QUESTION: I practice in South Carolina and have been asked to convert an impairment rating (IR) of the cervical spine to a percentage loss of the back. South Carolina Title 42-Workers’ Compensation, Section 42-9-30, provides a listing “for the loss of use of the back.” However, it does not provide one for the cervical spine. How do I make that conversion?

ANSWER: The spine is comprised of three segments: the cervical spine (neck), the thoracic spine (upper and mid back), and the lumbar spine (lower back). The AMA Guides’ cervical spine IR was never intended to be converted to “a percentage loss of the back.” To do so is medically nonsensical because the neck (cervical spine) and back (thoracolumbar spine) are two anatomically different entities. Similarly, being asked to convert a cervical spine impairment to a “head” impairment...

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