20 C.F.R. § 220 app 3 to Part 220

Current through October 31, 2024

Appendix 3 to Part 220 - Railroad Retirement Board Occupational Disability Standards

1. Introduction

1.01 The Board uses this appendix to adjudicate the occupational disability claims of employees with medical conditions and job titles covered by the Tables in this appendix. The Tables are divided into "Body Parts", with each Body Part further divided by job title. Under each job title there is a list of impairments and tests with accompanying test results which establish a finding of "D" (disabled). The use of these Tables is a three-step process. In the first step we determine whether the employee's regular railroad occupation is covered by the Tables; next we establish the existence of an impairment covered by the Tables; finally, we reach a disability determination. If we do not find an employee disabled under these Tables, the employee may still be found disabled using Independent Case Evaluation (ICE), as explained in subpart C of this part.

1.02 The Cancer Tables are treated in a different way than other body systems. Different types of cancer and their treatments have different functional impacts. In the Cancer Tables the impact of the impairment is seen as being significant or not significant. Therefore, these tables contain an "S" (significant) which is equivalent to a "D" rating. A detailed explanation of how to use those tables is in that section. The steps to use the remaining Tables are explained below:

2. Confirming the Impairment

2.01 Once we determine that the employee's regular railroad occupation is covered by the Job Titles in the Tables, we must determine the existence of an impairment covered by the Tables. This is done through the use of Confirmatory Tests. These tests can include information from medical records, surgical or operative reports, or specific diagnostic test results. Confirmatory Tests are listed in the initial section regarding each Body Part covered in the Tables. If an impairment cannot be confirmed because of inconsistent medical information, ICE may be required.

2.02 There are two types of Confirmatory Tests as follows.

2.03 "Highly Recommended" Tests-The designation of a confirmatory test as being "highly recommended" means that the test is almost always performed to confirm the existence of the impairment. For many conditions, only one "highly recommended" test finding is suggested to confirm the impairment. However, there may be times when that test is not available or is negative, but other more detailed testing confirms the impairment.

2.04 Example A: To confirm the condition of pulmonary hypertension, the Tables under Body Part C., Cardiac, designate as "highly recommended": an electrocardiogram which indicates definite right ventricular hypertrophy. However, the impairment may also be confirmed by insertion of a Swan-Ganz catheter into the pulmonary artery and the pulmonary artery pressure measured directly.

2.05 There may be some conditions for which several "highly recommended" tests are suggested to confirm an impairment. In these circumstances, we will use all "highly recommended" tests to establish the existence of the impairment.

2.06 Example B: Under Body Part E., Lumbar Sacral Spine, three highly recommended medical findings are identified for the diagnosis of chronic back pain, not otherwise specified. These findings include:

A. A history of back pain under medical treatment for at least one year, and

B. A history of back pain unresponsive to therapy for at least one year, and

C. A history of back pain with functional limitations for at least one year.

2.07 All three of these criteria must be satisfied to confirm the existence of chronic back pain.

2.08 Sometimes the employee may have undergone detailed testing which is as reliable as one of the "highly recommended" tests listed in the Tables. In cases where an impairment has not been confirmed by one of the designated "highly recommended" tests, the impairment may still be confirmed by "recommended" tests (see below) or by evidence acceptable under section 220.27 of this part.

2.09 Recommended Tests-The designation of a confirmatory test as "recommended" means that the test need not be performed, or be positive, to confirm the impairment. However, a positive test provides significant support for confirming the impairment. If there are no "highly recommended" tests for confirming the impairment, at least one of the "recommended" tests should be positive.

2.10 There are two categories of recommended tests which are described below.

A. Imaging studies -These studies can include MRI, CAT scan, myelogram, or plain film x-rays. For conditions where several of these imaging studies are identified as "recommended" tests, at least one of the test results should be positive and meet the confirmatory test criteria. For some conditions, such as degenerative disc condition, there are several equivalent imaging methods to confirm a diagnosis.

B. Other tests -This category of tests refers to non-imaging studies.

2.11 If there are no "highly recommended" confirmatory tests designated to confirm an impairment and the "recommended" confirmatory tests only include non-imaging procedures, at least one of these tests should be positive to confirm the impairment. The greater the number of tests that are positive, the greater the confidence that the correct diagnosis has been established.

2.12 Example: Under Body Part C., Cardiac, the diagnostic confirmatory tests for ventricular ectopy, a cardiac arrhythmia, include the following "recommended" tests:

A. Medical record review, i.e., a review of the claimant's medical records, or

B. Holter monitoring, or

C. Provocative testing producing a definite arrhythmia.

2.13 In this situation, only one of the "recommended" confirmatory tests need be positive to confirm the impairment. However, the more tests that are positive, the stronger the support for the diagnosis.

2.14 In no circumstance will the Board require that an invasive test be performed to confirm an impairment. Several of the Confirmatory Tests which are described in the Tables are invasive and it is not the intention of the Board to suggest that these be performed. The inclusion of invasive tests in the Tables Confirmatory Tests section is intended to help the Board evaluate the significance of findings from such tests that may have already been performed and which are part of the submitted medical record.

2.15 If an employee's impairment(s) cannot be confirmed by use of the confirmatory tests listed in the Tables, it still may be confirmed by medical evidence described in section 220.27 of this part. However, if a claimant's impairment(s) cannot be confirmed through use of the Tables or under section 220.27 , and the medical evidence is complete and in concordance, the claimant will be found not disabled.

3. Disability Determination

3.01 Once the Board determines that the employee's regular railroad occupation is covered by one of the Job Titles in the Tables and that his or her alleged impairment fits into a Body Part covered by the Tables and can be confirmed, we examine the results of any of the disability tests listed under the impairment. If the results from any of these tests indicate a "D" finding, the employee is found disabled. If none of the test results indicate a "D" finding, then the employee's claim is evaluated using ICE.

3.02 Example: A trainman has angina as confirmed by the recommended tests under Body Part A: Cardiac-Angina. An echocardiogram shows that he has poor ejection fraction [LESS THAN EQUAL TO]35%. The employee is rated disabled. If none of the results of the listed disability tests match the results required for a "D" finding, then the employee's claim is evaluated under ICE.

Tables

A. Cancer

B. Endocrine

C. Cardiac

D. Respiratory

E. Lumbar Sacral Spine

F. Cervical Spine

G. Shoulder and Elbow

H. Hand and Arm

I. Hip

J. Knee

K. Ankle and Foot

A. Cancer

Cancer

Cancer conditions can be viewed as belonging to one of three categories.

Category 1: Significant impact on functional capacity or anticipated life span.

Category 2: Intermediate impact on functional capacity; large individual variability.

Category 3: No significant impact on functional capacity or expected life span.

The factors that are considered in developing these categories include the following:

Type of Cancer

The functional impact of different malignancies varies tremendously and each malignancy has to be considered on an individual basis.

Magnitude of Disease

The disability standards are based upon the magnitude or extent of disease. The extent of disease affects both anticipated life span and the functional capacity or work ability of the individual. Localized cancer including cancer "in situ" can frequently be completely cured and not have an impact on functional capacity or life span. In contrast, many cancers that have distant or significant regional spread generally have a poor prognosis. The magnitude or extent of disease is classified into three categories: local, regional and distant.

The criteria which are used to classify a cancer into one of the three categories are based upon the distillation of several staging methods into a single system [Miller, et al. (1992). Cancer Statistics Review, 1973-1989; NIH Publication No. 92-2789].

Effects of Treatment

Although some types of cancer may be potentially curable with radical surgery and/or radiation therapy, the treatment regimen may result in a significant impairment that could affect functional capacity and ability to work. For example, a person with a laryngeal tumor which had spread regionally could be cured by a complete laryngectomy and radiotherapy. However, this treatment could result in a loss of speech and significantly impair the individual's communicative skills or ability to use certain types of respiratory protective equipment.

Prognosis

Some cancers may have minimal impact on a person's functional capacity, but have a very poor prognosis with respect to life expectancy. For example, an individual with early stage brain cancer may be minimally impaired, but have a poor prognosis and minimal potential for surviving longer than two years. Five and two year survival data are presented in the Cancer Disability Guideline Table which follows.

The Cancer Disability Guideline Table provides information concerning the probability of survival for five years for local, regional, and distant disease for each type of malignancy. In addition, two-year survival data are also presented for all disease stages. The five-year survival data are based upon data collected from population-based registries in Connecticut, New Mexico, Utah, Hawaii, Atlanta, Detroit, Seattle and the San Francisco and East Bay area between 1983 and 1987 (Miller, 1992). The two-year data are from a cohort study initially diagnosed in 1988.

Assessment

The malignancies are classified as disabling (Category 1), potentially disabling (Category 2) and non-disabling (Category 3). Category 2 conditions must be evaluated with respect to how the worker's tumor affects the worker's ability to perform the job and an assessment of his life span.

Information concerning the potential impact of the malignancy on a worker's ability to perform a job is identified in the Functional Impact column in the table. All railroad occupations in the Tables are considered together. Functional impacts are classified as significant if the treatment or sequelae from treatment including radiotherapy, chemotherapy and/or surgery is likely to impair the worker from performing the job. If the treatment results in a significant impairment of another organ system, the individual should be evaluated for disability associated with impairment of that body part. For example, a person undergoing an amputation for a bone malignancy would have to be evaluated for an amputation of that body part. For many cancers, it is difficult to make generalizations regarding the level of impairment that will occur after the person has initiated or completed treatment. Nonsignificant impacts include those that are unlikely to have any effect on the individual's work capacity.

Cancer type	2-year1	5-year1	Disability status2	Functional impact3
Brain:
Local		26	1	S
Regional		27.9	1	S
Distant		23.6	1	S
Female Breast:
Regional		71.1	2	S
Distant		17.8	1	S
Colon:
Local		91	2	S
Regional		60.1	2	S
Distant		6	1	S
Rectal:
Local		84.5	2	S
Regional		50.7	2	S
Distant		5.3	1	S
Esophagus:
Local		18.5	1	S
Regional		5.2	1	S
Distant		1.8	1	S
Hodgkin's Disease:4
Stage 1		90-95	3	S
Stage 2		86	2	S
Stage 3		[LESS THAN]80	2	S
Stage 4		[LESS THAN]80	1	S
Kidney/Renal Pelvis:
Local		85.4	3	S
Regional		56.3	2	S
Distant		9	1	S
Larynx:
Local		84.2	2	S
Regional		52.5	2	S
Distant		24	1	S
Acute Lymphocytic Leukemia:
All		51.1	2	S
Chronic Lymphocytic Leukemia:
All		66.2	2	S
Acute Myelogenous Leukemia:
All		9.7	1	S
Chronic Myelogenous Leukemia:
All		21.7	1	S
Liver/Intrahepatic Bile Duct:
Local		15.1	1	S
Regional		5.8	1	S
Distant		1.9	1	S
Lung/Bronchus:5
Local		45.6	2	S
Regional		13.1	1	S
Distant		1.3	1	S
Melanomas of Skin:
Regional		53.6	2	S
Distant		12.8	1	S
Oral Cavity/Pharyngeal:
Local		76.2	2	S
Regional		40.9	2	S
Distant		18.7	1	S
Pancreas:
Local		6.1	1	S
Regional		3.7	1	S
Distant		1.4	1	S
Prostate:
Local		91	3	S
Regional		80.4	2	S
Distant		28	1	S
Stomach:
Local		55.4	1	S
Regional		17.3	1	S
Distant		2.1	1	S
Testicular:
Distant		65.5	1	S
Thyroid:
Regional		93.1	3	S
Distant		47.2	1	S
Bladder:
Regional		46	2	S
Distant		9.1	1	S

¹Source of 2 and 5 year survival data: Miller BA et al. Cancer Statistics Review 1973-1989. NIH Publication No. 92-2789.

²Disability Status:

Category 1: Significant impact on functional capacity or life span.

Category 2: Intermediate impact.

Category 3: No significant impact on functional capacity or life span.

³Functional Impacts:

(S) Significant-significant potential for the effects of treatment (radiotheraphy, chemotherapy. surgery) to affect functional capacity.

⁴Hodgkin's disease data presented for each stage derived from American Cancer Society. American Cancer Society Textbook reference for unstaged cancer is derived from Cancer Statistics Review (See 3). In addition to other data, see: American Cancer Society Textbook of Clinical Oncology. Eds: Holleb AI, Fink DJ, Murphy GP, Atlanta: American Cancer Society, Inc. 1991.)

⁵Small cell carcinoma is classified as a 1.

B. Endocrine

Confirmatory test	Minimum result	Requirements
BODY PART: ENDOCRINE
CONFIRMATORY TESTS
Diabetes, requiring insulin (IDDM):
Medical record review	Confirmation of condition and need for insulin use	Highly recommended.

Disability test	Test result	Disability classification
BODY PART: ENDOCRINE
JOB TITLE: ENGINEER
Diabetes, requiring insulin (IDDM):
Medical record review	Confirmation of condition and need for insulin use	D

C. Cardiac

Confirmatory test	Minimum result	Requirements
BODY PART: CARDIAC
CONFIRMATORY TESTS
Angina:
Medical record review	Confirmed history of ischemia including copies of electrocardiogram	Recommended.
Stress test	Definite ischemia on exercise test	Recommended.
Thallium study	Definite ischemia with exercise	Recommended.
Aortic valve disease:
Cardiac catheterization	Proven and significant	Recommended.
Echocardiogram	Significant valve disease	Recommended.
Coronary artery disease:
Medical record review	Documented ischemia with electrocardiogram confirmation	Recommended.
Medical record review	Documented myocardial infarction	Recommended.
Stress test	Positive	Recommended.
Thallium study	Definite ischemia with exercise	Recommended.
Angiography	Definite occlusion ([GREATER THAN]60%) of one vessel	Recommended.
Cardiomyopathy:
Echocardiogram	Proven ejection fraction [LESS THAN EQUAL TO]35%	Recommended.
Catheterization	Poor global function and not coronary artery disease	Recommended.
Hypertension:
Medical record review	Documentation of hypertension for one year	Highly recommended.
Medical record review	Definite diagnosis by cardiologist or internist	Highly recommended.
Medical record review	Confirmation of medication use	Highly recommended.
Arrhythmia: heart block:
Medical record review	Proven episode with electrocardiogram confirmation	Recommended.
Electrocardiogram	Documentation of arrhythmia	Recommended.
Mitral valve disease:
Cardiac catheterization	Significant valve disease	Recommended.
Echocardiogram	Significant valve disease	Recommended.
Pericardial disease:
Medical record review	Confirmed by cardiologist or internist	Highly recommended.
Pulmonary hypertension:
Physical examination	Increased pulmonic sound or pulmonary ejection murmur by cardiologist or internist	Recommended.
Electrocardiogram	Definite right ventricular hypertension	Highly recommended.
Ventricular ectopy:
Medical record review	Definite episode within one year	Recommended.
Holter monitoring	Definite arrhythmia	Recommended.
Provocative testing	Positive response	Recommended.
Arrhythmia: supraventricular tachycardia:
Medical record review	Definite episode within one year	Recommended.
Holter monitoring	Definite arrhythmia	Recommended.
Post heart transplant:
Medical record review	Documented	Highly recommended.

Disability test	Test result	Disability classification
BODY PART: CARDIAC
JOB TITLE: TRAINMAN
Angina:
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]7 METS	D
Medical record review	Unstable as diagnosed by cardiologist	D
Stress test	Documented hypotensive response	D
Stress test: significant ST changes	Definite ischemia [LESS THAN EQUAL TO]7 METS	D
Aortic valve disease:
Cardiac catheterization	Aortic gradient 25-50 mm HG
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]7 METS	D
Coronary artery disease:
Myocardial infarction	Multiple infarctions	D
Echocardiogram	Confirmed ventricular aneurysm	D
Cardiac catheterization	Aortic gradient 25-50 mm Hg	D
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]7 METS	D
Medical record review	Unstable as diagnosed by a Cardiologist	D
Stress test	Documented hypotensive response	D
Stress test	Definite ischemia [LESS THAN EQUAL TO] 7 METS	D
Isotope, e.g., thallium study	Definite ischemia [LESS THAN EQUAL TO] 7 METS	D
Cardiomyopathy:
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]7 METS	D
Hypertension:
Medical record review	Diastolic [GREATER THAN]120 and systolic [GREATER THAN]160, 50% of the time and evidence of end organ damage (blood creatinine [GREATER THAN]2; urinary protein [GREATER THAN] 1/2 gm; or EKG evidence of ischemia)	D
Arrhythmia: heart block:
Holter	Documented asystole length [GREATER THAN]1.5-2 seconds	D
Medical record review	Documented syncope with proven arrhythmia	D
Mitral valve disease:
Cardiac catheterization	Mitral valve gradient [GREATER THAN EQUAL TO]5 mm Hg	D
Cardiac catheterization	Mitral regurgitation severe	D
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]7 METS	D
Pericardial disease:
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Ventricular ectopy:
Medical record review	Documented life threatening arrhythmia	D
Holter	Uncontrolled ventricular rhythm	D
Medical record review	Documented related syncope	D
Arrhythmia: supraventricular tachycardia:
Medical record review	Documented related syncope	D
Post heart transplant:
Medical record review	Post heart transplant	D
BODY PART: CARDIAC
JOB TITLE: ENGINEER
Angina:
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Medical record review	Unstable as diagnosed by cardiologist	D
Stress test	Documented hypotensive response	D
Stress test: significant ST changes	Definite ischemia [LESS THAN EQUAL TO]5 METS	D
Aortic valve disease:
Cardiac catheterization	Aortic gradient 25-50 mm HG	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Coronary artery disease:
Myocardial infarction	Multiple infarctions	D
Echocardiogram	Confirmed ventricular aneurysm	D
Cardiac catheterization	Aortic gradient 25-50 mm Hg	D
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Medical record review	Unstable as diagnosed by a Cardiologist	D
Stress test	Documented hypotensive response	D
Stress test	Definite ischemia [LESS THAN EQUAL TO]5 METS	D
Isotope, e.g., thallium study	Definite ischemia [LESS THAN EQUAL TO]5 METS	D
Cardiomyopathy:
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Hypertension:
Medical record review	Diastolic [GREATER THAN]120 and systolic [GREATER THAN]160, 50% of the time and evidence of end organ damage (blood creatinine [GREATER THAN]2; urinary protein [GREATER THAN] 1/2 gm; or EKG evidence of ischemia)	D
Arrhythmia: heart block:
Holter	Documented asystole length [GREATER THAN]1.5-2 seconds	D
Medical record review	Documented syncope with proven arrhythmia	D
Mitral valve disease:
Cardiac catheterization	Mitral valve gradient [GREATER THAN EQUAL TO]10 mm Hg	D
Cardiac catheterization	Mitral regurgitation severe	D
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Pericardial disease:
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Ventricular ectopy:
Medical record review	Documented life threatening arrhythmia	D
Holter	Uncontrolled ventricular rhythm	D
Medical record review	Documented related syncope	D
Arrhythmia: supraventricular tachycardia:
Medical record review	Documented related syncope	D
Post heart transplant:
Medical record review	Post heart transplant	D
BODY PART: CARDIAC
JOB TITLE: DISPATCHER
Angina:
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Medical record review	Unstable as diagnosed by cardiologist	D
Stress test	Documented hypotensive response	D
Stress test: significant ST changes	Definite ischemia [LESS THAN EQUAL TO]5 METS	D
Aortic valve disease:
Cardiac catheterization	Aortic gradient 25-50 mm Hg	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Coronary artery disease:
Myocardial infarction	Multiple infarctions	D
Echocardiogram	Confirmed ventricular aneurysm	D
Cardiac catheterization	Aortic gradient 25-50 mm Hg	D
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Medical record review	Unstable as diagnosed by cardiologist	D
Stress test	Documented hypotensive response	D
Stress test	Definite ischemia [LESS THAN EQUAL TO]5 METS	D
Isotope, e.g., thallium study	Definite ischemia [LESS THAN EQUAL TO]5 METS	D
Cardiomyopathy:
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Hypertension:
Medical record review	Diastolic [GREATER THAN]120 and systolic [GREATER THAN]160, 50% of the time and evidence of end organ damage (blood creatinine [GREATER THAN]2; urinary protein [GREATER THAN] 1/2 gm; or EKG evidence of ischemia)	D
Arrhythmia: heart block:
Holter	Documented asystole length [GREATER THAN]1.5-2 seconds	D
Medical record review	Documented syncope with proven arrhythmia	D
Mitral valve disease:
Cardiac catheterization	Mitral valve gradient [GREATER THAN EQUAL TO]10 mm Hg	D
Cardiac catheterization	Mitral regurgitation severe	D
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Pericardial disease:
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Ventricular ectopy:
Medical record review	Documented life threatening arrhythmia	D
Holter	Uncontrolled ventricular rhythm	D
Medical record review	Documented related syncope	D
Arrhythmia: supraventricular tachycardia:
Medical record review	Documented related syncope	D
Post heart transplant:
Medical record review	Post heart transplant	D
BODY PART: CARDIAC
JOB TITLE: CARMAN
Angina:
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Medical record review	Unstable as diagnosed by cardiologist	D
Stress test	Documented hypotensive response	D
Stress test: significant ST changes	Definite ischemia [LESS THAN EQUAL TO]5 METS	D
Aortic valve disease:
Cardiac catheterization	Aortic gradient 25-50 mm HG
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Coronary artery disease:
Myocardial infarction	Multiple infarctions	D
Echocardiogram	Confirmed ventricular aneurysm	D
Cardiac catheterization	Aortic gradient 25-50 mm Hg	D
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Medical record review	Unstable as diagnosed by a Cardiologist	D
Stress test	Documented hypotensive response	D
Stress test	Definite ischemia [LESS THAN EQUAL TO] 5 METS	D
Isotope, e.g., thallium study	Definite ischemia [LESS THAN EQUAL TO] 5 METS	D
Cardiomyopathy:
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Hypertension:
Medical record review	Diastolic [GREATER THAN]120 and systolic [GREATER THAN]160, 50% of the time and evidence of end organ damage (blood creatinine [GREATER THAN]2; urinary protein [GREATER THAN] 1/2 gm; or EKG evidence of ischemia)	D
Arrhythmia: heart block:
Holter	Documented asystole length [GREATER THAN]1.5-2 seconds	D
Medical record review	Documented syncope with proven arrhythmia	D
Mitral valve disease:
Cardiac catheterization	Mitral valve gradient [GREATER THAN EQUAL TO]10 mm Hg	D
Cardiac catheterization	Mitral regurgitation severe	D
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Pericardial disease:
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Ventricular ectopy:
Medical record review	Documented life threatening arrhythmia	D
Holter	Uncontrolled ventricular rhythm	D
Medical record review	Documented related syncope	D
Arrhythmia: supraventricular tachycardia:
Medical record review	Documented related syncope	D
Post heart transplant:
Medical record review	Post heart transplant	D
BODY PART: CARDIAC
JOB TITLE: SIGNALMAN
Angina:
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]7 METS	D
Medical record review	Unstable as diagnosed by cardiologist	D
Stress test	Documented hypotensive response	D
Stress test: significant ST changes	Definite ischemia [LESS THAN EQUAL TO]7 METS	D
Aortic valve disease:
Cardiac catheterization	Aortic gradient 25-50 mm HG	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]7 METS	D
Coronary artery disease:
Myocardial infarction	Multiple infractions	D
Echocardiogram	Confirmed ventricular aneurysm	D
Cardiac catheterization	Aortic gradient 25-50 mm Hg	D
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]7 METS	D
Medical record review	Unstable as diagnosed by cardiologist	D
Stress test	Documented hypotensive response	D
Stress test	Definite ischemia [LESS THAN EQUAL TO]7 METS	D
Isotope, e.g., thallium study	Definite ischemia [LESS THAN EQUAL TO]7 METS	D
Cardiomyopathy:
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]7 METS	D
Hypertension:
Medical record review	Diastolic [GREATER THAN]120 and systolic [GREATER THAN]160, 50% of the time and evidence of end organ damage (blood creatinine [GREATER THAN]2; urinary protein [GREATER THAN] 1/2 gm; or EKG evidence of ischemia)	D
Arrhythmia: heart block
Holter	Documented asystole length [GREATER THAN]1.5-2 seconds	D
Medical record review	Documented syncope with proven arrhythmia	D
Mitral valve disease:
Cardiac catheterization	Mitral valve gradient [GREATER THAN EQUAL TO]5 mm Hg	D
Cardiac catherization	Mitral regurgitation severe	D
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]7 METS	D
Pericardial disease:
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Ventricular ectopy:
Medical record review	Documented life threatening arrhythmia	D
Holter	Uncontrolled ventricular rhythm	D
Medical record review	Documented related syncope	D
Arrhythmia: supraventricular tachycardia:
Medical record review	Documented related syncope	D
Post heart transplant:
Medical record review	Post heart transplant	D
BODY PART: CARDIAC
JOB TITLE: TRACKMAN
Angina:
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]7 METS	D
Medical record review	Unstable as diagnosed by cardiologist	D
Stress test	Documented hypotensive response	D
Stress test: significant ST changes	Definite ischemia [LESS THAN EQUAL TO]7 METS	D
Aortic valve disease:
Cardiac catheterization	Aortic gradient 25-50 mm HG	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]7 METS	D
Coronary artery disease:
Myocardial infarction	Multiple infarctions	D
Echocardiogram	Confirmed ventricular aneurysm	D
Cardiac catheterization	Aortic gradient 25-50 mm Hg	D
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]7 METS	D
Medical record review	Unstable as diagnosed by a cardiologist	D
Stress test	Documented hypotensive response	D
Stress test	Definite ischemia [LESS THAN EQUAL TO]7 METS	D
Isotope, e.g., thallium study	Definite ischemia [LESS THAN EQUAL TO]7 METS	D
Cardiomyopathy:
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]7 METS	D
Hypertension:
Medical record review	Diastolic [GREATER THAN]120 and systolic [GREATER THAN]160, 50% of the time and evidence of end organ damage (blood creatinine [GREATER THAN]2; urinary protein [GREATER THAN] 1/2 gm; or EKG evidence of ischemia)	D
Arrhythmia: heart block:
Holter	Documented asystole length [GREATER THAN]1.5-2 seconds	D
Medical record review	Documented syncope with proven arrhythmia	D
Mitral valve disease:
Cardiac catheterization	Mitral valve gradient [GREATER THAN EQUAL TO]5 mm Hg	D
Cardiac catheterization	Mitral regurgitation severe	D
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]7 METS	D
Pericardial disease:
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Ventricular ectopy:
Medical record review	Documented life threatening arrhythmia	D
Holter	Uncontrolled ventricular rhythm	D
Medical record review	Documented related syncope	D
Arrhythmia: supraventricular tachycardia:
Medical record review	Documented related syncope	D
Post heart transplant:
Medical record review	Post heart transplant	D
BODY PART: CARDIAC
JOB TITLE: MACHINIST
Angina:
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Medical record review	Unstable as diagnosed by cardiologist	D
Stress test	Documented hypotensive response	D
Stress test: significant ST changes	Definite ischemia [LESS THAN EQUAL TO]5 METS	D
Aortic valve disease:
Cardiac catheterization	Aortic gradient 25-50 mm HG
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Coronary artery disease:
Myocardial infarction	Multiple infarctions	D
Echocardiogram	Confirmed ventricular aneurysm	D
Cardiac catheterization	Aortic gradient 25-50 mm Hg	D
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Medical record review	Unstable as diagnosed by a cardiologist	D
Stress test	Documented hypotensive response	D
Stress test	Definite ischemia [LESS THAN EQUAL TO]5 METS	D
Isotope, e.g., thallium study	Definite ischemia [LESS THAN EQUAL TO]5 METS	D
Cardiomyopathy:
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Hypertension:
Medical record review	Diastolic [GREATER THAN]120 and systolic [GREATER THAN]160, 50% of the time and evidence of end organ damage (blood creatinine [GREATER THAN]2; urinary protein [GREATER THAN] 1/2 gm; or EKG evidence of ischemia)	D
Arrhythmia: heart block:
Holter	Documented asystole length [GREATER THAN]1.5-2 seconds	D
Medical record review	Documented syncope with proven arrhythmia	D
Mitral valve disease:
Cardiac catheterization	Mitral valve gradient [GREATER THAN EQUAL TO]10 mm Hg	D
Cardiac catheterization	Mitral regurgitation severe	D
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Pericardial disease:
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Ventricular ectopy:
Medical record review	Documented life threatening arrhythmia	D
Holter	Uncontrolled ventricular rhythm	D
Medical record review	Documented related syncope	D
Arrhythmia: supraventricular tachycardia:
Medical record review	Documented related syncope	D
Post heart transplant:
Medical record review	Post heart transplant	D
BODY PART: CARDIAC
JOB TITLE: SHOP LABORER
Angina:
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Medical record review	Unstable as diagnosed by cardiologist	D
Stress test	Documented hypotensive response	D
Stress test: significant ST changes	Definite ischemia [LESS THAN EQUAL TO]5 METS	D
Aortic valve disease:
Cardiac catheterization	Aortic gradient 25-50 mm HG
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Coronary artery disease:
Myocardial infarction	Multiple infarctions	D
Echocardiogram	Confirmed ventricular aneurysm	D
Cardiac catheterization	Aortic gradient 25-50 mm Hg
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Medical record review	Unstable as diagnosed by a Cardiologist	D
Stress test	Documented hypotensive response	D
Stress test	Definite ischemia [LESS THAN EQUAL TO]5 METS	D
Isotope, e.g., thallium study	Definite ischemia [LESS THAN EQUAL TO]5 METS	D
Cardiomyopathy:
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Hypertension:
Medical record review	Diastolic [GREATER THAN]120 and systolic [GREATER THAN]160, 50% of the time and evidence of end organ damage (blood creatinine [GREATER THAN]2; urinary protein [GREATER THAN] 1/2 gm; or EKG evidence of ischemia)	D
Arrhythmia: heart block:
Holter	Documented asystole length [GREATER THAN]1.5-2 seconds	D
Medical record review	Documented syncope with proven arrhythmia	D
Mitral valve disease:
Cardiac catheterization	Mitral valve gradient [GREATER THAN EQUAL TO]10 mm Hg	D
Cardiac catheterization	Mitral regurgitation severe	D
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Pericardial disease:
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Ventricular ectopy:
Medical record review	Documented life threatening arrhythmia	D
Holter	Uncontrolled ventricular rhythm	D
Medical record review	Documented related syncope	D
Arrhythmia: supraventricular tachycardia:
Medical record review	Documented related syncope	D
Post heart transplant:
Medical record review	Post heart transplant	D
BODY PART: CARDIAC
JOB TITLE: SALES REPRESENTATIVE
Angina:
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Medical record review	Unstable as diagnosed by cardiologist	D
Stress test	Documented hypotensive response	D
Stress test: significant ST changes	Definite ischemia [LESS THAN EQUAL TO]5 METS	D
Aortic valve disease:
Cardiac catheterization	Aortic gradient 25-50 mm HG	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Coronary artery disease:
Myocardial infarction	Multiple infarctions	D
Echocardiogram	Confirmed ventricular aneurysm	D
Cardiac catheterization	Aortic gradient 25-50 mm Hg	D
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Medical record review	Unstable as diagnosed by a cardiologist	D
Stress test	Documented hypotensive response	D
Stress test	Definite ischemia [LESS THAN EQUAL TO]5 METS	D
Isotope, e.g., thallium study	Definite ischemia [LESS THAN EQUAL TO]5 METS	D
Cardiomyopathy:
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Hypertension:
Medical record review	Diastolic [GREATER THAN]120 and systolic [GREATER THAN]160, 50% of the time and evidence of end organ damage (blood creatinine [GREATER THAN]2; urinary protein [GREATER THAN] 1/2 gm; or EKG evidence of ischemia)	D
Arrhythmia: heart block:
Holter	Documented asystole length [GREATER THAN]1.5-2 seconds	D
Medical record review	Documented syncope with proven arrhythmia	D
Mitral valve disease:
Cardiac catheterization	Mitral valve gradient [GREATER THAN EQUAL TO]10 mm Hg	D
Cardiac catheterization	Mitral regurgitation severe	D
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Pericardial disease:
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Ventricular ectopy:
Medical record review	Documented life threatening arrhythmia	D
Holter	Uncontrolled ventricular rhythm	D
Medical record review	Documented related syncope	D
Arrhythmia: supraventricular tachycardia:
Medical record review	Documented related syncope	D
Post heart transplant:
Medical record review	Post heart transplant	D
BODY PART: CARDIAC
JOB TITLE: GENERAL OFFICE CLERK
Angina:
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Medical record review	Unstable as diagnosed by cardiologist	D
Stress test	Documented hypotensive response	D
Stress test: significant ST changes	Definite ischemia [LESS THAN EQUAL TO]5 METS	D
Aortic valve disease:
Cardiac catheterization	Aortic gradient 25-50 mm HG	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Coronary artery disease:
Myocardial infarction	Multiple infarctions	D
Echocardiogram	Confirmed ventricular aneurysm	D
Cardiac catheterization	Aortic gradient 25-50 mm Hg	D
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Medical record review	Unstable as diagnosed by a Cardiologist	D
Stress test	Documented hypotensive response	D
Stress test	Definite ischemia [LESS THAN EQUAL TO]5 METS	D
Isotope, e.g., thallium study	Definite ischemia [LESS THAN EQUAL TO]5 METS	D
Cardiomyopathy:
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Arrhythmia: heart block:
Holter	Documented asystole length [GREATER THAN]1.5-2 seconds	D
Medical record review	Documented syncope with proven arrhythmia	D
Mitral valve disease:
Cardiac catheterization	Mitral valve gradient [GREATER THAN EQUAL TO]10 mm Hg	D
Cardiac catheterization	Mitral regurgitation severe	D
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Stress test	Peak exercise [LESS THAN EQUAL TO]5 METS	D
Pericardial disease:
Cardiac catheterization	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Echocardiogram	Poor ejection fraction [LESS THAN EQUAL TO]35%	D
Ventricular ectopy:
Medical record review	Documented life threatening arrhythmia	D
Holter	Uncontrolled ventricular rhythm	D
Medical record review	Documented related syncope	D
Arrhythmia: supraventricular tachycardia:
Medical record review	Documented related syncope	D
Post heart transplant:
Medical record review	Post heart transplant	D

D. Respiratory

Confirmatory test	Minimum result	Requirements
BODY PART: RESPIRATORY
CONFIRMATORY TESTS
Asthma:
Spirometry	FEV1/FVC ratio diminished	Recommended.
Spirometry	[GREATER THAN]15% change with administration of bronchodilator	Recommended.
Methacholine challenge test	Positive: FEV1 decrease [GREATER THAN]20% at (PC [LESS THAN EQUAL TO]8 mg/ml)	Recommended
Bronchiectasis:
Medical record review	Chronic cough and sputum	Recommended.
Chest X-ray	Bronchiectasis demonstrated	Recommended.
Chest CAT scan	Bronchiectasis demonstrated	Recommended.
Chronic bronchitis:
Medical record review	Frequent cough-2 years duration	Highly recommended.
Chronic obstructive pulmonary disease:
Spirometry	FEV1/FVC ratio below 65% when stable	Highly recommended.
Spirometry	FEV1 below 75% of predicted when stable	Highly recommended.
Cor pulmonale:
Electrocardiogram	Definite right ventricular hypertrophy	Recommended.
Echocardiogram	Definite right ventricular hypertrophy	Recommended.
Pulmonary fibrosis:
Lung biopsy	Diffuse fibrosis	Recommended.
Chest CAT scan	More than minimal fibrosis	Recommended.
Lung resection:
Medical record review	At least one lobe resected	Highly recommended.
Pneumothorax:
Medical record review	Required hospitalization with chest tube drainage	Highly recommended.
Restrictive lung disease:
Chest X-ray	Restrictive lung changes	Recommended.
DLCO	Abnormal	Highly recommended.
Chest CAT scan	Restrictive lung changes	Recommended.
Spirometry	FVC [LESS THAN]75% predicted	Highly recommended.
Silicosis:
Medical record review	Occupational exposure for at least 1 year	Highly recommended.
Tuberculosis:
Chest X-ray	Evidence of changes consistent with tuberculosis infection	Recommended.
Culture	Positive	Recommended.

Disability test	Test result	Disability classification
BODY PART: RESPIRATORY
JOB TITLE: TRAINMAN
Asthma:
Spirometry	Repeated spirometry FEV1 [LESS THAN]40% over a 12 month period
Bronchiectasis:
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Chronic bronchitis:
Spirometry	Repeated spirometry FEV1 [LESS THAN]40% over a 12 month period	D
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Chronic obstructive pulmonary disease (COPD):
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Cor pulmonale:
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Pulmonary fibrosis:
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
DLCO	[LESS THAN]45% predicted	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Spirometry	FVC [LESS THAN]50% predicted	D
Lung resection:
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Restrictive lung disease:
DLCO	[LESS THAN]45% predicted	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Spirometry	FVC [LESS THAN]50% predicted	D
Electrocardiogram	efinite positive right ventricular hypertrophy	D
Silicosis:
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg If stable	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
BODY PART: RESPIRATORY
JOB TITLE: CARMAN
Asthma:
Spirometry	Repeated spirometry FEV1 [LESS THAN]40% over a 12 month period	D
Bronchiectasis:
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Chronic bronchitis:
Spirometry	Repeated spirometry FEV1 [LESS THAN]40% over a 12 month period	D
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Chronic obstructive pulmonary disease (COPD):
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Cor pulmonale:
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Pulmonary fibrosis:
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
DLCO	[LESS THAN]45% predicted	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Spirometry	FVC [LESS THAN]50% predicted	D
Lung resection:
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Restrictive lung disease:
DLCO	[LESS THAN]45% predicted	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Spirometry	FVC [LESS THAN]50% predicted	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Silicosis:
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
BODY PART: RESPIRATORY
JOB TITLE: SIGNALMAN
Asthma:
Spirometry	Repeated spirometry FEV1 [LESS THAN]40% over a 12 month period	D
Bronchiectasis:
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Chronic bronchitis:
Spirometry	Repeated spirometry FEV1 [LESS THAN]40% over a 12 month period	D
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Chronic obstructive pulmonary disease (COPD):
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Cor pulmonale:
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Pulmonary fibrosis:
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
DLCO	[LESS THAN]45% predicted	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Spirometry	FVC [LESS THAN]50% predicted	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Lung resection:
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Restrictive lung disease:
DLCO	[LESS THAN]45% predicted	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Spirometry	FVC [LESS THAN]50% predicted	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Silicosis:
Resting AGB	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
BODY PART: RESPIRATORY
JOB TITLE: TRACKMAN
Asthma:
Spirometry	Repeated spirometry FEV1 [LESS THAN]40% over a 12 month period	D
Bronchiectasis:
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
Pulmonary exercise test or exercise ABG	PO2 [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Chronic bronchitis:
Spirometry	Repeated spirometry FEV1 [LESS THAN]40% over a 12 month period	D
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Chronic obstructive pulmonary disease (COPD):
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Cor pulmonale:
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Pulmonary fibrosis:
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
DLCO	[LESS THAN]45% predicted	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Spirometry	FVC [LESS THAN]50% predicted	D
Lung resection:
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Restrictive lung disease:
DLCO	[LESS THAN]45% predicted	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Spirometry	FVC [LESS THAN]50% predicted	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Silicosis:
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
BODY PART: RESPIRATORY
JOB TITLE: MACHINIST
Asthma:
Spirometry	Repeated spirometry FEV1 [LESS THAN]40% over a 12 month period	D
Bronchiectasis:
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Chronic bronchitis:
Spirometry	Repeated spirometry FEV1 [LESS THAN]40% over a 12 month period	D
Resting AGB	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Chronic obstructive pulmonary disease (COPD):
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Cor pulmonale:
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Pulmonary fibrosis:
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
DLCO	[LESS THAN]45% predicted	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Spirometry	FVC [LESS THAN]50% predicted	D
Lung resection:
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Restrictive lung disease:
DLCO	[LESS THAN]45% predicted	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Spirometry	FVC [LESS THAN]50% predicted	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Silicosis:
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
BODY PART: RESPIRATORY
JOB TITLE: SHOP LABORER
Asthma:
Spirometry	Repeated spirometry FEV1 [LESS THAN]40% over a 12 month period	D
Bronchiectasis:
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Chronic bronchitis:
Spirometry	Repeated spirometry FEV1 [LESS THAN]40% over a 12 month period	D
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Chronic obstructive pulmonary disease (COPD):
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Cor pulmonale:
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Pulmonary fibrosis:
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
DLCO	[LESS THAN]45% predicted	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Spirometry	FVC [LESS THAN]50% predicted	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Lung resection:
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Restrictive lung disease:
DLCO	[LESS THAN]45% predicted	D
Pulmonary exercise test or exercise ABG	PO2 drop [GREATER THAN]5 torr at maximum exercise	D
Pulmonary exercise test	Maximum VO2 [LESS THAN]15 ml/kg	D
Spirometry	FVC [LESS THAN]50% predicted	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D
Silicosis:
Resting ABG	PCO2 arterial [GREATER THAN]50 mm Hg if stable	D
Electrocardiogram	Definite positive right ventricular hypertrophy	D

E. Lumbar Sacral Spine

Confirmatory test	Minimum result	Requirements
BODY PART: LS SPINE
CONFIRMATORY TESTS
Ankylosing spondylitis:
X-ray-lumbar sacral spine	Sacroilitis	Highly recommended.
HLA B27 (blood test)	Positive HLA B27 (90% case)	Recommended.
Backache, unspecified:
Medical record review	History of back pain under medical treatment for at least 1 year	Highly recommended.
Medical record review	History of back pain unresponsive to therapy for at least 1 year	Highly recommended.
Medical record review	History of back pain with functional limitations for at least 1 year	Highly recommended.
Chronic back pain, not otherwise specified:
Medical record review	History of back pain under medical treatment for at least 1 year	Highly recommended.
Medical record review	History of back pain unresponsive to therapy for at least 1 year	Highly recommended.
Medical record review	History of back pain with functional limitations for at least 1 year	Highly recommended.
Cauda equina syndrome with bowel or bladder dysfunction:
Magnetic resonance imaging	Neural impingement of spinal nerves below L1	Recommended.
Computerized tomography	Neural impingement of spinal nerves below L1	Recommended.
Cystometrogram	Impaired bladder function	Recommended.
Rectal examination	Diminished rectal sphincter tone	Recommended.
Myelogram	Neural impingement of spinal nerves below L1	Recommended.
Degeneration of lumbar disc:
X-ray lumbar sacral spine	Significant degenerative disc changes	Recommended.
Computerized tomography	Significant degenerative disc changes	Recommended.
Magnetic resonance imaging	Significant degenerative disc changes	Recommended.
Myelogram	Significant degenerative disc changes	Recommended.
Displacement of lumbar disc:
X-ray-lumbar sacral spine	Significant degenerative disc changes	Recommended.
Computerized tomography	Significant degenerative disc changes	Recommended.
Magnetic resonance imaging	Significant degenerative disc changes	Recommended.
Myelogram	Significant degenerative disc changes	Recommended.
Fracture: vertebral body:
Magnetic resonance imaging	Fracture vertebral body	Recommended.
Computerized tomography	Fracture vertebral body	Recommended.
X-ray-lumbar sacral spine	Fracture vertebral body	ommended.
Fracture: posterior element with spinal canal displacement:
Magnetic resonance imaging	Fracture posterior spinal element with displacement of spinal canal	Recommended.
Computerized tomography	Fracture posterior spinal element with displacement of spinal canal	Recommended.
X-ray-lumbar sacral spine	Fracture posterior spinal element with displacement of spinal canal	Recommended.
Fracture: posterior spinal element with no displacement:
X-ray-lumbar sacral spine	Fracture posterior spinal element	Recommended.
Magnetic resonance imaging	Fracture posterior spinal element	Recommended.
Computerized tomography	Fracture posterior spinal element	Recommended.
Fracture: spinous process:
X-ray-lumbar sacral spine	Spinous process fracture	Recommended.
Magnetic resonance imaging	Spinous process fracture	Recommended.
Computerized tomography	Spinous process fracture	Recommended.
Fracture: Transverse process:
Lumbar sacral spine	Transverse process fracture	Recommended.
Magnetic resonance imaging	Transverse process fracture	Recommended.
Computerized tomography	Transverse process fracture	Recommended.
Intervertebral disc disorder:
X-ray-lumbar sacral spine	Significant disc degeneration	Recommended.
Magnetic resonance imaging	Significant disc degeneration	Recommended.
Computerized tomography	Significant disc degeneration	Recommended.
Myelogram	Significant disc degeneration	Recommended.
Lumbago:
Medical record review: lumbar	History of back pain under medical treatment for at least 1 year	Highly recommended.
Medical record review: lumbar	History of back pain unresponsive to therapy for at least 1 year	Highly recommended.
Medical record review: lumbar	History of back pain with functional limitations for at least 1 year	Highly recommended.
Lumbosacral neuritis:
Magnetic resonance imaging	Evidence of neural compression	Recommended.
Electromyography	Definite denervation	Recommended.
Nerve conduction velocity	Definite slowing	Recommended.
Physical examination-atrophy	Atrophy in affected limb with 2 cm difference between limbs	Recommended.
Physical examination: straight leg raise	Positive straight leg raise	Recommended.
Sensory examination	Loss of sensation in affected dermatomes	Recommended.
Medical history	History of radicular pain	Highly recommended.
Computerized tomography	Evidence of neural compression	Recommended.
Lumbar spinal stenosis:
Computerized tomography	Significant narrowing: spinal cord canal or intervertebral foramen	Recommended.
Magnetic resonance imaging	Significant narrowing: spinal cord canal or intervertebral foramen	Recommended.
Myelogram	Significant narrowing: spinal cord canal or intervertebral foramen	Recommended.
Mechanical complication of internal orthopedic device:
Medical record review	Documentation of failure of implant following surgical procedure	Highly recommended.
Osteomalacia:
X-ray-lumbar sacral spine	Evidence of significant osteomalacia	Recommended.
Magnetic resonance imaging	Evidence of significant osteomalacia	Recommended.
Computerized tomography	Evidence of significant osteomalacia	Recommended.
Osteomyelitis, chronic-lumbar:
X-ray-lumbar sacral spine	Evidence of chronic infection	Recommended.
Magnetic resonance imaging	Evidence of chronic infection	Recommended.
Computerized tomography	Evidence of chronic infection	Recommended.
Osteoporosis:
Computerized tomography	Significant bone density loss	Recommended.
Dual photon absorptiometry	Significant bone density loss	Recommended.
X-ray-lumbar sacral spine	Significant bone density loss	Recommended.
Post laminectomy syndrome with radiculopathy:
Medical record review: lumbar	Documented surgical history of laminectomy	Highly recommended.
Magnetic resonance imaging	Evidence of laminectomy	Recommended.
Electromyography	Definite denervation	Recommended.
Nerve conduction velocity	Definite slowing	Recommended.
Physical examination-atrophy	Atrophy in affected limb with 2 cm difference between limbs	Recommended.
Physical examination: straight leg raise	Positive straight leg raise	Recommended.
Sensory examination	Loss of sensation in affected dermatomes	Recommended.
Medical record review: lumbar	History of radicular pain	Highly recommended.
Computerized tomography	Evidence of laminectomy	Recommended.
Myelogram	Evidence of laminectomy	Recommended.
Radiculopathy:
Magnetic resonance imaging	Evidence of neural compression	Recommended.
Electromyography	Definite denervation	Recommended.
Nerve conduction velocity	Definite slowing	Recommended.
Physical examination-atrophy	Atrophy in affected limb with 2 cm difference between limbs	Recommended.
Physical examination: straight leg raise	Positive straight leg raise	Recommended.
Sensory examination	Loss of sensation in affected dermatomes	Recommended.
Medical record review: lumbar	History of radicular pain	Highly recommended.
Computerized tomography	Evidence of neural compression	Recommended.
Myelogram	Evidence of neural compression	Recommended.
Sciatica:
Magnetic resonance imaging	Evidence of neural compression	Recommended.
Electromyography	Definite denervation	Recommended.
Nerve conduction velocity	Definite slowing	Recommended.
Physical examination-atrophy	Atrophy in affected limb with 2 cm difference between limbs	Recommended.
Physical examination: straight leg raise	Positive straight leg raise	Recommended.
Sensory examination	Loss of sensation in affected dermatomes	Recommended.
Medical history	History of radicular pain	Highly recommended.
Computerized tomography	Evidence of neural compression	Recommended.
Myelogram	Evidence of neural compression	Recommended.
Strains and sprains, unspecified:
Medical record review	History of back pain under medical treatment for at least 1 year	Highly recommended.
Medical record review	History of back pain unresponsive to therapy for at least 1 year	Highly recommended.
Medical record review	History of back pain with functional limitations for at least 1 year	Highly recommended.
Medical record review	Documented history of strain and/or sprain	Highly recommended.
Spondylolisthesis grade 1:
X-ray-lumbar sacral spine	1-25% slippage	Recommended.
Computerized tomography	1-25% slippage	Recommended.
Magnetic resonance imaging	1-25% slippage	Recommended.
Spondylolisthesis grade 2:
X-ray-lumbar sacral spine	26-50% slippage	Recommended.
Computerized tomography	26-50% slippage	Recommended.
Magnetic resonance imaging	26-50% slippage	Recommended.
Spondylolisthesis grade 3:
X-ray-lumbar sacral spine	51-75% slippage	Recommended.
Computerized tomography	51-75% slippage	Recommended.
Magnetic resonance imaging	51-75% slippage	Recommended.
Spondylolisthesis grade 4:
X-ray-lumbar sacral spine	Complete slippage	Recommended.
Computerized tomography	Complete slippage	Recommended.
Magnetic resonance imaging	Complete slippage	Recommended.
Spondylolisthesis-acquired:
X-ray-lumbar sacral spine	Slippage	Recommended.
Computerized tomography	Slippage	Recommended.
Magnetic resonance imaging	Slippage	Recommended.
Spondylolsis:
X-ray-lumbar sacral spine	Defect-pars interarticularis	Recommended.
Computerized tomography	Defect-pars interarticularis	Recommended.
Magnetic resonance imaging	Defect-pars interarticularis	Recommended.
Sprains and strains, sacral:
Medical record review: lumbar	History of back pain under medical treatment for at least 1 year	Highly recommended.
Medical record review: lumbar	History of back pain unresponsive to therapy for at least 1 year	Highly recommended.
Medical record review: lumbar	History of back with functional limitations for at least 1 year	Highly recommended.
Medical record review: lumbar	Documented history of strain and/or sprain	Highly recommended.
Sprains and strains, sacroiliac:
Medical record review: lumbar	History of back pain under medical treatment for at least 1 year	Highly recommended.
Medical record review: lumbar	History of back pain unresponsive to therapy for at least 1 year	Highly recommended.
Medical record review: lumbar	History of back pain with functional limitations for at least 1 year	Highly recommended.
Medical record review: lumbar	Documented history of strain and/or sprain	Highly recommended.

Disability test	Test result	Disability classification
BODY PART: LS SPINE
JOB TITLE: TRAINMAN
Ankylosing spondylitis:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Backache, unspecified:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Chronic back pain, not otherwise specified:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Cauda equina syndrome with bowel or bladder dysfunction:
Computerized tomography	Disc extrusion with neural impingement, nerves [LESS THAN] L1	D
Magnetic resonance imaging	Disc extrusion with neural impingement, nerves [LESS THAN] L1	D
Physical examination	Lower extremity weakness	D
Cystometrogram	Impaired bladder function	D
Myelogram	Disc extrusion with neural impingement, nerves [LESS THAN]L1	D
Physical examination: rectal	Impairment of sphincter tone	D
Muscle strength assessment	Lifting capacity diminished by 50%	D
Degeneration of lumbar disc:
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Muscle strength assessment	Lifting capacity diminished by 50%	D
Displacement of lumbar disc:
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture: vertebral body:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture: posterior spinal element with displacement:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture: posterior spinal element with no displacement:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture: spinous process:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture transverse process:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Intervertebral disc disorder:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Lumbago:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Lumbosacral neuritis:
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Muscle strength assessment	Lifting capacity diminished by 50%	D
Physical examination	Lower extremity weakness	D
Lumbar spinal stenosis:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Significant narrowing of the spinal canal	D
Magnetic resonance imaging	Significant narrowing of the spinal canal	D
Myelogram	Significant narrowing of the spinal canal	D
Physical examination	Significant lower extremity weakness	D
Mechanical complication of internal orthopedic device:
Muscle strength assessment	Lifting capacity diminished by 50%	D
X-ray flexion/extension	Segmental instability	D
Osteomalacia:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Osteomyelitis, chronic-lumbar:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Medical record review	Frequent flare-ups with objective findings	D
Osteoporosis:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Post laminectomy syndrome with radiculopathy:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Physical examination	Significant lower extremity weakness	D
Post laminectomy syndrome:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Physical examination	Significant lower extremity weakness	D
X-ray flexion/extension	Segmental instability	D
Radiculopathy:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Physical examination	Significant lower extremity weakness	D
Sciatica:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Physical examination	Significant lower extremity weakness	D
Strains and sprains, unspecified:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Spondylolisthesis grade 1:
Muscle strength assessment	Lifting capacity diminished by 50%	D
X-ray flexion/extension	Segmental instability	D
Spondylolisthesis grade 2:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Spondylolisthesis grade 3:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Spondylolisthesis grade 4:
Muscle strength assessment	Lifting capacity diminished by 50%	D
X-ray flexion/extension	Segmental instability	D
Spondylolisthesis-acquired:
X-ray flexion/extension	Segmental instability	D
Spondylolysis:
X-ray flexion/extension	Segmental instability	D
Sprains and strains, sacral:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Sprains and strains, sacroiliac:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Vertebral body compression fracture:
Muscle strength assessment	Lifting capacity diminished by 50%	D
BODY PART: LS SPINE
JOB TITLE: ENGINEER
Cauda equina syndrome with bowel or bladder dysfunction:
Computerized tomography	Disc extrusion with neural impingement, nerves [LESS THAN]L1	D
Magnetic resonance imaging	Disc extrusion with neural impingement, nerves [LESS THAN]L1	D
Physical examination	Lower extremity weakness	D
Cystometrogram	Impaired bladder function	D
Myelogram	Disc extrusion with neural impingement, nerves [LESS THAN]L1	D
Physical examination: rectal	Impairment of sphincter tone	D
BODY PART: LS SPINE
JOB TITLE: CARMAN
Ankylosing spondylitis:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Backache, unspecified:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Chronic back pain, not otherwise specified:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Cauda equina syndrome with bowel or bladder dysfunction:
Computerized tomography	Disc extrusion with neural impingement, nerves [LESS THAN]L1	D
Magnetic resonance imaging	Disc extrusion with neural impingement, nerves [LESS THAN]L1	D
Physical examination	Lower extremity weakness	D
Cystometrogram	Impaired bladder function	D
Myeolgram	Disc extrusion with neural impingement, nerves [LESS THAN]L1	D
Physical examination: rectal	Impairment of sphincter tone	D
Muscle strength assessment	Lifting capacity diminished by 50%	D
Degeneration of lumbar disc:
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Muscle strength assessment	Lifting capacity diminished by 50%	D
Displacement of lumbar disc:
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture: vertebral body:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture: posterior spinal element with displacement:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture: posterior spinal element with no displacement:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture: spinous process:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture transverse process:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Intervertebral disc disorder:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Lumbago:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Lumbosacral neuritis:
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Muscle strength assessment	Lifting capacity diminished by 50%	D
Physical examination	Lower extremity weakness	D
Lumbar spinal stenosis:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Significant narrowing of the spinal canal	D
Magnetic resonance imaging	Significant narrowing of the spinal canal	D
Myelogram	Significant narrowing of the spinal canal	D
Physical examination	Significant lower extremity weakness	D
Mechanical complication of internal orthopedic device:
Muscle strength assessment	Lifting capacity diminished by 50%	D
X-ray flexion/extension	Segmental instability	D
Osteomalacia:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Osteomyelitis, chronic-lumbar:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Medical record review	Frequent flare-ups with objective findings	D
Osteoporosis:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Post laminectomy syndrome with radiculopathy:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Physical examination	Significant lower extremity weakness	D
Post laminectomy syndrome:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Physical examination	Significant lower extremity weakness	D
X-ray flexion/extension	Segmental instability	D
Radiculopathy:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Physical examination	Significant lower extremity weakness	D
Sciatica:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Physical examination	Significant lower extremity weakness	D
Strains and sprains, unspecified:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Spondylolisthesis grade 1:
Muscle strength assessment	Lifting capacity diminished by 50%	D
X-ray flexion/extension	Segmental instability	D
Spondylolisthesis grade 2:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Spondylolisthesis grade 3:
Muscle strength assessment	Lifting capacity diminshed by 50%	D
Spondylolisthesis grade 4:
Muscle strength assessment	Lifting capacity diminished by 50%	D
X-ray flexion/extension	Segmental instability	D
Spondylolisthesis-acquired:
X-ray flexion/extension	Segmental instability	D
Spondylolysis:
X-ray flexion/extension	Segmental instability	D
Sprains and strains, sacral:
Muscle strength assessment	Lifting capacity diminshed by 50%	D
Sprains and strains, sacroiliac:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Vertebral body compression fracture:
Muscle strength assessment	Lifting capacity diminshed by 50%	D
BODY PART: LS SPINE
JOB TITLE: SIGNALMAN
Ankylosing spondylitis:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Backache, unspecified:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Chronic back pain, not otherwise specified:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Cauda equina syndrome with bowel or bladder dysfunction:
Computerized tomography	Disc extrusion with neural impingement, nerves [LESS THAN]L1	D
Magnetic resonance imaging	Disc extrusion with neural impingement, nerves [LESS THAN]L1	D
Physical examination	Lower extremity weakness	D
Cystometrogram	Impaired bladder function	D
Myelogram	Disc extrusion with neural impingement, nerves [LESS THAN]L1	D
Physical examination: rectal	Impairment of sphincter tone	D
Muscle strength assessment	Lifting capacity diminished by 50%	D
Degeneration of lumbar disc:
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Muscle strength assessment	Lifting capacity diminished by 50%	D
Displacement of lumbar disc:
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture: vertebral body:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture: posterior spinal element with displacement:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture: posterior spinal element with no displacement:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture: spinous process:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture transverse process:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Intervertebral disc disorder:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Lumbago:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Lumbosacral neuritis:
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Muscle strength assessment	Lifting capacity diminished by 50%	D
Physical examination	Lower extremity weakness	D
Lumbar spinal stenosis:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Significant narrowing of the spinal canal	D
Magnetic resonance imaging	Significant narrowing of the spinal canal	D
Myelogram	Significant narrowing of the spinal canal	D
Physical examination	Significant lower extremity weakness	D
Mechanical complication of internal orthopedic device:
Muscle strength assessment	Lifting capacity diminished by 50%	D
X-ray flexion/extension	Segmental instability	D
Osteomalacia:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Osteomyelitis, chronic-lumbar:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Medical record review	Frequent flare-ups with objective findings	D
Osteoporosis:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Post laminectomy syndrome with radiculopathy:
Muscle strength assessment	Lifing capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Physical examination	Significant lower extremity weakness	D
Post laminectomy syndrome:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Physical examination	Significant lower extremity weakness	D
X-ray flexion/extension	Segmental instability	D
Radiculopathy:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Physical examination	Significant lower extremity weakness	D
Sciatica:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Physical examination	Significant lower extremity weakness	D
Strains and sprains, unspecified:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Spondylolisthesis grade 1:
Muscle strength assessment	Lifting capacity diminished by 50%	D
X-ray flexion/extension	Segmental instability	D
Spondylolisthesis grade 2:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Spondylolisthesis grade 3:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Spondylolisthesis grade 4:
Muscle strength assessment	Lifting capacity diminished by 50%	D
X-ray flexion/extension	Segmental instability	D
Spondylolisthesis-acquired:
X-ray flexion/extension	Segmental instability	D
Spondylolysis:
X-ray flexion/extension	Segmental instability	D
Sprains and strains, sacral:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Sprains and strains, sacroiliac:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Vertebral body compression fracture:
Muscle strength assessment	Lifting capacity diminished by 50%	D
BODY PART: LS SPINE
JOB TITLE: TRACKMAN
Ankylosing spondylitis:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Backache, unspecified:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Chronic back pain, not otherwise specified:
Muscle strength assessment	Lifing capacity diminished by 50%	D
Cauda equina syndrome with bowel or bladder dysfunction:
Computerized tomography	Disc extrusion with neural impingement, nerves [LESS THAN]L1	D
Magnetic resonance imaging	Disc extrusion with neural impingement, nerves [LESS THAN]L1	D
Physical examination	Lower extremity weakness	D
Cystometrogram	Impaired bladder function	D
Myelogram	Disc extrusion with neural impingement, nerves [LESS THAN]L1	D
Physical examination: rectal	Impairment of sphincter tone	D
Muscle strength assessment	Lifting capacity diminished by 50%	D
Degeneration of lumbar disc:
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Muscle strength assessment	Lifting capacity diminished by 50%	D
Displacement of lumbar disc:
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture: vertebral body:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture: posterior spinal element with displacement:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture: posterior spinal element with no displacement:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture: spinous process:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture transverse process:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Intervertebral disc disorder:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Lumbago:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Lumbosacral neuritis:
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Muscle strength assessment	Lifting capacity diminished by 50%	D
Physical examination	Lower extremity weakness	D
Lumbar spinal stenosis:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Significant narrowing of the spinal canal	D
Magnetic resonance imaging	Significant narrowing of the spinal canal	D
Myelogram	Significant narrowing of the spinal canal	D
Physcial examination	Significant lower extremity weakness	D
Mechanical complication of internal orthopedic device:
Muscle strength assessment	Lifting capacity diminished by 50%	D
X-ray flexion/extension	Segmental instability	D
Osteomalacia:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Osteomyelitis, chronic-lumbar:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Medical record review	Frequent flare-ups with objective findings	D
Osteoporosis:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Post laminectomy syndrome with radiculopathy:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Physical examination	Significant lower extremity weakness	D
Post laminectomy syndrome:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Physical examination	Significant lower extremity weakness	D
X-ray flexion/extension	Segmental instability	D
Radiculopathy:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Physical examination	Significant lower extremity weakness	D
Sciatica:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Physical examination	Significant lower extremity weakness	D
Strains and sprains, unspecified:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Spondylolisthesis grade 1:
Muscle strength assessment	Lifting capacity diminished by 50%	D
X-ray flexion/extension	Segmental instability	D
Spondylolisthesis grade 2:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Spondylolisthesis grade 3:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Spondylolisthesis grade 4:
Muscle strength assessment	Lifting capacity diminished by 50%	D
X-ray flexion/extension	Segmental instability	D
Spondylolisthesis-acquired:
X-ray flexion/extension	Segmental instability	D
Spondylolysis:
X-ray flexion/extension	Segmental instability	D
Sprains and strains, sacral:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Sprains and strains, sacroiliac:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Vetebral body compression fracture:
Muscle strength assessment	Lifting capacity diminished by 50%
BODY PART: LS SPINE
JOB TITLE: MACHINIST
Ankylosing spondylitis:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Backache, unspecified:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Chronic back pain, not otherwise specified:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Cauda equina syndrome with bowel or bladder dysfunction:
Computerized tomography	Disc extrusion with neural impingement, nerves [LESS THAN]L1	D
Magnetic resonance imaging	Disc extrusion with neural impingement, nerves [LESS THAN]L1	D
Physical examination	Lower extremity weakness	D
Cystometrogram	Impaired bladder function	D
Myelogram	Disc extrusion with neural impingement, nerves [LESS THAN]L1	D
Physical examination: rectal	Impairment of sphincter tone	D
Muscle strength assessment	Lifting capacity diminished by 50%	D
Degeneration of lumbar disc:
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Muscle strength assessment	Lifting capacity diminished by 50%	D
Displacement of lumbar disc:
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture: vertebral body:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture: posterior spinal element with displacement:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture: posterior spinal element with no displacement:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture: spinous process:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture transverse process:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Intervertebral disc disorder:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Lumbago:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Lumbosacral neuritis:
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Muscle strength assessment	Lifting capacity diminished by 50%	D
Physical examination	Lower extremity weakness	D
Lumbar spinal stenosis:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Significant narrowing of the spinal canal	D
Magnetic resonance imaging	Significant narrowing of the spinal canal	D
Myelogram	Significant narrowing of the spinal canal	D
Physical examination	Significant lower extremity weakness	D
Mechanical complication of internal orthopedic device:
Muscle strength assessment	Lifting capacity diminished by 50%	D
X-ray flexion/extension	Segmental instability	D
Osteomalacia:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Osteomyelitis, chronic-lumbar:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Medical record review	Frequent flare-ups with objective findings	D
Osteoporosis:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Post laminectomy syndrome with radiculopathy:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Physical examination	Significant lower extremity weakness	D
Post laminectomy syndrome:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Physical examination	Significant lower extremity weakness	D
X-ray flexion/extension	Segmental instability	D
Radiculopathy:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Physical examination	Significant lower extremity weakness	D
Sciatica:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Physical examination	Significant lower extremity weakness	D
Strains and sprains, unspecified:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Spondylolisthesis grade I:
Muscle strength assessment	Lifting capacity diminished by 50%	D
X-ray flexion/extension	Segmental instability	D
Spondylolisthesis grade 2:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Spondylolisthesis grade 3:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Spondylolisthesis grade 4:
Muscle strength assessment	Lifting capacity diminished by 50%	D
X-ray flexion/extension	Segmental instability	D
Spondylolisthesis-acquired:
X-ray flexion/extension	Segmental instability	D
Spondylolysis:
X-ray flexion/extension	Segmental instability	D
Sprains and strains, sacral:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Sprains and strains, sacroiliac:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Vertebral body compression fracture:
Muscle strength assessment	Lifting capacity diminished by 50%	D
BODY PART: LS SPINE
JOB TITLE: SHOP LABORER
Ankylosing spondylitis:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Backache, unspecified:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Chronic back pain, not otherwise specified:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Cauda equina syndrome with bowel or bladder dysfunction:
Computerized tomography	Disc extrusion with neural impingement, nerves [LESS THAN]L1	D
Magnetic resonance imaging	Disc extrusion with neural impingement, nerves [LESS THAN]L1	D
Physical examination	Lower extremity weakness	D
Cystometrogram	Impaired bladder function	D
Myelogram	Disc extrusion with neural impingement, nerves [LESS THAN]L1	D
Physical examination: rectal	Impairment of sphincter tone	D
Muscle strength assessment	Lifting capacity diminished by 50%	D
Degeneration of lumbar disc:
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Muscle strength assessment	Lifting capacity diminished by 50%	D
Displacement of lumber disc:
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture: vertebral body:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture: posterior spinal element with displacement:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture: posterior spinal element with no displacement:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture: spinous process:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Fracture transverse process:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Intervertebral disc disorder:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Lumbago:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Lumbosacral neuritis:
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Muscle strength assessment	Lifting capacity diminished by 50%	D
Physical examination	Lower extremity weakness	D
Lumbar spinal stenosis:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Significant narrowing of the spinal canal	D
Magnetic resonance imaging	Significant narrowing of the spinal canal	D
Myelogram	Significant narrowing of the spinal canal	D
Physical examination	Significant lower extremity weakness	D
Mechanical complication of internal orthopedic device:
Muscle strength assessment	Lifting capacity diminished by 50%	D
X-ray flexion/extension	Segmental instability	D
Osteomalacia:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Osteomyelitis, chronic-lumbar:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Medical record review	Frequent flare-ups with objective findings	D
Osteoporosis:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Post laminectomy syndrome with radiculopathy:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Physical examination	Significant lower extremity weakness	D
Post laminectomy syndrome:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Physical examination	Significant lower extremity weakness	D
X-ray flexion/extension	Segmental instability	D
Radiculopathy:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Physical examination	Significant lower extremity weakness	D
Sciatica:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Computerized tomography	Disc extrusion with neural impingement	D
Magnetic resonance imaging	Disc extrusion with neural impingement	D
Myelogram	Disc extrusion with neural impingement	D
Physical examination	Significant lower extremity weakness	D
Strains and sprains, unspecified:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Spondylolisthesis grade 1:
Muscle strength assessment	Lifting capacity diminished by 50%	D
X-ray flexion/extension	Segmental instability	D
Spondylolisthesis grade 2:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Spondylolisthesis grade 3:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Spondylolisthesis grade 4:
Muscle strength assessment	Lifting capacity diminished by 50%	D
X-ray flexion/extension	Segmental instability	D
Spondylolisthesis-acquired:
X-ray flexion/extension	Segmental instability	D
Spondylolysis:
X-ray flexion/extension	Segmental instability	D
Sprains and strains, sacral:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Sprains and strains, sacroiliac:
Muscle strength assessment	Lifting capacity diminished by 50%	D
Vertebral body compression fracture:
Muscle strength assessment	Lifting capacity diminished by 50%	D

F. Cervical Spine

Confirmatory test	Minimum result	Requirements
BODY PART: CE SPINE
CONFIRMATORY TESTS
Cervical disc disease with myelopathy:
Physical examination: cervical	Evidence of myelopathy	Highly recommended.
Myelogram	Evidence of neurogenic compression	Recommended.
Computerized axial tomography	Evidence of neurogenic compression	Recommended.
Magnetic resonance imaging	Evidence of neurogenic compression	Recommended.
Chronic herniated disc:
X-ray: cervical spine	Evidence of significant disc degeneration	Recommended.
Myelogram	Evidence of significant disc degeneration	Recommended.
Computerized axial tomography	Evidence of significant disc degeneration	Recommended.
Magnetic resonance imaging	Evidence of significant disc degeneration	Recommended.
Cervical spondylolysis:
X-ray: cervical spine	Evidence of significant disc degeneration	Recommended.
Computerized axial tomography	Evidence of significant disc degeneration	Recommended.
Magnetic resonance imaging	Evidence of significant disc degeneration	Recommended.
Cervical intervertebral disc degeneration:
X-ray: cervical spine	Evidence of significant disc degeneration	Recommended.
Myelogram	Evidence of significant disc degeneration	Recommended.
Magnetic resonance imaging	Evidence of significant disc degeneration	Recommended.
Fracture: posterior element with spinal canal displacement:
X-ray: cervical spine	Fractured posterior element with canal displacement	Recommended.
Computerized axial tomography	Fractured posterior element with canal displacement	Recommended.
Magnetic resonance imaging	Fractured posterior element with canal displacement	Recommended.
Fracture: transverse, spinous or posterior process:
X-ray: cervical spine	Fracture of relevant part	Recommended.
Computerized axial tomography	Fracture of relevant part	Recommended.
Magnetic resonance imaging	Fracture of relevant part	Recommended.
Osteoarthritis, cervical:
X-ray: cervical spine	Evidence of extensive disc degeneration	Recommended.
Computerized axial tomography	Evidence of extensive disc degeneration	Recommended.
Magnetic resonance imaging	Evidence of extensive disc degeneration	Recommended.
Post laminectomy syndrome:
Medical records: cervical	Confirmed surgical history	Highly recommended.
Medical records: cervical	Continued pain post-surgery	Highly recommended.
Radiculopathy:
Medical records: cervical	History of radicular pain	Highly recommended.
Physical examination: arm	Loss of reflexes in affected dermatomes	Recommended.
Physical examination: arm	Evidence of atrophy [GREATER THAN]2 cm	Recommended.
Electromyography	Definite denervation in muscle of affected nerve root	Recommended.
Myelogram	Evidence of neurogenic compression	Recommended.
Magnetic resonance imaging	Compression of spinal nerves	Recommended.
Computerized axial tomography	Compression of spinal nerves	Recommended.
Rheumatoid arthritis, cervical:
Rheumatoid factor (blood test)	Titer of rheumatoid factor	Recommended.
X-ray: cervical spine	Rheumatoid changes of spine	Highly recommended.
Medical records review: cervical	Confirmation by rheumatologist or internist	Highly recommended.
Spondylogenic compression of spinal cord:
Physical examination: cervical	Evidence of myelopathy	Highly recommended.
Computerized axial tomography	Evidence of neurogenic compression	Recommended.
Magnetic resonance imaging	Evidence of neurogenic compression	Recommended.
Myelogram	Evidence of neurogenic compression	Recommended.

Disability test	Test result	Disability classification
BODY PART: CE SPINE
JOB TITLE: TRAINMAN
Cervical disc disease with myelopathy:
Computerized axial tomography	Significant spinal cord pressure	D
Magnetic resonance imaging	Significant spinal cord pressure	D
Myelogram	Significant spinal cord pressure	D
Cystometrogram	Impaired bladder function	D
Physical examination: rectal	Impairment of sphincter tone
Physical examination: lower limb	Lower extremity weakness or significant spasticity	D
Physical examination	Multi-level neurologic compromise	D
Chronic herniated disc:
Physical examination	Multi-level neurologic compromise	D
Cervical spondylolysis:
Physical examination	Multi-level neurologic compromise	D
Cervical intervertebral disc degeneration:
Physical examination	Multi-level neurologic compromise	D
Fracture: posterior element with spinal canal displacement:
Physical examination	Multi-level neurologic compromise	D
Post laminectomy syndrome:
Physical examination	Multi-level neurologic compromise	D
Cervical radiculopathy:
Physical examination	Multi-level neurologic compromise	D
Spondylogenic compression of spinal cord:
Computerized axial tomography	Significant spinal cord pressure	D
Magnetic resonance imaging	Significant spinal cord pressure	D
Cystometrogram	Impaired bladder function	D
Myelogram	Significant spinal cord pressure	D
Physical examination: rectal	Impairment of sphincter tone	D
Physical examination	Multi-level neurologic compromise	D
Physical examination: lower limb	Lower extremity weakness or significant spasticity	D
BODY PART: CE SPINE
JOB TITLE: ENGINEER
Cervical disc disease with myelopathy:
Computerized axial tomography	Significant spinal cord pressure	D
Magnetic resonance imaging	Significant spinal cord pressure	D
Myelogram	Significant spinal cord pressure	D
Cystometrogram	Impaired bladder function	D
Physical examination: rectal	Impairment of sphincter tone	D
Physical examination: lower limb	Lower extremity weakness or significant spasticity	D
Physical examination	Multi-level neurologic compromise	D
Chronic herniated disc:
Physical examination	Multi-level neurologic compromise	D
Cervical spondylolysis:
Physical examination	Multi-level neurologic compromise	D
Cervical intervertebral disc degeneration:
Physical examination	Multi-level neurologic compromise	D
Fracture: posterior element with spinal canal displacement:
Physical examination	Multi-level neurologic compromise	D
Post laminectomy syndrome:
Physical examination	Multi-level neurologic compromise	D
Cervical radiculopathy:
Physical examination:	Multi-level neurologic compromise	D
Spondylogenic compression of spinal cord:
Computerized axial tomography	Significant spinal cord pressure	D
Magnetic resonance imaging	Significant spinal cord pressure	D
Cystometrogram	Impaired bladder function	D
Myelogram	Significant spinal cord pressure	D
Physical examination: rectal	Impairment of sphincter tone	D
Physical examination	Multi-level neurologic compromise	D
Physical examination: lower limb	Lower extremity weakness or significant spasticity	D
BODY PART: CE SPINE
JOB TITLE: DISPATCHER
Cervical disc disease with myelopathy:
Cystometrogram	Impaired bladder function	D
Physical examination: rectal	Impairment of sphincter tone	D
Spondylogenic compression of spinal cord:
Cystometrogram	Impaired bladder function	D
Physical examination: rectal	Impairment of sphincter tone	D
BODY PART: CE SPINE
JOB TITLE: CARMAN
Cervical disc disease with myelopathy:
Computerized axial tomography	Significant spinal cord pressure	D
Magnetic resonance imaging	Significant spinal cord pressure	D
Myelogram	Significant spinal cord pressure	D
Cystometrogram	Impaired bladder function	D
Physical examination: rectal	Impairment of sphincter tone	D
Physical examination: lower limb	Lower extremity weakness or significant spasticity	D
Physical examination	Multi-level neurologic compromise	D
Chronic herniated disc:
Physical examination	Multi-level neurologic compromise	D
Cervical spondylolysis:
Physical examination	Multi-level neurologic compromise	D
Cervical intervertebral disc degeneration:
Physical examination	Multi-level neurologic compromise	D
Fracture: posterior element with spinal canal displacement:
Physical examination	Multi-level neurologic compromise	D
Post laminectomy syndrome:
Physical examination	Multi-level neurologic compromise	D
Cervical radiculopathy:
Physical examination	Multi-level neurologic compromise	D
Spondylogenic compression of spinal cord:
Computerized axial tomography	Significant spinal cord pressure	D
Magnetic resonance imaging	Significant spinal cord pressure	D
Cystometrogram	Impaired bladder function	D
Myelogram	Significant spinal cord pressure	D
Physical examination: rectal	Impairment of sphincter tone	D
Physical examination	Multi-level neurologic compromise	D
Physical examination: lower limb	Lower extremity weakness or significant spasticity	D
BODY PART; CE SPINE
JOB TITLE: SIGNALMAN
Cervical disc disease with myelopathy:
Computerized axial tomography	Significant spinal cord pressure	D
Magnetic resonance imaging	Significant spinal cord pressure	D
Myelogram	Significant spinal cord pressure	D
Cystometrogram	Impaired bladder function	D
Physical examination: rectal	Impairment of sphincter tone	D
Physical examination: lower limb	Lower extremity weakness or significant spasticity	D
Physical examination	Multi-level neurologic compromise	D
Chronic herniated disc:
Physical examination	Multi-level neurologic compromise	D
Cervical spondylolysis:
Physical examination	Multi-level neurologic compromise	D
Cervical intervertebral disc degeneration:
Physical examination	Multi-level neurologic compromise	D
Fracture: posterior element with spinal canal displacement:
Physical examination	Multi-level neurologic compromise	D
Post laminectomy syndrome:
Physical examination	Multi-level neurologic compromise	D
Cervical radiculopathy:
Physical examination	Multi-level neurologic compromise	D
Spondylogenic compression of spinal cord:
Computerized axial tomography	Significant spinal cord pressure	D
Magnetic resonance imaging	Significant spinal cord pressure	D
Cystometrogram	Impaired bladder function	D
Myelogram	Significant spinal cord pressure	D
Physical examination: rectal	Impairment of sphincter tone	D
Physical examination	Multi-level neurologic compromise	D
Physical examination: lower limb	Lower extremity weakness or significant spasticity	D
BODY PART: CE SPINE
JOB TITLE: TRACKMAN
Cervical disc disease with myelopathy:
Computerized axial tomography	Significant spinal cord pressure	D
Magnetic resonance imaging	Significant spinal cord pressure	D
Myelogram	Significant spinal cord pressure	D
Cystometrogram	Impaired bladder function	D
Physical examination: rectal	Impairment of sphincter tone	D
Physical examination: lower limb	Lower extremity weakness or significant spasticity	D
Physical examination	Multi-level neurologic compromise	D
Chronic herniated disc:
Physical examination	Multi-level neurologic compromise	D
Cervical spondyloysis:
Physical examination	Multi-level neurologic compromise	D
Cervical intervertebral disc degeneration:
Physical examination	Multi-level neurologic compromise	D
Fracture: posterior element with spinal canal displacement:
Physical examination	Multi-level neurologic compromise	D
Post laminectomy syndrome:
Physical examination	Multi-level neurologic compromise	D
Cervical radiculopathy:
Physical examination	Multi-level neurologic compromise	D
Spondylogenic compression of spinal cord:
Computerized axial tomography	Significant spinal cord pressure	D
Magnetic resonance imaging	Significant spinal cord pressure	D
Cystometrogram	Impaired bladder function	D
Myelogram	Significant spinal cord pressure	D
Physical examination: rectal	Impairment of sphincter tone	D
Physical examination	Multi-level neurologic compromise	D
Physical examination: lower limb	Lower extremity weakness or significant spasticity	D
BODY PART: CE SPINE
JOB TITLE: MACHINIST
Cervical disc disease with myelopathy:
Computerized axial tomography	Significant spinal cord pressure	D
Magnetic resonance imaging	Significant spinal cord pressure	D
Myelogram	Significant spinal cord pressure	D
Cystometrogram	Impaired bladder function	D
Physical examination: rectal	Impairment of sphincter tone	D
Physical examination: lower limb	Lower extremity weakness or significant spasticity	D
Physical examination	Multi-level neurologic compromise	D
Chronic herniated disc:
Physical examination	Multi-level neurologic compromise	D
Cervical spondylolysis:
Physical examination	Multi-level neurologic compromise	D
Cervical intervertebral disc degeneration:
Physical examination	Multi-level neurologic compromise	D
Fracture: posterior element with spinal canal displacement:
Physical examination	Multi-level neurologic compromise	D
Post laminectomy syndrome:
Physical examination	Multi-level neurologic compromise	D
Cervical radiculopathy:
Physical examination	Multi-level neurologic compromise	D
Spondylogenic compression of spinal cord:
Computerized axial tomography	Significant spinal cord pressure	D
Magnetic resonance imaging	Significant spinal cord pressure	D
Cystometrogram	Impaired bladder function	D
Myelogram	Significant spinal cord pressure	D
Physical examination: rectal	Impairment of sphincter tone	D
Physical examination	Multi-level neurologic compromise	D
Physical examination: lower limb	Lower extremity weakness or significant spasticity	D
BODY PART: CE SPINE
JOB TITLE: SHOP LABORER
Cervical disc disease with myelopathy:
Computerized axial tomography	Significant spinal cord pressure	D
Magnetic resonance imaging	Significant spinal cord pressure	D
Myelogram	Significant spinal cord pressure	D
Cystometrogram	Impaired bladder function	D
Physical examination: rectal	Impairment of sphincter tone	D
Physical examination: lower limb	Lower extremity weakness or significant spasticity	D
Physical examination	Multi-level neurologic compromise	D
Chronic herniated disc:
Physical examination	Multi-level neurologic compromise	D
Cervical spondylolysis:
Physical examination	Multi-level neurologic compromise	D
Cervical intervertebral disc degeneration:
Physical examination	Multi-level neurologic compromise	D
Fracture: posterior element with spinal canal displacement:
Physical examination	Multi-level neurologic compromise	D
Post laminectomy syndrome:
Physical examination	Multi-level neurologic compromise	D
Cervical radiculopathy:
Physical examination	Multi-level neurologic compromise	D
Spondylogenic compression of spinal cord:
Computerized axial tomography	Significant spinal cord pressure	D
Magnetic resonance imaging	Significant spinal cord pressure	D
Cystometrogram	Impaired bladder function	D
Myelogram	Significant spinal cord pressure	D
Physical examination: rectal	Impairment of sphincter tone	D
Physical examination	Multi-level neurologic compromise	D
Physical examination: lower limb	Lower extremity weakness or significant spasticity	D
BODY PART: CE SPINE
JOB TITLE: SALES REPRESENTATIVE
Cervical disc disease with myelopathy:
Cystometrogram	Impaired bladder function	D
Physical examination: rectal	Impairment of sphincter tone	D
Spondylogenic compression of spinal cord:
Cystometrogram	Impaired bladder function	D
Physical examination: rectal	Impairment of sphincter tone	D
BODY PART: CE SPINE
JOB TITLE: GENERAL OFFICE CLERK
Cervical disc disease with myelopathy:
Cystometrogram	Impaired bladder function	D
Physical examination: rectal	Impairment of sphincter tone	D
Spondylogenic compression of spinal cord:
Cystometrogram	Impaired bladder function	D
Physical examination: rectal	Impairment of sphincter tone	D

G. Shoulder and Elbow

Confirmatory test	Minimum result	Requirements.
BODY PART: SHOULDER AND ELBOW
CONFIRMATORY TESTS
Arthritis, acromioclavicular:
X-ray: shoulder	Significant degenerative changes of joint	Recommended.
Computerized tomography	Significant degenerative changes of joint	Recommended.
Magnetic resonance imaging	Significant degenerative changes of joint	Recommended.
Arthritis, glenohumeral:
X-ray: shoulder	Significant degenerative changes of joint	Recommended.
Computerized tomography	Significant degenerative changes of joint	Recommended.
Magnetic resonance imaging	Significant degenerative changes of joint	Recommended.
Rotator cuff tear:
Computerized tomography	Tear of rotator cuff	Recommended.
Magnetic resonance imaging	Tear of rotator cuff	Recommended.
Medical diagnosis leading to a permanent functional limitation of the elbow:
Medical record review	Condition with permanent functional limitation	Highly recommended.
X-ray: elbow	Imaging confirmation of functional diagnosis	Recommended.
Magnetic resonance imaging	Imaging confirmation of functional diagnosis	Recommended.

Disability test	Test result	Disability classification
BODY PART: SHOULDER AND ELBOW
JOB TITLE: TRAINMAN
Arthritis, acromioclavicular:
Physical examination-range of motion	[LESS THAN]40 degrees flexion	D
Physical examination-range of motion	[LESS THAN]40 degrees abduction	D
Arthritis, glenohumeral:
Physical examination-range of motion	[LESS THAN]40 degrees flexion	D
Physical examination-range of motion	[LESS THAN]40 degrees abduction	D
Rotator cuff tear:
Physical examination-range of motion	[LESS THAN]40 degrees flexion	D
Physical examination-range of motion	[LESS THAN]40 degrees abduction	D
Permanent functional limitation, elbow:
Physical examination	[GREATER THAN]40 degrees deviation	D
Physical examination-range of motion	Flexion limit to 60 degrees	D
BODY PART: SHOULDER AND ELBOW
JOB TITLE: ENGINEER
Arthritis, acromioclavicular:
Physical examination-range of motion	[LESS THAN]40 degrees flexion	D
Physical examination-range of motion	[LESS THAN]40 degrees abduction	D
Arthritis, glenohumeral:
Physical examination-range of motion	[LESS THAN]40 degrees flexion	D
Physical examination-range of motion	[LESS THAN]40 degrees abduction	D
Rotator cuff tear:
Physical examination-range of motion	[LESS THAN]40 degrees flexion	D
Physical examination-range of moiton	[LESS THAN]40 degrees abduction	D
Permanent functional limitation, elbow:
Physical examination	[GREATER THAN]40 degrees deviation	D
Physical examination-range of motion	Flexion limit to 60 degrees	D
BODY PART: SHOULDER AND ELBOW
JOB TITLE: CARMAN
Arthritis, acromioclavicular:
Physical examination-range of motion	[LESS THAN]40 degrees flexion	D
Physical examination-range of motion	[LESS THAN]40 degrees abduction	D
Arthritis, glenohumeral:
Physical examination-range of motion	[LESS THAN]40 degrees flexion	D
Physical examination-range of motion	[LESS THAN]40 degrees abduction	D
Rotator cuff tear:
Physical examination-range of motion	[LESS THAN]40 degrees flexion	D
Physical examination-range of motion	[LESS THAN]40 degrees abduction	D
Permanent functional limitation, elbow:
Physical examination	[GREATER THAN]40 degrees deviation	D
Physical examination-range of motion	Flexion limit to 60 degrees	D
BODY PART: SHOULDER AND ELBOW
JOB TITLE: SIGNALMAN
Arthritis, acromioclavicular:
Physical examination-range of motion	[LESS THAN]40 degrees flexion	D
Physical examination-range of motion	[LESS THAN]40 degrees abduction	D
Arthritis, glenohumeral:
Physical examination-range of motion	[LESS THAN]40 degrees flexion	D
Physical examination-range of motion	[LESS THAN]40 degrees abduction	D
Rotator cuff tear:
Physical examination-range of motion	[LESS THAN]40 degrees flexion	D
Physical examination-range of motion	[LESS THAN]40 degrees abduction	D
Permanent functional limitation, elbow:
Physical examination	[GREATER THAN]40 degrees deviation	D
Physical examination-range of motion	Flexion limit to 60 degrees	D
BODY PART: SHOULDER AND ELBOW
JOB TITLE: TRACKMAN
Arthritis, acromioclavicular:
Physical examination-range of motion	[LESS THAN]40 degrees flexion	D
Physical examination-range of motion	[LESS THAN]40 degrees abduction	D
Arthritis, glenohumeral:
Physical examination-range of motion	[LESS THAN]40 degrees flexion	D
Physical examination-range of motion	[LESS THAN]40 degrees abduction	D
Rotator cuff tear:
Physical examination-range of motion	[LESS THAN]40 degrees flexion	D
Physical examination-range of motion	[LESS THAN]40 degrees abduction	D
Permanent functional limitation, elbow:
Physical examination	[GREATER THAN]40 degrees deviation	D
Physical examination-range of motion	Flexion limit to 60 degrees	D
BODY PART: SHOULDER AND ELBOW
JOB TITLE: MACHINIST
Arthritis, acromioclavicular:
Physical examination-range of motion	[LESS THAN]40 degrees flexion	D
Physical examination-range of motion	[LESS THAN]40 degrees abduction	D
Arthritis, glenohumeral:
Physical examination-range of motion	[LESS THAN]40 degrees flexion	D
Physical examination-range of motion	[LESS THAN]40 degrees abduction	D
Rotator cuff tear:
Physical examination-range of motion	[LESS THAN]40 degrees flexion	D
Physical examination-range of motion	[LESS THAN]40 degrees abduction	D
Permanent functional limitation, elbow:
Physical examination	[GREATER THAN]40 degrees deviation	D
Physical examination-range of motion	Flexion limit to 60 degrees	D
BODY PART: SHOULDER AND ELBOW
JOB TITLE: SHOP LABORER
Arthritis, acromioclavicular:
Physical examination-range of motion	[LESS THAN]40 degrees flexion	D
Physical examination-range of motion	[LESS THAN]40 degrees abduction	D
Arthritis, glenohumeral:
Physical examination-range of motion	[LESS THAN]40 degrees flexion	D
Physical examination-range of motion	[LESS THAN]40 degrees abduction	D
Rotator cuff tear:
Physical examination-range of motion	[LESS THAN]40 degrees flexion	D
Physical examination-range of motion	[LESS THAN]40 degrees abduction	D
Permanent functional limitation, elbow:
Physical examination	[GREATER THAN]40 degrees deviation	D
Physical examination-range of motion	Flexion limit to 60 degrees	D

H. Hand and Arm

Confirmatory test	Minimum result	Requirements
BODY PART: HAND AND ARM
CONFIRMATORY TESTS
Carpal tunnel syndrome:
Medical record review	Pain, paresthesia and weakness in distribution median nerve	Highly recommended.
Nerve conduction testing	Definite median nerve conduction slowing at wrist	Highly recommended.
Electromyography	Denervation in severe cases	Recommended.
Fracture: wrist:
X-ray: wrist	Evidence of fracture	Highly recommended.
Hand: permanent functional limitation:
Medical record review	Documentation of medical condition for permanent limitation	Highly recommended.
Physical examination	Definite reproducible evidence of limitation	Highly recommended.
Imaging study (e.g. X-ray, CAT, MRI)	Positive confirmation of underlying condition	Highly recommended.
Rheumatoid arthritis: hand:
Rheumatoid factor	Titer of rheumatoid factor	Recommended.
Medical record review	History of objective findings including serological studies	Highly recommended.
X-ray: hand	Characteristic rheumatoid changes	Highly recommended.
Tenosynovitis:
Medical record review	History of chronic tenosynovitis and objective findings	Highly recommended.
Physical examination	Definite evidence of tenosynovitis	Highly recommended.
Thumb: Permanent functional limitation:
Medical record review	Documentation of medical condition for permanent limitation	Highly recommended.
Physical examination	Definite reproducible evidence of limitation	Highly recommended.
Imaging study (X-ray, CAT, MRI)	Positive confirmation of underlying condition	Highly recommended.
Wrist: Permanent functional limitation:
Medical record review	Documentation of medical condition for permanent limitation	Highly recommended.
Physical examination	Definite reproducible evidence of limitation	Highly recommended.
Imaging study (e.g. X-ray, CAT, MRI)	Positive confirmation of underlying condition	Highly recommended.

Disability test	Test result	Disability classification
BODY PART: HAND AND ARM
JOB TITLE: TRAINMAN
Fracture, wrist:
Physical examination-range of motion	Extension-limit to 30 degrees	D
Physical examination-range of motion	Flexion-limit to 30 degrees	D
Physical examination-range of motion	Ankylosis: [GREATER THAN]20 degrees from neutral	D
Rheumatoid arthritis hand:
Physical examination	Significant deformity	D
Medical record review	Significant flare-ups, under treatment with rheumatologist	D
Medical record review	Extensive medication use, under treatment with rheumatologist	D
Thumb: permanent functional limitation:
Adduction of thumb	Loss [LESS THAN EQUAL TO]4 cm	D
Ankylosis: degree from neutral	[LESS THAN]20 degrees extension	D
Ankylosis: degree from neutral	[LESS THAN]40 degrees flexion	D
Loss of extension or flexion	MCP or PIP: maximum flexion [LESS THAN]40 degrees	D
Opposition	Loss [LESS THAN EQUAL TO]4 cm	D
Wrist: permanent functional limitation:
Physical examination-range of motion	Extension-limit to 30 degrees	D
Physical examination-range of motion	Flexion-limit to 30 degrees	D
Physical examination-range of motion	Ankylosis: [GREATER THAN]20 degrees from neutral	D
BODY PART: HAND AND ARM
JOB TITLE ENGINEER
Fracture, wrist:
Physical examination-range of motion	Extension-limit to 30 degrees	D
Physical examination-range of motion	Flexion-limit to 30 degrees	D
Physical examination-range of motion	Ankylosis: [GREATER THAN]20 degrees from neutral	D
Rheumatoid arthritis hand:
Physical examination	Significant deformity	D
Medical record review	Significant flare-ups, under treatment with rheumatologist	D
Medical record review	Extensive medication use, under treatment with rheumatologist	D
Thumb: permanent functional limitation:
Adduction of thumb	Loss [LESS THAN EQUAL TO]4 cm	D
Ankylosis: degree from neutral	[LESS THAN]20 degrees extension	D
Ankylosis: degree from neutral	[LESS THAN]40 degrees flexion	D
Loss of extension or flexion	MCP or PIP: maximum flexion [LESS THAN]40 degrees	D
Opposition	Loss [LESS THAN EQUAL TO]4 cm	D
Wrist: permanent functional limitation:
Physical examination-range of motion	Extension-limit to 30 degrees	D
Physical examination-range of motion	Flexion-limit to 30 degrees	D
Physical examination-range of motion	Ankylosis: [GREATER THAN]20 degrees from neutral	D
BODY PART: HAND AND ARM
JOB TITLE: DISPATCHER
Fracture, wrist:
Physical examination-range of motion	Extension-limit to 30 degrees	D
Physical examination-range of motion	Flexion-limit to 30 degrees	D
Physical examination-range of motion	Ankylosis: [GREATER THAN]20 degrees from neutral	D
Rheumatoid arthritis hand:
Physical examination	Significant deformity	D
Medical record review	Significant flare-ups, under treatment with rheumatologist	D
Medical record review	Extensive medication use, under treatment with rheumatologist	D
Thumb: permanent functional limitation:
Adduction of thumb	Loss [LESS THAN EQUAL TO]4 cm	D
Ankylosis: degree from neutral	[LESS THAN]20 degrees extension	D
Ankylosis: degree from neutral	[LESS THAN]40 degrees flexion	D
Loss of extension or flexion	MCP or PIP: maximum flexion [LESS THAN]40 degrees	D
Opposition	Loss [LESS THAN EQUAL TO]4 cm	D
Wrist: permanent functional limitation:
Physical examination-range of motion	Extension-limit to 30 degrees	D
Physical examination-range of motion	Flexion-limit to 30 degrees	D
Physical examination-range of motion	Ankylosis: [GREATER THAN]20 degrees from neutral	D
BODY PART: HAND AND ARM
JOB TITLE: CARMAN
Fracture, wrist:
Physical examination-range of motion	Extension-limit to 30 degrees	D
Physical examination-range of motion	Flexion-limit to 30 degrees	D
Physical examination-range of motion	Ankylosis: [GREATER THAN]20 degrees from neutral	D
Rheumatoid arthritis hand:
Physical examination	Significant deformity	D
Medical record review	Significant flare-ups, under treatment with rheumatologist	D
Medical record review	Extensive medication use, under treatment with rheumatologist	D
Thumb: permanent functional limitation:
Adduction of thumb:	Loss [LESS THAN EQUAL TO]4 cm	D
Ankylosis: degree from neutral	[LESS THAN]20 degrees extension	D
Ankylosis: degree from neutral	[LESS THAN]40 degrees flexion	D
Loss of extension or flexion	MCP of PIP: maximum flexion [LESS THAN]40 degrees	D
Opposition	Loss [LESS THAN EQUAL TO]4 cm	D
Wrist: permanent functional limitation:
Physical examination-range of motion	Extension-limit to 30 degrees	D
Physical examination-range of motion	Flexion-limit to 30 degrees	D
Physical examination-range of motion	Ankylosis: [GREATER THAN]20 degrees from neutral	D
BODY PART: HAND AND ARM
JOB TITLE: SIGNALMAN
Fracture, wrist:
Physical examination-range of motion	Extension-limit to 30 degrees	D
Physical examination-range of motion	Flexion-limit to 30 degrees	D
Physical examination-range of motion	Ankylosis: [GREATER THAN]20 degrees from neutral	D
Rheumatoid arthritis hand:
Physical examination	Significant deformity	D
Medical record review	Significant flare-ups, under treatment with rheumatologist	D
Medical record review	Extensive medication use, under treatment with rheumatologist	D
Thumb: permanent functional limitation:
Adduction of thumb	Loss [LESS THAN EQUAL TO]4 cm	D
Ankylosis: degree from neutral	[LESS THAN]20 degrees extension	D
Ankylosis: degree from neutral	[LESS THAN]40 degrees flexion	D
Loss of extension or flexion	MCP or PIP: maximum flexion [LESS THAN]40 degrees	D
Opposition	Loss [LESS THAN EQUAL TO]4 cm	D
Wrist: permanent functional limitation:
Physical examination-range of motion	Extension-limit to 30 degrees	D
Physical examination-range of motion	Flexion-limit to 30 degrees	D
Physical examination-range of motion	Ankylosis: [GREATER THAN]20 degrees from neutral	D
BODY PART: HAND AND ARM
JOB TITLE: TRACKMAN
Fracture, wrist:
Physical examination-range of motion	Extension-limit to 30 degrees	D
Physical examination-range of motion	Flexion-limit to 30 degrees	D
Physical examination-range of motion	Ankylosis: [GREATER THAN]20 degrees from neutral	D
Rheumatoid arthritis hand:
Physical examination	Significant deformity	D
Medical record review	Significant flare-ups, under treatment with rheumatologist	D
Medical record review	Extensive medication use, under treatment with rheumatologist	D
Thumb: permanent functional limitation:
Adduction of thumb	Loss [LESS THAN EQUAL TO]4 cm	D
Ankylosis: degree from neutral	[LESS THAN]20 degrees extension	D
Ankylosis: degree from neutral	[LESS THAN]40 degrees flexion	D
Loss of extension or flexion	MCP or PIP: maximum flexion [LESS THAN]40 degrees	D
Opposition	Loss [LESS THAN EQUAL TO]4 cm	D
Wrist: permanent functional limitation:
Physical examination-range of motion	Extension-limit to 30 degrees	D
Physical examination-range of motion	Flexion-limit to 30 degrees	D
Physical examination-range of motion	Ankylosis: [GREATER THAN]20 degrees from neutral	D
BODY PART: HAND AND ARM
JOB TITLE: MACHINIST
Fracture, wrist:
Physical examination-range of motion	Extension-limit to 30 degrees	D
Physical examination-range of motion	Flexion-limit to 30 degrees	D
Physical examination-range of motion	Ankylosis: [GREATER THAN]20 degrees from neutral	D
Rheumatoid arthritis hand:
Physical examination	Significant deformity	D
Medical record review	Significant flare-ups, under treatment with rheumatologist	D
Medical record review	Extensive medication use, under treatment with rheumatologist	D
Thumb: permanent functional limitation:
Adduction of thumb	Loss [LESS THAN EQUAL TO]4 cm	D
Ankylosis: degree from neutral	[LESS THAN]20 degrees extension	D
Ankylosis: degree from neutral	[LESS THAN]40 degrees flexion	D
Loss of extension or flexion	MCP or PIP: maximum flexion [LESS THAN]40 degrees	D
Opposition	Loss [LESS THAN EQUAL TO]4 cm	D
Wrist: permanent functional limitation:
Physical examination-range of motion	Extension-limit to 30 degrees	D
Physical examination-range of motion	Flexion-limit to 30 degrees	D
Physical examination-range of motion	Ankylosis: [GREATER THAN]20 degrees from neutral	D
BODY PART: HAND AND ARM
JOB TITLE: SHOP LABORER
Fracture, wrist:
Physical examination-range of motion	Extension-limit to 30 degrees	D
Physical examination-range of motion	Flexion-limit to 30 degrees	D
Physical examination-range of motion	Ankylosis: [GREATER THAN]20 degrees from neutral	D
Rheumatoid arthritis hand:
Physical examination	Significant deformity	D
Medical record review	Significant flare-ups, under treatment with rheumatologist	D
Medical record review	Extensive medication use, under treatment with rheumatologist	D
Thumb: permanent functional limitation:
Adduction of thumb	Loss [LESS THAN EQUAL TO]4 cm	D
Ankylosis: degree from neutral	[LESS THAN]20 degrees extension	D
Ankylosis: degree from neutral	[LESS THAN]40 degrees flexion	D
Loss of extension or flexion	MCP or PIP: maximum flexion [LESS THAN]40 degrees	D
Opposition	Loss [LESS THAN EQUAL TO]4 cm	D
Wrist: permanent functional limitation:
Physical examination-range of motion	Extension-limit to 30 degrees	D
Physical examination-range of motion	Flexion-limit to 30 degrees	D
Physical examination-range of motion	Ankylosis: [GREATER THAN]20 degrees from neutral	D
BODY PART: HAND AND ARM
JOB TITLE: SALES REPRESENTATIVE
Fracture, wrist:
Physical examination-range of motion	Extension-limit to 30 degrees	D
Physical examination-range of motion	Flexion-limit to 30 degrees	D
Physical examination-range of motion	Ankylosis: [GREATER THAN]20 degrees from neutral	D
Rheumatoid arthritis hand:
Physical examination	Significant deformity	D
Medical record review	Significant flare-ups, under treatment with rheumatologist	D
Medical record review	Extensive medication use, under treatment with rheumatologist	D
Thumb: permanent functional limitation:
Adduction of thumb	Loss [LESS THAN EQUAL TO]4 cm	D
Ankylosis: degree from neutral	[LESS THAN]20 degrees extension	D
Ankylosis: degree from neutral	[LESS THAN]40 degrees flexion	D
Loss of extension or flexion	MCP or PIP: maximum flexion [LESS THAN]40 degrees	D
Opposition	Loss [LESS THAN EQUAL TO]4 cm	D
Wrist: permanent functional limitation:
Physical examination-range of motion	Extension-limit to 30 degrees	D
Physical examination-range of motion	Flexion-limit to 30 degrees	D
Physical examination-range of motion	Ankylosis: [GREATER THAN]20 degrees from neutral	D
BODY PART: HAND AND ARM
JOB TITLE: GENERAL OFFICE CLERK
Fracture, wrist:
Physical examination-range of motion	Extension-limit to 30 degrees	D
Physical examination-range of motion	Flexion-limit to 30 degrees	D
Physical examination-range of motion	Ankylosis: [GREATER THAN]20 degrees from neutral	D
Rheumatoid arthritis hand:
Physical examination	Significant deformity	D
Medical record review	Significant flare-ups, under treatment with rheumatologist	D
Medical record review	Extensive medication use, under treatment with rheumatologist	D
Thumb: permanent functional limitation:
Adduction of thumb	Loss [LESS THAN EQUAL TO]4 cm	D
Ankylosis: degree from neutral	[LESS THAN]20 degree extension	D
Ankylosis: degree from neutral	[LESS THAN]40 degree flexion	D
Loss of extension or flexion	MCP or PIP: maximum flexion [LESS THAN]40 degrees	D
Opposition	Loss [LESS THAN EQUAL TO]4 cm	D
Wrist: permanent functional limitation:
Physical examination-range of motion	Extension-limit to 30 degrees	D
Physical examination-range of motion	Flexion-limit to 30 degrees	D
Physical examination-range of motion	Ankylosis: [GREATER THAN]20 degrees from neutral	D

I. Hip

Confirmatory test	Minimum result	Requirements
BODY PART: HIP
CONFIRMATORY TESTS
Ankylosis, hip:
X-ray: hip	Extreme joint destruction	Highly Recommended.
Physical examination-range of motion	No mobility	Highly Recommended.
Osteoarthritis, hip:
X-ray: hip	[LESS THAN]4 mm joint space, or other positive evidence	Recommended.
Magnetic resonance imaging	[LESS THAN]4 mm joint space, or other positive evidence	Recommended.
Computerized axial tomography	[LESS THAN]4 mm joint space, or other positive evidence	Recommended.
Osteomyelitis, hip:
X-ray: hip	Evidence of chronic infection	Recommended.
Computerized axial tomography	Evidence of chronic infection	Recommended.
Paget's disease:
X-ray: hip	Osteolytic or blastic lesions	Highly Recommended.
Alkaline phosphatase	Increased up to 50 times	Highly Recommended.
Hip replacement surgery:
X-ray: hip	Evidence of artificial hip	Recommended.
Medical record review	Documentation of prior hip replacement	Recommended.

Disability test	Test result	Disability classification
BODY PART: HIP
JOB TITLE: TRAINMAN
Ankylosis, hip:
Physical examination-range of motion	Ankylosis 5 degrees or [GREATER THAN]flexion	D
Physical examination-range of motion	Ankylosis internal rotation [GREATER THAN]5 degrees	D
Physical examination-range of motion	Ankylosis external rotation [GREATER THAN]10 degrees	D
Physical examination-range of motion	Ankylosis in abduction [GREATER THAN]5 degrees	D
Physical examination-range of motion	Ankylosis in adduction [GREATER THAN]5 degrees	D
Osteoarthritis, hip:
X-ray: hip	0 mm cartilage interval	D
Physical examination-range of motion	30 degrees flexion contracture	D
Physical examination-range of motion	[LESS THAN]50 degrees flexion	D
Physical examination-range of motion	[LESS THAN]5 degrees abduction	D
Osteomyelitis, chronic hip:
X-ray: hip	Significant joint destruction	D
Physical examination-range of motion	30 degrees flexion contracture	D
Physical examination-range of motion	[LESS THAN]50 degrees flexion	D
Physical examination-range of motion	[LESS THAN]5 degrees abduction	D
Medical record review	Documented occurrence of recurring infections with treatment	D
Paget's disease:
X-ray: hip	Significant joint destruction	D
Physical examination-range of motion	30 degrees flexion contracture	D
Physical examination-range of motion	[LESS THAN]50 degrees flexion	D
Physical examination-range of motion	[LESS THAN]5 degrees abduction	D
Hip replacement surgery:
X-ray: hip	Evidence of artificial hip joint	D
Medical record review	Documentation of prior hip replacement	D
BODY PART: HIP
JOB TITLE: ENGINEER
Ankylosis, hip:
Physical examination-range of motion	Ankylosis 5 degrees or [GREATER THAN]flexion	D
Physical examination-range of motion	Ankylosis internal rotation [GREATER THAN]5 degrees	D
Physical examination-range of motion	Ankylosis external rotation [GREATER THAN]10 degrees	D
Physical examination-range of motion	Ankylosis in abduction [GREATER THAN]5 degrees	D
Physical examination-range of motion	Ankylosis in adduction [GREATER THAN]5 degrees	D
Osteoarthritis, hip:
X-ray: hip	0 mm cartilage interval	D
Physical examination-range of motion	30 degrees flexion contracture	D
Physical examination-range of motion	[LESS THAN]50 degrees flexion	D
Physical examination-range of motion	[LESS THAN]5 degrees abduction	D
Osteomyelitis, chronic hip:
X-ray: hip	Signficant joint destruction	D
Physical examination-range of motion	30 degrees flexion contracture	D
Physical examination-range of motion	[LESS THAN]50 degrees flexion	D
Physical examination-range of motion	[LESS THAN]5 degrees abduction	D
Medical record review	Documented occurrence of recurring infections with treatment	D
Paget's disease:
X-ray: hip	Significant joint destruction	D
Physical examination-range of motion	30 degrees flexion contracture	D
Physical examination-range of motion	[LESS THAN]50 degrees flexion	D
Physical examination-range of motion	[LESS THAN]5 degrees abduction	D
Hip replacement surgery:
X-ray: hip	Evidence of artificial hip joint	D
Medical record review	Documentation of prior hip replacement	D
BODY PART: HIP
JOB TITLE: CARMAN
Ankylosis, hip:
Physical examination-range of motion	Ankylosis 5 degrees or [GREATER THAN]flexion	D
Physical examination-range of motion	Ankylosis internal rotation [GREATER THAN]5 degrees	D
Physical examination-range of motion	Ankylosis external rotation [GREATER THAN]10 degrees	D
Physical examination-range of motion	Ankylosis in abduction [GREATER THAN]5 degrees	D
Physical examination-range of motion	Ankylosis in adduction [GREATER THAN]5 degrees	D
Osteoarthritis, hip:
X-ray: hip	0 mm cartilage interval	D
Physical examination-range of motion	30 degrees flexion contracture	D
Physical examination-range of motion	[LESS THAN]50 degrees flexion	D
Physical examination-range of motion	[LESS THAN]5 degrees abduction	D
Osteomyelitis, chronic hip:
X-ray: hip	Significant joint destruction	D
Physical examination-range of motion	30 degrees flexion contracture	D
Physical examination-range of motion	[LESS THAN]50 degrees flexion	D
Physical examination-range of motion	[LESS THAN]5 degrees abduction	D
Medical record review	Documented occurrence of recurring infections with treatment	D
Paget's disease:
X-ray: hip	Significant joint destruction	D
Physical examination-range of motion	30 degrees flexion contracture	D
Physical examination-range of motion	[LESS THAN]50 degrees flexion	D
Physical examination-range of motion	[LESS THAN]5 degrees abduction	D
Hip replacement surgery:
X-ray: hip	Evidence of artificial hip joint	D
Medical record review	Documentation of prior hip replacement	D
BODY PART: HIP
JOB TITLE: SIGNALMAN
Ankylosis, hip:
Physical examination-range of motion	Ankylosis 5 degrees or [GREATER THAN]flexion	D
Physical examination-range of motion	Ankylosis internal rotation [GREATER THAN]5 degrees	D
Physical examination-range of motion	Ankylosis external rotation [GREATER THAN]10 degrees	D
Physical examination-range of motion	Ankylosis in abduction [GREATER THAN]5 degrees	D
Physical examination-range of motion	Ankylosis in adduction [GREATER THAN]5 degrees	D
Osteoarthritis, hip:
X-ray: hip	0 mm cartilage interval	D
Physical examination-range of motion	30 degrees flexion contracture	D
Physical examination-range of motion	[LESS THAN]50 degrees flexion	D
Physical examination-range of motion	[LESS THAN]5 degrees abduction	D
Osteomyelitis, chronic hip:
X-ray: hip	Significant joint destruction	D
Physical examination-range of motion	30 degrees flexion contracture	D
Physical examination-range of motion	[LESS THAN]50 degrees flexion	D
Physical examination-range of motion	[LESS THAN]5 degrees abduction	D
Medical record review	Documented occurrence of recurring infections with treatment	D
Paget's disease:
X-ray: hip	Significant joint destruction	D
Physical examination-range of motion	30 degrees flexion contracture	D
Physical examination-range of motion	[LESS THAN]50 degrees flexion	D
Physical examination-range of motion	[LESS THAN]5 degrees abduction	D
Hip replacement surgery:
X-ray: hip	Evidence of artificial hip joint	D
Medical record review	Documentation of prior hip replacement	D
BODY PART: HIP
JOB TITLE: TRACKMAN
Ankylosis, hip:
Physical examination-range of motion	Ankylosis 5 degrees or [GREATER THAN]flexion	D
Physical examination-range of motion	Ankylosis internal rotation [GREATER THAN]5 degrees	D
Physical examination-range of motion	Ankylosis external rotation [GREATER THAN]10 degrees	D
Physical examination-range of motion	Ankylosis in abduction [GREATER THAN]5 degrees	D
Physical examination-range of motion	Ankylosis in adduction [GREATER THAN]5 degrees	D
Osteoarthritis, hip:
X-ray: hip	0 mm cartilage interval	D
Physical examination-range of motion	30 degrees flexion contracture	D
Physical examination-range of motion	[LESS THAN]50 degrees flexion	D
Physical examination-range of motion	[LESS THAN]5 degrees abduction	D
Osteomyelitis, chronic hip:
X-ray: hip	Significant joint destruction	D
Physical examination-range of motion	30 degrees flexion contracture	D
Physical examination-range of motion	[LESS THAN]50 degrees flexion	D
Physical examination-range of motion	[LESS THAN]5 degrees abduction	D
Medical record review	Documented occurrence of recurring infections with treatment	D
Paget's disease:
X-ray: hip	Significant joint destruction	D
Physical examination-range of motion	30 degrees flexion contracture	D
Physical examination-range of motion	[LESS THAN]50 degrees flexion	D
Physical examination-range of motion	[LESS THAN]5 degrees abduction	D
Hip replacement surgery:
X-ray: hip	Evidence of artificial hip joint	D
Medical record review	Documentation of prior hip replacement	D
BODY PART: HIP
JOB TITLE: MACHINIST
Ankylosis, hip:
Physical examination-range of motion	Ankylosis 5 degrees or [GREATER THAN]flexion	D
Physical examination-range of motion	Ankylosis internal rotation [GREATER THAN]5 degrees	D
Physical examination-range of motion	Ankylosis external rotation [GREATER THAN]10 degrees	D
Physical examination-range of motion	Ankylosis in abduction [GREATER THAN]5 degrees	D
Physical examination-range of motion	Ankylosis in adduction [GREATER THAN]5 degrees	D
Osteoarthritis, hip:
X-ray: hip	0 mm cartilage interval	D
Physical examination-range of motion	30 degrees flexion contracture	D
Physical examination-range of motion	[LESS THAN]50 degrees flexion	D
Physical examination-range of motion	[LESS THAN]5 degrees abduction	D
Osteomyelitis, chronic hip:
X-ray: hip	Significant joint destruction	D
Physical examination-range of motion	30 degrees flexion contracture	D
Physical examination-range of motion	[LESS THAN]50 degrees flexion	D
Physical examination-range of motion	[LESS THAN]5 degrees abduction	D
Medical record review	Documented occurrence of recurring infections with treatment	D
Paget's disease:
X-ray: hip	Significant joint destruction	D
Physical examination-range of motion	30 degrees flexion contracture	D
Physical examination-range of motion	[LESS THAN]50 degrees flexion	D
Physical examination-range of motion	[LESS THAN]5 degrees abudction	D
Hip replacement surgery:
X-ray: hip	Evidence of artificial hip joint	D
Medical record review	Documentation of prior hip replacement	D
BODY PART: HIP
JOB TITLE: SHOP LABORER
Ankylosis, hip:
Physical examination-range of motion	Ankylosis 5 degrees of [GREATER THAN]flexion	D
Physical examination-range of motion	Ankylosis internal rotation [GREATER THAN]5 degrees	D
Physical examination-range of motion	Ankylosis external rotation [GREATER THAN]10 degrees	D
Physical examination-range of motion	Ankylosis in abduction [GREATER THAN]5 degrees	D
Physical examination-range of motion	Ankylosis in adduction [GREATER THAN]5 degrees	D
Osteoarthritis, hip:
X-ray: hip	0 mm cartilage interval	D
Physical examination-range of motion	30 degrees flexion contracture	D
Physical examination-range of motion	[LESS THAN]50 degrees flexion	D
Physical examination-range of motion	[LESS THAN]5 degrees abduction	D
Osteomyelitis, chronic hip:
X-ray: hip	Significant joint destruction	D
Physical examination-range of motion	30 degrees flexion contracture	D
Physical examination-range of motion	[LESS THAN]50 degrees flexion	D
Physical examination-range of motion	[LESS THAN]5 degrees abduction	D
Medical record review	Documented occurrence of recurring infections with treatment	D
Paget's disease:
X-ray; hip	Significant joint destruction	D
Physical examination-range of motion	30 degrees flexion contracture	D
Physical examination-range of motion	[LESS THAN]50 degrees flexion	D
Physical examination-range of motion	[LESS THAN]5 degrees abduction	D
Hip replacement surgery:
X-ray: hip	Evidence of artificial hip joint	D
Medical record review	Documentation of prior hip replacement	D

J. Knee

Confirmatory test	Minimum result	Requirements
BODY PART: KNEE
CONFIRMATORY TESTS
Arthritis: knee:
X-ray: knee	Evidence of significant degenerative changes	Recommended.
Collateral ligament tear with laxity:
Physical examination: knee	Evidence of ligamentous laxity	Highly Recommended.
Magnetic resonance imaging	Evidence of ligamentous tear	Recommended.
Cruciate and collateral ligament tear with laxity:
Magnetic resonance imaging	Tear of both ligaments	Recommended.
Physical examination	Evidence of ligamentous laxity	Highly Recommended.
Medical record review	Documentation of tear by arthroscopy	Recommended.
Cruciate ligament tear with laxity:
Physical examination: knee	Evidence of ligamentous laxity	Highly Recommended.
Magnetic resonance imaging	Evidence of cruciate tear	Recommended.
Medical record review	Documentation of tear by arthroscopy	Recommended.
Intercondylar fracture:
X-ray: knee	Evidence of fracture	Highly Recommended.
Osteomyelitis: knee:
Medical record review	Documented history of osteomyelitis requiring treatment	Highly Recommended.
X-ray: knee	Evidence of chronic infection	Recommended.
Computerized tomography	Evidence of chronic infection	Recommended.
Magnetic resonance imaging	Evidence of chronic infection	Recommended.
Osteonecrosis:
X-ray: knee	Necrosis of femoral condyle or tibial plateau	Recommended.
Computerized tomography	Necrosis of femoral condyle or tibial plateau	Recommended.
Magnetic resonance imaging	Necrosis of femoral condyle or tibial plateau	Recommended.
Patellofemoral arthritis:
X-ray: knee	Evidence of arthritis	Recommended.
Magnetic resonance imaging	Evidence of arthritis	Recommended.
Physical examination	Crepitation with movement	Highly Recommended.
Patellar fracture nonunion with displacement:
X-ray: knee	Nonunion and displacement	Recommended.
Magnetic resonance imaging	Nonunion and displacement	Recommended.
Computerized tomography	Nonunion and displacement	Recommended.
Plateau fracture:
X-ray: knee	Evidence of fracture	Recommended.
Computerized tomography	Evidence of fracture	Recommended.
Magnetic resonance imaging	Evidence of fracture	Recommended.
Meniscectomy-medial or lateral:
Medical record review	History of surgery	Highly Recommended.
Patellectomy:
Physical examination: knee	Absent patella	Highly Recommended.
Patellar-subluxation-recurrent:
Medical record review	History of recurrent subluxation	Highly Recommended.
Supracondylar fracture:
X-ray: knee	Evidence of fracture	Recommended.
Magnetic resonance imaging	Evidence of fracture	Recommended.
Computerized tomography	Evidence of fracture	Recommended.
Total knee replacement:
X-ray: knee	Presence of replacement knee	Recommended.
Medical record review	Documented surgical history	Recommended.
Tibial shaft fracture:
X-ray: leg	Fracture of shaft	Recommended.
Magnetic resonance imaging	Evidence of fracture	Recommended.
Computerized tomography	Evidence of fracture	Recommended.

Disability test	Test result	Disability classification
BODY PART: KNEE
JOB TITLE: TRAINMAN
Arthritis knee:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
X-ray knee	0-1 mm cartilage interval with degenerative change	D
Meniscectomy, medial or lateral:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN]degrees)	D
Collateral ligament tear with laxity:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Cruciate and collateral ligament tear:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Cruciate ligament tear with laxity:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Intercondylar fracture:
Post fracture angulation	[GREATER THAN]20 degrees angulation	D
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Osteomyelitis, chronic knee:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
Medical record review	Frequent episodes of infection requiring treatment	D
X-ray knee	0-1 mm cartilage interval with degenerative change	D
Osteonecrosis:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
X-ray knee	0-1 mm cartilage interval with degenerative change	D
Patellofemoral arthritis:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
X-ray knee: patello femoral joint	0 mm cartilage interval with degenerative change	D
Patellar fracture nonunion with displacement:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
X-ray knee	Nonunion and [GREATER THAN]3 mm displacement	D
Plateau fracture:
Post fracture angulation	[GREATER THAN]20 degrees angulation	D
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Patellectomy:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Patellar, subluxation, recurrent:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Supracondylar fracture:
Post fracture angulation	[GREATER THAN]20 degrees angulation	D
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Tibial shaft fracture:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Post fracture angulation	[GREATER THAN]20 degrees malalignment	D
BODY PART: KNEE
JOB TITLE: ENGINEER
Arthritis knee:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
X-ray knee	0-1 mm cartilage interval with degenerative change	D
Meniscectomy, medial or lateral:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Collateral ligament tear with laxity:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Cruciate and collateral ligament tear:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Cruciate ligament tear with laxity:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Intercondylar fracture:
Post fracture angulation	[GREATER THAN]20 degrees angulation	D
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Osteomyelitis, chronic knee:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
Medical record review	Frequent episodes of infection requiring treatment	D
X-ray knee	0-1 mm cartilage interval with degenerative change	D
Osteonecrosis:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
X-ray knee	0-1 mm cartilage interval with degenerative change	D
Patellofemoral arthritis:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
X-ray knee: patello femoral joint	0 mm cartilage interval with degenerative change	D
Patellar fracture nonunion with displacement:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
X-ray knee	Nonunion and [GREATER THAN]3 mm displacement	D
Plateau fracture:
Post fracture angulation	[GREATER THAN]20 degrees angulation	D
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Patellectomy:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Patellar, subluxation, recurrent:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Supracondylar fracture:
Post fracture angulation	[GREATER THAN]20 degrees angulation	D
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Tibial shaft fracture:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Post fracture angulation	[GREATER THAN]20 degrees malalignment	D
BODY PART: KNEE
JOB TITLE: CARMAN
Arthritis knee:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
X-ray knee	0-1 mm cartilage interval with degenerative change	D
Meniscectomy, medial or lateral:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Collateral ligament tear with laxity:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Cruciate and collateral ligament tear:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Cruciate ligament tear with laxity:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Intercondylar fracture:
Post fracture angulation	[GREATER THAN]20 degrees angulation	D
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Osteomyelitis, chronic knee:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
Medical record review	Frequent episodes of infection requiring treatment	D
X-ray knee	0-1 mm cartilage interval with degenerative change	D
Osteonecrosis:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
X-ray knee	0-1 mm cartilage interval with degenerative change	D
Patellofemoral arthritis:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
X-ray knee: patello femoral joint	0 mm cartilage interval with degenerative change	D
Patellar fracture nonunion with displacement:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
X-ray knee	Nonunion and [GREATER THAN]3 mm displacement	D
Plateau fracture:
Post fracture angulation	[GREATER THAN]20 degrees angulation	D
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Patellectomy:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Patellar, subluxation, recurrent:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Supracondylar fracture:
Post fracture angulation	[GREATER THAN]20 degrees angulation	D
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Tibial shaft fracture:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Post fracture angulation	[GREATER THAN]20 degrees malalignment	D
BODY PART: KNEE
JOB TITLE: SIGNALMAN
Arthritis knee:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
X-ray knee	0-1 mm cartilage interval with degenerative change	D
Meniscectomy, medial or lateral:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Collateral ligament tear with laxity:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Cruciate and collateral ligament tear:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Cruciate ligament tear with laxity:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Intercondylar fracture:
Post fracture angulation	[GREATER THAN]20 degrees angulation	D
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Osteomyelitis, chronic knee:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
Medical record review	Frequent episodes of infection requiring treatment	D
X-ray knee	0-1 mm cartilage interval with degenerative change	D
Osteonecrosis:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
X-ray knee	0-1 mm cartilage interval with degenerative change	D
Patellofemoral arthritis:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
X-ray knee: patello femoral joint	0 mm cartilage interval with degenerative change	D
Patellar fracture nonunion with displacement:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
X-ray knee	Nonunion and [GREATER THAN]3 mm displacement	D
Plateau fracture:
Post fracture angulation	[GREATER THAN]20 degrees angulation	D
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Patellectomy:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Patellar, subluxation, recurrent:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Supracondylar fracture:
Post fracture angulation	[GREATER THAN]20 degrees angulation	D
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Tibial shaft fracture:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Post fracture angulation	[GREATER THAN]20 degrees malalignment	D
BODY PART: KNEE
JOB TITLE: TRACKMAN
Arthritis knee:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
X-ray knee	0-1 mm cartilage interval with degenerative change	D
Meniscectomy, medial or lateral:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Collateral ligament tear with laxity:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Cruciate and collateral ligament tear:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Cruciate ligament tear with laxity:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Intercondylar fracture:
Post fracture angulation	[GREATER THAN]20 degree angulation	D
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Osteomyelitis, chronic knee:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
Medical record review	Frequent episodes of infection requiring treatment	D
X-ray knee	0-1 mm cartilage interval with degenerative change	D
Osteonecrosis:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
X-ray knee	0-1 mm cartilage interval with degenerative change	D
Patellofemoral arthritis:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
X-ray knee: patello femoral joint	0 mm cartilage interval with degenerative change	D
Patellar fracture nonunion with displacement:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
X-ray knee	Nonunion and [GREATER THAN]3 mm displacement	D
Plateau fracture:
Post fracture angulation	[GREATER THAN]20 degrees angulation	D
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Patellectomy:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Patellar, subluxation, recurrent:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Supracondylar fracture:
Post fracture angulation	[GREATER THAN]20 degrees angulation	D
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Tibial shaft fracture:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Post fracture angulation	[GREATER THAN]20 degrees malalignment	D
BODY PART: KNEE
JOB TITLE: MACHINIST
Arthritis knee:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
X-ray knee	0-1 mm cartilage interval with degenerative change	D
Meniscectomy, medial or lateral:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Collateral ligament tear with laxity:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Cruciate and collateral ligament tear:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Cruciate ligament tear with laxity:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Intercondylar fracture:
Post fracture angulation	[GREATER THAN]20 degrees angulation	D
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Osteomyelitis, chronic knee:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
Medical record review	Frequent episodes of infection requiring treatment	D
X-ray knee	0-1 mm cartilage interval with degenerative change	D
Osteonecrosis:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
X-ray knee	0-1 mm cartilage interval with degenerative change	D
Patellofemoral arthritis:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
X-ray knee	0 mm cartilage interval with degenerative change	D
Patellar fracture nonunion with displacement:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
X-ray knee	Nonunion and [GREATER THAN]3 mm displacement	D
Plateau fracture:
Post fracture angulation	[GREATER THAN]20 degrees angulation	D
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Patellectomy:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Patellar, subluxation, recurrent:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Supracondylar fracture:
Post fracture angulation	[GREATER THAN]20 degrees angulation	D
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Tibial shaft fracture:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Post fracture angulation	[GREATER THAN]20 degrees malalignment	D
BODY PART: KNEE
JOB TITLE: SHOP LABORER
Arthritis knee:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
X-ray knee	0-1 mm cartilage interval with degenerative change	D
Meniscectomy, medial or lateral:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Collateral ligament tear with laxity:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Cruciate and collateral ligament tear:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Cruciate ligament tear with laxity:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Intercondylar fracture:
Post fracture angulation	[GREATER THAN]20 degrees angulation	D
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Osteomyelitis, chronic knee:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
Medical record review	Frequent episodes of infection requiring treatment	D
X-ray knee	0-1 mm cartilage interval with degenerative change	D
Osteonecrosis:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
X-ray knee	0-1 mm cartilage interval with degenerative change	D
Patellofemoral arthritis:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Physical examination	Valgus deformity, 16-20 degrees	D
Physical examination	Varus deformity, 8-12 degrees	D
X-ray knee: patellofemoral joint	0 mm cartilage interval with degenerative change	D
Patellar fracture nonunion with displacement:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
X-ray knee	Nonunion and [GREATER THAN]3 mm displacement	D
Plateau fracture:
Post fracture angulation	[GREATER THAN]20 degrees angulation	D
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Patellectomy:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Patellar, subluxation, recurrent:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Supracondylar fracture:
Post fracture angulation	[GREATER THAN]20 degrees angulation	D
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Tibial shaft fracture:
Physical examination-range of motion	Range of motion: flexion [LESS THAN]60 degrees	D
Physical examination-range of motion	Flexion contracture (20 or [GREATER THAN] degrees)	D
Post fracture angulation	[GREATER THAN]20 degrees malalignment	D

K. Ankle and Foot

Confirmatory test	Minimum result	Requirements
BODY PART: ANKLE AND FOOT
CONFIRMATORY TESTS
Ankle fracture:
Medical record review	Documented history of ankle fracture	Recommended.
X-ray: ankle	Ankle fracture	Highly recommended.
Ankylosis, ankle:
X-ray: ankle	Extensive joint destruction	Highly recommended.
Physical examination	No mobility	Highly recommended.
Arthritis, subtalar joint:
X-ray: ankle	Evidence of significant arthritis: subtalar joint	Highly recommended.
Arthritis, talonavicular joint:
X-ray: ankle	Significant arthritis: talonavicular joint	Highly recommended.
Achilles tendon rupture:
Medical record review	Documentation of achilles tendon rupture	Highly recommended.
Physical examination	Rupture of achilles tendon	Highly recommended.
Arthritis, ankle:
X-ray: ankle	Significant arthritis	Highly recommended.
Hindfoot fracture:
X-ray: foot and ankle	Documentation of fracture	Highly recommended.
Rheumatoid arthritis, foot:
Medical History	Documented history of condition	Highly recommended.
X-ray: foot	Significant arthritis	Highly recommended.

Disability test	Test result	Disability classification
BODY PART: ANKLE AND FOOT
JOB TITLE: TRAINMAN
Ankle fracture:
X-ray: ankle	Displaced intra-articular fracture	D
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Ankylosis, ankle:
Physical examination-range of motion	Ankylosis in 20 degree or [LESS THAN EQUAL TO] dorsiflexion	D
Physical examination-range of motion	Ankylosis in 20 degree plantar flexion	D
Physical examination-range of motion	Ankylosis in int or ext malrotation [GREATER THAN]15 degrees	D
Physical examination-range of motion	Ankylosis in varus 10 or more degrees	D
Physical examination-range of motion	Ankylosis in valgus 10 or more degrees	D
Arthritis, subtalar joint (hindfoot):
X-ray: ankle-subtalar joint	Subtalar joint space 0 mm	D
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Arthritis, talonavicular joint (hindfoot):
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
X-ray: ankle-talonavicular joint	Talonavicular joint space 0 mm	D
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Achilles tendon rupture:
Physical examination-range of motion	Plantar flexion capability, [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture, 20 degrees	D
Arthritis, ankle:
X-ray: ankle	0 mm	D
Physical examination-range of motion	Plantar flexion capability, [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture, 20 degrees	D
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Hindfoot fracture:
X-ray: foot	Calcaneal fracture with Boehler angle [LESS THAN]95 degrees	D
X-ray: foot	Subtalar fracture with Boehler angle [LESS THAN]95 degrees	D
Physical examination	Varus angulation [GREATER THAN]20 degrees (hindfoot)	D
Physical examination	Valgus angulation [GREATER THAN]20 degrees (hindfoot)	D
Rheumatoid arthritis, foot:
X-ray: foot	Significant degeneration	D
Medical record review	Chronic flare-up with treatment	D
BODY PART: ANKLE AND FOOT
JOB TITLE: ENGINEER
Ankle fracture:
X-ray: ankle	Displaced intra-articular fracture	D
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Ankylosis, ankle:
Physical examination-range of motion	Ankylosis in 20 degree or [GREATER THAN] dorsiflexion	D
Physical examination-range of motion	Ankylosis in 20 degree plantar flexion	D
Physical examination-range of motion	Ankylosis in int or ext malrotation [GREATER THAN]15 degrees	D
Physical examination-range of motion	Ankylosis in varus 10 or more degrees	D
Physical examination-range of motion	Ankylosis in valgus 10 or more degrees	D
Arthritis, subtalar joint (hindfoot):
X-ray: ankle-subtalar joint	Subtalar joint space 0 mm	D
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Arthritis, talonavicular joint (hindfoot):
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
X-ray ankle-talonavicular joint	Talonavicular joint space 0 mm	D
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Achilles tendon rupture:
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Arthritis, ankle:
X-ray: ankle	0 mm	D
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Hindfoot fracture:
X-ray: foot	Calcaneal fracture with Boehler angle [LESS THAN]95 degrees	D
X-ray: foot	Subtalar fracture with Boehler angle [LESS THAN]95 degrees	D
Physical examination	Varus angulation [GREATER THAN]20 degrees (hindfoot)	D
Physical examination	Valgus angulation [GREATER THAN]20 degrees (hindfoot)	D
Rheumatoid arthritis, foot:
X-ray: foot	Significant degeneration	D
Medical record review	Chronic flare-up with treatment	D
BODY PART: ANKLE AND FOOT
JOB TITLE: DISPATCHER
Achilles tendon rupture:
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Arthritis, ankle:
X-ray: ankle	0 mm	D
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Hindfoot fracture:
X-ray: foot	Calcaneal fracture with Boehler angle [LESS THAN]95 degrees	D
X-ray: foot	Subtalar fracture with Boehler angle [LESS THAN]95 degrees	D
Physical examination	Varus angulation [GREATER THAN]20 degrees (hindfoot)	D
Physical examination	Valgus angulation [GREATER THAN]20 degrees (hindfoot)	D
Rheumatoid arthritis, foot:
X-ray: foot	Significant degeneration	D
Medical record review	Chronic flare-up with treatment	D
BODY PART: ANKLE AND FOOT
JOB TITLE: CARMAN
Ankle fracture:
X-ray: ankle	Displaced intra-articular fracture	D
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Ankylosis, ankle:
Physical examination-range of motion	Ankylosis in 20 degree or [GREATER THAN] dorisiflexion	D
Physical examination-range of motion	Ankylosis in 20 degree plantar flexion	D
Physical examination-range of motion	Ankylois in int or ext malrotation [GREATER THAN]15 degrees	D
Physical examination-range of motion	Ankylosis in varus 10 or more degrees	D
Physical examination-range of motion	Ankylosis in valgus 10 or more degrees	D
Arthritis, subtalar joint (hindfoot):
X-ray: ankle-subtalar joint	Subtalar joint space 0 mm	D
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Arthritis, talonavicular joint (hindfoot):
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
X-ray: ankle-talonavicular joint	Talonavicular joint space 0 mm	0
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Achilles tendon rupture:
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Arthritis, ankle:
X-ray: ankle	0 mm	D
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Hindfoot fracture:
X-ray: foot	Calcaneal fracture with Boehler angle [LESS THAN]95 degrees	D
X-ray: foot	Subtalar fracture with Boehler angle [LESS THAN]95 degrees	D
Physical examination	Varus angulation [GREATER THAN]20 degrees (hindfoot)	D
Physical examination	Valgus angulation [GREATER THAN]20 degrees (hindfoot)	D
Rheumatoid arthritis, foot:
X-ray: foot	Significant degeneration	D
Medical record review	Chronic flare-up with treatment	D
BODY PART: ANKLE AND FOOT
JOB TITLE: SIGNALMAN
Ankle fracture:
X-ray: ankle	Displaced intra-articular fracture	D
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Ankylosis, ankle:
Physical examination-range of motion	Ankylosis in 20 degree or [GREATER THAN] dorsiflexion	D
Physical examination-range of motion	Ankylosis in 20 degree plantar flexion	D
Physical examination-range of motion	Ankylosis in int or ext malrotation [GREATER THAN]15 degrees	D
Physical examination-range of motion	Ankylosis in varus 10 or more degrees	D
Physical examination-range of motion	Ankylosis in valgus 10 or more degrees	D
Arthritis, subtalar joint (hindfoot):
X-ray: ankle-subtalar joint	Subtalar joint space 0 mm	D
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Arthritis, talonavicular joint (hindfoot):
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
X-ray: ankle-talonavicular joint	Talonavicular joint space 0 mm	D
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Achilles tendon rupture:
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Arthritis, ankle:
X-ray: ankle	0 mm	D
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Hindfoot fracture:
X-ray: foot	Calcaneal fracture with Boehler angle [LESS THAN]95 degrees	D
X-ray: foot	Subtalar fracture with Boehler angle [LESS THAN]95 degrees	D
Physical examination	Varus angulation [GREATER THAN]20 degrees (hindfoot)	D
Physical examination	Valgus angulation [GREATER THAN]20 degrees (hindfoot)	D
Rheumatoid arthritis, foot:
X-ray: foot	Significant degeneration	D
Medical record review	Chronic flare-up with treatment	D
BODY PART: ANKLE AND FOOT
JOB TITLE: TRACKMAN
Ankle fracture:
X-ray: ankle	Displaced intra-articular fracture	D
Physical examination-range of motion	Varus deformity [GREATER THAN]15 degrees	D
Physical examination-range of motion	Plantar flexion capability [LESS THAN EQUAL TO]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Ankylosis, ankle:
Physical examination-range of motion	Ankylosis in 20 degree or [GREATER THAN] dorsiflexion	D
Physical examination-range of motion	Ankylosis in 20 degree plantar flexion	D
Physical examination-range of motion	Ankylosis in int or ext malrotation [GREATER THAN]15 degrees	D
Physical examination-range of motion	Ankylosis in varus 10 or more degrees	D
Physical examination-range of motion	Ankylosis in valgus 10 or more degrees	D
Arthritis, subtalar joint (hindfoot):
X-ray: ankle-subtalar joint	Subtalar joint space 0 mm	D
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Arthritis, talonavicular joint (hindfoot):
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
X-ray: angle-talonavicular joint	Talonavicular joint space 0 mm	D
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Achilles tendon rupture:
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Arthritis, ankle:
X-ray: ankle	0 mm	D
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Hindfoot fracture:
X-ray: foot	Calcaneal fracture with Boehler angle [LESS THAN]95 degrees	D
X-ray: foot	Subtalar fracture with Boehler angle [LESS THAN]95 degrees	D
Physical examination	Varus angulation [GREATER THAN]20 degrees (hindfoot)	D
Physical examination	Valgus angulation [GREATER THAN]20 degrees (hindfoot)	D
Rheumatoid arthritis, foot:
X-ray: foot	Significant degeneration	D
Medical record review	Chronic flare-up with treatment	D
BODY PART: ANKLE AND FOOT
JOB TITLE: MACHINIST
Ankle fracture:
X-ray: ankle	Displaced intra-articular fracture	D
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Ankylosis, ankle:
Physical examination-range of motion	Ankylosis in 20 degree or [GREATER THAN] dorsiflexion	D
Physical examination-range of motion	Ankylosis in 20 degree plantar flexion	D
Physical examination-range of motion	Ankylosis in int or ext malrotation [GREATER THAN]15 degrees	D
Physical examination-range of motion	Ankylosis in varus 10 or more degrees	D
Physical examination-range of motion	Ankylosis in valgus 10 or more degrees	D
Arthritis, subtalar joint (hindfoot):
X-ray: ankle-subtalar joint	Subtalar joint space 0 mm	D
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Arthritis, talonavicular joint (hindfoot):
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
X-ray: ankle-talonavicular joint	Talonavicular joint space 0 mm	D
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Achilles tendon rupture:
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Arthritis, ankle:
X-ray: ankle	0 mm	D
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Physical examination	Varus deformity [LESS THAN EQUAL TO]15 degrees	D
Hindfoot fracture:
X-ray: foot	Calcaneal fracture with Boehler angle [LESS THAN]95 degrees	D
X-ray: foot	Subtalar fracture with Boehler angle [LESS THAN]95 degrees	D
Physical examination	Varus angulation [GREATER THAN]20 degrees (hindfoot)	D
Physical examination	Valgus angulation [GREATER THAN]20 degrees (hindfoot)	D
Rheumatoid arthritis, foot:
X-ray: foot	Significant degeneration	D
Medical record review	Chronic flare-up with treatment	D
BODY PART: ANKLE AND FOOT
JOB TITLE: SHOP LABORER
Ankle fracture:
X-ray: ankle	Displaced intra-articular fracture	D
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Ankylosis, ankle:
Physical examination-range of motion	Ankylosis in 20 degree or [GREATER THAN] dorsiflexion	D
Physical examination-range of motion	Ankylosis in 20 degree plantar flexion	D
Physical examination-range of motion	Ankylosis in int or ext malrotation [GREATER THAN]15 degrees	D
Physical examination-range of motion	Ankylosis in varus 10 or more degrees	D
Physical examination-range of motion	Ankylosis in valgus 10 or more degrees	D
Arthritis, subtalar joint (hindfoot):
X-ray: ankle-subtalar joint	Subtalar joint space 0 mm	D
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Arthritis, talonavicular joint (hindfoot):
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
X-ray: ankle-talonavicular joint	Talonavicular joint space 0 mm	D
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Achilles tendon rupture:
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Arthritis, ankle:
X-ray: ankle	0 mm	D
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Hindfoot fracture:
X-ray: foot	Calcaneal fracture with Boehler angle [LESS THAN]95 degrees	D
X-ray: foot	Subtalar fracture with Boehler angle [LESS THAN]95 degrees	D
Physical examination	Varus angulation [GREATER THAN]20 degrees (hindfoot)	D
Physical examination	Valgus angulation [GREATER THAN]20 degrees (hindfoot)	D
Rheumatoid arthritis, foot:
X-ray: foot	Significant degeneration	D
Medical record review	Chronic flare-up with treatment	D

Disability test	Test result	Disability classification
BODY PART: ANKLE AND FOOT
JOB TITLE: SALES REPRESENTATIVES
Achilles tendon rupture:
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Arthritis, ankle:
X-ray: ankle	0 mm	D
Physical examination-range of motion	Plantar flexion capability [LESS THAN]5 degrees	D
Physical examination-range of motion	Plantar flexion contracture 20 degrees	D
Physical examination	Varus deformity [GREATER THAN]15 degrees	D
Hindfoot fracture:
X-ray: foot	Calcaneal fracture with Boehler angle [LESS THAN]95 degrees	D
X-ray: foot	Subtalar fracture with Boehler angle [LESS THAN]95 degrees	D
Physical examination	Varus angulation [GREATER THAN]20 degrees (hindfoot)	D
Physical examination	Valgus angulation [GREATER THAN]20 degrees (hindfoot)	D
Rheumatoid arthritis, foot:
X-ray: foot	Significant degeneration	D
Medical record review	Chronic flare-up with treatment	D

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20 C.F.R. § 220 app 3 to Part 220

63 FR 7543, Feb. 13, 1998

88 FR 61958 , 9/8/2023