Question:

When rating impairment for an upper extremity disorder associated with a range of motion deficit, should I also assess the contralateral, uninjured extremity? How should I rate impairment when the injured extremity has normal motion per the Guides, but the contralateral extremity has greater motion?

Answer:

“The Guides recognizes that ‘normal’ is not a fine point or an absolute in terms of physical and mental functioning and good health. More often, normality is a range …normal can vary with age, sex, and other factors…. An interpretation of normal that is too strict can result in overestimation or underestimation of impairment (4th ed., 2).”

Impairments for upper extremity motion deficits are provided in a series of pie charts in section 3.1. These were “derived on a 100% scale for each motion unit of each upper extremity joint taking into...

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