Question: My question relates to how to rate a patient with a catastrophic foot injury resulting in multiple metatarsal amputations. The patient is a 55-year-old man. Approximately 15 years ago, a long, heavy pipe fell and crushed the distal lateral aspect of his left foot. His multiple surgeries have included a partial ray amputation of his fourth and fifth meta-tarsals and neuroma excisions. Approximately 8 months ago, he had a partial third ray amputation, and thus a new impairment rating is needed. He has had significant problems with chronic foot pain and is on chronic opioids. He does not use a gait aid. His Pain Disability Questionnaire is 75. An amputation of the second toe or a transmetatarsal amputation has been suggested; however, the patient prefers not to have surgery. Examination at this time reveals a slight limp,...
