Guidelines For Work Capacity

CALIFORNIA WORKERS’ COMPENSATION

Guidelines For Work Capacity – Spine and Torso

Guidelines using work capacity as an index apply to neck, back, pelvis, heart, pulmonary and abdominal disabilities.

This is being written to give the evaluator, whether a Primary Treating Physician or a QME/AME, an overview of exactly what type of disability description to give to best describe the patient's limitations and what percentage of disability the description gives. This will be given in more than one format.

First I will recapitulate the disability descriptions as they are listed as categories.

Category Standard Rating

a) Disability Precluding Very Heavy Lifting..……………………………………...................10%

contemplates the individual has lost approximately one- quarter of his pre-injury capacity for lifting.

{A statement "inability to lift 50 pounds" is not meaningful. The total lifting effort, including weight, distance, endurance, frequency, body position and similar factors should be considered with reference to the particular individual.}

b) Disability Precluding Very Heavy Work.......……………………………………................15%

contemplates the individual has lost approximately one- quarter of his pre-injury capacity for performing such activities as bending, stooping, lifting, pushing, pulling and climbing or other activities involving comparable effort.

c) Disability Precluding Heavy Lifting..............……………………………………….............20%

contemplates the individual has lost one-half of his pre-injury capacity for lifting.

{see statement regarding lifting under a) above}

d) Disability Precluding Heavy Lifting, Repeated Bending and Stooping……………25%

contemplates the individual has lost approximately half of his pre-injury capacity for lifting, bending and stooping.

e) Disability Precluding Heavy Work……………………………………………………..........30%

contemplates the individual has lost approximately half of his pre-injury capacity for performing such activities as bending, stooping, lifting, pushing, pulling, and climbing or other activities involving comparable physical effort.

New Disability Precluding Substantial Work……..……………………………………................40%

Contemplates the individual has lost approximately 75% of pre-injury capacity for performing such activities as bending, stooping, lifting, pushing, pulling, and climbing or other activities involving comparable physical effort.

f) Disability Resulting in Limitation to Light Work……………………………….............….50%

contemplates the individual can do work in a standing or walking position, with a minimum of demands for physical effort.

g) Disability Resulting in Limitation to Semi-Sedentary Work..…………………........……..60%

contemplates the individual can do work approximately one-half the time in a sitting position, and approximately one-half the time in a standing or walking position, with a minimum of demands for physical effort whether standing, walking or sitting.

h) Disability Resulting in Limitation to Sedentary Work………………………………..........70%

contemplates the individual can do work predominantly in a sitting position at a bench, desk or table with a minimum of demands for physical effort and with some degree of walking and standing being permitted.

The next listing of guidelines does not have a category letter.

Disability Precluding Squatting and/or Kneeling………………………………….........……5%

Contemplates loss of approximately 90-100% of worker’s pre-injury capacity for squatting and/or kneeling.

Disability Precluding Climbing……………………………………………………..........…...10%

Contemplates loss of approximately 90-100% of worker’s pre-injury capacity for climbing.

Disability Precluding Walking Over Uneven Ground………………………………............10%

Contemplates loss of approximately 90-100% of worker’s pre-injury capacity for walking over rough terrain.

Disability Precluding Climbing, Walking Over Uneven Ground, Squatting, Kneeling, Crouching, Crawling, and Pivoting, or other activities involving comparable physical effort…………………………………………………………………………………...........…..20%

Disability Precluding Prolonged Weight-Bearing……………………………………......................20%

contemplates ability to do work approximately 75% of time in standing and walking position, and requires sitting approximately 25% of time.

Disability Precluding Heavy Lifting, and Precluding Climbing, Walking Over Uneven Ground, Squatting, Kneeling, Crouching, Crawling, and Pivoting, or other activities involving comparable physical effort…………………………………………………..............................................................30%

Disability Precluding Heavy Lifting, Prolonged Weight-Bearing, and Precluding Climbing, Walking Over Uneven Ground, Squatting, Kneeling, Crouching, Crawling, and Pivoting, or other activities involving comparable physical effort……………….40%

Disability Resulting in Limitation of Weight-bearing to Half Time…………………...........40%

Contemplates ability to do work approximately 50% of the time in a standing and walking position, and requires sitting approximately 50% of time.

Note:

1. Need for orthopedic appliances may be considered in conjunction with other elements comprising the disability.

2. When warranted by facts and evidence, additional factors may be considered resulting in a change in the disability rating.

Work Capacity or Subjective Factor as Index ^3,4,5Standard Rating

Disability Resulting from Constant Slight Pain……………………………………….............10%

Contemplates an individual with pain which can be tolerated, nut causes some handicap in performance of activity

Disability Precluding Repetitive Motions of Neck or Back…………………………............15%

Contemplates the individual has lost approximately 50% of pre-injury capacity for flexing, extending, bending, and rotating neck or back.

Disability Resulting from Constant Slight to Moderate Pain…………………………............30%

Disability Precluding Substantial Work……………………………………………...................40%

Disability Resulting from Constant Moderate Pain…………………………...……….........50%

Contemplates an individual with pain which can be tolerated, but causes marked handicap in performance of activity.

Note:

1. Either or both indexes of disability may be used to describe a particular condition. The

final rating is to be based on the index yielding the higher rating.

2. When warranted by facts and evidence, additional factors may be considered resulting

in a change in the disability rating.

3. Guidelines using work capacity as an index apply to neck, back, pelvis, heart,

pulmonary and abdominal disabilities.

4. Guidelines using subjective factors as index apply to neck, back, pelvis and abdominal

disabilities. Subjective disability should be identified as prescribed in 8CCR9727.

5. Objective factors of disability may be considered in conjunction with spine or torso

pain.

Compiled from official material by Dr. Alan Lyons,D.C., A.F.I.C.C. 10-06-1999