In the Sixth Edition distal clavicle resection (resection arthroplasty of the acromioclavicular joint) results in ratable impairment. However, only a single diagnosis within a region may be rated. Therefore, if another impairing condition is present in the shoulder region, such as impingement syndrome or rotator cuff disease, only that resulting in the greatest causally-related impairment is rated.
The rating for distal clavicle resection is based on loss of the distal-most clavicle and hence acromioclavicular joint (ACJ). However, in the setting of an occupational or other compensable injury or illness, causation of the impairment is often an important issue. Typically only impairment causally-related to the injury is rated. Assume for example a lifting injury at work caused a tear in a rotator cuff tendon already attenuated by repetitive impingement on inferiorly projecting spurs from longstanding degenerative arthritis of the...
