Impairment Assessment Case Study: Shoulder rotator cuff pathology

May 12, 2016
Impairment Assess.
Patient suffering from rotator cuff pathology of the shoulder

Shoulder: Rotator Cuff Pathology 

A 50 year old male suffered for several years from severe rotator cuff pathology on the left shoulder. The patient did not undergo any operative intervention.

In order to perform an impairment assessment, please familiarise yourself with: American Medical Association Guidelines (4th Edition)


Figure 36, page 3/42

Figure 38, page 3/43

Figure 39, page 3/43

Figure 41, page 3/44

Figure 42, page 3/44

Figure 44, page 3/45

Left Shoulder

According to figure 38, page 3/43

Flexion of 90º equates to 6% of upper extremity impairment (IF%)

Extension of 30º equates to 1% of upper extremity impairment (IE%)

According to figure 41, page 3/44

Abduction of 50º equates to 6% of upper extremity impairment (IABD%)

Adduction of 30º equates to 1% of upper extremity impairment (IABD%)

According to figure 44, page 3/45

Internal Rotation of 45º equates to 3% of upper extremity impairment (IIR%)

External Rotation of 60º equates to 0% of upper extremity impairment (IER%)

The total upper impairment assessment is calculated as the sum of individual values of the right upper extremity.

Fig/Page         Movement      Measurement                        %UEI

38 / 3-43          flexion                          90º                               6%

38 / 3-43          extension                    30º                               1%

41 / 3-44          abduction                    50º                               6%

41 / 3-44          adduction                    30º                               1%

44 / 3-45          internal rotation           45º                               3%

44 / 3-45          external rotation          60º                               0%

                                                                                  Total 17%

The total Upper Extremity Impairment (UEI) equals 17%. This value is then converted into the Whole Person Impairment (WPI) using Table 3, Page 3/20.

The WPI for this patient is 10% according to the guidelines of evaluation of impairment assessment, American Medical Association Guidelines (4th Edition).

Thomas Kossmann

Mr Kossmann is an Orthopaedic and Trauma Surgeon, Independent Medical Examiner. Founder and CEO of Lex Medicus and Co-Founder of Medicus Publishing

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