W. Va. Code R. § 85-20-64

Current through Register Vol. XLI, No. 50, December 13, 2024

Section 85-20-64 - Ranges of partial disability awards for common injuries and diseases

64.1. Pursuant to W. Va. Code § 23-4-3b(b), the Commission or Insurance Commissioner, whichever is applicable, hereby adopts the following ranges of permanent partial disability for common injuries and diseases. Permanent partial disability assessments shall be determined based upon the range of motion models contained in the Guides Fourth. Once an impairment level has been determined by range of motion assessment, that level will be compared with the ranges set forth below. Permanent partial disability assessments in excess of the range provided in the appropriate category as identified by the rating physician shall be reduced to the within the ranges set forth below:

64.2. Lumbar Spine Impairment: The range of motion methodology for assessing permanent impairment shall be used. However, a single injury or cumulative injuries that lead to a permanent impairment to the Lumbar Spine area of one's person shall cause an injured worker to be eligible to receive a permanent partial disability award within the ranges identified in Table §85-20-C. The rating physician must identify the appropriate impairment category and then assign an impairment within the appropriate range designated for that category.

64.3. Thoracic Spine Impairment: A single injury or cumulative injuries that lead to a permanent impairment to the Thoracic Spine area of one's person shall cause an injured worker to be eligible to receive a permanent partial disability award within the ranges identified in Table §85-20-D. The rating physician must identify the appropriate impairment category and then assign an impairment within the appropriate range designated for that category.

64.4. Cervical Spine Impairment: A single injury or cumulative injuries that lead to a permanent impairment to the Thoracic Spine area of one's person shall cause an injured worker to be eligible to receive a permanent partial disability award within the ranges identified in Table §85-20-E. The rating physician must identify the appropriate impairment category and then assign an impairment within the appropriate range designated for that category.

64.5. Carpal Tunnel Syndrome Impairment: An injured worker who can otherwise show entitlement to a permanent partial disability award for carpal tunnel syndrome shall be eligible to receive a permanent partial disability award of 0%-6% in each affected hand.

64.6. Mental Impairment: Psychiatric disability ranges, along with all other ranges in this Rule, must be strictly adhered to and ratings in excess of the ranges shall be considered evidence of abuse under W. Va. Code § 23-4-3c.

64.7. Arm: The statutory impairment for the amputation of an injured worker's arm is 60%. Accordingly, a single or all cumulative injuries to an individual's arm shall not total more than 60%. As an example, if an injured worker receives a 6% award for unilateral carpal tunnel, a 30% award for a shoulder injury, and a 10% award for an elbow injury, he shall not be entitled to any future award for injuries sustained to his shoulder in excess of 14%. The "bundling" of awards for injuries to the arm shall not exceed the 60% amputation award.

64.8. Leg: The statutory impairment for the amputation of an injured worker's leg is 45%. Accordingly, a single or all cumulative injuries to an individual's leg shall not total more than 45%. As an example, if an injured worker is awarded a 20% award for a permanently impaired hip and then is later awarded a 15% permanent impairment for an injury to his knee, then he shall only be entitled to an additional 5% permanent award in future injuries to his hip, thigh, knee, shin, ankle, foot, or any other part of his leg. The "bundling" of awards for injuries to the leg shall not exceed the 45% amputation award.

W. Va. Code R. § 85-20-64