Rating Impairment for Digital Nerve Lesions

Saturday, April 21, 2007 | 0

By Dr. Christopher Brigham

Greetings and welcome to this week's impairment tip.

Digital nerve lesions require 4 distinct components of documentation, as explained in Section 16.3 Sensory Impairment Due to Digital Nerve Lesions (5th ed., 445  450):

* Digit involved.

* Length of digit affected.

* Quality of sensory loss in 2-point discrimination.

* Nerves affected (radial and/or ulnar).

The method of rating impairment for this condition is as follows:

* Measure sensory loss as total (>15 mm) or partial (7-15 mm) dependent on results of two-point discrimination testing. (Note specific requirements for this testing on page 446)

* Determine distribution of sensory loss as either longitudinal (one nerve) or transverse (both nerves).

* Identify level of involvement (i.e. percentage of digit length).

* Use the above information to apply to Table 16-6 or 16-7 (5th ed., 448) for determining the impairment.

Following the above steps will ensure an accurate impairment rating for this condition.

Common errors we see with these ratings are:

* Rating prior to maximum medical improvement (nerve lesions may take over a year to improve).

* Rating for subjective complaints of decreased sensation without objective evidence of nerve injury.

* Invalid sensory assessment of two-point discrimination.

* Rating for digital nerve lesions using Table 16-10 (5th ed., 482). (Page 480 states: 'Sensory deficits in the digits strictly due to lesions of digital nerves are evaluated according to Section 16.3')

Tip: Total loss of sensory function (i.e. full length, both sides, and two point discrimination > 15 mm.) results in 50% digit impairment. You can easily convert impairments using our free impairment converter at www.impairment.com/tools. (http://rs6.net/tn.jsp?t=a8uyq5bab0.idqd48bab.84wzdpbab.10354&ts=S0241&p=http%3A%2F%2Fwww.impairment.com%2Ftools%2F)

Brigham is the editor of the Guides Newsletter and Guides Casebook. To view more of these tips visit:

www.impairment.com/tips

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