QUESTION: A man fell and sustained facial fractures that required surgery. He was left without residual deformity, disfigurement, scar, or other ratable conditions. Per the AMA Guides Sixth Edition, Chapter 11, Ear, Nose, Throat and Related Structures, there is no ratable impairment. However, he does have a residual small area of numbness over his right upper lip noticed occasionally when touching the spot or chewing. There is no interference with activities of daily living (ADLs) and no facial neuralgia. Would I rate him per Table 13-20, Criteria for Rating Miscellaneous Peripheral Nerves (6th ed, 344) as class 1 with “sensory loss only in an anatomic distribution” and 1% whole person permanent impairment? However, the trigeminal nerve is not listed in Table 13-20.

ANSWER: Table 13-20 does not list the trigeminal nerve; however you could consider this by analogy....

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