Minn. R. 5223.0110 - MUSCULOSKELETAL SCHEDULE; SHOULDER

Subpart 1. General.

For permanent partial disability to the shoulder, disability of the whole body is as in subparts 2 and 3.

Subp. 2. Range of motion.

A. Total ankylosis in optimum position, abduction 60 degrees, flexion ten degrees, rotation, neutral position, 30 percent;

B. Total ankylosis in mal-position, grade upward to 50 percent;

C. Mild limitation of motion: no abduction beyond 90 degrees, rotation no more than 40 degrees with full flexion and extension, 3 percent;

D. Moderate limitation of motion: no abduction beyond 60 degrees, rotation no more than 20 degrees, with flexion and extension limited to 30 degrees, 12 percent;

E. Severe limitation of motion: no abduction beyond 25 degrees, rotation no more than ten degrees, flexion and extension limited to 20 degrees, 30 percent.

Subp. 3. Procedures or conditions.

A. Acromio clavicular separation of the following severity:

(1) grade 1, 0 percent;

(2) grade 2, 3 percent;

(3) grade 3, 6 percent.

B. Anterior or posterior shoulder dislocation, no surgery, single episode, 3 percent.

C. Recurrent dislocation, at least three times in six months, 10 percent.

D. Repair recurrent shoulder dislocation:

(1) no loss of motion, 6 percent;

(2) if mild limitation of motion, 9 percent;

(3) if moderate or severe limitation of motion, rate as in subpart 2, items D and E.

E. Resection distal end of clavicle, 3 percent.

F. Humeral shaft fracture, normal range of motion both joints, 0 percent.

G. Humeral shaft fracture, open reduction, mild restriction of shoulder and elbow motion, 6 percent. For moderate or severe limitation of motion, rate as in subpart 2, items D and E.

H. Surgical neck fracture, healed, no loss of motion, 0 percent; if loss of motion, rate as in subpart 2.

I. Greater tuberosity fracture, normal range of motion, 0 percent. If loss of motion, rate as in subpart 2.

Notes

Minn. R. 5223.0110

10 SR 1124

Statutory Authority: MS s 176.105