Most impairment ratings for conditions affecting the cervical spine are relatively straightforward and can be addressed using the first three categories of the Injury Model. The following real-life example of a more complicated case illustrates: 1) how higher impairment categories are applied, including combining categories; 2) the importance of rating the patient's condition based on the injury (as opposed to treatment outcome); and 3) how apportionment is handled in many jurisdictions.

Mr Smith, a 64-year old high school principal, presented with numbness and burning pain from the chest to the feet, unsteadiness of gait, and difficulty maintaining an erection (he was able, however, to obtain an erection and to ejaculate).

These symptoms reportedly had begun two years earlier, when he had tripped and fallen down a flight of stairs at work, striking his face. After the accident, he...

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