Rating Upper Extremity Nerve Deficit

Saturday, July 29, 2006 | 0

by Mark Kremer

Upper Extremity Nerve Deficit rating has an unusually high error rate. Claims examiners and attorneys reviewing medical reports need to be able to review the process and identify errors.

Rating Nerve Deficit requires a four step procedure. First, the involved nerve is identified per table 16-15. Second, the deficit is graded on a 0-5 scale (table 16-10 or 16-11). Third, an impairment percentage within the grade's range is selected (table 16-10 or 16-11). Finally, the impairment percentage is multiplied by the maximum value of the nerve (table 16-15) to determine the upper extremity impairment.

Let's work through an example. A well written medical report finds a Grade 4 Sensory Loss of the median nerve below the midforearm. Physician selects a 25% impairment percentage from within the grade 4 range.

What do you do? First, consult Table 16-15 (page 492). Under the "Nerve" column, locate Median (below midforearm). Next, as we are dealing with a sensory loss, find the corresponding figure under the "Sensory Deficit or Pain" column. We find a value of 39% upper extremity impairment (UEI). We will use this figure later. Second, we see the physician selected a grade 4 deficit. A review of table 16-10 (sensory loss table) indicates grade 4 has a range of 1-25%. Physician chose a 25% impairment level. Finally, this 25% figure is multiplied by the maximum value of the nerve (39). 25% multiplied by 39 equals 9.75, which rounds up to 10% UEI. This figure equates to 6% WPI. This figure is then adjusted for Future Earnings Capacity, Age & Occupation.

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