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-4, Elbow Regional Grid; and 15-5, Shoulder Regional Grid provide the same guidance (6th ed, 391, 395, 398, and 401): If motion loss is present, this impairment may alternatively be assessed using Section 15.7, Range of Motion Impairment. A range of motion impairment stands alone and is not combined with diagnosis impairment. However, this instruction is not provided in the LE tables. Functionally, motion is of greater importance in the UE. With the LE, stability is key for standing and locomotion. Some LE diagnosis-based impairment grids refer to the ROM
examiner calculates the impairment for the injured joint and the uninjured contralateral joint and subtracts the impairment of the contralateral joint from the impairment of the injured joint. The result is the impairment of the injured joint resulting from the injury. Instead of using ROM as the rating method, ROM measurement can be the basis for the GMPE in the diagnosis-based impairment (DBI), as explained in Section 15.3b, Adjustment Grid: Physical Examination (6th ed, 407). Many IR reports do not document UE atrophy or joint stability. These omissions may lead to
Chapter 15, The Upper Extremities (6th ed, 383-492) is the longest and most complex chapter, reflective of the complexities of the upper limb and the type of injuries encountered. This chapter incorporates the following changes: (1) International Classification of Functioning, Disability, and Health (ICF) Model of Functioning and Disability is used to provide a common basis for the description of human functioning and impairments, (2) principles of assessment have been simplified and clarified, (3) specific diagnosis-based rating tables for the most common
