Minimum percentages of loss of use for amputation levels, losses of motion, sensory losses and surgical procedures.
Note: An example would be where in addition to a described loss of motion, pain and circulatory disturbance further limits the use of an arm or a leg. A meniscectomy in a knee with less than a good result would call for an estimate higher than 5% loss of use of the leg at the knee. The same principle would apply to surgical procedures on the back. The schedule of minimum disabilities contained in this section was adopted upon the advice of a worker's compensation advisory council subcommittee after a survey of doctors experienced in treating industrial injuries.
At functional level | Equivalent to amputation at midpoint |
Stump unsuitable to accommodate prosthesis | Equivalent to amputation at next most proximal joint |
Stump not functional | Grade upward |
All ranges of joint motion or degrees of ankylosis not listed below are to be interpolated from existing percent of disability listed. |
All ranges of joint motion or degrees of ankylosis not listed below are to be interpolated from existing percent of disability listed.
Ankylosis, optimum position, generally 15° to 30° flexion | 50% |
Mal position | Grade upward |
To compute disabilities for loss of motion relate % of motion lost to average range Shortening of leg (no posterior or lateral angulation) No disability for shortening less than 3/4 inch | |
3/4 inch | 5% |
1 inch | 7% |
1-1/2inches | 14% |
2 inches | 22% |
Greater than 2 inches of shortening results in greater proportionate rating than above | |
Prosthesis Total | Minimum of 40% |
Partial | 35% |
Ankylosis, optimum position, 170° | 40% |
Remaining range, 180° - 135° | 25% |
Remaining range, 180° - 90° | 10% |
Prosthesis Total | 50% |
Partial | 45% |
Removal of patella | To be based on functional impairment |
Total or partial meniscectomy (open or closed procedure) | |
Excellent to good result | 5% |
Anterior cruciate ligament repair | Minimum of 10% |
Total ankylosis, optimum position, total loss of motion | 40% |
Ankylosis ankle joint Loss of dorsi and plantar flexion | 30% |
Subtalar ankylosis Loss of inversion and eversion | 15% |
Ankylosis great toe at proximal joint | 50% |
All other toes at proximal | 40% |
Ankylosis great toe at distal joint | 15% |
All other toes at any interphalangeal | If no deformity, no |
joint | disability |
Mal position | On merits |
Loss of motion | No disability |
Ankylosis, optimum position, scapula free | 55% |
In mal position | Grade upward |
Limitation of active elevation in flexion and abduction to 45 but otherwise normal | 30% |
Limitation of active elevation in flexion and abduction to 90 but otherwise normal | 20% |
Limitation of active elevation in flexion and abduction to 135° but otherwise normal | 5% |
Prosthesis | 50% |
Ankylosis, optimum position, 45° angle | |
With radio-ulnar motion destroyed | 60% |
With radio-ulnar motion in tact | 45% |
Rotational ankylosis in neutral | 20% |
position | |
Any mal position | Grade upward |
Limitation of motion elbow joint, radio-ulnar motion | |
unaffected | |
Remaining range-180° - 135° | 35% |
Remaining range-135° - 90° | 20% |
Remaining range-180° - 90° | 10% |
Rotation at elbow joint | |
Neutral to full pronation | 10% |
Neutral to full supination | 15% |
Ankylosis, optimum position 30° | 30% |
dorsiflexion | |
Mal position | Grade upward |
Total loss dorsiflexion | 12-1/2% |
Total loss palmarflexion | 7-1/2% |
Total loss inversion | 5% |
Total loss eversion | 5% |
Any digit | 50% Lesser involvement to be graded appropriately- 35% for palmar, 15% for dorsal surface |
Total median sensory loss to hand | 65-75% |
Total ulnar sensory loss to hand | 25% |
Ulnar nerve paralysis | |
Above elbow, sensory involvement | 50% at wrist |
Below elbow, motor and sensory involvement | 45-50% at wrist |
Below elbow, motor involvement only | 35-45% at wrist |
Below elbow, sensory involvement | |
only | 5-10% at wrist |
Median nerve paralysis | |
Above elbow, motor and sensory involvement | 55-65% at wrist |
Thenar paralysis with sensory loss | 40-50% at wrist |
Radial nerve paralysis | |
Complete loss of extension, wrist and fingers | 45-55% at wrist |
Paroneal nerve paralysis | |
At level below knee | 25-30% at knee |
Removal of disc material, no undue symptomatic complaints or any objective findings | 5% |
Chymopapain injection | To be rated by doctor |
Spinal fusion, good results | 5% minimum per level |
Implantation of an artificial spinal disc | 7.5% per level |
Removal of disc material and fusion | 10% per level |
Cervical fusion, successful | 5% |
Compression fractures of vertebrae of such degree to cause permanent disability may be rated 5% and graded upward |
Note: It is the subcommittee's intention that a separate minimum 5% allowance be given for every surgical procedure (open or closed, radical or partial) that is done to relieve from the effects of a disc lesion or spinal cord pressure. Each disc treated or surgical procedure performed will qualify for a 5% rating. Due to the fact a fusion involves 2 procedures a 1) laminectomy (dissectomy) and a 2) fusion procedure, 10% permanent total disability will apply when the 2 surgical procedures are done at the same time or separately.
Examples:
Patient A | 12/01/1990 | Laminectomy | 5% PTD |
05/01/1992 | Fusion | increases to 10% PTD | |
Patient B | 12/01/1990 | Laminectomy & Fusion | 10% PTD |
05/01/1992 | Re-fusion | increases to 15% PTD | |
12/01/1992 | Laminectomy at New Level | increases to 20% PTD | |
05/01/1993 | Fusion at 12/1/92 Level | increases to 25% PTD | |
12/01/1993 | Re-fusion at 5/1/93 Level | increases to 30% PTD |
Thumb | Mid-position | Complete Extension |
Distal joint only ......... | 25% | 35% |
Proximal joint only ...... | 15% | 20% |
Distal and proximal joints. | 35% | 65% |
Carpometacarpal joint only | 20% | 20% |
Distal, proximal and carpometacarpal joints . . .. | 85% | 100% |
Fingers | ||
Distal joint only ......... | 25% | 35% |
Middle joint only ........ | 75% | 85% |
Proximal joint only ...... | 40% | 50% |
Distal and middle joints . .. | 85% | 100% |
Distal, middle and proximal joints ................. | 100% | 100% |
Fingers | Loss of Flexion | Loss of Use | Loss of Extension | Loss of Use |
Distal joint only . .. | 10% - | 1% | 10% - | 2% |
20% - | 2% | 20% - | 4% | |
40% - | 3% | 30% - | 6% | |
40% - | 5% | 40% - | 8% | |
50% - | 10% | 50% - | 15% | |
60% - | 15% | 60% - | 20% | |
70% - | 20% | 70% - | 30% | |
80% - | 25% | 80% - | 40% | |
100% - | 60% | |||
Middle joint only .. | 10% - | 5% | 10% - | 2 1/2% |
20% - | 10% | 20% - | 5% | |
30% - | 15% | 30% - | 10% | |
40% - | 25% | 40% - | 15% | |
50% - | 40% | 50% - | 30% | |
60% - | 50% | 60% - | 50% | |
70% - | 60% | 70% - | 70% | |
80% - | 70% | 80% - | 90% | |
100% - | 100% | |||
Proximal joint only | 10% - | 5% | 10% - | 2 1/2% |
20% - | 10% | 20% - | 5% | |
30% - | 15% | 30% - | 15% | |
40% - | 20% | 40% - | 20% | |
50% - | 25% | 50% - | 25% | |
60% - | 30% | 60% - | 40% | |
70% - | 35% | 70% - | 75% | |
80% - | 40% | 80% - | 85% | |
90% - | 100% |
Loss of one kidney 5% permanent total disability.
Total loss of sense of smell 2-1/2% permanent total dis - ability.
Wis. Admin. Code Department of Workforce Development DWD 80.32