{"data":{"id":"us/20-cfr-appendix-3-to-part-220","jurisdiction":"us","citation":"20 CFR Appendix 3 to Part 220","heading":"Appendix 3 to Part 220—Railroad Retirement Board Occupational Disability Standards","body":"1. Introduction\n1.01 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.\n1.02 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:\n2. Confirming the Impairment\n2.01 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.\n2.02 There are two types of Confirmatory Tests as follows.\n2.03 “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.\n2.04 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.\n2.05 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.\n2.06 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:\nA. A history of back pain under medical treatment for at least one year, and\nB. A history of back pain unresponsive to therapy for at least one year, and\nC. A history of back pain with functional limitations for at least one year.\n2.07 All three of these criteria must be satisfied to confirm the existence of chronic back pain.\n2.08 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.\n2.09 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.\n2.10 There are two categories of recommended tests which are described below.\nA. 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.\nB. Other tests—This category of tests refers to non-imaging studies.\n2.11 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.\n2.12 Example: Under Body Part C., Cardiac, the diagnostic confirmatory tests for ventricular ectopy, a cardiac arrhythmia, include the following “recommended” tests:\nA. Medical record review, i.e., a review of the claimant's medical records, or\nB. Holter monitoring, or\nC. Provocative testing producing a definite arrhythmia.\n2.13 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.\n2.14 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.\n2.15 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.\n3. Disability Determination\n3.01 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.\n3.02 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 ≤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.\nTables\nA. Cancer\nB. Endocrine\nC. Cardiac\nD. Respiratory\nE. Lumbar Sacral Spine\nF. Cervical Spine\nG. Shoulder and Elbow\nH. Hand and Arm\nI. Hip\nJ. Knee\nK. Ankle and Foot\nA. Cancer\nCancer\nCancer conditions can be viewed as belonging to one of three categories.\nCategory 1: Significant impact on functional capacity or anticipated life span.\nCategory 2: Intermediate impact on functional capacity; large individual variability.\nCategory 3: No significant impact on functional capacity or expected life span.\nThe factors that are considered in developing these categories include the following:\nType of Cancer\nThe functional impact of different malignancies varies tremendously and each malignancy has to be considered on an individual basis.\nMagnitude of Disease\nThe 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.\nThe 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].\nEffects of Treatment\nAlthough 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.\nPrognosis\nSome 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.\nThe 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.\nAssessment\nThe 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.\nInformation 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.\nCancer type 2-year1 5-year1 Disability status2 Functional impact3\nBrain:\nLocal 26 1 S\nRegional 27.9 1 S\nDistant 23.6 1 S\nFemale Breast:\nRegional 71.1 2 S\nDistant 17.8 1 S\nColon:\nLocal 91 2 S\nRegional 60.1 2 S\nDistant 6 1 S\nRectal:\nLocal 84.5 2 S\nRegional 50.7 2 S\nDistant 5.3 1 S\nEsophagus:\nLocal 18.5 1 S\nRegional 5.2 1 S\nDistant 1.8 1 S\nHodgkin's Disease:4\nStage 1 90-95 3 S\nStage 2 86 2 S\nStage 3 \u003c80 2 S\nStage 4 \u003c80 1 S\nKidney/Renal Pelvis:\nLocal 85.4 3 S\nRegional 56.3 2 S\nDistant 9 1 S\nLarynx:\nLocal 84.2 2 S\nRegional 52.5 2 S\nDistant 24 1 S\nAcute Lymphocytic Leukemia:\nAll 51.1 2 S\nChronic Lymphocytic Leukemia:\nAll 66.2 2 S\nAcute Myelogenous Leukemia:\nAll 9.7 1 S\nChronic Myelogenous Leukemia:\nAll 21.7 1 S\nLiver/Intrahepatic Bile Duct:\nLocal 15.1 1 S\nRegional 5.8 1 S\nDistant 1.9 1 S\nLung/Bronchus:5\nLocal 45.6 2 S\nRegional 13.1 1 S\nDistant 1.3 1 S\nMelanomas of Skin:\nRegional 53.6 2 S\nDistant 12.8 1 S\nOral Cavity/Pharyngeal:\nLocal 76.2 2 S\nRegional 40.9 2 S\nDistant 18.7 1 S\nPancreas:\nLocal 6.1 1 S\nRegional 3.7 1 S\nDistant 1.4 1 S\nProstate:\nLocal 91 3 S\nRegional 80.4 2 S\nDistant 28 1 S\nStomach:\nLocal 55.4 1 S\nRegional 17.3 1 S\nDistant 2.1 1 S\nTesticular:\nDistant 65.5 1 S\nThyroid:\nRegional 93.1 3 S\nDistant 47.2 1 S\nBladder:\nRegional 46 2 S\nDistant 9.1 1 S\n1 Source of 2 and 5 year survival data: Miller BA et al. Cancer Statistics Review 1973-1989. NIH Publication No. 92-2789.\n2 Disability Status:\nCategory 1: Significant impact on functional capacity or life span.\nCategory 2: Intermediate impact.\nCategory 3: No significant impact on functional capacity or life span.\n3 Functional Impacts:\n(S) Significant—significant potential for the effects of treatment (radiotheraphy, chemotherapy. surgery) to affect functional capacity.\n4 Hodgkin'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.)\n5 Small cell carcinoma is classified as a 1.\nB. Endocrine\nConfirmatory test Minimum result Requirements\nBODY PART: ENDOCRINE\nCONFIRMATORY TESTS\nDiabetes, requiring insulin (IDDM):\nMedical record review Confirmation of condition and need for insulin use Highly recommended.\nDisability test Test result Disability classification\nBODY PART: ENDOCRINE\nJOB TITLE: ENGINEER\nDiabetes, requiring insulin (IDDM):\nMedical record review Confirmation of condition and need for insulin use D\nC. Cardiac\nConfirmatory test Minimum result Requirements\nBODY PART: CARDIAC\nCONFIRMATORY TESTS\nAngina:\nMedical record review Confirmed history of ischemia including copies of electrocardiogram Recommended.\nStress test Definite ischemia on exercise test Recommended.\nThallium study Definite ischemia with exercise Recommended.\nAortic valve disease:\nCardiac catheterization Proven and significant Recommended.\nEchocardiogram Significant valve disease Recommended.\nCoronary artery disease:\nMedical record review Documented ischemia with electrocardiogram confirmation Recommended.\nMedical record review Documented myocardial infarction Recommended.\nStress test Positive Recommended.\nThallium study Definite ischemia with exercise Recommended.\nAngiography Definite occlusion (\u003e60%) of one vessel Recommended.\nCardiomyopathy:\nEchocardiogram Proven ejection fraction ≤35% Recommended.\nCatheterization Poor global function and not coronary artery disease Recommended.\nHypertension:\nMedical record review Documentation of hypertension for one year Highly recommended.\nMedical record review Definite diagnosis by cardiologist or internist Highly recommended.\nMedical record review Confirmation of medication use Highly recommended.\nArrhythmia: heart block:\nMedical record review Proven episode with electrocardiogram confirmation Recommended.\nElectrocardiogram Documentation of arrhythmia Recommended.\nMitral valve disease:\nCardiac catheterization Significant valve disease Recommended.\nEchocardiogram Significant valve disease Recommended.\nPericardial disease:\nMedical record review Confirmed by cardiologist or internist Highly recommended.\nPulmonary hypertension:\nPhysical examination Increased pulmonic sound or pulmonary ejection murmur by cardiologist or internist Recommended.\nElectrocardiogram Definite right ventricular hypertension Highly recommended.\nVentricular ectopy:\nMedical record review Definite episode within one year Recommended.\nHolter monitoring Definite arrhythmia Recommended.\nProvocative testing Positive response Recommended.\nArrhythmia: supraventricular tachycardia:\nMedical record review Definite episode within one year Recommended.\nHolter monitoring Definite arrhythmia Recommended.\nPost heart transplant:\nMedical record review Documented Highly recommended.\nDisability test Test result Disability classification\nBODY PART: CARDIAC\nJOB TITLE: TRAINMAN\nAngina:\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤7 METS D\nMedical record review Unstable as diagnosed by cardiologist D\nStress test Documented hypotensive response D\nStress test: significant ST changes Definite ischemia ≤7 METS D\nAortic valve disease:\nCardiac catheterization Aortic gradient 25-50 mm HG\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤7 METS D\nCoronary artery disease:\nMyocardial infarction Multiple infarctions D\nEchocardiogram Confirmed ventricular aneurysm D\nCardiac catheterization Aortic gradient 25-50 mm Hg D\nCardiac catheterization Poor ejection fraction ≤35% D\nStress test Peak exercise ≤7 METS D\nMedical record review Unstable as diagnosed by a Cardiologist D\nStress test Documented hypotensive response D\nStress test Definite ischemia ≤ 7 METS D\nIsotope, e.g., thallium study Definite ischemia ≤ 7 METS D\nCardiomyopathy:\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤7 METS D\nHypertension:\nMedical record review Diastolic \u003e120 and systolic \u003e160, 50% of the time and evidence of end organ damage (blood creatinine \u003e2; urinary protein \u003e1⁄2 gm; or EKG evidence of ischemia) D\nArrhythmia: heart block:\nHolter Documented asystole length \u003e1.5-2 seconds D\nMedical record review Documented syncope with proven arrhythmia D\nMitral valve disease:\nCardiac catheterization Mitral valve gradient ≥5 mm Hg D\nCardiac catheterization Mitral regurgitation severe D\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤7 METS D\nPericardial disease:\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nVentricular ectopy:\nMedical record review Documented life threatening arrhythmia D\nHolter Uncontrolled ventricular rhythm D\nMedical record review Documented related syncope D\nArrhythmia: supraventricular tachycardia:\nMedical record review Documented related syncope D\nPost heart transplant:\nMedical record review Post heart transplant D\nBODY PART: CARDIAC\nJOB TITLE: ENGINEER\nAngina:\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nMedical record review Unstable as diagnosed by cardiologist D\nStress test Documented hypotensive response D\nStress test: significant ST changes Definite ischemia ≤5 METS D\nAortic valve disease:\nCardiac catheterization Aortic gradient 25-50 mm HG D\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nCoronary artery disease:\nMyocardial infarction Multiple infarctions D\nEchocardiogram Confirmed ventricular aneurysm D\nCardiac catheterization Aortic gradient 25-50 mm Hg D\nCardiac catheterization Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nMedical record review Unstable as diagnosed by a Cardiologist D\nStress test Documented hypotensive response D\nStress test Definite ischemia ≤5 METS D\nIsotope, e.g., thallium study Definite ischemia ≤5 METS D\nCardiomyopathy:\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nHypertension:\nMedical record review Diastolic \u003e120 and systolic \u003e160, 50% of the time and evidence of end organ damage (blood creatinine \u003e2; urinary protein \u003e1⁄2 gm; or EKG evidence of ischemia) D\nArrhythmia: heart block:\nHolter Documented asystole length \u003e1.5-2 seconds D\nMedical record review Documented syncope with proven arrhythmia D\nMitral valve disease:\nCardiac catheterization Mitral valve gradient ≥10 mm Hg D\nCardiac catheterization Mitral regurgitation severe D\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nPericardial disease:\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nVentricular ectopy:\nMedical record review Documented life threatening arrhythmia D\nHolter Uncontrolled ventricular rhythm D\nMedical record review Documented related syncope D\nArrhythmia: supraventricular tachycardia:\nMedical record review Documented related syncope D\nPost heart transplant:\nMedical record review Post heart transplant D\nBODY PART: CARDIAC\nJOB TITLE: DISPATCHER\nAngina:\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nMedical record review Unstable as diagnosed by cardiologist D\nStress test Documented hypotensive response D\nStress test: significant ST changes Definite ischemia ≤5 METS D\nAortic valve disease:\nCardiac catheterization Aortic gradient 25-50 mm Hg D\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nCoronary artery disease:\nMyocardial infarction Multiple infarctions D\nEchocardiogram Confirmed ventricular aneurysm D\nCardiac catheterization Aortic gradient 25-50 mm Hg D\nCardiac catheterization Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nMedical record review Unstable as diagnosed by cardiologist D\nStress test Documented hypotensive response D\nStress test Definite ischemia ≤5 METS D\nIsotope, e.g., thallium study Definite ischemia ≤5 METS D\nCardiomyopathy:\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nHypertension:\nMedical record review Diastolic \u003e120 and systolic \u003e160, 50% of the time and evidence of end organ damage (blood creatinine \u003e2; urinary protein \u003e1⁄2 gm; or EKG evidence of ischemia) D\nArrhythmia: heart block:\nHolter Documented asystole length \u003e1.5-2 seconds D\nMedical record review Documented syncope with proven arrhythmia D\nMitral valve disease:\nCardiac catheterization Mitral valve gradient ≥10 mm Hg D\nCardiac catheterization Mitral regurgitation severe D\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nPericardial disease:\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nVentricular ectopy:\nMedical record review Documented life threatening arrhythmia D\nHolter Uncontrolled ventricular rhythm D\nMedical record review Documented related syncope D\nArrhythmia: supraventricular tachycardia:\nMedical record review Documented related syncope D\nPost heart transplant:\nMedical record review Post heart transplant D\nBODY PART: CARDIAC\nJOB TITLE: CARMAN\nAngina:\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nMedical record review Unstable as diagnosed by cardiologist D\nStress test Documented hypotensive response D\nStress test: significant ST changes Definite ischemia ≤5 METS D\nAortic valve disease:\nCardiac catheterization Aortic gradient 25-50 mm HG\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nCoronary artery disease:\nMyocardial infarction Multiple infarctions D\nEchocardiogram Confirmed ventricular aneurysm D\nCardiac catheterization Aortic gradient 25-50 mm Hg D\nCardiac catheterization Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nMedical record review Unstable as diagnosed by a Cardiologist D\nStress test Documented hypotensive response D\nStress test Definite ischemia ≤ 5 METS D\nIsotope, e.g., thallium study Definite ischemia ≤ 5 METS D\nCardiomyopathy:\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nHypertension:\nMedical record review Diastolic \u003e120 and systolic \u003e160, 50% of the time and evidence of end organ damage (blood creatinine \u003e2; urinary protein \u003e1⁄2 gm; or EKG evidence of ischemia) D\nArrhythmia: heart block:\nHolter Documented asystole length \u003e1.5-2 seconds D\nMedical record review Documented syncope with proven arrhythmia D\nMitral valve disease:\nCardiac catheterization Mitral valve gradient ≥10 mm Hg D\nCardiac catheterization Mitral regurgitation severe D\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nPericardial disease:\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nVentricular ectopy:\nMedical record review Documented life threatening arrhythmia D\nHolter Uncontrolled ventricular rhythm D\nMedical record review Documented related syncope D\nArrhythmia: supraventricular tachycardia:\nMedical record review Documented related syncope D\nPost heart transplant:\nMedical record review Post heart transplant D\nBODY PART: CARDIAC\nJOB TITLE: SIGNALMAN\nAngina:\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤7 METS D\nMedical record review Unstable as diagnosed by cardiologist D\nStress test Documented hypotensive response D\nStress test: significant ST changes Definite ischemia ≤7 METS D\nAortic valve disease:\nCardiac catheterization Aortic gradient 25-50 mm HG D\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤7 METS D\nCoronary artery disease:\nMyocardial infarction Multiple infractions D\nEchocardiogram Confirmed ventricular aneurysm D\nCardiac catheterization Aortic gradient 25-50 mm Hg D\nCardiac catheterization Poor ejection fraction ≤35% D\nStress test Peak exercise ≤7 METS D\nMedical record review Unstable as diagnosed by cardiologist D\nStress test Documented hypotensive response D\nStress test Definite ischemia ≤7 METS D\nIsotope, e.g., thallium study Definite ischemia ≤7 METS D\nCardiomyopathy:\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤7 METS D\nHypertension:\nMedical record review Diastolic \u003e120 and systolic \u003e160, 50% of the time and evidence of end organ damage (blood creatinine \u003e2; urinary protein \u003e1⁄2 gm; or EKG evidence of ischemia) D\nArrhythmia: heart block\nHolter Documented asystole length \u003e1.5-2 seconds D\nMedical record review Documented syncope with proven arrhythmia D\nMitral valve disease:\nCardiac catheterization Mitral valve gradient ≥5 mm Hg D\nCardiac catherization Mitral regurgitation severe D\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤7 METS D\nPericardial disease:\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nVentricular ectopy:\nMedical record review Documented life threatening arrhythmia D\nHolter Uncontrolled ventricular rhythm D\nMedical record review Documented related syncope D\nArrhythmia: supraventricular tachycardia:\nMedical record review Documented related syncope D\nPost heart transplant:\nMedical record review Post heart transplant D\nBODY PART: CARDIAC\nJOB TITLE: TRACKMAN\nAngina:\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤7 METS D\nMedical record review Unstable as diagnosed by cardiologist D\nStress test Documented hypotensive response D\nStress test: significant ST changes Definite ischemia ≤7 METS D\nAortic valve disease:\nCardiac catheterization Aortic gradient 25-50 mm HG D\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤7 METS D\nCoronary artery disease:\nMyocardial infarction Multiple infarctions D\nEchocardiogram Confirmed ventricular aneurysm D\nCardiac catheterization Aortic gradient 25-50 mm Hg D\nCardiac catheterization Poor ejection fraction ≤35% D\nStress test Peak exercise ≤7 METS D\nMedical record review Unstable as diagnosed by a cardiologist D\nStress test Documented hypotensive response D\nStress test Definite ischemia ≤7 METS D\nIsotope, e.g., thallium study Definite ischemia ≤7 METS D\nCardiomyopathy:\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤7 METS D\nHypertension:\nMedical record review Diastolic \u003e120 and systolic \u003e160, 50% of the time and evidence of end organ damage (blood creatinine \u003e2; urinary protein \u003e1⁄2 gm; or EKG evidence of ischemia) D\nArrhythmia: heart block:\nHolter Documented asystole length \u003e1.5-2 seconds D\nMedical record review Documented syncope with proven arrhythmia D\nMitral valve disease:\nCardiac catheterization Mitral valve gradient ≥5 mm Hg D\nCardiac catheterization Mitral regurgitation severe D\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤7 METS D\nPericardial disease:\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nVentricular ectopy:\nMedical record review Documented life threatening arrhythmia D\nHolter Uncontrolled ventricular rhythm D\nMedical record review Documented related syncope D\nArrhythmia: supraventricular tachycardia:\nMedical record review Documented related syncope D\nPost heart transplant:\nMedical record review Post heart transplant D\nBODY PART: CARDIAC\nJOB TITLE: MACHINIST\nAngina:\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nMedical record review Unstable as diagnosed by cardiologist D\nStress test Documented hypotensive response D\nStress test: significant ST changes Definite ischemia ≤5 METS D\nAortic valve disease:\nCardiac catheterization Aortic gradient 25-50 mm HG\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nCoronary artery disease:\nMyocardial infarction Multiple infarctions D\nEchocardiogram Confirmed ventricular aneurysm D\nCardiac catheterization Aortic gradient 25-50 mm Hg D\nCardiac catheterization Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nMedical record review Unstable as diagnosed by a cardiologist D\nStress test Documented hypotensive response D\nStress test Definite ischemia ≤5 METS D\nIsotope, e.g., thallium study Definite ischemia ≤5 METS D\nCardiomyopathy:\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nHypertension:\nMedical record review Diastolic \u003e120 and systolic \u003e160, 50% of the time and evidence of end organ damage (blood creatinine \u003e2; urinary protein \u003e1⁄2 gm; or EKG evidence of ischemia) D\nArrhythmia: heart block:\nHolter Documented asystole length \u003e1.5-2 seconds D\nMedical record review Documented syncope with proven arrhythmia D\nMitral valve disease:\nCardiac catheterization Mitral valve gradient ≥10 mm Hg D\nCardiac catheterization Mitral regurgitation severe D\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nPericardial disease:\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nVentricular ectopy:\nMedical record review Documented life threatening arrhythmia D\nHolter Uncontrolled ventricular rhythm D\nMedical record review Documented related syncope D\nArrhythmia: supraventricular tachycardia:\nMedical record review Documented related syncope D\nPost heart transplant:\nMedical record review Post heart transplant D\nBODY PART: CARDIAC\nJOB TITLE: SHOP LABORER\nAngina:\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nMedical record review Unstable as diagnosed by cardiologist D\nStress test Documented hypotensive response D\nStress test: significant ST changes Definite ischemia ≤5 METS D\nAortic valve disease:\nCardiac catheterization Aortic gradient 25-50 mm HG\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nCoronary artery disease:\nMyocardial infarction Multiple infarctions D\nEchocardiogram Confirmed ventricular aneurysm D\nCardiac catheterization Aortic gradient 25-50 mm Hg\nCardiac catheterization Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nMedical record review Unstable as diagnosed by a Cardiologist D\nStress test Documented hypotensive response D\nStress test Definite ischemia ≤5 METS D\nIsotope, e.g., thallium study Definite ischemia ≤5 METS D\nCardiomyopathy:\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nHypertension:\nMedical record review Diastolic \u003e120 and systolic \u003e160, 50% of the time and evidence of end organ damage (blood creatinine \u003e2; urinary protein \u003e1⁄2 gm; or EKG evidence of ischemia) D\nArrhythmia: heart block:\nHolter Documented asystole length \u003e1.5-2 seconds D\nMedical record review Documented syncope with proven arrhythmia D\nMitral valve disease:\nCardiac catheterization Mitral valve gradient ≥10 mm Hg D\nCardiac catheterization Mitral regurgitation severe D\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nPericardial disease:\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nVentricular ectopy:\nMedical record review Documented life threatening arrhythmia D\nHolter Uncontrolled ventricular rhythm D\nMedical record review Documented related syncope D\nArrhythmia: supraventricular tachycardia:\nMedical record review Documented related syncope D\nPost heart transplant:\nMedical record review Post heart transplant D\nBODY PART: CARDIAC\nJOB TITLE: SALES REPRESENTATIVE\nAngina:\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nMedical record review Unstable as diagnosed by cardiologist D\nStress test Documented hypotensive response D\nStress test: significant ST changes Definite ischemia ≤5 METS D\nAortic valve disease:\nCardiac catheterization Aortic gradient 25-50 mm HG D\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nCoronary artery disease:\nMyocardial infarction Multiple infarctions D\nEchocardiogram Confirmed ventricular aneurysm D\nCardiac catheterization Aortic gradient 25-50 mm Hg D\nCardiac catheterization Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nMedical record review Unstable as diagnosed by a cardiologist D\nStress test Documented hypotensive response D\nStress test Definite ischemia ≤5 METS D\nIsotope, e.g., thallium study Definite ischemia ≤5 METS D\nCardiomyopathy:\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nHypertension:\nMedical record review Diastolic \u003e120 and systolic \u003e160, 50% of the time and evidence of end organ damage (blood creatinine \u003e2; urinary protein \u003e1⁄2 gm; or EKG evidence of ischemia) D\nArrhythmia: heart block:\nHolter Documented asystole length \u003e1.5-2 seconds D\nMedical record review Documented syncope with proven arrhythmia D\nMitral valve disease:\nCardiac catheterization Mitral valve gradient ≥10 mm Hg D\nCardiac catheterization Mitral regurgitation severe D\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nPericardial disease:\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nVentricular ectopy:\nMedical record review Documented life threatening arrhythmia D\nHolter Uncontrolled ventricular rhythm D\nMedical record review Documented related syncope D\nArrhythmia: supraventricular tachycardia:\nMedical record review Documented related syncope D\nPost heart transplant:\nMedical record review Post heart transplant D\nBODY PART: CARDIAC\nJOB TITLE: GENERAL OFFICE CLERK\nAngina:\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nMedical record review Unstable as diagnosed by cardiologist D\nStress test Documented hypotensive response D\nStress test: significant ST changes Definite ischemia ≤5 METS D\nAortic valve disease:\nCardiac catheterization Aortic gradient 25-50 mm HG D\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nCoronary artery disease:\nMyocardial infarction Multiple infarctions D\nEchocardiogram Confirmed ventricular aneurysm D\nCardiac catheterization Aortic gradient 25-50 mm Hg D\nCardiac catheterization Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nMedical record review Unstable as diagnosed by a Cardiologist D\nStress test Documented hypotensive response D\nStress test Definite ischemia ≤5 METS D\nIsotope, e.g., thallium study Definite ischemia ≤5 METS D\nCardiomyopathy:\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nArrhythmia: heart block:\nHolter Documented asystole length \u003e1.5-2 seconds D\nMedical record review Documented syncope with proven arrhythmia D\nMitral valve disease:\nCardiac catheterization Mitral valve gradient ≥10 mm Hg D\nCardiac catheterization Mitral regurgitation severe D\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nStress test Peak exercise ≤5 METS D\nPericardial disease:\nCardiac catheterization Poor ejection fraction ≤35% D\nEchocardiogram Poor ejection fraction ≤35% D\nVentricular ectopy:\nMedical record review Documented life threatening arrhythmia D\nHolter Uncontrolled ventricular rhythm D\nMedical record review Documented related syncope D\nArrhythmia: supraventricular tachycardia:\nMedical record review Documented related syncope D\nPost heart transplant:\nMedical record review Post heart transplant D\nD. Respiratory\nConfirmatory test Minimum result Requirements\nBODY PART: RESPIRATORY\nCONFIRMATORY TESTS\nAsthma:\nSpirometry FEV1/FVC ratio diminished Recommended.\nSpirometry \u003e15% change with administration of bronchodilator Recommended.\nMethacholine challenge test Positive: FEV1 decrease \u003e20% at (PC ≤8 mg/ml) Recommended\nBronchiectasis:\nMedical record review Chronic cough and sputum Recommended.\nChest X-ray Bronchiectasis demonstrated Recommended.\nChest CAT scan Bronchiectasis demonstrated Recommended.\nChronic bronchitis:\nMedical record review Frequent cough—2 years duration Highly recommended.\nChronic obstructive pulmonary disease:\nSpirometry FEV1/FVC ratio below 65% when stable Highly recommended.\nSpirometry FEV1 below 75% of predicted when stable Highly recommended.\nCor pulmonale:\nElectrocardiogram Definite right ventricular hypertrophy Recommended.\nEchocardiogram Definite right ventricular hypertrophy Recommended.\nPulmonary fibrosis:\nLung biopsy Diffuse fibrosis Recommended.\nChest CAT scan More than minimal fibrosis Recommended.\nLung resection:\nMedical record review At least one lobe resected Highly recommended.\nPneumothorax:\nMedical record review Required hospitalization with chest tube drainage Highly recommended.\nRestrictive lung disease:\nChest X-ray Restrictive lung changes Recommended.\nDLCO Abnormal Highly recommended.\nChest CAT scan Restrictive lung changes Recommended.\nSpirometry FVC \u003c75% predicted Highly recommended.\nSilicosis:\nMedical record review Occupational exposure for at least 1 year Highly recommended.\nTuberculosis:\nChest X-ray Evidence of changes consistent with tuberculosis infection Recommended.\nCulture Positive Recommended.\nDisability test Test result Disability classification\nBODY PART: RESPIRATORY\nJOB TITLE: TRAINMAN\nAsthma:\nSpirometry Repeated spirometry FEV1 \u003c40% over a 12 month period\nBronchiectasis:\nResting ABG PCO2 arterial \u003e50 mm Hg if stable D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nChronic bronchitis:\nSpirometry Repeated spirometry FEV1 \u003c40% over a 12 month period D\nResting ABG PCO2 arterial \u003e50 mm Hg if stable D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nChronic obstructive pulmonary disease (COPD):\nResting ABG PCO2 arterial \u003e50 mm Hg if stable D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nCor pulmonale:\nElectrocardiogram Definite positive right ventricular hypertrophy D\nPulmonary fibrosis:\nResting ABG PCO2 arterial \u003e50 mm Hg if stable D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nDLCO \u003c45% predicted D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nSpirometry FVC \u003c50% predicted D\nLung resection:\nElectrocardiogram Definite positive right ventricular hypertrophy D\nRestrictive lung disease:\nDLCO \u003c45% predicted D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nSpirometry FVC \u003c50% predicted D\nElectrocardiogram efinite positive right ventricular hypertrophy D\nSilicosis:\nResting ABG PCO2 arterial \u003e50 mm Hg If stable D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nBODY PART: RESPIRATORY\nJOB TITLE: CARMAN\nAsthma:\nSpirometry Repeated spirometry FEV1 \u003c40% over a 12 month period D\nBronchiectasis:\nResting ABG PCO2 arterial \u003e50 mm Hg if stable D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nChronic bronchitis:\nSpirometry Repeated spirometry FEV1 \u003c40% over a 12 month period D\nResting ABG PCO2 arterial \u003e50 mm Hg if stable D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nChronic obstructive pulmonary disease (COPD):\nResting ABG PCO2 arterial \u003e50 mm Hg if stable D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nCor pulmonale:\nElectrocardiogram Definite positive right ventricular hypertrophy D\nPulmonary fibrosis:\nResting ABG PCO2 arterial \u003e50 mm Hg if stable D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nDLCO \u003c45% predicted D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nSpirometry FVC \u003c50% predicted D\nLung resection:\nElectrocardiogram Definite positive right ventricular hypertrophy D\nRestrictive lung disease:\nDLCO \u003c45% predicted D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nSpirometry FVC \u003c50% predicted D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nSilicosis:\nResting ABG PCO2 arterial \u003e50 mm Hg if stable D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nBODY PART: RESPIRATORY\nJOB TITLE: SIGNALMAN\nAsthma:\nSpirometry Repeated spirometry FEV1 \u003c40% over a 12 month period D\nBronchiectasis:\nResting ABG PCO2 arterial \u003e50 mm Hg if stable D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nChronic bronchitis:\nSpirometry Repeated spirometry FEV1 \u003c40% over a 12 month period D\nResting ABG PCO2 arterial \u003e50 mm Hg if stable D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nChronic obstructive pulmonary disease (COPD):\nResting ABG PCO2 arterial \u003e50 mm Hg if stable D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nCor pulmonale:\nElectrocardiogram Definite positive right ventricular hypertrophy D\nPulmonary fibrosis:\nResting ABG PCO2 arterial \u003e50 mm Hg if stable D\nDLCO \u003c45% predicted D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nSpirometry FVC \u003c50% predicted D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nLung resection:\nElectrocardiogram Definite positive right ventricular hypertrophy D\nRestrictive lung disease:\nDLCO \u003c45% predicted D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nSpirometry FVC \u003c50% predicted D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nSilicosis:\nResting AGB PCO2 arterial \u003e50 mm Hg if stable D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nBODY PART: RESPIRATORY\nJOB TITLE: TRACKMAN\nAsthma:\nSpirometry Repeated spirometry FEV1 \u003c40% over a 12 month period D\nBronchiectasis:\nResting ABG PCO2 arterial \u003e50 mm Hg if stable D\nPulmonary exercise test or exercise ABG PO2 \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nChronic bronchitis:\nSpirometry Repeated spirometry FEV1 \u003c40% over a 12 month period D\nResting ABG PCO2 arterial \u003e50 mm Hg if stable D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nChronic obstructive pulmonary disease (COPD):\nResting ABG PCO2 arterial \u003e50 mm Hg if stable D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nCor pulmonale:\nElectrocardiogram Definite positive right ventricular hypertrophy D\nPulmonary fibrosis:\nResting ABG PCO2 arterial \u003e50 mm Hg if stable D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nDLCO \u003c45% predicted D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nSpirometry FVC \u003c50% predicted D\nLung resection:\nElectrocardiogram Definite positive right ventricular hypertrophy D\nRestrictive lung disease:\nDLCO \u003c45% predicted D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nSpirometry FVC \u003c50% predicted D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nSilicosis:\nResting ABG PCO2 arterial \u003e50 mm Hg if stable D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nBODY PART: RESPIRATORY\nJOB TITLE: MACHINIST\nAsthma:\nSpirometry Repeated spirometry FEV1 \u003c40% over a 12 month period D\nBronchiectasis:\nResting ABG PCO2 arterial \u003e50 mm Hg if stable D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nChronic bronchitis:\nSpirometry Repeated spirometry FEV1 \u003c40% over a 12 month period D\nResting AGB PCO2 arterial \u003e50 mm Hg if stable D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nChronic obstructive pulmonary disease (COPD):\nResting ABG PCO2 arterial \u003e50 mm Hg if stable D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nCor pulmonale:\nElectrocardiogram Definite positive right ventricular hypertrophy D\nPulmonary fibrosis:\nResting ABG PCO2 arterial \u003e50 mm Hg if stable D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nDLCO \u003c45% predicted D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nSpirometry FVC \u003c50% predicted D\nLung resection:\nElectrocardiogram Definite positive right ventricular hypertrophy D\nRestrictive lung disease:\nDLCO \u003c45% predicted D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nSpirometry FVC \u003c50% predicted D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nSilicosis:\nResting ABG PCO2 arterial \u003e50 mm Hg if stable D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nBODY PART: RESPIRATORY\nJOB TITLE: SHOP LABORER\nAsthma:\nSpirometry Repeated spirometry FEV1 \u003c40% over a 12 month period D\nBronchiectasis:\nResting ABG PCO2 arterial \u003e50 mm Hg if stable D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nChronic bronchitis:\nSpirometry Repeated spirometry FEV1 \u003c40% over a 12 month period D\nResting ABG PCO2 arterial \u003e50 mm Hg if stable D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nChronic obstructive pulmonary disease (COPD):\nResting ABG PCO2 arterial \u003e50 mm Hg if stable D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nCor pulmonale:\nElectrocardiogram Definite positive right ventricular hypertrophy D\nPulmonary fibrosis:\nResting ABG PCO2 arterial \u003e50 mm Hg if stable D\nDLCO \u003c45% predicted D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nSpirometry FVC \u003c50% predicted D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nLung resection:\nElectrocardiogram Definite positive right ventricular hypertrophy D\nRestrictive lung disease:\nDLCO \u003c45% predicted D\nPulmonary exercise test or exercise ABG PO2 drop \u003e5 torr at maximum exercise D\nPulmonary exercise test Maximum VO2 \u003c15 ml/kg D\nSpirometry FVC \u003c50% predicted D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nSilicosis:\nResting ABG PCO2 arterial \u003e50 mm Hg if stable D\nElectrocardiogram Definite positive right ventricular hypertrophy D\nE. Lumbar Sacral Spine\nConfirmatory test Minimum result Requirements\nBODY PART: LS SPINE\nCONFIRMATORY TESTS\nAnkylosing spondylitis:\nX-ray-lumbar sacral spine Sacroilitis Highly recommended.\nHLA B27 (blood test) Positive HLA B27 (90% case) Recommended.\nBackache, unspecified:\nMedical record review History of back pain under medical treatment for at least 1 year Highly recommended.\nMedical record review History of back pain unresponsive to therapy for at least 1 year Highly recommended.\nMedical record review History of back pain with functional limitations for at least 1 year Highly recommended.\nChronic back pain, not otherwise specified:\nMedical record review History of back pain under medical treatment for at least 1 year Highly recommended.\nMedical record review History of back pain unresponsive to therapy for at least 1 year Highly recommended.\nMedical record review History of back pain with functional limitations for at least 1 year Highly recommended.\nCauda equina syndrome with bowel or bladder dysfunction:\nMagnetic resonance imaging Neural impingement of spinal nerves below L1 Recommended.\nComputerized tomography Neural impingement of spinal nerves below L1 Recommended.\nCystometrogram Impaired bladder function Recommended.\nRectal examination Diminished rectal sphincter tone Recommended.\nMyelogram Neural impingement of spinal nerves below L1 Recommended.\nDegeneration of lumbar disc:\nX-ray lumbar sacral spine Significant degenerative disc changes Recommended.\nComputerized tomography Significant degenerative disc changes Recommended.\nMagnetic resonance imaging Significant degenerative disc changes Recommended.\nMyelogram Significant degenerative disc changes Recommended.\nDisplacement of lumbar disc:\nX-ray-lumbar sacral spine Significant degenerative disc changes Recommended.\nComputerized tomography Significant degenerative disc changes Recommended.\nMagnetic resonance imaging Significant degenerative disc changes Recommended.\nMyelogram Significant degenerative disc changes Recommended.\nFracture: vertebral body:\nMagnetic resonance imaging Fracture vertebral body Recommended.\nComputerized tomography Fracture vertebral body Recommended.\nX-ray-lumbar sacral spine Fracture vertebral body ommended.\nFracture: posterior element with spinal canal displacement:\nMagnetic resonance imaging Fracture posterior spinal element with displacement of spinal canal Recommended.\nComputerized tomography Fracture posterior spinal element with displacement of spinal canal Recommended.\nX-ray-lumbar sacral spine Fracture posterior spinal element with displacement of spinal canal Recommended.\nFracture: posterior spinal element with no displacement:\nX-ray-lumbar sacral spine Fracture posterior spinal element Recommended.\nMagnetic resonance imaging Fracture posterior spinal element Recommended.\nComputerized tomography Fracture posterior spinal element Recommended.\nFracture: spinous process:\nX-ray-lumbar sacral spine Spinous process fracture Recommended.\nMagnetic resonance imaging Spinous process fracture Recommended.\nComputerized tomography Spinous process fracture Recommended.\nFracture: Transverse process:\nLumbar sacral spine Transverse process fracture Recommended.\nMagnetic resonance imaging Transverse process fracture Recommended.\nComputerized tomography Transverse process fracture Recommended.\nIntervertebral disc disorder:\nX-ray-lumbar sacral spine Significant disc degeneration Recommended.\nMagnetic resonance imaging Significant disc degeneration Recommended.\nComputerized tomography Significant disc degeneration Recommended.\nMyelogram Significant disc degeneration Recommended.\nLumbago:\nMedical record review: lumbar History of back pain under medical treatment for at least 1 year Highly recommended.\nMedical record review: lumbar History of back pain unresponsive to therapy for at least 1 year Highly recommended.\nMedical record review: lumbar History of back pain with functional limitations for at least 1 year Highly recommended.\nLumbosacral neuritis:\nMagnetic resonance imaging Evidence of neural compression Recommended.\nElectromyography Definite denervation Recommended.\nNerve conduction velocity Definite slowing Recommended.\nPhysical examination—atrophy Atrophy in affected limb with 2 cm difference between limbs Recommended.\nPhysical examination: straight leg raise Positive straight leg raise Recommended.\nSensory examination Loss of sensation in affected dermatomes Recommended.\nMedical history History of radicular pain Highly recommended.\nComputerized tomography Evidence of neural compression Recommended.\nLumbar spinal stenosis:\nComputerized tomography Significant narrowing: spinal cord canal or intervertebral foramen Recommended.\nMagnetic resonance imaging Significant narrowing: spinal cord canal or intervertebral foramen Recommended.\nMyelogram Significant narrowing: spinal cord canal or intervertebral foramen Recommended.\nMechanical complication of internal orthopedic device:\nMedical record review Documentation of failure of implant following surgical procedure Highly recommended.\nOsteomalacia:\nX-ray-lumbar sacral spine Evidence of significant osteomalacia Recommended.\nMagnetic resonance imaging Evidence of significant osteomalacia Recommended.\nComputerized tomography Evidence of significant osteomalacia Recommended.\nOsteomyelitis, chronic-lumbar:\nX-ray-lumbar sacral spine Evidence of chronic infection Recommended.\nMagnetic resonance imaging Evidence of chronic infection Recommended.\nComputerized tomography Evidence of chronic infection Recommended.\nOsteoporosis:\nComputerized tomography Significant bone density loss Recommended.\nDual photon absorptiometry Significant bone density loss Recommended.\nX-ray-lumbar sacral spine Significant bone density loss Recommended.\nPost laminectomy syndrome with radiculopathy:\nMedical record review: lumbar Documented surgical history of laminectomy Highly recommended.\nMagnetic resonance imaging Evidence of laminectomy Recommended.\nElectromyography Definite denervation Recommended.\nNerve conduction velocity Definite slowing Recommended.\nPhysical examination—atrophy Atrophy in affected limb with 2 cm difference between limbs Recommended.\nPhysical examination: straight leg raise Positive straight leg raise Recommended.\nSensory examination Loss of sensation in affected dermatomes Recommended.\nMedical record review: lumbar History of radicular pain Highly recommended.\nComputerized tomography Evidence of laminectomy Recommended.\nMyelogram Evidence of laminectomy Recommended.\nRadiculopathy:\nMagnetic resonance imaging Evidence of neural compression Recommended.\nElectromyography Definite denervation Recommended.\nNerve conduction velocity Definite slowing Recommended.\nPhysical examination—atrophy Atrophy in affected limb with 2 cm difference between limbs Recommended.\nPhysical examination: straight leg raise Positive straight leg raise Recommended.\nSensory examination Loss of sensation in affected dermatomes Recommended.\nMedical record review: lumbar History of radicular pain Highly recommended.\nComputerized tomography Evidence of neural compression Recommended.\nMyelogram Evidence of neural compression Recommended.\nSciatica:\nMagnetic resonance imaging Evidence of neural compression Recommended.\nElectromyography Definite denervation Recommended.\nNerve conduction velocity Definite slowing Recommended.\nPhysical examination—atrophy Atrophy in affected limb with 2 cm difference between limbs Recommended.\nPhysical examination: straight leg raise Positive straight leg raise Recommended.\nSensory examination Loss of sensation in affected dermatomes Recommended.\nMedical history History of radicular pain Highly recommended.\nComputerized tomography Evidence of neural compression Recommended.\nMyelogram Evidence of neural compression Recommended.\nStrains and sprains, unspecified:\nMedical record review History of back pain under medical treatment for at least 1 year Highly recommended.\nMedical record review History of back pain unresponsive to therapy for at least 1 year Highly recommended.\nMedical record review History of back pain with functional limitations for at least 1 year Highly recommended.\nMedical record review Documented history of strain and/or sprain Highly recommended.\nSpondylolisthesis grade 1:\nX-ray-lumbar sacral spine 1-25% slippage Recommended.\nComputerized tomography 1-25% slippage Recommended.\nMagnetic resonance imaging 1-25% slippage Recommended.\nSpondylolisthesis grade 2:\nX-ray-lumbar sacral spine 26-50% slippage Recommended.\nComputerized tomography 26-50% slippage Recommended.\nMagnetic resonance imaging 26-50% slippage Recommended.\nSpondylolisthesis grade 3:\nX-ray-lumbar sacral spine 51-75% slippage Recommended.\nComputerized tomography 51-75% slippage Recommended.\nMagnetic resonance imaging 51-75% slippage Recommended.\nSpondylolisthesis grade 4:\nX-ray-lumbar sacral spine Complete slippage Recommended.\nComputerized tomography Complete slippage Recommended.\nMagnetic resonance imaging Complete slippage Recommended.\nSpondylolisthesis-acquired:\nX-ray-lumbar sacral spine Slippage Recommended.\nComputerized tomography Slippage Recommended.\nMagnetic resonance imaging Slippage Recommended.\nSpondylolsis:\nX-ray-lumbar sacral spine Defect—pars interarticularis Recommended.\nComputerized tomography Defect—pars interarticularis Recommended.\nMagnetic resonance imaging Defect—pars interarticularis Recommended.\nSprains and strains, sacral:\nMedical record review: lumbar History of back pain under medical treatment for at least 1 year Highly recommended.\nMedical record review: lumbar History of back pain unresponsive to therapy for at least 1 year Highly recommended.\nMedical record review: lumbar History of back with functional limitations for at least 1 year Highly recommended.\nMedical record review: lumbar Documented history of strain and/or sprain Highly recommended.\nSprains and strains, sacroiliac:\nMedical record review: lumbar History of back pain under medical treatment for at least 1 year Highly recommended.\nMedical record review: lumbar History of back pain unresponsive to therapy for at least 1 year Highly recommended.\nMedical record review: lumbar History of back pain with functional limitations for at least 1 year Highly recommended.\nMedical record review: lumbar Documented history of strain and/or sprain Highly recommended.\nDisability test Test result Disability classification\nBODY PART: LS SPINE\nJOB TITLE: TRAINMAN\nAnkylosing spondylitis:\nMuscle strength assessment Lifting capacity diminished by 50% D\nBackache, unspecified:\nMuscle strength assessment Lifting capacity diminished by 50% D\nChronic back pain, not otherwise specified:\nMuscle strength assessment Lifting capacity diminished by 50% D\nCauda equina syndrome with bowel or bladder dysfunction:\nComputerized tomography Disc extrusion with neural impingement, nerves \u003c L1 D\nMagnetic resonance imaging Disc extrusion with neural impingement, nerves \u003c L1 D\nPhysical examination Lower extremity weakness D\nCystometrogram Impaired bladder function D\nMyelogram Disc extrusion with neural impingement, nerves \u003cL1 D\nPhysical examination: rectal Impairment of sphincter tone D\nMuscle strength assessment Lifting capacity diminished by 50% D\nDegeneration of lumbar disc:\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nMuscle strength assessment Lifting capacity diminished by 50% D\nDisplacement of lumbar disc:\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture: vertebral body:\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture: posterior spinal element with displacement:\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture: posterior spinal element with no displacement:\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture: spinous process:\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture transverse process:\nMuscle strength assessment Lifting capacity diminished by 50% D\nIntervertebral disc disorder:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nLumbago:\nMuscle strength assessment Lifting capacity diminished by 50% D\nLumbosacral neuritis:\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nMuscle strength assessment Lifting capacity diminished by 50% D\nPhysical examination Lower extremity weakness D\nLumbar spinal stenosis:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Significant narrowing of the spinal canal D\nMagnetic resonance imaging Significant narrowing of the spinal canal D\nMyelogram Significant narrowing of the spinal canal D\nPhysical examination Significant lower extremity weakness D\nMechanical complication of internal orthopedic device:\nMuscle strength assessment Lifting capacity diminished by 50% D\nX-ray flexion/extension Segmental instability D\nOsteomalacia:\nMuscle strength assessment Lifting capacity diminished by 50% D\nOsteomyelitis, chronic-lumbar:\nMuscle strength assessment Lifting capacity diminished by 50% D\nMedical record review Frequent flare-ups with objective findings D\nOsteoporosis:\nMuscle strength assessment Lifting capacity diminished by 50% D\nPost laminectomy syndrome with radiculopathy:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nPhysical examination Significant lower extremity weakness D\nPost laminectomy syndrome:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nPhysical examination Significant lower extremity weakness D\nX-ray flexion/extension Segmental instability D\nRadiculopathy:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nPhysical examination Significant lower extremity weakness D\nSciatica:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nPhysical examination Significant lower extremity weakness D\nStrains and sprains, unspecified:\nMuscle strength assessment Lifting capacity diminished by 50% D\nSpondylolisthesis grade 1:\nMuscle strength assessment Lifting capacity diminished by 50% D\nX-ray flexion/extension Segmental instability D\nSpondylolisthesis grade 2:\nMuscle strength assessment Lifting capacity diminished by 50% D\nSpondylolisthesis grade 3:\nMuscle strength assessment Lifting capacity diminished by 50% D\nSpondylolisthesis grade 4:\nMuscle strength assessment Lifting capacity diminished by 50% D\nX-ray flexion/extension Segmental instability D\nSpondylolisthesis—acquired:\nX-ray flexion/extension Segmental instability D\nSpondylolysis:\nX-ray flexion/extension Segmental instability D\nSprains and strains, sacral:\nMuscle strength assessment Lifting capacity diminished by 50% D\nSprains and strains, sacroiliac:\nMuscle strength assessment Lifting capacity diminished by 50% D\nVertebral body compression fracture:\nMuscle strength assessment Lifting capacity diminished by 50% D\nBODY PART: LS SPINE\nJOB TITLE: ENGINEER\nCauda equina syndrome with bowel or bladder dysfunction:\nComputerized tomography Disc extrusion with neural impingement, nerves \u003cL1 D\nMagnetic resonance imaging Disc extrusion with neural impingement, nerves \u003cL1 D\nPhysical examination Lower extremity weakness D\nCystometrogram Impaired bladder function D\nMyelogram Disc extrusion with neural impingement, nerves \u003cL1 D\nPhysical examination: rectal Impairment of sphincter tone D\nBODY PART: LS SPINE\nJOB TITLE: CARMAN\nAnkylosing spondylitis:\nMuscle strength assessment Lifting capacity diminished by 50% D\nBackache, unspecified:\nMuscle strength assessment Lifting capacity diminished by 50% D\nChronic back pain, not otherwise specified:\nMuscle strength assessment Lifting capacity diminished by 50% D\nCauda equina syndrome with bowel or bladder dysfunction:\nComputerized tomography Disc extrusion with neural impingement, nerves \u003cL1 D\nMagnetic resonance imaging Disc extrusion with neural impingement, nerves \u003cL1 D\nPhysical examination Lower extremity weakness D\nCystometrogram Impaired bladder function D\nMyeolgram Disc extrusion with neural impingement, nerves \u003cL1 D\nPhysical examination: rectal Impairment of sphincter tone D\nMuscle strength assessment Lifting capacity diminished by 50% D\nDegeneration of lumbar disc:\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nMuscle strength assessment Lifting capacity diminished by 50% D\nDisplacement of lumbar disc:\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture: vertebral body:\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture: posterior spinal element with displacement:\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture: posterior spinal element with no displacement:\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture: spinous process:\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture transverse process:\nMuscle strength assessment Lifting capacity diminished by 50% D\nIntervertebral disc disorder:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nLumbago:\nMuscle strength assessment Lifting capacity diminished by 50% D\nLumbosacral neuritis:\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nMuscle strength assessment Lifting capacity diminished by 50% D\nPhysical examination Lower extremity weakness D\nLumbar spinal stenosis:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Significant narrowing of the spinal canal D\nMagnetic resonance imaging Significant narrowing of the spinal canal D\nMyelogram Significant narrowing of the spinal canal D\nPhysical examination Significant lower extremity weakness D\nMechanical complication of internal orthopedic device:\nMuscle strength assessment Lifting capacity diminished by 50% D\nX-ray flexion/extension Segmental instability D\nOsteomalacia:\nMuscle strength assessment Lifting capacity diminished by 50% D\nOsteomyelitis, chronic-lumbar:\nMuscle strength assessment Lifting capacity diminished by 50% D\nMedical record review Frequent flare-ups with objective findings D\nOsteoporosis:\nMuscle strength assessment Lifting capacity diminished by 50% D\nPost laminectomy syndrome with radiculopathy:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nPhysical examination Significant lower extremity weakness D\nPost laminectomy syndrome:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nPhysical examination Significant lower extremity weakness D\nX-ray flexion/extension Segmental instability D\nRadiculopathy:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nPhysical examination Significant lower extremity weakness D\nSciatica:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nPhysical examination Significant lower extremity weakness D\nStrains and sprains, unspecified:\nMuscle strength assessment Lifting capacity diminished by 50% D\nSpondylolisthesis grade 1:\nMuscle strength assessment Lifting capacity diminished by 50% D\nX-ray flexion/extension Segmental instability D\nSpondylolisthesis grade 2:\nMuscle strength assessment Lifting capacity diminished by 50% D\nSpondylolisthesis grade 3:\nMuscle strength assessment Lifting capacity diminshed by 50% D\nSpondylolisthesis grade 4:\nMuscle strength assessment Lifting capacity diminished by 50% D\nX-ray flexion/extension Segmental instability D\nSpondylolisthesis-acquired:\nX-ray flexion/extension Segmental instability D\nSpondylolysis:\nX-ray flexion/extension Segmental instability D\nSprains and strains, sacral:\nMuscle strength assessment Lifting capacity diminshed by 50% D\nSprains and strains, sacroiliac:\nMuscle strength assessment Lifting capacity diminished by 50% D\nVertebral body compression fracture:\nMuscle strength assessment Lifting capacity diminshed by 50% D\nBODY PART: LS SPINE\nJOB TITLE: SIGNALMAN\nAnkylosing spondylitis:\nMuscle strength assessment Lifting capacity diminished by 50% D\nBackache, unspecified:\nMuscle strength assessment Lifting capacity diminished by 50% D\nChronic back pain, not otherwise specified:\nMuscle strength assessment Lifting capacity diminished by 50% D\nCauda equina syndrome with bowel or bladder dysfunction:\nComputerized tomography Disc extrusion with neural impingement, nerves \u003cL1 D\nMagnetic resonance imaging Disc extrusion with neural impingement, nerves \u003cL1 D\nPhysical examination Lower extremity weakness D\nCystometrogram Impaired bladder function D\nMyelogram Disc extrusion with neural impingement, nerves \u003cL1 D\nPhysical examination: rectal Impairment of sphincter tone D\nMuscle strength assessment Lifting capacity diminished by 50% D\nDegeneration of lumbar disc:\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nMuscle strength assessment Lifting capacity diminished by 50% D\nDisplacement of lumbar disc:\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture: vertebral body:\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture: posterior spinal element with displacement:\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture: posterior spinal element with no displacement:\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture: spinous process:\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture transverse process:\nMuscle strength assessment Lifting capacity diminished by 50% D\nIntervertebral disc disorder:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nLumbago:\nMuscle strength assessment Lifting capacity diminished by 50% D\nLumbosacral neuritis:\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nMuscle strength assessment Lifting capacity diminished by 50% D\nPhysical examination Lower extremity weakness D\nLumbar spinal stenosis:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Significant narrowing of the spinal canal D\nMagnetic resonance imaging Significant narrowing of the spinal canal D\nMyelogram Significant narrowing of the spinal canal D\nPhysical examination Significant lower extremity weakness D\nMechanical complication of internal orthopedic device:\nMuscle strength assessment Lifting capacity diminished by 50% D\nX-ray flexion/extension Segmental instability D\nOsteomalacia:\nMuscle strength assessment Lifting capacity diminished by 50% D\nOsteomyelitis, chronic-lumbar:\nMuscle strength assessment Lifting capacity diminished by 50% D\nMedical record review Frequent flare-ups with objective findings D\nOsteoporosis:\nMuscle strength assessment Lifting capacity diminished by 50% D\nPost laminectomy syndrome with radiculopathy:\nMuscle strength assessment Lifing capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nPhysical examination Significant lower extremity weakness D\nPost laminectomy syndrome:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nPhysical examination Significant lower extremity weakness D\nX-ray flexion/extension Segmental instability D\nRadiculopathy:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nPhysical examination Significant lower extremity weakness D\nSciatica:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nPhysical examination Significant lower extremity weakness D\nStrains and sprains, unspecified:\nMuscle strength assessment Lifting capacity diminished by 50% D\nSpondylolisthesis grade 1:\nMuscle strength assessment Lifting capacity diminished by 50% D\nX-ray flexion/extension Segmental instability D\nSpondylolisthesis grade 2:\nMuscle strength assessment Lifting capacity diminished by 50% D\nSpondylolisthesis grade 3:\nMuscle strength assessment Lifting capacity diminished by 50% D\nSpondylolisthesis grade 4:\nMuscle strength assessment Lifting capacity diminished by 50% D\nX-ray flexion/extension Segmental instability D\nSpondylolisthesis-acquired:\nX-ray flexion/extension Segmental instability D\nSpondylolysis:\nX-ray flexion/extension Segmental instability D\nSprains and strains, sacral:\nMuscle strength assessment Lifting capacity diminished by 50% D\nSprains and strains, sacroiliac:\nMuscle strength assessment Lifting capacity diminished by 50% D\nVertebral body compression fracture:\nMuscle strength assessment Lifting capacity diminished by 50% D\nBODY PART: LS SPINE\nJOB TITLE: TRACKMAN\nAnkylosing spondylitis:\nMuscle strength assessment Lifting capacity diminished by 50% D\nBackache, unspecified:\nMuscle strength assessment Lifting capacity diminished by 50% D\nChronic back pain, not otherwise specified:\nMuscle strength assessment Lifing capacity diminished by 50% D\nCauda equina syndrome with bowel or bladder dysfunction:\nComputerized tomography Disc extrusion with neural impingement, nerves \u003cL1 D\nMagnetic resonance imaging Disc extrusion with neural impingement, nerves \u003cL1 D\nPhysical examination Lower extremity weakness D\nCystometrogram Impaired bladder function D\nMyelogram Disc extrusion with neural impingement, nerves \u003cL1 D\nPhysical examination: rectal Impairment of sphincter tone D\nMuscle strength assessment Lifting capacity diminished by 50% D\nDegeneration of lumbar disc:\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nMuscle strength assessment Lifting capacity diminished by 50% D\nDisplacement of lumbar disc:\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture: vertebral body:\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture: posterior spinal element with displacement:\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture: posterior spinal element with no displacement:\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture: spinous process:\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture transverse process:\nMuscle strength assessment Lifting capacity diminished by 50% D\nIntervertebral disc disorder:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nLumbago:\nMuscle strength assessment Lifting capacity diminished by 50% D\nLumbosacral neuritis:\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nMuscle strength assessment Lifting capacity diminished by 50% D\nPhysical examination Lower extremity weakness D\nLumbar spinal stenosis:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Significant narrowing of the spinal canal D\nMagnetic resonance imaging Significant narrowing of the spinal canal D\nMyelogram Significant narrowing of the spinal canal D\nPhyscial examination Significant lower extremity weakness D\nMechanical complication of internal orthopedic device:\nMuscle strength assessment Lifting capacity diminished by 50% D\nX-ray flexion/extension Segmental instability D\nOsteomalacia:\nMuscle strength assessment Lifting capacity diminished by 50% D\nOsteomyelitis, chronic-lumbar:\nMuscle strength assessment Lifting capacity diminished by 50% D\nMedical record review Frequent flare-ups with objective findings D\nOsteoporosis:\nMuscle strength assessment Lifting capacity diminished by 50% D\nPost laminectomy syndrome with radiculopathy:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nPhysical examination Significant lower extremity weakness D\nPost laminectomy syndrome:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nPhysical examination Significant lower extremity weakness D\nX-ray flexion/extension Segmental instability D\nRadiculopathy:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nPhysical examination Significant lower extremity weakness D\nSciatica:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nPhysical examination Significant lower extremity weakness D\nStrains and sprains, unspecified:\nMuscle strength assessment Lifting capacity diminished by 50% D\nSpondylolisthesis grade 1:\nMuscle strength assessment Lifting capacity diminished by 50% D\nX-ray flexion/extension Segmental instability D\nSpondylolisthesis grade 2:\nMuscle strength assessment Lifting capacity diminished by 50% D\nSpondylolisthesis grade 3:\nMuscle strength assessment Lifting capacity diminished by 50% D\nSpondylolisthesis grade 4:\nMuscle strength assessment Lifting capacity diminished by 50% D\nX-ray flexion/extension Segmental instability D\nSpondylolisthesis-acquired:\nX-ray flexion/extension Segmental instability D\nSpondylolysis:\nX-ray flexion/extension Segmental instability D\nSprains and strains, sacral:\nMuscle strength assessment Lifting capacity diminished by 50% D\nSprains and strains, sacroiliac:\nMuscle strength assessment Lifting capacity diminished by 50% D\nVetebral body compression fracture:\nMuscle strength assessment Lifting capacity diminished by 50%\nBODY PART: LS SPINE\nJOB TITLE: MACHINIST\nAnkylosing spondylitis:\nMuscle strength assessment Lifting capacity diminished by 50% D\nBackache, unspecified:\nMuscle strength assessment Lifting capacity diminished by 50% D\nChronic back pain, not otherwise specified:\nMuscle strength assessment Lifting capacity diminished by 50% D\nCauda equina syndrome with bowel or bladder dysfunction:\nComputerized tomography Disc extrusion with neural impingement, nerves \u003cL1 D\nMagnetic resonance imaging Disc extrusion with neural impingement, nerves \u003cL1 D\nPhysical examination Lower extremity weakness D\nCystometrogram Impaired bladder function D\nMyelogram Disc extrusion with neural impingement, nerves \u003cL1 D\nPhysical examination: rectal Impairment of sphincter tone D\nMuscle strength assessment Lifting capacity diminished by 50% D\nDegeneration of lumbar disc:\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nMuscle strength assessment Lifting capacity diminished by 50% D\nDisplacement of lumbar disc:\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture: vertebral body:\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture: posterior spinal element with displacement:\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture: posterior spinal element with no displacement:\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture: spinous process:\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture transverse process:\nMuscle strength assessment Lifting capacity diminished by 50% D\nIntervertebral disc disorder:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nLumbago:\nMuscle strength assessment Lifting capacity diminished by 50% D\nLumbosacral neuritis:\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nMuscle strength assessment Lifting capacity diminished by 50% D\nPhysical examination Lower extremity weakness D\nLumbar spinal stenosis:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Significant narrowing of the spinal canal D\nMagnetic resonance imaging Significant narrowing of the spinal canal D\nMyelogram Significant narrowing of the spinal canal D\nPhysical examination Significant lower extremity weakness D\nMechanical complication of internal orthopedic device:\nMuscle strength assessment Lifting capacity diminished by 50% D\nX-ray flexion/extension Segmental instability D\nOsteomalacia:\nMuscle strength assessment Lifting capacity diminished by 50% D\nOsteomyelitis, chronic-lumbar:\nMuscle strength assessment Lifting capacity diminished by 50% D\nMedical record review Frequent flare-ups with objective findings D\nOsteoporosis:\nMuscle strength assessment Lifting capacity diminished by 50% D\nPost laminectomy syndrome with radiculopathy:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nPhysical examination Significant lower extremity weakness D\nPost laminectomy syndrome:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nPhysical examination Significant lower extremity weakness D\nX-ray flexion/extension Segmental instability D\nRadiculopathy:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nPhysical examination Significant lower extremity weakness D\nSciatica:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nPhysical examination Significant lower extremity weakness D\nStrains and sprains, unspecified:\nMuscle strength assessment Lifting capacity diminished by 50% D\nSpondylolisthesis grade I:\nMuscle strength assessment Lifting capacity diminished by 50% D\nX-ray flexion/extension Segmental instability D\nSpondylolisthesis grade 2:\nMuscle strength assessment Lifting capacity diminished by 50% D\nSpondylolisthesis grade 3:\nMuscle strength assessment Lifting capacity diminished by 50% D\nSpondylolisthesis grade 4:\nMuscle strength assessment Lifting capacity diminished by 50% D\nX-ray flexion/extension Segmental instability D\nSpondylolisthesis-acquired:\nX-ray flexion/extension Segmental instability D\nSpondylolysis:\nX-ray flexion/extension Segmental instability D\nSprains and strains, sacral:\nMuscle strength assessment Lifting capacity diminished by 50% D\nSprains and strains, sacroiliac:\nMuscle strength assessment Lifting capacity diminished by 50% D\nVertebral body compression fracture:\nMuscle strength assessment Lifting capacity diminished by 50% D\nBODY PART: LS SPINE\nJOB TITLE: SHOP LABORER\nAnkylosing spondylitis:\nMuscle strength assessment Lifting capacity diminished by 50% D\nBackache, unspecified:\nMuscle strength assessment Lifting capacity diminished by 50% D\nChronic back pain, not otherwise specified:\nMuscle strength assessment Lifting capacity diminished by 50% D\nCauda equina syndrome with bowel or bladder dysfunction:\nComputerized tomography Disc extrusion with neural impingement, nerves \u003cL1 D\nMagnetic resonance imaging Disc extrusion with neural impingement, nerves \u003cL1 D\nPhysical examination Lower extremity weakness D\nCystometrogram Impaired bladder function D\nMyelogram Disc extrusion with neural impingement, nerves \u003cL1 D\nPhysical examination: rectal Impairment of sphincter tone D\nMuscle strength assessment Lifting capacity diminished by 50% D\nDegeneration of lumbar disc:\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nMuscle strength assessment Lifting capacity diminished by 50% D\nDisplacement of lumber disc:\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture: vertebral body:\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture: posterior spinal element with displacement:\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture: posterior spinal element with no displacement:\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture: spinous process:\nMuscle strength assessment Lifting capacity diminished by 50% D\nFracture transverse process:\nMuscle strength assessment Lifting capacity diminished by 50% D\nIntervertebral disc disorder:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nLumbago:\nMuscle strength assessment Lifting capacity diminished by 50% D\nLumbosacral neuritis:\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nMuscle strength assessment Lifting capacity diminished by 50% D\nPhysical examination Lower extremity weakness D\nLumbar spinal stenosis:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Significant narrowing of the spinal canal D\nMagnetic resonance imaging Significant narrowing of the spinal canal D\nMyelogram Significant narrowing of the spinal canal D\nPhysical examination Significant lower extremity weakness D\nMechanical complication of internal orthopedic device:\nMuscle strength assessment Lifting capacity diminished by 50% D\nX-ray flexion/extension Segmental instability D\nOsteomalacia:\nMuscle strength assessment Lifting capacity diminished by 50% D\nOsteomyelitis, chronic-lumbar:\nMuscle strength assessment Lifting capacity diminished by 50% D\nMedical record review Frequent flare-ups with objective findings D\nOsteoporosis:\nMuscle strength assessment Lifting capacity diminished by 50% D\nPost laminectomy syndrome with radiculopathy:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nPhysical examination Significant lower extremity weakness D\nPost laminectomy syndrome:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nPhysical examination Significant lower extremity weakness D\nX-ray flexion/extension Segmental instability D\nRadiculopathy:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nPhysical examination Significant lower extremity weakness D\nSciatica:\nMuscle strength assessment Lifting capacity diminished by 50% D\nComputerized tomography Disc extrusion with neural impingement D\nMagnetic resonance imaging Disc extrusion with neural impingement D\nMyelogram Disc extrusion with neural impingement D\nPhysical examination Significant lower extremity weakness D\nStrains and sprains, unspecified:\nMuscle strength assessment Lifting capacity diminished by 50% D\nSpondylolisthesis grade 1:\nMuscle strength assessment Lifting capacity diminished by 50% D\nX-ray flexion/extension Segmental instability D\nSpondylolisthesis grade 2:\nMuscle strength assessment Lifting capacity diminished by 50% D\nSpondylolisthesis grade 3:\nMuscle strength assessment Lifting capacity diminished by 50% D\nSpondylolisthesis grade 4:\nMuscle strength assessment Lifting capacity diminished by 50% D\nX-ray flexion/extension Segmental instability D\nSpondylolisthesis-acquired:\nX-ray flexion/extension Segmental instability D\nSpondylolysis:\nX-ray flexion/extension Segmental instability D\nSprains and strains, sacral:\nMuscle strength assessment Lifting capacity diminished by 50% D\nSprains and strains, sacroiliac:\nMuscle strength assessment Lifting capacity diminished by 50% D\nVertebral body compression fracture:\nMuscle strength assessment Lifting capacity diminished by 50% D\nF. Cervical Spine\nConfirmatory test Minimum result Requirements\nBODY PART: CE SPINE\nCONFIRMATORY TESTS\nCervical disc disease with myelopathy:\nPhysical examination: cervical Evidence of myelopathy Highly recommended.\nMyelogram Evidence of neurogenic compression Recommended.\nComputerized axial tomography Evidence of neurogenic compression Recommended.\nMagnetic resonance imaging Evidence of neurogenic compression Recommended.\nChronic herniated disc:\nX-ray: cervical spine Evidence of significant disc degeneration Recommended.\nMyelogram Evidence of significant disc degeneration Recommended.\nComputerized axial tomography Evidence of significant disc degeneration Recommended.\nMagnetic resonance imaging Evidence of significant disc degeneration Recommended.\nCervical spondylolysis:\nX-ray: cervical spine Evidence of significant disc degeneration Recommended.\nComputerized axial tomography Evidence of significant disc degeneration Recommended.\nMagnetic resonance imaging Evidence of significant disc degeneration Recommended.\nCervical intervertebral disc degeneration:\nX-ray: cervical spine Evidence of significant disc degeneration Recommended.\nMyelogram Evidence of significant disc degeneration Recommended.\nMagnetic resonance imaging Evidence of significant disc degeneration Recommended.\nFracture: posterior element with spinal canal displacement:\nX-ray: cervical spine Fractured posterior element with canal displacement Recommended.\nComputerized axial tomography Fractured posterior element with canal displacement Recommended.\nMagnetic resonance imaging Fractured posterior element with canal displacement Recommended.\nFracture: transverse, spinous or posterior process:\nX-ray: cervical spine Fracture of relevant part Recommended.\nComputerized axial tomography Fracture of relevant part Recommended.\nMagnetic resonance imaging Fracture of relevant part Recommended.\nOsteoarthritis, cervical:\nX-ray: cervical spine Evidence of extensive disc degeneration Recommended.\nComputerized axial tomography Evidence of extensive disc degeneration Recommended.\nMagnetic resonance imaging Evidence of extensive disc degeneration Recommended.\nPost laminectomy syndrome:\nMedical records: cervical Confirmed surgical history Highly recommended.\nMedical records: cervical Continued pain post-surgery Highly recommended.\nRadiculopathy:\nMedical records: cervical History of radicular pain Highly recommended.\nPhysical examination: arm Loss of reflexes in affected dermatomes Recommended.\nPhysical examination: arm Evidence of atrophy \u003e2 cm Recommended.\nElectromyography Definite denervation in muscle of affected nerve root Recommended.\nMyelogram Evidence of neurogenic compression Recommended.\nMagnetic resonance imaging Compression of spinal nerves Recommended.\nComputerized axial tomography Compression of spinal nerves Recommended.\nRheumatoid arthritis, cervical:\nRheumatoid factor (blood test) Titer of rheumatoid factor Recommended.\nX-ray: cervical spine Rheumatoid changes of spine Highly recommended.\nMedical records review: cervical Confirmation by rheumatologist or internist Highly recommended.\nSpondylogenic compression of spinal cord:\nPhysical examination: cervical Evidence of myelopathy Highly recommended.\nComputerized axial tomography Evidence of neurogenic compression Recommended.\nMagnetic resonance imaging Evidence of neurogenic compression Recommended.\nMyelogram Evidence of neurogenic compression Recommended.\nDisability test Test result Disability classification\nBODY PART: CE SPINE\nJOB TITLE: TRAINMAN\nCervical disc disease with myelopathy:\nComputerized axial tomography Significant spinal cord pressure D\nMagnetic resonance imaging Significant spinal cord pressure D\nMyelogram Significant spinal cord pressure D\nCystometrogram Impaired bladder function D\nPhysical examination: rectal Impairment of sphincter tone\nPhysical examination: lower limb Lower extremity weakness or significant spasticity D\nPhysical examination Multi-level neurologic compromise D\nChronic herniated disc:\nPhysical examination Multi-level neurologic compromise D\nCervical spondylolysis:\nPhysical examination Multi-level neurologic compromise D\nCervical intervertebral disc degeneration:\nPhysical examination Multi-level neurologic compromise D\nFracture: posterior element with spinal canal displacement:\nPhysical examination Multi-level neurologic compromise D\nPost laminectomy syndrome:\nPhysical examination Multi-level neurologic compromise D\nCervical radiculopathy:\nPhysical examination Multi-level neurologic compromise D\nSpondylogenic compression of spinal cord:\nComputerized axial tomography Significant spinal cord pressure D\nMagnetic resonance imaging Significant spinal cord pressure D\nCystometrogram Impaired bladder function D\nMyelogram Significant spinal cord pressure D\nPhysical examination: rectal Impairment of sphincter tone D\nPhysical examination Multi-level neurologic compromise D\nPhysical examination: lower limb Lower extremity weakness or significant spasticity D\nBODY PART: CE SPINE\nJOB TITLE: ENGINEER\nCervical disc disease with myelopathy:\nComputerized axial tomography Significant spinal cord pressure D\nMagnetic resonance imaging Significant spinal cord pressure D\nMyelogram Significant spinal cord pressure D\nCystometrogram Impaired bladder function D\nPhysical examination: rectal Impairment of sphincter tone D\nPhysical examination: lower limb Lower extremity weakness or significant spasticity D\nPhysical examination Multi-level neurologic compromise D\nChronic herniated disc:\nPhysical examination Multi-level neurologic compromise D\nCervical spondylolysis:\nPhysical examination Multi-level neurologic compromise D\nCervical intervertebral disc degeneration:\nPhysical examination Multi-level neurologic compromise D\nFracture: posterior element with spinal canal displacement:\nPhysical examination Multi-level neurologic compromise D\nPost laminectomy syndrome:\nPhysical examination Multi-level neurologic compromise D\nCervical radiculopathy:\nPhysical examination: Multi-level neurologic compromise D\nSpondylogenic compression of spinal cord:\nComputerized axial tomography Significant spinal cord pressure D\nMagnetic resonance imaging Significant spinal cord pressure D\nCystometrogram Impaired bladder function D\nMyelogram Significant spinal cord pressure D\nPhysical examination: rectal Impairment of sphincter tone D\nPhysical examination Multi-level neurologic compromise D\nPhysical examination: lower limb Lower extremity weakness or significant spasticity D\nBODY PART: CE SPINE\nJOB TITLE: DISPATCHER\nCervical disc disease with myelopathy:\nCystometrogram Impaired bladder function D\nPhysical examination: rectal Impairment of sphincter tone D\nSpondylogenic compression of spinal cord:\nCystometrogram Impaired bladder function D\nPhysical examination: rectal Impairment of sphincter tone D\nBODY PART: CE SPINE\nJOB TITLE: CARMAN\nCervical disc disease with myelopathy:\nComputerized axial tomography Significant spinal cord pressure D\nMagnetic resonance imaging Significant spinal cord pressure D\nMyelogram Significant spinal cord pressure D\nCystometrogram Impaired bladder function D\nPhysical examination: rectal Impairment of sphincter tone D\nPhysical examination: lower limb Lower extremity weakness or significant spasticity D\nPhysical examination Multi-level neurologic compromise D\nChronic herniated disc:\nPhysical examination Multi-level neurologic compromise D\nCervical spondylolysis:\nPhysical examination Multi-level neurologic compromise D\nCervical intervertebral disc degeneration:\nPhysical examination Multi-level neurologic compromise D\nFracture: posterior element with spinal canal displacement:\nPhysical examination Multi-level neurologic compromise D\nPost laminectomy syndrome:\nPhysical examination Multi-level neurologic compromise D\nCervical radiculopathy:\nPhysical examination Multi-level neurologic compromise D\nSpondylogenic compression of spinal cord:\nComputerized axial tomography Significant spinal cord pressure D\nMagnetic resonance imaging Significant spinal cord pressure D\nCystometrogram Impaired bladder function D\nMyelogram Significant spinal cord pressure D\nPhysical examination: rectal Impairment of sphincter tone D\nPhysical examination Multi-level neurologic compromise D\nPhysical examination: lower limb Lower extremity weakness or significant spasticity D\nBODY PART; CE SPINE\nJOB TITLE: SIGNALMAN\nCervical disc disease with myelopathy:\nComputerized axial tomography Significant spinal cord pressure D\nMagnetic resonance imaging Significant spinal cord pressure D\nMyelogram Significant spinal cord pressure D\nCystometrogram Impaired bladder function D\nPhysical examination: rectal Impairment of sphincter tone D\nPhysical examination: lower limb Lower extremity weakness or significant spasticity D\nPhysical examination Multi-level neurologic compromise D\nChronic herniated disc:\nPhysical examination Multi-level neurologic compromise D\nCervical spondylolysis:\nPhysical examination Multi-level neurologic compromise D\nCervical intervertebral disc degeneration:\nPhysical examination Multi-level neurologic compromise D\nFracture: posterior element with spinal canal displacement:\nPhysical examination Multi-level neurologic compromise D\nPost laminectomy syndrome:\nPhysical examination Multi-level neurologic compromise D\nCervical radiculopathy:\nPhysical examination Multi-level neurologic compromise D\nSpondylogenic compression of spinal cord:\nComputerized axial tomography Significant spinal cord pressure D\nMagnetic resonance imaging Significant spinal cord pressure D\nCystometrogram Impaired bladder function D\nMyelogram Significant spinal cord pressure D\nPhysical examination: rectal Impairment of sphincter tone D\nPhysical examination Multi-level neurologic compromise D\nPhysical examination: lower limb Lower extremity weakness or significant spasticity D\nBODY PART: CE SPINE\nJOB TITLE: TRACKMAN\nCervical disc disease with myelopathy:\nComputerized axial tomography Significant spinal cord pressure D\nMagnetic resonance imaging Significant spinal cord pressure D\nMyelogram Significant spinal cord pressure D\nCystometrogram Impaired bladder function D\nPhysical examination: rectal Impairment of sphincter tone D\nPhysical examination: lower limb Lower extremity weakness or significant spasticity D\nPhysical examination Multi-level neurologic compromise D\nChronic herniated disc:\nPhysical examination Multi-level neurologic compromise D\nCervical spondyloysis:\nPhysical examination Multi-level neurologic compromise D\nCervical intervertebral disc degeneration:\nPhysical examination Multi-level neurologic compromise D\nFracture: posterior element with spinal canal displacement:\nPhysical examination Multi-level neurologic compromise D\nPost laminectomy syndrome:\nPhysical examination Multi-level neurologic compromise D\nCervical radiculopathy:\nPhysical examination Multi-level neurologic compromise D\nSpondylogenic compression of spinal cord:\nComputerized axial tomography Significant spinal cord pressure D\nMagnetic resonance imaging Significant spinal cord pressure D\nCystometrogram Impaired bladder function D\nMyelogram Significant spinal cord pressure D\nPhysical examination: rectal Impairment of sphincter tone D\nPhysical examination Multi-level neurologic compromise D\nPhysical examination: lower limb Lower extremity weakness or significant spasticity D\nBODY PART: CE SPINE\nJOB TITLE: MACHINIST\nCervical disc disease with myelopathy:\nComputerized axial tomography Significant spinal cord pressure D\nMagnetic resonance imaging Significant spinal cord pressure D\nMyelogram Significant spinal cord pressure D\nCystometrogram Impaired bladder function D\nPhysical examination: rectal Impairment of sphincter tone D\nPhysical examination: lower limb Lower extremity weakness or significant spasticity D\nPhysical examination Multi-level neurologic compromise D\nChronic herniated disc:\nPhysical examination Multi-level neurologic compromise D\nCervical spondylolysis:\nPhysical examination Multi-level neurologic compromise D\nCervical intervertebral disc degeneration:\nPhysical examination Multi-level neurologic compromise D\nFracture: posterior element with spinal canal displacement:\nPhysical examination Multi-level neurologic compromise D\nPost laminectomy syndrome:\nPhysical examination Multi-level neurologic compromise D\nCervical radiculopathy:\nPhysical examination Multi-level neurologic compromise D\nSpondylogenic compression of spinal cord:\nComputerized axial tomography Significant spinal cord pressure D\nMagnetic resonance imaging Significant spinal cord pressure D\nCystometrogram Impaired bladder function D\nMyelogram Significant spinal cord pressure D\nPhysical examination: rectal Impairment of sphincter tone D\nPhysical examination Multi-level neurologic compromise D\nPhysical examination: lower limb Lower extremity weakness or significant spasticity D\nBODY PART: CE SPINE\nJOB TITLE: SHOP LABORER\nCervical disc disease with myelopathy:\nComputerized axial tomography Significant spinal cord pressure D\nMagnetic resonance imaging Significant spinal cord pressure D\nMyelogram Significant spinal cord pressure D\nCystometrogram Impaired bladder function D\nPhysical examination: rectal Impairment of sphincter tone D\nPhysical examination: lower limb Lower extremity weakness or significant spasticity D\nPhysical examination Multi-level neurologic compromise D\nChronic herniated disc:\nPhysical examination Multi-level neurologic compromise D\nCervical spondylolysis:\nPhysical examination Multi-level neurologic compromise D\nCervical intervertebral disc degeneration:\nPhysical examination Multi-level neurologic compromise D\nFracture: posterior element with spinal canal displacement:\nPhysical examination Multi-level neurologic compromise D\nPost laminectomy syndrome:\nPhysical examination Multi-level neurologic compromise D\nCervical radiculopathy:\nPhysical examination Multi-level neurologic compromise D\nSpondylogenic compression of spinal cord:\nComputerized axial tomography Significant spinal cord pressure D\nMagnetic resonance imaging Significant spinal cord pressure D\nCystometrogram Impaired bladder function D\nMyelogram Significant spinal cord pressure D\nPhysical examination: rectal Impairment of sphincter tone D\nPhysical examination Multi-level neurologic compromise D\nPhysical examination: lower limb Lower extremity weakness or significant spasticity D\nBODY PART: CE SPINE\nJOB TITLE: SALES REPRESENTATIVE\nCervical disc disease with myelopathy:\nCystometrogram Impaired bladder function D\nPhysical examination: rectal Impairment of sphincter tone D\nSpondylogenic compression of spinal cord:\nCystometrogram Impaired bladder function D\nPhysical examination: rectal Impairment of sphincter tone D\nBODY PART: CE SPINE\nJOB TITLE: GENERAL OFFICE CLERK\nCervical disc disease with myelopathy:\nCystometrogram Impaired bladder function D\nPhysical examination: rectal Impairment of sphincter tone D\nSpondylogenic compression of spinal cord:\nCystometrogram Impaired bladder function D\nPhysical examination: rectal Impairment of sphincter tone D\nG. Shoulder and Elbow\nConfirmatory test Minimum result Requirements.\nBODY PART: SHOULDER AND ELBOW\nCONFIRMATORY TESTS\nArthritis, acromioclavicular:\nX-ray: shoulder Significant degenerative changes of joint Recommended.\nComputerized tomography Significant degenerative changes of joint Recommended.\nMagnetic resonance imaging Significant degenerative changes of joint Recommended.\nArthritis, glenohumeral:\nX-ray: shoulder Significant degenerative changes of joint Recommended.\nComputerized tomography Significant degenerative changes of joint Recommended.\nMagnetic resonance imaging Significant degenerative changes of joint Recommended.\nRotator cuff tear:\nComputerized tomography Tear of rotator cuff Recommended.\nMagnetic resonance imaging Tear of rotator cuff Recommended.\nMedical diagnosis leading to a permanent functional limitation of the elbow:\nMedical record review Condition with permanent functional limitation Highly recommended.\nX-ray: elbow Imaging confirmation of functional diagnosis Recommended.\nMagnetic resonance imaging Imaging confirmation of functional diagnosis Recommended.\nDisability test Test result Disability classification\nBODY PART: SHOULDER AND ELBOW\nJOB TITLE: TRAINMAN\nArthritis, acromioclavicular:\nPhysical examination—range of motion \u003c40 degrees flexion D\nPhysical examination—range of motion \u003c40 degrees abduction D\nArthritis, glenohumeral:\nPhysical examination—range of motion \u003c40 degrees flexion D\nPhysical examination—range of motion \u003c40 degrees abduction D\nRotator cuff tear:\nPhysical examination—range of motion \u003c40 degrees flexion D\nPhysical examination—range of motion \u003c40 degrees abduction D\nPermanent functional limitation, elbow:\nPhysical examination \u003e40 degrees deviation D\nPhysical examination—range of motion Flexion limit to 60 degrees D\nBODY PART: SHOULDER AND ELBOW\nJOB TITLE: ENGINEER\nArthritis, acromioclavicular:\nPhysical examination—range of motion \u003c40 degrees flexion D\nPhysical examination—range of motion \u003c40 degrees abduction D\nArthritis, glenohumeral:\nPhysical examination—range of motion \u003c40 degrees flexion D\nPhysical examination—range of motion \u003c40 degrees abduction D\nRotator cuff tear:\nPhysical examination—range of motion \u003c40 degrees flexion D\nPhysical examination—range of moiton \u003c40 degrees abduction D\nPermanent functional limitation, elbow:\nPhysical examination \u003e40 degrees deviation D\nPhysical examination—range of motion Flexion limit to 60 degrees D\nBODY PART: SHOULDER AND ELBOW\nJOB TITLE: CARMAN\nArthritis, acromioclavicular:\nPhysical examination—range of motion \u003c40 degrees flexion D\nPhysical examination—range of motion \u003c40 degrees abduction D\nArthritis, glenohumeral:\nPhysical examination—range of motion \u003c40 degrees flexion D\nPhysical examination—range of motion \u003c40 degrees abduction D\nRotator cuff tear:\nPhysical examination—range of motion \u003c40 degrees flexion D\nPhysical examination—range of motion \u003c40 degrees abduction D\nPermanent functional limitation, elbow:\nPhysical examination \u003e40 degrees deviation D\nPhysical examination—range of motion Flexion limit to 60 degrees D\nBODY PART: SHOULDER AND ELBOW\nJOB TITLE: SIGNALMAN\nArthritis, acromioclavicular:\nPhysical examination—range of motion \u003c40 degrees flexion D\nPhysical examination—range of motion \u003c40 degrees abduction D\nArthritis, glenohumeral:\nPhysical examination—range of motion \u003c40 degrees flexion D\nPhysical examination—range of motion \u003c40 degrees abduction D\nRotator cuff tear:\nPhysical examination—range of motion \u003c40 degrees flexion D\nPhysical examination—range of motion \u003c40 degrees abduction D\nPermanent functional limitation, elbow:\nPhysical examination \u003e40 degrees deviation D\nPhysical examination—range of motion Flexion limit to 60 degrees D\nBODY PART: SHOULDER AND ELBOW\nJOB TITLE: TRACKMAN\nArthritis, acromioclavicular:\nPhysical examination—range of motion \u003c40 degrees flexion D\nPhysical examination—range of motion \u003c40 degrees abduction D\nArthritis, glenohumeral:\nPhysical examination—range of motion \u003c40 degrees flexion D\nPhysical examination—range of motion \u003c40 degrees abduction D\nRotator cuff tear:\nPhysical examination—range of motion \u003c40 degrees flexion D\nPhysical examination—range of motion \u003c40 degrees abduction D\nPermanent functional limitation, elbow:\nPhysical examination \u003e40 degrees deviation D\nPhysical examination—range of motion Flexion limit to 60 degrees D\nBODY PART: SHOULDER AND ELBOW\nJOB TITLE: MACHINIST\nArthritis, acromioclavicular:\nPhysical examination—range of motion \u003c40 degrees flexion D\nPhysical examination—range of motion \u003c40 degrees abduction D\nArthritis, glenohumeral:\nPhysical examination—range of motion \u003c40 degrees flexion D\nPhysical examination—range of motion \u003c40 degrees abduction D\nRotator cuff tear:\nPhysical examination—range of motion \u003c40 degrees flexion D\nPhysical examination—range of motion \u003c40 degrees abduction D\nPermanent functional limitation, elbow:\nPhysical examination \u003e40 degrees deviation D\nPhysical examination—range of motion Flexion limit to 60 degrees D\nBODY PART: SHOULDER AND ELBOW\nJOB TITLE: SHOP LABORER\nArthritis, acromioclavicular:\nPhysical examination—range of motion \u003c40 degrees flexion D\nPhysical examination—range of motion \u003c40 degrees abduction D\nArthritis, glenohumeral:\nPhysical examination—range of motion \u003c40 degrees flexion D\nPhysical examination—range of motion \u003c40 degrees abduction D\nRotator cuff tear:\nPhysical examination—range of motion \u003c40 degrees flexion D\nPhysical examination—range of motion \u003c40 degrees abduction D\nPermanent functional limitation, elbow:\nPhysical examination \u003e40 degrees deviation D\nPhysical examination—range of motion Flexion limit to 60 degrees D\nH. Hand and Arm\nConfirmatory test Minimum result Requirements\nBODY PART: HAND AND ARM\nCONFIRMATORY TESTS\nCarpal tunnel syndrome:\nMedical record review Pain, paresthesia and weakness in distribution median nerve Highly recommended.\nNerve conduction testing Definite median nerve conduction slowing at wrist Highly recommended.\nElectromyography Denervation in severe cases Recommended.\nFracture: wrist:\nX-ray: wrist Evidence of fracture Highly recommended.\nHand: permanent functional limitation:\nMedical record review Documentation of medical condition for permanent limitation Highly recommended.\nPhysical examination Definite reproducible evidence of limitation Highly recommended.\nImaging study (e.g. X-ray, CAT, MRI) Positive confirmation of underlying condition Highly recommended.\nRheumatoid arthritis: hand:\nRheumatoid factor Titer of rheumatoid factor Recommended.\nMedical record review History of objective findings including serological studies Highly recommended.\nX-ray: hand Characteristic rheumatoid changes Highly recommended.\nTenosynovitis:\nMedical record review History of chronic tenosynovitis and objective findings Highly recommended.\nPhysical examination Definite evidence of tenosynovitis Highly recommended.\nThumb: Permanent functional limitation:\nMedical record review Documentation of medical condition for permanent limitation Highly recommended.\nPhysical examination Definite reproducible evidence of limitation Highly recommended.\nImaging study (X-ray, CAT, MRI) Positive confirmation of underlying condition Highly recommended.\nWrist: Permanent functional limitation:\nMedical record review Documentation of medical condition for permanent limitation Highly recommended.\nPhysical examination Definite reproducible evidence of limitation Highly recommended.\nImaging study (e.g. X-ray, CAT, MRI) Positive confirmation of underlying condition Highly recommended.\nDisability test Test result Disability classification\nBODY PART: HAND AND ARM\nJOB TITLE: TRAINMAN\nFracture, wrist:\nPhysical examination—range of motion Extension—limit to 30 degrees D\nPhysical examination—range of motion Flexion—limit to 30 degrees D\nPhysical examination—range of motion Ankylosis: \u003e20 degrees from neutral D\nRheumatoid arthritis hand:\nPhysical examination Significant deformity D\nMedical record review Significant flare-ups, under treatment with rheumatologist D\nMedical record review Extensive medication use, under treatment with rheumatologist D\nThumb: permanent functional limitation:\nAdduction of thumb Loss ≤4 cm D\nAnkylosis: degree from neutral \u003c20 degrees extension D\nAnkylosis: degree from neutral \u003c40 degrees flexion D\nLoss of extension or flexion MCP or PIP: maximum flexion \u003c40 degrees D\nOpposition Loss ≤4 cm D\nWrist: permanent functional limitation:\nPhysical examination—range of motion Extension—limit to 30 degrees D\nPhysical examination—range of motion Flexion—limit to 30 degrees D\nPhysical examination—range of motion Ankylosis: \u003e20 degrees from neutral D\nBODY PART: HAND AND ARM\nJOB TITLE ENGINEER\nFracture, wrist:\nPhysical examination—range of motion Extension-limit to 30 degrees D\nPhysical examination—range of motion Flexion-limit to 30 degrees D\nPhysical examination—range of motion Ankylosis: \u003e20 degrees from neutral D\nRheumatoid arthritis hand:\nPhysical examination Significant deformity D\nMedical record review Significant flare-ups, under treatment with rheumatologist D\nMedical record review Extensive medication use, under treatment with rheumatologist D\nThumb: permanent functional limitation:\nAdduction of thumb Loss ≤4 cm D\nAnkylosis: degree from neutral \u003c20 degrees extension D\nAnkylosis: degree from neutral \u003c40 degrees flexion D\nLoss of extension or flexion MCP or PIP: maximum flexion \u003c40 degrees D\nOpposition Loss ≤4 cm D\nWrist: permanent functional limitation:\nPhysical examination—range of motion Extension—limit to 30 degrees D\nPhysical examination—range of motion Flexion—limit to 30 degrees D\nPhysical examination—range of motion Ankylosis: \u003e20 degrees from neutral D\nBODY PART: HAND AND ARM\nJOB TITLE: DISPATCHER\nFracture, wrist:\nPhysical examination—range of motion Extension—limit to 30 degrees D\nPhysical examination—range of motion Flexion—limit to 30 degrees D\nPhysical examination—range of motion Ankylosis: \u003e20 degrees from neutral D\nRheumatoid arthritis hand:\nPhysical examination Significant deformity D\nMedical record review Significant flare-ups, under treatment with rheumatologist D\nMedical record review Extensive medication use, under treatment with rheumatologist D\nThumb: permanent functional limitation:\nAdduction of thumb Loss ≤4 cm D\nAnkylosis: degree from neutral \u003c20 degrees extension D\nAnkylosis: degree from neutral \u003c40 degrees flexion D\nLoss of extension or flexion MCP or PIP: maximum flexion \u003c40 degrees D\nOpposition Loss ≤4 cm D\nWrist: permanent functional limitation:\nPhysical examination—range of motion Extension—limit to 30 degrees D\nPhysical examination—range of motion Flexion—limit to 30 degrees D\nPhysical examination—range of motion Ankylosis: \u003e20 degrees from neutral D\nBODY PART: HAND AND ARM\nJOB TITLE: CARMAN\nFracture, wrist:\nPhysical examination—range of motion Extension—limit to 30 degrees D\nPhysical examination—range of motion Flexion—limit to 30 degrees D\nPhysical examination—range of motion Ankylosis: \u003e20 degrees from neutral D\nRheumatoid arthritis hand:\nPhysical examination Significant deformity D\nMedical record review Significant flare-ups, under treatment with rheumatologist D\nMedical record review Extensive medication use, under treatment with rheumatologist D\nThumb: permanent functional limitation:\nAdduction of thumb: Loss ≤4 cm D\nAnkylosis: degree from neutral \u003c20 degrees extension D\nAnkylosis: degree from neutral \u003c40 degrees flexion D\nLoss of extension or flexion MCP of PIP: maximum flexion \u003c40 degrees D\nOpposition Loss ≤4 cm D\nWrist: permanent functional limitation:\nPhysical examination—range of motion Extension—limit to 30 degrees D\nPhysical examination—range of motion Flexion—limit to 30 degrees D\nPhysical examination—range of motion Ankylosis: \u003e20 degrees from neutral D\nBODY PART: HAND AND ARM\nJOB TITLE: SIGNALMAN\nFracture, wrist:\nPhysical examination—range of motion Extension—limit to 30 degrees D\nPhysical examination—range of motion Flexion—limit to 30 degrees D\nPhysical examination—range of motion Ankylosis: \u003e20 degrees from neutral D\nRheumatoid arthritis hand:\nPhysical examination Significant deformity D\nMedical record review Significant flare-ups, under treatment with rheumatologist D\nMedical record review Extensive medication use, under treatment with rheumatologist D\nThumb: permanent functional limitation:\nAdduction of thumb Loss ≤4 cm D\nAnkylosis: degree from neutral \u003c20 degrees extension D\nAnkylosis: degree from neutral \u003c40 degrees flexion D\nLoss of extension or flexion MCP or PIP: maximum flexion \u003c40 degrees D\nOpposition Loss ≤4 cm D\nWrist: permanent functional limitation:\nPhysical examination—range of motion Extension—limit to 30 degrees D\nPhysical examination—range of motion Flexion—limit to 30 degrees D\nPhysical examination—range of motion Ankylosis: \u003e20 degrees from neutral D\nBODY PART: HAND AND ARM\nJOB TITLE: TRACKMAN\nFracture, wrist:\nPhysical examination—range of motion Extension—limit to 30 degrees D\nPhysical examination—range of motion Flexion—limit to 30 degrees D\nPhysical examination—range of motion Ankylosis: \u003e20 degrees from neutral D\nRheumatoid arthritis hand:\nPhysical examination Significant deformity D\nMedical record review Significant flare-ups, under treatment with rheumatologist D\nMedical record review Extensive medication use, under treatment with rheumatologist D\nThumb: permanent functional limitation:\nAdduction of thumb Loss ≤4 cm D\nAnkylosis: degree from neutral \u003c20 degrees extension D\nAnkylosis: degree from neutral \u003c40 degrees flexion D\nLoss of extension or flexion MCP or PIP: maximum flexion \u003c40 degrees D\nOpposition Loss ≤4 cm D\nWrist: permanent functional limitation:\nPhysical examination—range of motion Extension—limit to 30 degrees D\nPhysical examination—range of motion Flexion—limit to 30 degrees D\nPhysical examination—range of motion Ankylosis: \u003e20 degrees from neutral D\nBODY PART: HAND AND ARM\nJOB TITLE: MACHINIST\nFracture, wrist:\nPhysical examination—range of motion Extension—limit to 30 degrees D\nPhysical examination—range of motion Flexion—limit to 30 degrees D\nPhysical examination—range of motion Ankylosis: \u003e20 degrees from neutral D\nRheumatoid arthritis hand:\nPhysical examination Significant deformity D\nMedical record review Significant flare-ups, under treatment with rheumatologist D\nMedical record review Extensive medication use, under treatment with rheumatologist D\nThumb: permanent functional limitation:\nAdduction of thumb Loss ≤4 cm D\nAnkylosis: degree from neutral \u003c20 degrees extension D\nAnkylosis: degree from neutral \u003c40 degrees flexion D\nLoss of extension or flexion MCP or PIP: maximum flexion \u003c40 degrees D\nOpposition Loss ≤4 cm D\nWrist: permanent functional limitation:\nPhysical examination—range of motion Extension—limit to 30 degrees D\nPhysical examination—range of motion Flexion—limit to 30 degrees D\nPhysical examination—range of motion Ankylosis: \u003e20 degrees from neutral D\nBODY PART: HAND AND ARM\nJOB TITLE: SHOP LABORER\nFracture, wrist:\nPhysical examination—range of motion Extension—limit to 30 degrees D\nPhysical examination—range of motion Flexion—limit to 30 degrees D\nPhysical examination—range of motion Ankylosis: \u003e20 degrees from neutral D\nRheumatoid arthritis hand:\nPhysical examination Significant deformity D\nMedical record review Significant flare-ups, under treatment with rheumatologist D\nMedical record review Extensive medication use, under treatment with rheumatologist D\nThumb: permanent functional limitation:\nAdduction of thumb Loss ≤4 cm D\nAnkylosis: degree from neutral \u003c20 degrees extension D\nAnkylosis: degree from neutral \u003c40 degrees flexion D\nLoss of extension or flexion MCP or PIP: maximum flexion \u003c40 degrees D\nOpposition Loss ≤4 cm D\nWrist: permanent functional limitation:\nPhysical examination—range of motion Extension—limit to 30 degrees D\nPhysical examination—range of motion Flexion—limit to 30 degrees D\nPhysical examination—range of motion Ankylosis: \u003e20 degrees from neutral D\nBODY PART: HAND AND ARM\nJOB TITLE: SALES REPRESENTATIVE\nFracture, wrist:\nPhysical examination—range of motion Extension—limit to 30 degrees D\nPhysical examination—range of motion Flexion—limit to 30 degrees D\nPhysical examination—range of motion Ankylosis: \u003e20 degrees from neutral D\nRheumatoid arthritis hand:\nPhysical examination Significant deformity D\nMedical record review Significant flare-ups, under treatment with rheumatologist D\nMedical record review Extensive medication use, under treatment with rheumatologist D\nThumb: permanent functional limitation:\nAdduction of thumb Loss ≤4 cm D\nAnkylosis: degree from neutral \u003c20 degrees extension D\nAnkylosis: degree from neutral \u003c40 degrees flexion D\nLoss of extension or flexion MCP or PIP: maximum flexion \u003c40 degrees D\nOpposition Loss ≤4 cm D\nWrist: permanent functional limitation:\nPhysical examination—range of motion Extension—limit to 30 degrees D\nPhysical examination—range of motion Flexion—limit to 30 degrees D\nPhysical examination—range of motion Ankylosis: \u003e20 degrees from neutral D\nBODY PART: HAND AND ARM\nJOB TITLE: GENERAL OFFICE CLERK\nFracture, wrist:\nPhysical examination—range of motion Extension—limit to 30 degrees D\nPhysical examination—range of motion Flexion—limit to 30 degrees D\nPhysical examination—range of motion Ankylosis: \u003e20 degrees from neutral D\nRheumatoid arthritis hand:\nPhysical examination Significant deformity D\nMedical record review Significant flare-ups, under treatment with rheumatologist D\nMedical record review Extensive medication use, under treatment with rheumatologist D\nThumb: permanent functional limitation:\nAdduction of thumb Loss ≤4 cm D\nAnkylosis: degree from neutral \u003c20 degree extension D\nAnkylosis: degree from neutral \u003c40 degree flexion D\nLoss of extension or flexion MCP or PIP: maximum flexion \u003c40 degrees D\nOpposition Loss ≤4 cm D\nWrist: permanent functional limitation:\nPhysical examination—range of motion Extension—limit to 30 degrees D\nPhysical examination—range of motion Flexion—limit to 30 degrees D\nPhysical examination—range of motion Ankylosis: \u003e20 degrees from neutral D\nI. Hip\nConfirmatory test Minimum result Requirements\nBODY PART: HIP\nCONFIRMATORY TESTS\nAnkylosis, hip:\nX-ray: hip Extreme joint destruction Highly Recommended.\nPhysical examination—range of motion No mobility Highly Recommended.\nOsteoarthritis, hip:\nX-ray: hip \u003c4 mm joint space, or other positive evidence Recommended.\nMagnetic resonance imaging \u003c4 mm joint space, or other positive evidence Recommended.\nComputerized axial tomography \u003c4 mm joint space, or other positive evidence Recommended.\nOsteomyelitis, hip:\nX-ray: hip Evidence of chronic infection Recommended.\nComputerized axial tomography Evidence of chronic infection Recommended.\nPaget's disease:\nX-ray: hip Osteolytic or blastic lesions Highly Recommended.\nAlkaline phosphatase Increased up to 50 times Highly Recommended.\nHip replacement surgery:\nX-ray: hip Evidence of artificial hip Recommended.\nMedical record review Documentation of prior hip replacement Recommended.\nDisability test Test result Disability classification\nBODY PART: HIP\nJOB TITLE: TRAINMAN\nAnkylosis, hip:\nPhysical examination—range of motion Ankylosis 5 degrees or \u003eflexion D\nPhysical examination—range of motion Ankylosis internal rotation \u003e5 degrees D\nPhysical examination—range of motion Ankylosis external rotation \u003e10 degrees D\nPhysical examination—range of motion Ankylosis in abduction \u003e5 degrees D\nPhysical examination—range of motion Ankylosis in adduction \u003e5 degrees D\nOsteoarthritis, hip:\nX-ray: hip 0 mm cartilage interval D\nPhysical examination—range of motion 30 degrees flexion contracture D\nPhysical examination—range of motion \u003c50 degrees flexion D\nPhysical examination—range of motion \u003c5 degrees abduction D\nOsteomyelitis, chronic hip:\nX-ray: hip Significant joint destruction D\nPhysical examination—range of motion 30 degrees flexion contracture D\nPhysical examination—range of motion \u003c50 degrees flexion D\nPhysical examination—range of motion \u003c5 degrees abduction D\nMedical record review Documented occurrence of recurring infections with treatment D\nPaget's disease:\nX-ray: hip Significant joint destruction D\nPhysical examination—range of motion 30 degrees flexion contracture D\nPhysical examination—range of motion \u003c50 degrees flexion D\nPhysical examination—range of motion \u003c5 degrees abduction D\nHip replacement surgery:\nX-ray: hip Evidence of artificial hip joint D\nMedical record review Documentation of prior hip replacement D\nBODY PART: HIP\nJOB TITLE: ENGINEER\nAnkylosis, hip:\nPhysical examination—range of motion Ankylosis 5 degrees or \u003eflexion D\nPhysical examination—range of motion Ankylosis internal rotation \u003e5 degrees D\nPhysical examination—range of motion Ankylosis external rotation \u003e10 degrees D\nPhysical examination—range of motion Ankylosis in abduction \u003e5 degrees D\nPhysical examination—range of motion Ankylosis in adduction \u003e5 degrees D\nOsteoarthritis, hip:\nX-ray: hip 0 mm cartilage interval D\nPhysical examination—range of motion 30 degrees flexion contracture D\nPhysical examination—range of motion \u003c50 degrees flexion D\nPhysical examination—range of motion \u003c5 degrees abduction D\nOsteomyelitis, chronic hip:\nX-ray: hip Signficant joint destruction D\nPhysical examination—range of motion 30 degrees flexion contracture D\nPhysical examination—range of motion \u003c50 degrees flexion D\nPhysical examination—range of motion \u003c5 degrees abduction D\nMedical record review Documented occurrence of recurring infections with treatment D\nPaget's disease:\nX-ray: hip Significant joint destruction D\nPhysical examination—range of motion 30 degrees flexion contracture D\nPhysical examination—range of motion \u003c50 degrees flexion D\nPhysical examination—range of motion \u003c5 degrees abduction D\nHip replacement surgery:\nX-ray: hip Evidence of artificial hip joint D\nMedical record review Documentation of prior hip replacement D\nBODY PART: HIP\nJOB TITLE: CARMAN\nAnkylosis, hip:\nPhysical examination—range of motion Ankylosis 5 degrees or \u003eflexion D\nPhysical examination—range of motion Ankylosis internal rotation \u003e5 degrees D\nPhysical examination—range of motion Ankylosis external rotation \u003e10 degrees D\nPhysical examination—range of motion Ankylosis in abduction \u003e5 degrees D\nPhysical examination—range of motion Ankylosis in adduction \u003e5 degrees D\nOsteoarthritis, hip:\nX-ray: hip 0 mm cartilage interval D\nPhysical examination—range of motion 30 degrees flexion contracture D\nPhysical examination—range of motion \u003c50 degrees flexion D\nPhysical examination—range of motion \u003c5 degrees abduction D\nOsteomyelitis, chronic hip:\nX-ray: hip Significant joint destruction D\nPhysical examination—range of motion 30 degrees flexion contracture D\nPhysical examination—range of motion \u003c50 degrees flexion D\nPhysical examination—range of motion \u003c5 degrees abduction D\nMedical record review Documented occurrence of recurring infections with treatment D\nPaget's disease:\nX-ray: hip Significant joint destruction D\nPhysical examination—range of motion 30 degrees flexion contracture D\nPhysical examination—range of motion \u003c50 degrees flexion D\nPhysical examination—range of motion \u003c5 degrees abduction D\nHip replacement surgery:\nX-ray: hip Evidence of artificial hip joint D\nMedical record review Documentation of prior hip replacement D\nBODY PART: HIP\nJOB TITLE: SIGNALMAN\nAnkylosis, hip:\nPhysical examination—range of motion Ankylosis 5 degrees or \u003eflexion D\nPhysical examination—range of motion Ankylosis internal rotation \u003e5 degrees D\nPhysical examination—range of motion Ankylosis external rotation \u003e10 degrees D\nPhysical examination—range of motion Ankylosis in abduction \u003e5 degrees D\nPhysical examination—range of motion Ankylosis in adduction \u003e5 degrees D\nOsteoarthritis, hip:\nX-ray: hip 0 mm cartilage interval D\nPhysical examination—range of motion 30 degrees flexion contracture D\nPhysical examination—range of motion \u003c50 degrees flexion D\nPhysical examination—range of motion \u003c5 degrees abduction D\nOsteomyelitis, chronic hip:\nX-ray: hip Significant joint destruction D\nPhysical examination—range of motion 30 degrees flexion contracture D\nPhysical examination—range of motion \u003c50 degrees flexion D\nPhysical examination—range of motion \u003c5 degrees abduction D\nMedical record review Documented occurrence of recurring infections with treatment D\nPaget's disease:\nX-ray: hip Significant joint destruction D\nPhysical examination—range of motion 30 degrees flexion contracture D\nPhysical examination—range of motion \u003c50 degrees flexion D\nPhysical examination—range of motion \u003c5 degrees abduction D\nHip replacement surgery:\nX-ray: hip Evidence of artificial hip joint D\nMedical record review Documentation of prior hip replacement D\nBODY PART: HIP\nJOB TITLE: TRACKMAN\nAnkylosis, hip:\nPhysical examination—range of motion Ankylosis 5 degrees or \u003eflexion D\nPhysical examination—range of motion Ankylosis internal rotation \u003e5 degrees D\nPhysical examination—range of motion Ankylosis external rotation \u003e10 degrees D\nPhysical examination—range of motion Ankylosis in abduction \u003e5 degrees D\nPhysical examination—range of motion Ankylosis in adduction \u003e5 degrees D\nOsteoarthritis, hip:\nX-ray: hip 0 mm cartilage interval D\nPhysical examination—range of motion 30 degrees flexion contracture D\nPhysical examination—range of motion \u003c50 degrees flexion D\nPhysical examination—range of motion \u003c5 degrees abduction D\nOsteomyelitis, chronic hip:\nX-ray: hip Significant joint destruction D\nPhysical examination—range of motion 30 degrees flexion contracture D\nPhysical examination—range of motion \u003c50 degrees flexion D\nPhysical examination—range of motion \u003c5 degrees abduction D\nMedical record review Documented occurrence of recurring infections with treatment D\nPaget's disease:\nX-ray: hip Significant joint destruction D\nPhysical examination—range of motion 30 degrees flexion contracture D\nPhysical examination—range of motion \u003c50 degrees flexion D\nPhysical examination—range of motion \u003c5 degrees abduction D\nHip replacement surgery:\nX-ray: hip Evidence of artificial hip joint D\nMedical record review Documentation of prior hip replacement D\nBODY PART: HIP\nJOB TITLE: MACHINIST\nAnkylosis, hip:\nPhysical examination—range of motion Ankylosis 5 degrees or \u003eflexion D\nPhysical examination—range of motion Ankylosis internal rotation \u003e5 degrees D\nPhysical examination—range of motion Ankylosis external rotation \u003e10 degrees D\nPhysical examination—range of motion Ankylosis in abduction \u003e5 degrees D\nPhysical examination—range of motion Ankylosis in adduction \u003e5 degrees D\nOsteoarthritis, hip:\nX-ray: hip 0 mm cartilage interval D\nPhysical examination—range of motion 30 degrees flexion contracture D\nPhysical examination—range of motion \u003c50 degrees flexion D\nPhysical examination—range of motion \u003c5 degrees abduction D\nOsteomyelitis, chronic hip:\nX-ray: hip Significant joint destruction D\nPhysical examination—range of motion 30 degrees flexion contracture D\nPhysical examination—range of motion \u003c50 degrees flexion D\nPhysical examination—range of motion \u003c5 degrees abduction D\nMedical record review Documented occurrence of recurring infections with treatment D\nPaget's disease:\nX-ray: hip Significant joint destruction D\nPhysical examination—range of motion 30 degrees flexion contracture D\nPhysical examination—range of motion \u003c50 degrees flexion D\nPhysical examination—range of motion \u003c5 degrees abudction D\nHip replacement surgery:\nX-ray: hip Evidence of artificial hip joint D\nMedical record review Documentation of prior hip replacement D\nBODY PART: HIP\nJOB TITLE: SHOP LABORER\nAnkylosis, hip:\nPhysical examination—range of motion Ankylosis 5 degrees of \u003eflexion D\nPhysical examination—range of motion Ankylosis internal rotation \u003e5 degrees D\nPhysical examination—range of motion Ankylosis external rotation \u003e10 degrees D\nPhysical examination—range of motion Ankylosis in abduction \u003e5 degrees D\nPhysical examination—range of motion Ankylosis in adduction \u003e5 degrees D\nOsteoarthritis, hip:\nX-ray: hip 0 mm cartilage interval D\nPhysical examination—range of motion 30 degrees flexion contracture D\nPhysical examination—range of motion \u003c50 degrees flexion D\nPhysical examination—range of motion \u003c5 degrees abduction D\nOsteomyelitis, chronic hip:\nX-ray: hip Significant joint destruction D\nPhysical examination—range of motion 30 degrees flexion contracture D\nPhysical examination—range of motion \u003c50 degrees flexion D\nPhysical examination—range of motion \u003c5 degrees abduction D\nMedical record review Documented occurrence of recurring infections with treatment D\nPaget's disease:\nX-ray; hip Significant joint destruction D\nPhysical examination—range of motion 30 degrees flexion contracture D\nPhysical examination—range of motion \u003c50 degrees flexion D\nPhysical examination—range of motion \u003c5 degrees abduction D\nHip replacement surgery:\nX-ray: hip Evidence of artificial hip joint D\nMedical record review Documentation of prior hip replacement D\nJ. Knee\nConfirmatory test Minimum result Requirements\nBODY PART: KNEE\nCONFIRMATORY TESTS\nArthritis: knee:\nX-ray: knee Evidence of significant degenerative changes Recommended.\nCollateral ligament tear with laxity:\nPhysical examination: knee Evidence of ligamentous laxity Highly Recommended.\nMagnetic resonance imaging Evidence of ligamentous tear Recommended.\nCruciate and collateral ligament tear with laxity:\nMagnetic resonance imaging Tear of both ligaments Recommended.\nPhysical examination Evidence of ligamentous laxity Highly Recommended.\nMedical record review Documentation of tear by arthroscopy Recommended.\nCruciate ligament tear with laxity:\nPhysical examination: knee Evidence of ligamentous laxity Highly Recommended.\nMagnetic resonance imaging Evidence of cruciate tear Recommended.\nMedical record review Documentation of tear by arthroscopy Recommended.\nIntercondylar fracture:\nX-ray: knee Evidence of fracture Highly Recommended.\nOsteomyelitis: knee:\nMedical record review Documented history of osteomyelitis requiring treatment Highly Recommended.\nX-ray: knee Evidence of chronic infection Recommended.\nComputerized tomography Evidence of chronic infection Recommended.\nMagnetic resonance imaging Evidence of chronic infection Recommended.\nOsteonecrosis:\nX-ray: knee Necrosis of femoral condyle or tibial plateau Recommended.\nComputerized tomography Necrosis of femoral condyle or tibial plateau Recommended.\nMagnetic resonance imaging Necrosis of femoral condyle or tibial plateau Recommended.\nPatellofemoral arthritis:\nX-ray: knee Evidence of arthritis Recommended.\nMagnetic resonance imaging Evidence of arthritis Recommended.\nPhysical examination Crepitation with movement Highly Recommended.\nPatellar fracture nonunion with displacement:\nX-ray: knee Nonunion and displacement Recommended.\nMagnetic resonance imaging Nonunion and displacement Recommended.\nComputerized tomography Nonunion and displacement Recommended.\nPlateau fracture:\nX-ray: knee Evidence of fracture Recommended.\nComputerized tomography Evidence of fracture Recommended.\nMagnetic resonance imaging Evidence of fracture Recommended.\nMeniscectomy—medial or lateral:\nMedical record review History of surgery Highly Recommended.\nPatellectomy:\nPhysical examination: knee Absent patella Highly Recommended.\nPatellar—subluxation—recurrent:\nMedical record review History of recurrent subluxation Highly Recommended.\nSupracondylar fracture:\nX-ray: knee Evidence of fracture Recommended.\nMagnetic resonance imaging Evidence of fracture Recommended.\nComputerized tomography Evidence of fracture Recommended.\nTotal knee replacement:\nX-ray: knee Presence of replacement knee Recommended.\nMedical record review Documented surgical history Recommended.\nTibial shaft fracture:\nX-ray: leg Fracture of shaft Recommended.\nMagnetic resonance imaging Evidence of fracture Recommended.\nComputerized tomography Evidence of fracture Recommended.\nDisability test Test result Disability classification\nBODY PART: KNEE\nJOB TITLE: TRAINMAN\nArthritis knee:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nX-ray knee 0-1 mm cartilage interval with degenerative change D\nMeniscectomy, medial or lateral:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003edegrees) D\nCollateral ligament tear with laxity:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nCruciate and collateral ligament tear:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nCruciate ligament tear with laxity:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nIntercondylar fracture:\nPost fracture angulation \u003e20 degrees angulation D\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nOsteomyelitis, chronic knee:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nMedical record review Frequent episodes of infection requiring treatment D\nX-ray knee 0-1 mm cartilage interval with degenerative change D\nOsteonecrosis:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nX-ray knee 0-1 mm cartilage interval with degenerative change D\nPatellofemoral arthritis:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nX-ray knee: patello femoral joint 0 mm cartilage interval with degenerative change D\nPatellar fracture nonunion with displacement:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nX-ray knee Nonunion and \u003e3 mm displacement D\nPlateau fracture:\nPost fracture angulation \u003e20 degrees angulation D\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPatellectomy:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPatellar, subluxation, recurrent:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nSupracondylar fracture:\nPost fracture angulation \u003e20 degrees angulation D\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nTibial shaft fracture:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPost fracture angulation \u003e20 degrees malalignment D\nBODY PART: KNEE\nJOB TITLE: ENGINEER\nArthritis knee:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nX-ray knee 0-1 mm cartilage interval with degenerative change D\nMeniscectomy, medial or lateral:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nCollateral ligament tear with laxity:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nCruciate and collateral ligament tear:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nCruciate ligament tear with laxity:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nIntercondylar fracture:\nPost fracture angulation \u003e20 degrees angulation D\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nOsteomyelitis, chronic knee:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nMedical record review Frequent episodes of infection requiring treatment D\nX-ray knee 0-1 mm cartilage interval with degenerative change D\nOsteonecrosis:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nX-ray knee 0-1 mm cartilage interval with degenerative change D\nPatellofemoral arthritis:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nX-ray knee: patello femoral joint 0 mm cartilage interval with degenerative change D\nPatellar fracture nonunion with displacement:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nX-ray knee Nonunion and \u003e3 mm displacement D\nPlateau fracture:\nPost fracture angulation \u003e20 degrees angulation D\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPatellectomy:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPatellar, subluxation, recurrent:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nSupracondylar fracture:\nPost fracture angulation \u003e20 degrees angulation D\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nTibial shaft fracture:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPost fracture angulation \u003e20 degrees malalignment D\nBODY PART: KNEE\nJOB TITLE: CARMAN\nArthritis knee:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nX-ray knee 0-1 mm cartilage interval with degenerative change D\nMeniscectomy, medial or lateral:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nCollateral ligament tear with laxity:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nCruciate and collateral ligament tear:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nCruciate ligament tear with laxity:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nIntercondylar fracture:\nPost fracture angulation \u003e20 degrees angulation D\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nOsteomyelitis, chronic knee:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nMedical record review Frequent episodes of infection requiring treatment D\nX-ray knee 0-1 mm cartilage interval with degenerative change D\nOsteonecrosis:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nX-ray knee 0-1 mm cartilage interval with degenerative change D\nPatellofemoral arthritis:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nX-ray knee: patello femoral joint 0 mm cartilage interval with degenerative change D\nPatellar fracture nonunion with displacement:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nX-ray knee Nonunion and \u003e3 mm displacement D\nPlateau fracture:\nPost fracture angulation \u003e20 degrees angulation D\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPatellectomy:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPatellar, subluxation, recurrent:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nSupracondylar fracture:\nPost fracture angulation \u003e20 degrees angulation D\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nTibial shaft fracture:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPost fracture angulation \u003e20 degrees malalignment D\nBODY PART: KNEE\nJOB TITLE: SIGNALMAN\nArthritis knee:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nX-ray knee 0-1 mm cartilage interval with degenerative change D\nMeniscectomy, medial or lateral:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nCollateral ligament tear with laxity:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nCruciate and collateral ligament tear:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nCruciate ligament tear with laxity:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nIntercondylar fracture:\nPost fracture angulation \u003e20 degrees angulation D\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nOsteomyelitis, chronic knee:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nMedical record review Frequent episodes of infection requiring treatment D\nX-ray knee 0-1 mm cartilage interval with degenerative change D\nOsteonecrosis:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nX-ray knee 0-1 mm cartilage interval with degenerative change D\nPatellofemoral arthritis:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nX-ray knee: patello femoral joint 0 mm cartilage interval with degenerative change D\nPatellar fracture nonunion with displacement:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nX-ray knee Nonunion and \u003e3 mm displacement D\nPlateau fracture:\nPost fracture angulation \u003e20 degrees angulation D\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPatellectomy:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPatellar, subluxation, recurrent:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nSupracondylar fracture:\nPost fracture angulation \u003e20 degrees angulation D\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nTibial shaft fracture:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPost fracture angulation \u003e20 degrees malalignment D\nBODY PART: KNEE\nJOB TITLE: TRACKMAN\nArthritis knee:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nX-ray knee 0-1 mm cartilage interval with degenerative change D\nMeniscectomy, medial or lateral:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nCollateral ligament tear with laxity:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nCruciate and collateral ligament tear:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nCruciate ligament tear with laxity:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nIntercondylar fracture:\nPost fracture angulation \u003e20 degree angulation D\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nOsteomyelitis, chronic knee:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nMedical record review Frequent episodes of infection requiring treatment D\nX-ray knee 0-1 mm cartilage interval with degenerative change D\nOsteonecrosis:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nX-ray knee 0-1 mm cartilage interval with degenerative change D\nPatellofemoral arthritis:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nX-ray knee: patello femoral joint 0 mm cartilage interval with degenerative change D\nPatellar fracture nonunion with displacement:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nX-ray knee Nonunion and \u003e3 mm displacement D\nPlateau fracture:\nPost fracture angulation \u003e20 degrees angulation D\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPatellectomy:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPatellar, subluxation, recurrent:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nSupracondylar fracture:\nPost fracture angulation \u003e20 degrees angulation D\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nTibial shaft fracture:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPost fracture angulation \u003e20 degrees malalignment D\nBODY PART: KNEE\nJOB TITLE: MACHINIST\nArthritis knee:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nX-ray knee 0-1 mm cartilage interval with degenerative change D\nMeniscectomy, medial or lateral:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nCollateral ligament tear with laxity:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nCruciate and collateral ligament tear:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nCruciate ligament tear with laxity:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nIntercondylar fracture:\nPost fracture angulation \u003e20 degrees angulation D\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nOsteomyelitis, chronic knee:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nMedical record review Frequent episodes of infection requiring treatment D\nX-ray knee 0-1 mm cartilage interval with degenerative change D\nOsteonecrosis:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nX-ray knee 0-1 mm cartilage interval with degenerative change D\nPatellofemoral arthritis:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nX-ray knee 0 mm cartilage interval with degenerative change D\nPatellar fracture nonunion with displacement:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nX-ray knee Nonunion and \u003e3 mm displacement D\nPlateau fracture:\nPost fracture angulation \u003e20 degrees angulation D\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPatellectomy:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPatellar, subluxation, recurrent:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nSupracondylar fracture:\nPost fracture angulation \u003e20 degrees angulation D\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nTibial shaft fracture:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPost fracture angulation \u003e20 degrees malalignment D\nBODY PART: KNEE\nJOB TITLE: SHOP LABORER\nArthritis knee:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nX-ray knee 0-1 mm cartilage interval with degenerative change D\nMeniscectomy, medial or lateral:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nCollateral ligament tear with laxity:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nCruciate and collateral ligament tear:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nCruciate ligament tear with laxity:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nIntercondylar fracture:\nPost fracture angulation \u003e20 degrees angulation D\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nOsteomyelitis, chronic knee:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nMedical record review Frequent episodes of infection requiring treatment D\nX-ray knee 0-1 mm cartilage interval with degenerative change D\nOsteonecrosis:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nX-ray knee 0-1 mm cartilage interval with degenerative change D\nPatellofemoral arthritis:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPhysical examination Valgus deformity, 16-20 degrees D\nPhysical examination Varus deformity, 8-12 degrees D\nX-ray knee: patellofemoral joint 0 mm cartilage interval with degenerative change D\nPatellar fracture nonunion with displacement:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nX-ray knee Nonunion and \u003e3 mm displacement D\nPlateau fracture:\nPost fracture angulation \u003e20 degrees angulation D\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPatellectomy:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPatellar, subluxation, recurrent:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nSupracondylar fracture:\nPost fracture angulation \u003e20 degrees angulation D\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nTibial shaft fracture:\nPhysical examination—range of motion Range of motion: flexion \u003c60 degrees D\nPhysical examination—range of motion Flexion contracture (20 or \u003e degrees) D\nPost fracture angulation \u003e20 degrees malalignment D\nK. Ankle and Foot\nConfirmatory test Minimum result Requirements\nBODY PART: ANKLE AND FOOT\nCONFIRMATORY TESTS\nAnkle fracture:\nMedical record review Documented history of ankle fracture Recommended.\nX-ray: ankle Ankle fracture Highly recommended.\nAnkylosis, ankle:\nX-ray: ankle Extensive joint destruction Highly recommended.\nPhysical examination No mobility Highly recommended.\nArthritis, subtalar joint:\nX-ray: ankle Evidence of significant arthritis: subtalar joint Highly recommended.\nArthritis, talonavicular joint:\nX-ray: ankle Significant arthritis: talonavicular joint Highly recommended.\nAchilles tendon rupture:\nMedical record review Documentation of achilles tendon rupture Highly recommended.\nPhysical examination Rupture of achilles tendon Highly recommended.\nArthritis, ankle:\nX-ray: ankle Significant arthritis Highly recommended.\nHindfoot fracture:\nX-ray: foot and ankle Documentation of fracture Highly recommended.\nRheumatoid arthritis, foot:\nMedical History Documented history of condition Highly recommended.\nX-ray: foot Significant arthritis Highly recommended.\nDisability test Test result Disability classification\nBODY PART: ANKLE AND FOOT\nJOB TITLE: TRAINMAN\nAnkle fracture:\nX-ray: ankle Displaced intra-articular fracture D\nPhysical examination Varus deformity \u003e15 degrees D\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nAnkylosis, ankle:\nPhysical examination—range of motion Ankylosis in 20 degree or ≤ dorsiflexion D\nPhysical examination—range of motion Ankylosis in 20 degree plantar flexion D\nPhysical examination—range of motion Ankylosis in int or ext malrotation \u003e15 degrees D\nPhysical examination—range of motion Ankylosis in varus 10 or more degrees D\nPhysical examination—range of motion Ankylosis in valgus 10 or more degrees D\nArthritis, subtalar joint (hindfoot):\nX-ray: ankle—subtalar joint Subtalar joint space 0 mm D\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nPhysical examination Varus deformity \u003e15 degrees D\nArthritis, talonavicular joint (hindfoot):\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nX-ray: ankle—talonavicular joint Talonavicular joint space 0 mm D\nPhysical examination Varus deformity \u003e15 degrees D\nAchilles tendon rupture:\nPhysical examination—range of motion Plantar flexion capability, \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture, 20 degrees D\nArthritis, ankle:\nX-ray: ankle 0 mm D\nPhysical examination—range of motion Plantar flexion capability, \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture, 20 degrees D\nPhysical examination Varus deformity \u003e15 degrees D\nHindfoot fracture:\nX-ray: foot Calcaneal fracture with Boehler angle \u003c95 degrees D\nX-ray: foot Subtalar fracture with Boehler angle \u003c95 degrees D\nPhysical examination Varus angulation \u003e20 degrees (hindfoot) D\nPhysical examination Valgus angulation \u003e20 degrees (hindfoot) D\nRheumatoid arthritis, foot:\nX-ray: foot Significant degeneration D\nMedical record review Chronic flare-up with treatment D\nBODY PART: ANKLE AND FOOT\nJOB TITLE: ENGINEER\nAnkle fracture:\nX-ray: ankle Displaced intra-articular fracture D\nPhysical examination Varus deformity \u003e15 degrees D\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nAnkylosis, ankle:\nPhysical examination—range of motion Ankylosis in 20 degree or \u003e dorsiflexion D\nPhysical examination—range of motion Ankylosis in 20 degree plantar flexion D\nPhysical examination—range of motion Ankylosis in int or ext malrotation \u003e15 degrees D\nPhysical examination—range of motion Ankylosis in varus 10 or more degrees D\nPhysical examination—range of motion Ankylosis in valgus 10 or more degrees D\nArthritis, subtalar joint (hindfoot):\nX-ray: ankle—subtalar joint Subtalar joint space 0 mm D\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nPhysical examination Varus deformity \u003e15 degrees D\nArthritis, talonavicular joint (hindfoot):\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nX-ray ankle—talonavicular joint Talonavicular joint space 0 mm D\nPhysical examination Varus deformity \u003e15 degrees D\nAchilles tendon rupture:\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nArthritis, ankle:\nX-ray: ankle 0 mm D\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nPhysical examination Varus deformity \u003e15 degrees D\nHindfoot fracture:\nX-ray: foot Calcaneal fracture with Boehler angle \u003c95 degrees D\nX-ray: foot Subtalar fracture with Boehler angle \u003c95 degrees D\nPhysical examination Varus angulation \u003e20 degrees (hindfoot) D\nPhysical examination Valgus angulation \u003e20 degrees (hindfoot) D\nRheumatoid arthritis, foot:\nX-ray: foot Significant degeneration D\nMedical record review Chronic flare-up with treatment D\nBODY PART: ANKLE AND FOOT\nJOB TITLE: DISPATCHER\nAchilles tendon rupture:\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nArthritis, ankle:\nX-ray: ankle 0 mm D\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nPhysical examination Varus deformity \u003e15 degrees D\nHindfoot fracture:\nX-ray: foot Calcaneal fracture with Boehler angle \u003c95 degrees D\nX-ray: foot Subtalar fracture with Boehler angle \u003c95 degrees D\nPhysical examination Varus angulation \u003e20 degrees (hindfoot) D\nPhysical examination Valgus angulation \u003e20 degrees (hindfoot) D\nRheumatoid arthritis, foot:\nX-ray: foot Significant degeneration D\nMedical record review Chronic flare-up with treatment D\nBODY PART: ANKLE AND FOOT\nJOB TITLE: CARMAN\nAnkle fracture:\nX-ray: ankle Displaced intra-articular fracture D\nPhysical examination Varus deformity \u003e15 degrees D\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nAnkylosis, ankle:\nPhysical examination—range of motion Ankylosis in 20 degree or \u003e dorisiflexion D\nPhysical examination—range of motion Ankylosis in 20 degree plantar flexion D\nPhysical examination—range of motion Ankylois in int or ext malrotation \u003e15 degrees D\nPhysical examination—range of motion Ankylosis in varus 10 or more degrees D\nPhysical examination—range of motion Ankylosis in valgus 10 or more degrees D\nArthritis, subtalar joint (hindfoot):\nX-ray: ankle—subtalar joint Subtalar joint space 0 mm D\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nPhysical examination Varus deformity \u003e15 degrees D\nArthritis, talonavicular joint (hindfoot):\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nX-ray: ankle—talonavicular joint Talonavicular joint space 0 mm 0\nPhysical examination Varus deformity \u003e15 degrees D\nAchilles tendon rupture:\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nArthritis, ankle:\nX-ray: ankle 0 mm D\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nPhysical examination Varus deformity \u003e15 degrees D\nHindfoot fracture:\nX-ray: foot Calcaneal fracture with Boehler angle \u003c95 degrees D\nX-ray: foot Subtalar fracture with Boehler angle \u003c95 degrees D\nPhysical examination Varus angulation \u003e20 degrees (hindfoot) D\nPhysical examination Valgus angulation \u003e20 degrees (hindfoot) D\nRheumatoid arthritis, foot:\nX-ray: foot Significant degeneration D\nMedical record review Chronic flare—up with treatment D\nBODY PART: ANKLE AND FOOT\nJOB TITLE: SIGNALMAN\nAnkle fracture:\nX-ray: ankle Displaced intra-articular fracture D\nPhysical examination Varus deformity \u003e15 degrees D\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nAnkylosis, ankle:\nPhysical examination—range of motion Ankylosis in 20 degree or \u003e dorsiflexion D\nPhysical examination—range of motion Ankylosis in 20 degree plantar flexion D\nPhysical examination—range of motion Ankylosis in int or ext malrotation \u003e15 degrees D\nPhysical examination—range of motion Ankylosis in varus 10 or more degrees D\nPhysical examination—range of motion Ankylosis in valgus 10 or more degrees D\nArthritis, subtalar joint (hindfoot):\nX-ray: ankle—subtalar joint Subtalar joint space 0 mm D\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nPhysical examination Varus deformity \u003e15 degrees D\nArthritis, talonavicular joint (hindfoot):\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nX-ray: ankle—talonavicular joint Talonavicular joint space 0 mm D\nPhysical examination Varus deformity \u003e15 degrees D\nAchilles tendon rupture:\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nArthritis, ankle:\nX-ray: ankle 0 mm D\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nPhysical examination Varus deformity \u003e15 degrees D\nHindfoot fracture:\nX-ray: foot Calcaneal fracture with Boehler angle \u003c95 degrees D\nX-ray: foot Subtalar fracture with Boehler angle \u003c95 degrees D\nPhysical examination Varus angulation \u003e20 degrees (hindfoot) D\nPhysical examination Valgus angulation \u003e20 degrees (hindfoot) D\nRheumatoid arthritis, foot:\nX-ray: foot Significant degeneration D\nMedical record review Chronic flare-up with treatment D\nBODY PART: ANKLE AND FOOT\nJOB TITLE: TRACKMAN\nAnkle fracture:\nX-ray: ankle Displaced intra-articular fracture D\nPhysical examination—range of motion Varus deformity \u003e15 degrees D\nPhysical examination—range of motion Plantar flexion capability ≤5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nAnkylosis, ankle:\nPhysical examination—range of motion Ankylosis in 20 degree or \u003e dorsiflexion D\nPhysical examination—range of motion Ankylosis in 20 degree plantar flexion D\nPhysical examination—range of motion Ankylosis in int or ext malrotation \u003e15 degrees D\nPhysical examination—range of motion Ankylosis in varus 10 or more degrees D\nPhysical examination—range of motion Ankylosis in valgus 10 or more degrees D\nArthritis, subtalar joint (hindfoot):\nX-ray: ankle—subtalar joint Subtalar joint space 0 mm D\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nPhysical examination Varus deformity \u003e15 degrees D\nArthritis, talonavicular joint (hindfoot):\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nX-ray: angle—talonavicular joint Talonavicular joint space 0 mm D\nPhysical examination Varus deformity \u003e15 degrees D\nAchilles tendon rupture:\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nArthritis, ankle:\nX-ray: ankle 0 mm D\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination Varus deformity \u003e15 degrees D\nHindfoot fracture:\nX-ray: foot Calcaneal fracture with Boehler angle \u003c95 degrees D\nX-ray: foot Subtalar fracture with Boehler angle \u003c95 degrees D\nPhysical examination Varus angulation \u003e20 degrees (hindfoot) D\nPhysical examination Valgus angulation \u003e20 degrees (hindfoot) D\nRheumatoid arthritis, foot:\nX-ray: foot Significant degeneration D\nMedical record review Chronic flare-up with treatment D\nBODY PART: ANKLE AND FOOT\nJOB TITLE: MACHINIST\nAnkle fracture:\nX-ray: ankle Displaced intra-articular fracture D\nPhysical examination Varus deformity \u003e15 degrees D\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nAnkylosis, ankle:\nPhysical examination—range of motion Ankylosis in 20 degree or \u003e dorsiflexion D\nPhysical examination—range of motion Ankylosis in 20 degree plantar flexion D\nPhysical examination—range of motion Ankylosis in int or ext malrotation \u003e15 degrees D\nPhysical examination—range of motion Ankylosis in varus 10 or more degrees D\nPhysical examination—range of motion Ankylosis in valgus 10 or more degrees D\nArthritis, subtalar joint (hindfoot):\nX-ray: ankle—subtalar joint Subtalar joint space 0 mm D\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nPhysical examination Varus deformity \u003e15 degrees D\nArthritis, talonavicular joint (hindfoot):\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nX-ray: ankle—talonavicular joint Talonavicular joint space 0 mm D\nPhysical examination Varus deformity \u003e15 degrees D\nAchilles tendon rupture:\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nArthritis, ankle:\nX-ray: ankle 0 mm D\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nPhysical examination Varus deformity ≤15 degrees D\nHindfoot fracture:\nX-ray: foot Calcaneal fracture with Boehler angle \u003c95 degrees D\nX-ray: foot Subtalar fracture with Boehler angle \u003c95 degrees D\nPhysical examination Varus angulation \u003e20 degrees (hindfoot) D\nPhysical examination Valgus angulation \u003e20 degrees (hindfoot) D\nRheumatoid arthritis, foot:\nX-ray: foot Significant degeneration D\nMedical record review Chronic flare-up with treatment D\nBODY PART: ANKLE AND FOOT\nJOB TITLE: SHOP LABORER\nAnkle fracture:\nX-ray: ankle Displaced intra-articular fracture D\nPhysical examination Varus deformity \u003e15 degrees D\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nAnkylosis, ankle:\nPhysical examination—range of motion Ankylosis in 20 degree or \u003e dorsiflexion D\nPhysical examination—range of motion Ankylosis in 20 degree plantar flexion D\nPhysical examination—range of motion Ankylosis in int or ext malrotation \u003e15 degrees D\nPhysical examination—range of motion Ankylosis in varus 10 or more degrees D\nPhysical examination—range of motion Ankylosis in valgus 10 or more degrees D\nArthritis, subtalar joint (hindfoot):\nX-ray: ankle—subtalar joint Subtalar joint space 0 mm D\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nPhysical examination Varus deformity \u003e15 degrees D\nArthritis, talonavicular joint (hindfoot):\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nX-ray: ankle—talonavicular joint Talonavicular joint space 0 mm D\nPhysical examination Varus deformity \u003e15 degrees D\nAchilles tendon rupture:\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nArthritis, ankle:\nX-ray: ankle 0 mm D\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nPhysical examination Varus deformity \u003e15 degrees D\nHindfoot fracture:\nX-ray: foot Calcaneal fracture with Boehler angle \u003c95 degrees D\nX-ray: foot Subtalar fracture with Boehler angle \u003c95 degrees D\nPhysical examination Varus angulation \u003e20 degrees (hindfoot) D\nPhysical examination Valgus angulation \u003e20 degrees (hindfoot) D\nRheumatoid arthritis, foot:\nX-ray: foot Significant degeneration D\nMedical record review Chronic flare-up with treatment D\nDisability test Test result Disability classification\nBODY PART: ANKLE AND FOOT\nJOB TITLE: SALES REPRESENTATIVES\nAchilles tendon rupture:\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nArthritis, ankle:\nX-ray: ankle 0 mm D\nPhysical examination—range of motion Plantar flexion capability \u003c5 degrees D\nPhysical examination—range of motion Plantar flexion contracture 20 degrees D\nPhysical examination Varus deformity \u003e15 degrees D\nHindfoot fracture:\nX-ray: foot Calcaneal fracture with Boehler angle \u003c95 degrees D\nX-ray: foot Subtalar fracture with Boehler angle \u003c95 degrees D\nPhysical examination Varus angulation \u003e20 degrees (hindfoot) D\nPhysical examination Valgus angulation \u003e20 degrees (hindfoot) D\nRheumatoid arthritis, foot:\nX-ray: foot Significant degeneration D\nMedical record review Chronic flare-up with treatment D\nJob Information Forms","path":["Title 20—Employees' Benefits","CHAPTER II—RAILROAD RETIREMENT BOARD","SUBCHAPTER B—REGULATIONS UNDER THE RAILROAD RETIREMENT ACT","PART 220—DETERMINING DISABILITY"],"source_url":"https://www.ecfr.gov/api/versioner/v1/full/2026-08-25/title-20.xml","current_through":"2026-08-25","vintage":"","retrieved_at":"2026-08-27T02:24:45Z","sha256":"13b6e430da16b30b5d3ee11e997f1581379074455004dc9a4ae715ed5122aaa1","source_id":"us-cfr","stale":true,"prev":"us/20-cfr-appendix-2-to-part-220","next":"us/20-cfr-221.1"},"notice":"GroundRules: Original legal text. Not legal advice."}