 9: The Hematopoietic System
Tables
Table 9-1: Functional Classification of Hematologic System Disease
Table 9-2: Criteria for Rating Permanent Impairment Due to Anemia
Table 9-3: Criteria for Rating Impairment Due to White Blood Cell Disease
Table 9-4: Criteria for Rating Permanent Impairment Due to Hemorrhagic and Platelet Disorders
Table 9-5: Hematologic Impairment Evaluation Summary

Chapter 10: The Endocrine System
Tables
Table 10-1: Criteria for Rating Permanent Impairment Due to Hypothalamic-Pituitary Axis Disorders
Table 10-2: Criteria for Rating Permanent Impairment Due to Thyroid Disease
Table 10-3: Impairments Related to Hyperparathyroidism
Table 10-4: Impairments Related to Hypoparathyroidism
Table 10-5: Impairments Related to Hypoadrenalism
Table 10-6: Impairments Related to Hyperadrenocorticism
Table 10-7: Permanent Impairment Related to Phenochromocytoma
Table 10-8: Criteria for Rating Permanent Impairment Due to Diabetes Mellitus
Table 10-9: Criteria for Rating Permanent Impairment due to Hypoglycemia
Table 10-10: Endocrine System Impairment Evaluation Summary

Chapter 11: Ear, Nose, Throat, and Related Structures
Tables
Table 11-1: Monaural Hearing Loss and Impairment
Table 11-2: Computation of Binaural Hearing Impairment
Table 11-3: Relationship of Binaural Hearing Impairment to Impairment of the Whole Person
Table 11-4: Criteria for Rating Impairments due to Vestibular Disorders
Table 11-5: Criteria for Rating Impairment due to Facial Disorders and/or Disfigurement
Table 11-6: Criteria for Rating Impairment due to Air Passage Defects
Table 11-7: Relationship of Dietary Restrictions to Permanent Impairment
Table 11-8: Classification of Voice/Speech Impairment
Table 11-9: Voice/Speech Impairment Related to Impairment of the Whole Person
Table 11-10: Ear, Nose, Throat, and Related Structures Impairment Evaluation Summary

Chapter 12: The Visual System
Tables
Table 12-1: Calculation of the Impairment Rating for the Visual System
Table 12-2: Impairment of Visual Acuity
Table 12-3: Calculation of the Acuity-Related Impairment Rating
Table 12-4: Classification of Visual Acuity Impairment
Table 12-5: Impairment of Visual Field
Table 12-6: Calculation of the Field-Related Impairment Rating
Table 12-7: Classification of the Visual Impairment
Table 12-8: Conversion of Field Radius to Field Score
Table 12-9: Correction for Central Scotomata
Table 12-10: Classification of Impairment of the Visual System and of the Whole Person
Table 12-11: Determination of Reading Acuity and Impairment Rating, Using Letter Size and Viewing Distance

Chapter 13: The Central and Peripheral Nervous System
Tables
Table 13-1: Neurologic Impairments That Are Combined With the Most Severe Cerebral Impairment
Table 13-2: Criteria for Rating Impairment of Consciousness and Awareness
Table 13-3: Criteria for Rating Impairment Due to Episodic Loss of Consciousness or Awareness
Table 13-4: Criteria for Rating Impairment Due to Sleep and Arousal Disorders
Table 13-5: Clinical Dementia Rating (CDR)
Table 13-6: Criteria for Rating Impairment due to Mental Status
Table 13-7: Criteria for Rating Impairment Due to Aphasia or Dysphasia
Table 13-8: Criteria for Rating Impairment Due to Emotional or Behavioral Disorders
Table 13-9: Examples of Whole Person Impairment Due to Visual Acuity Loss (see also Table 12-4)
Table 13-10: Examples of Whole Person Impairment (WPI) Due to Visual Field Loss (See also Table 12-7)
Table 13-11: Criteria for Rating Impairment of the Cranial Nerve V (Trigeminal Nerve)
Table 13-12: Criteria for Rating Impairment of the Cranial Nerve VII (Facial Nerve)
Table 13-13: Criteria for Rating Impairment of the Cranial Nerve VIII (Vestibulocochlear Nerve)
Table 13-14: Criteria for Rating Impairment of the Cranial Nerves IX,X, and XII (Glossopharyngeal, Vagus, and Hypoglossal Nerves)
Table 13-15: Criteria for Rating Impairments Due to Station and Gait Disorders
Table 13-16: Criteria for Rating Impairment of One Upper Extremity
Table 13-17: Criteria for Rating Impairment of Two Upper Extremities
Table 13-18: Criteria for Rating Neurologic Impairment of Respiration
Table 13-19: Criteria for Rating Neurologic Impairment of the Bladder
Table 13-20: Criteria for Rating Neurologic Anorectal Impairment
Table 13-21: Criteria for Rating Neurologic Sexual Impairment
Table 13-22: Criteria for Rating Impairment Related to Chronic Pain in One Upper Extremity
Table 13-23: Classification and Procedure for Determining Impairment Due to Pain or Sensory Deficit Resulting
Table 13-24: Classification and Procedure for Determining Nervous System Impairment Due to Loss of Muscle Power and Motor Function Resulting From Peripheral Nerve Disorders
Table 13-25: Nervous System Impairment Evaluation Summary

Chapter 14: Mental and Behavioral Disorders
Tables
Table 14-1: Classes of Impairment Due to Mental and Behavioral Disorders
Table 14-2: Selected Impairments and Common Limitations in Ability

Chapter 15: The Spine
Tables
Table 15-1: Physical Examination
Table 15-2: Common Radicular Syndromes
Table 15-3: Criteria for Rating Impairment Due to Lumbar Spine Injury
Table 15-4 Criteria for Rating Impairment Due to Thoracic Spine Injury
Table 15-5: Criteria for Rating Impairment Due to Cervical Disorders
Table 15-6: Rating Corticospinal Tract Impairment
Table 15-7 Criteria for Rating Whole Person Impairment Percent Due to Specific Spine Disorders to Be Used as Part of the ROM Method
Table 15-8 Impairment Due to Abnormal Motion of the Lumbar Region: Flexion and Extension
Table 15-9: Impairment Due to Abnormal Motion and Ankylosis of the Lumbar Region: Lateral Bending
Table 15-10: Impairment Due to Abnormal Motion (Flexion) and Ankylosis of the Thoracic Region
Table 15-11: Impairment Due to Abnormal Motion and Ankylosis of the Thoracic Region: Rotation
Table 15-12: Cervical Region Impairment from Abnormal Extension or Flexion or Ankylosis
Table 15-13: Impairment Due to Abnormal Motion and Ankylosis of the Cervical Region: Lateral Bending
Table 15-14: Determining Impairment Due to Abnormal Motion and Ankylosis of the Cervical Region: Rotation
Table 15-15: Determining Impairment Due to Sensory Loss
Table 15-16: Determining Impairment Impairment Due to Loss of Power and Motor Deficits
Table 15-17: Unilateral Spinal Nerve Root Impairment Affecting the Upper Extremity
Table 15-18: Unilateral Spinal Nerve Root Impairment Affecting the Lower Extremity
Table 15-19: Whole Person Impairment Due to Selected Disorders of the Pelvis
Table 15-20: Spine Evaluation Summary

Chapter 16: The Upper Extremities
Tables

Table 16-1: Conversion of Impairment of the Digits to Impairment of the Hand

Table 16-2:Conversion of Impairments of the Hand to Impairment of the Upper Extremity

Table 16-3: Conversion of Impairment of the Upper Extremity to the Impairment of the Whole Person

Table 16-4: Impairment Estimates for Upper Limb Amputation at Various Levels

Table 16-5: Sensory Quality Impairment Classification

Table 16-6: Digit Impairment for Transverse and Longitudinal Sensory Losses in Thumb and Little Finger Based on the Percentage of Digit Length Involved

Table 16-7: Digit Impairment for Transverse and Longitudinal Sensory Losses in Index, Middle, and Ring Fingers Based on Percentage of Digit Length Involved

Table 16-8a: Thumb Impairment Values Due to Lack of Radial Abduction and to Ankylosis

Table 16-8b: Thumb Impairment Values Due to Lack of Abduction and to Ankylosis

Table 16-9: Thumb Impairments Due to Lack of Opposition and Ankylosis

Table 16-10: Determining Impairment of the Upper Extremity Due to Motor and Loss-of-Power Deficits Resulting From Peripheral Nerve Disorders

Table 16-11: Determining Impairment of the Upper Extremity Due to Motor and Loss-of-Power Deficits Resulting From Peripheral Nerve Disorders Based on Individual Muscle Rating

Table 16-12a: Origins and Functions of the Peripheral Nerves of the Upper Extremity Emanating From the Brachial Plexus

Table 16-12b: Origins and Functions of the Peripheral Nerves of the Upper Extremity Emanating From the Brachial Plexus

Table 16-13: Maximum Upper Extremity Impairment Due to Unilateral Sensory or Motor Deficits of Individual Spinal Nerves or to Combined 100% Deficits

Table 16-14: Maximum Upper Extremity Impairments Due to Unilateral Sensory or Motor Deficits of Brachial Plexus or to Combined 100% Deficits

Table 16-15: Maximum Upper Extremity Impairment Due to Unilateral Sensory or Motor Deficits or Combined 100% Deficits of the Major Peripheral Nerves

Table 16-16: Objective Diagnostic Criteria for CRPS (RSD and causalgia

Table 16-17: Impairment of the Upper Extremity Due to Peripheral Vascular Disease

Table 16-18: Maximum Impairment Values for the Digits, Hand, Wrist, Elbow, and Shoulder Due to Specific Joints or Units

Table 16-19: Joint Impairment From Synovial Hypertrophy

Table 16-20: Digit Impairment Due to Active Ulnar or Radial Deviation

Table 16-21: Digit Impairment from Rotational Deformity

Table 16-22: Joint Impairment from Persistent Subluxation or Dislocation

Table 16-23: Joint Impairment Due to Excessive Passive Mediolateral Instability

Table 16-24: Wrist and Elbow Joint Impairment From Excessive Active Mediolateral Deviation

Table 16-25: Upper Extremity Impairment Due to Carpal Instability Patterns

Table 16-26: Upper Extremity Impairment Due to Symptomatic Shoulder Instability Patterns

Table 16-27: Impairment of the Upper Extremity After Arthroplasty of Specific Bones or Joints

Table 16-28: Digit Impairment Due to Intrinsic Tightness

Table 16-29: Digit Impairment Due to Constrictive Tenosynovitis

Table 16-30: Digit Impairment Due to Extensor Tendon Subluxation Over the MP Joint

Table 16-31: Average Strength of Unsupported Grip by Occupation in 100 Subjects

Table 16-32: Average Strength of Grip by Age in 100 Subjects

Table 16-33: Average Strength of Unsupported Grip by Occupation in 100 Subjects

Table 16-34: Upper Extremity Joint Impairment Due to Loss or Grip or Pinch Strength

Table 16-35: Impairment of the Upper Extremity Due to Strength Deficit From Musculoskeletal Disorders Based on Manual Muscle Testing of Individual Units of Motion of the Shoulder and Elbow

Chapter 17: The Lower Extremities
Tables
Table 17-1: Methods Used to Evaluate Impairments of the Lower Extremities
Table 17-2: Guide to the Appropriate Combination of Evaluation Methods
Table 17-3: Whole Person Impairment Values Calculated From Lower Extremity Impairment
Table 17-4: Impairment Due to Limb Length Discrepancy
Table 17-5: Lower Limb Impairment Due to Gait Derangement
Table 17-6: Impairment Due to Unilateral Leg Muscle Atrophy
Table 17-7: Criteria for Grades of Muscle Functions of the Lower Extremity
Table 17-8: Impairment Due to Lower Extremity Muscle Weakness
Table 17-9: Hip Motion Impairment
Table 17-10: Knee Impairment
Table 17-11: Ankle Motion Impairment Estimates
Table 17-12: Hindfoot Impairment Estimates
Table 17-13: Ankle or Hindfoot Deformity Impairments
Table 17-14: Toe Impairments
Table 17-15: Impairment Due to Ankylosis in Hip Flexion
Table 17-16: Impairment Due to Ankylosis in Hip Internal Rotation
Table 17-17: Impairment Due to Ankylosis in Hip External Rotation
Table 17-18: Impairment Due to Ankylosis in Hip Abduction
Table 17-19: Impairment Due to Ankylosis in Hip Abduction
Table 17-20: Impairment Due to Knee Ankylosis in Varus
Table 17-21: Impairment Due to Knee Ankylosis in Valgus
Table 17-22: Impairment Due to Knee Ankylosis in Flexion
Table 17-23: Impairment Due to Knee Ankylosis in Varus
Table 17-24: Impairment Due to Ankylosis in Internal or External Malrotation
Table 17-25: Impairment Due to Ankylosis in Varus Position
Table 17-26: Impairment Due to Ankylosis in Varus Position
Table 17-27: Impairment Due to Ankylosis in Internal Malrotation
Table 17-28: Impairment Due to Ankylosis in External Malrotation
Table 17-29: Impairments for the Loss of Tibia-Os Calcis Angle
Table 17-30: Impairment of the Foot Due to Ankylosis of Toes
Table 17-31: Arthritis Impairments Based on Roentgenographically Determined Cartilage Intervals
Table 17-32: Impairment Estimates for Amputations
Table 17-33: Impairment Estimates for Certain Lower Extremity Impairments
Table 17-34: Rating Hip Replacement Results
Table 17-35: Rating Knee Replacement Results
Table 17-36: Impairments for Skin Loss
Table 17-37: Impairments Due to Nerve Defects
Table 17-38: Lower Extremity Impairment Due to Peripheral Vascular Disease

Chapter 18: Pain
Tables
Table 18-1: Illustrative List of Well-Established Pain Syndromes Without Significant Identifiable Organ Dysfunction to Explain the Pain
Table 18-2: Illustrative List of Associated Pain Syndromes
Table 18-3: Impairment Classification Due to Pain Disorders
Table 18-4: Ratings Determining Impairment Associated With Pain
Table 18-5: Assessment of Pain Behavior
Table 18-6: Worksheet for Calculating Total Pain-Related Impairment Score
Table 18-7: Determining Impairment Class on the Basis of Total Pain-Related Impairment Score

Appendix
Tables
Table A-1: Recording ROM Measurements for the Upper Extremities
Table A-2: Recording ROM Measurements for the Upper Spine
Table A-3: Recording ROM Measurements for the Lower Extremities

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