Workers compensation Scheduled Loss

of Use for Hand and Wrist

If you were hurt at work and are wondering what “Scheduled Loss of Use” (SLU) means for your hand and wrist, you’ve come to the correct spot! You could be eligible for a compensation payment that is determined by the Workers’ Compensation Board’s guidelines. Our report will state that because of your work-related accident, you have lost function in the harmed body part that will last a lifetime.

Workers’ Compensation Guidelines for Determining Impairment are followed in our report. The provisions of this article are based on New York state workers compensation guidelines.

We’ll explain how we evaluate your SLU status for your your hand and wrist.

Objectives for Determining Impairment for Hand and Wrist

A crucial component of the finger and thumb movements is the hand and wrist. The wrist also functions as a link between the forearm and hand’s related structures. Complex flexion/extension and radial/ulnar movements of the hand are made possible by the wrist.

Assessing the patient’s permanent residual physical deficits as a result of their injury is the objective of doing the scheduled loss of use. The evaluation should, to the greatest extent feasible, be based on facts discovered during the history and physical examination, as well as any results of necessary diagnostic testing.

Methods we use to Assess Permanent Impairment

At the point of greatest medical improvement, when further healing is not anticipated, the degree of a permanent residual physical deficit is evaluated. Based on the results of the clinical course of treatment, our experience, and any additional treatment alternatives accessible to the patient, the maximum medical improvement is assessed.

Where appropriate, the contralateral extremity and expected/normal values is taken into account by us when determining the degree of persistent residual physical deficit. The interval between an injury and the point of greatest medical progress can vary, although in most situations it is one year after the injury or the most recent surgery.

The mechanism of the injury has little impact on how severe the permanent residual physical deficit is. In addition to physical injury to bone, muscles, cartilage, tendons, nerves, blood vessels, and other tissues, it can also reflect the permanent residual physical deficit at the time of the maximum medical improvement.

Our evaluation of permanent impairment report is truthful, thorough, and impartial. We look at maximum medical improvement; the level of permanent impairment brought on by the accident or condition; and, if appropriate, the percentage of permanent impairment attributable to any prior injuries, pre-existing conditions, or abnormalities.

Our report includes accurate information based on all medical data and investigation findings, as well as the physician’s own clinical examination and history gathering. Our report will also properly cite any further reports or investigations that were used to form an diagnosis (if not already achieved a this stage).

Wrist Range of Motion

 

(a) Dorsi flexion and Palmar flexion of the Wrist (Percent Loss of Use of the Hand)

(b) Pronation – Supination of the Wrist (as measured with the elbow flexed to 90 degrees, and arm adducted along the chest wall).

(c) Lateral Wrist Motion

Calculating Loss of Use

We determine whether any unusual circumstances exist before calculating the wrist’s overall schedule loss of function. If not, we add Palmar Flexion (A) + Dorsi Flexion (B) + Pronation/Supination (C), to the degree there is a deficit in these ranges of motion, to determine the total schedule loss of wrist usage. However, schedule loss of use cannot surpass 55% when there are clear limitations in all wrist motions.

Wrist
Percent Loss of Use of Wrist
Instructions: To the extent there are deficits, add A+B+C or values as indicated per notes.
Maximum value for marked cannot exceed 55%.
Schedule loss of use percentages for ranges of motion values above/below those
depicted here should be adjusted proportionally

 

 

 

 

 

 

 

 

 

We use a lower figure for one deficit and higher figure when both are affected

There is a monetary compensation that compensates you for the reduction in your ability to make a living due to a permanent functional impairment of the wrist brought on by your workplace injury. You loses some of their ability to earn a living depending on the part of the wrist afflicted and the type of permanent disability. The table above compares the alteration in normal range of motion based on severity of physical deficits

Additionally,

  • Complete loss of Palmar flexion equals 25% loss of the hand.
  • Complete loss of Dorsi flexion equals 33⅓ % loss of the hand.
  • Complete loss of both pronation and supination equals 35% loss of use of the hand.
  • Deficits in radial-lateral motion and ulnar motion may be separately considered if other findings in the wrist are normal.

We use the following Special Considerations

We also consider specific factors for schedule loss of use figures. If a deficit is indicated or if a schedule value is not provided, additional deficits may be introduced. Except for Special Consideration Number One listed below, the Maximum Schedule Loss of Use Value cannot, exceed the Value of Ankylosis.

  1. Complete wrist drop, also known as radial nerve palsy, results in a 66 ⅔% loss of hand function; partial wrist drop results in a lower percentage.
  2. The Darrach procedure (resection of the distal ulna) results in a 10% reduction in hand function due to bone loss and mobility issues.
  3. Resection of the “proximal row” carpal bones results in a 20% reduction in hand function due to bone loss alone, plus any mobility issues that may be present.
  4. Navicular fracture – Hold non-union cases for two years. If the X-rays show signs of clinical union (fibrous) and the pain is not severe, schedule loss of hand function. Consider classification when dealing with unusually painful situations.
  5. Hold until X-rays reveal a static situation if you have Kienböck’s disease (aseptic necrosis of the carpal lunate). If the problem is symptomatic, consider classification.
  6. Carpal Tunnel Syndrome: If asymptomatic, schedule one-year post decompression. Consider classification if symptoms persist and grow severe and incapacitating. [Values are listed in Nerve Section 10] .3A]
  7. Depending on the limitations, De Quervain’s disease causes a 7½-20% loss of thumb function with or without surgical release. Give a schedule for loss of hand usage if the wrist has a residual deficit and the hand’s grip strength is compromised.
  8. Depending on the medical findings, the wrist ganglion might range from 0- 7½%percent of the hand.

Amputation

One of the most severe sorts of workplace injuries, amputation has long-lasting effects on a worker’s livelihood and well-being. Where an injury has prevented the body from healing injured bone or tissue, surgical amputation may be required.

It becomes necessary to amputate a damaged limb when it can no longer get blood that carries oxygen and nutrients because the cells begin to slowly degenerate and lose function.

Amputation is always the last option for medical professionals due to the trauma it causes to the body and a claimant’s mental health. An amputee may require months of therapy following surgery and develop post-traumatic stress disorder.

It could imply being unable to make a living after the accident or making less money. The patients quality of life will be forever impacted by any type of amputation.

A wrist amputation results in complete loss of hand function (80 percent loss of use of the arm).

Please refer to the Workers Compensation Board website of your state or speak with your Workers Compensation attorney for more information.

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4.9
Based on 92 reviews
Dr Vaksha, is a great doctor very professional knows what he talking about. Treat patient with upmost respect. Thank You
Troy Spencer
16:46 19 Jan 23
Dr. Karkare is an amazing doctor, very caring and attentive, the girl at the front desk is very kind and helpful. .elizabeth .thank you so much .
blanca ventura
21:32 26 Oct 22
Been going to this place before my accident and after I had my knee surgery. So happy how I been treated and how well I am getting. Thank you all and specially Dr. VAKSHA for everything and getting back on track.
Ita Opico
19:01 25 Oct 22
Love this place From the minute I called I was treated kindly. When I arrived The Dr saw me right away he was compassionate and ordered the appropriate tests for me. I came back in for my follow up and had the same great experience.
Christine Rostock
21:28 23 May 22
Dr Vaksha and Dr karkare are 2 of the best orthopedic doctors around my wife Susan had a very serious broken ankle in March of 2019 she didn't think she was going to walk again Dr vaksha did an excellent surgery on her ankle he said it was his toughest he ever did he put a lot of hardware in her ankle and told her she would be alright she made remarkable recovery thanks to his surgery as of now she regained 100 percent use of her ankle she would highly recommend him to anyone. My own experience with Dr karkare has been wonderful he takes his time with you listens to what you have to say and prescribes various treatments and is very caring I would highly recommend him to anyone I would give both doctors a 10 plus rating we are very happy with them the best.
Harry Jones
23:31 19 May 22
Complete orthopedics is a wonderful place to go when you hurt or injured a great staff and wonderful doctors very knowledgeable and helpful I would recommend this place to all of my family and friends that is in me of orthopedic care I give them 10 thumbs up
Wayne Pemberton
17:39 18 May 22
The staff is very professional and helpful. Dr. Vaksha is excellent. He takes time to listen and offer suggestions to help you get better. I’m very thankful and happy to be a patient here at Complete Orthopedics.
Phoenix Rising
19:54 16 May 22
Dr.Karkare is the best. He listens to everything and explains everything I recommend him to everyone. I am so happy he is my doctor.
Myrna James
00:48 13 May 22
Dr.Kuo is amazing very attentive,caring,and passionate and staff is awsome too.Thank you for everything Dr.kuo.
Erick Murillo
23:17 12 May 22
I was in a car accident November 1 I was referred to Dr. Vaksha For shoulder surgery . I he was amazing he made me feel very comfortable and explained everything that was going to happen from surgery all the way through my physical therapy highly recommend Dr. Vaksha
Yolanda Ojeda
19:37 09 May 22
My appointment with Dr. Vaksha was amazing. Dr. Vaksha was very thorough and kind. I would refer this office to anyone who needs a great orthopedic doctor.
John Senechal
19:54 05 May 22
Scheduling my appointment was quick and easy. The staff was super friendly and down to earth. I was seen on time. The appropriate test, “x-rays” were taken before the conversation with doctor, something I really liked, test for analysis and conversation was done upfront. Dr. V had a great personality and was no BS, straight forward diagnosis and a play on next steps. I am happy I found them and would refer them to friends and family.
Sam
00:46 03 May 22
I have seen Dr. Kuo two times already and he's awesome along with his staff. Very friendly office and I'm glad to be a patient here.
Camaris A
20:01 28 Apr 22
Amazing team!! Very caring, profesional, and friendly!! Dr. Kevin Kuo, you are the best, very passionate, caring, and helping thank you for getting me better and being so kind to me! Elizabeth you the best thank you for you help always and you big smile and positive actitud❤️🙏🏼
breidy valerio
19:01 22 Apr 22
The staff is truly exceptional, they make you feel comfortable and welcomed. The doctors are amazing,always professional, compassionate and great listeners.
Elizabeth Collado
03:25 09 Apr 22
What a great place! The place is clean and organized.The staff is wonderful. Setting up physical therapy is right there as well.I'm so glad I found this place.
Donna Anne
22:45 05 Apr 22
This was my 1st time breaking something in my 27 years on this planet. I was recommended here by a friend Dr. Vashka helped me from day 1 and still continues to check in on me and my healing ankle. Would highly recommend
tyron davis
16:06 01 Apr 22
Brand new office, same great doctors! Rooms are clean, plenty of parking, physical therapy attached, Dr. Karkare and his staff are awesome. Thank you!
Emily B
02:49 24 Mar 22
Dr.VAksha is the best, I love the way he treats me as his patient, he is caring,understanding and very attentive to my needs
Mirna Caballero
14:53 03 Mar 22
Great staff. Dr. Vaksha is awesome and takes the time to listen to his patients. He is very compassionate. I would highly recommend this office.
Bebe Doyle
01:24 23 Feb 22
After suffering from a severe ankle injury Dr. V was able to help me heal and return back to work completely to a job where I stand for 12 hours a day. The office is very clean and I appreciated the reminders of my appointments via phone call and through text. The patient portal made it easy for me to access all my documents including work notes. The office staff is wonderful and Rebecca was able to schedule me with a busy schedule and awesome at answering all of my questions including referring me to a great physical therapy office. I highly recommend this office to anyone who’s looking for knowledgeable and kind orthopedic office.
Elizabeth Birchwell
21:31 28 Jan 21
The staff here are great, I was seen at the time of my appointment and was well taken care of!
Shaun Berry
18:14 07 Jan 21
They are an excellent practice. The front and back office people are amazing and so helpful. Rebecca is such a kind and understanding person. I had an issue with paperwork and she cleared it right up. Dr. Karkare is very knowledgeable, helpful, and caring.
Matt S.
19:31 18 Nov 20
Rebecca K. - What a true burst of sunshine. Very friendly and definitely an asset to the practice!
Laura Aston
18:17 17 Nov 20
Great experience, the Doctor is nice but the staff is incredible. I worked with Linda, who was profession and assisted me beyond what any person has done at other practices. Complete Ortho should be complimented for having such a person on their staff.I highly recommend this place!!!
Joe Allen
17:26 17 Nov 20
Linda and Becca they are so good ever time I come they are very nice I would tell everyone I no to come to this office..
Barbara Victor
16:45 17 Nov 20
I was rear ended in an auto accident , Dr Vashka was recommended by a friend of mine .I was experiencing Back , neck , and shoulder pain . After a thorough examination and given exercises to do at home , I am feeling much better , and I ended up avoiding surgery . The staff at Complete Ortho is extremely attentive and show great care when making an appointment and are very friendly and i never waited more than 5 minutes for my appointment . So I would strongly recommend Complete Orthopedics for any aches and pains that one might be experiencing.....
Bill Becht
04:44 17 Nov 20
It was the afternoon of Friday Sept. 24. We were in Pt. Jefferson and my wife, Mary Ann, broke her hip. We went to Mather Hospital and it was determined that she would have to have an operation to have it repaired. This would be her third time under the knife in the past year. It just so happened that we were very fortunate enough to have Dr. Karkare, who was on standby, perform the surgery. He put in a rod and two screws in her hip. She spent a few days in the hospital and then went to Gurwin rehabilitee for another few weeks.It has now been almost six weeks and we both worked the election the other day. If it wasn’t for Dr. Karkare’s expertise she never would have been able to work. She is able to walk with a walker and is doing physical therapy three times a week.We can not thank the doctor enough for the compassion and dedication that he puts into his work. It allows Mary Ann do the things that she likes to do, even on a limited basis for a while. I know that with her will, perseverance and the great work that the surgeon performed she will be back on her feet in no time.Sincerely:John V. PlumpEast Northport, NY 11731
Jack Harris
14:36 06 Nov 20
In the year of 2018 I was referred to Dr. Karkare because I was experiencing severe knee joint pain. After exhausting physical therapy and trying to labor through the pain, I had to make a quality of life decision. Total knee replacement was the only viable option. Dr. Karkare made my decision easy as he walked me through the whole process from surgery to recovery.On 12/13/19 ( Friday the 13th) I enter Lenox Hill Hospital in great hands. From the time I entered Dr. Karkare’s office for the first time until now, his staff has been amazing. Andrea the medical coordinator walked me through all the paper work and necessary preparations for the surgery. Courtesy and kind would be an understatement. Dr. Karkare went over and beyond from the wellness checks and phone calls all to assure me that I was important to him. This was the right decision no pain and no limp. Complete Orthopedics should be your choice!
Kenneth Randolph
22:18 25 Sep 20
Dr. Vadshka has a great bedside manner. He really takes his time and explains treatment options.
T Lee
12:33 09 Sep 20
I suffered with pain in both knees for years. My orthopedic doctor kept recommending knee replacement . I fought it for years, as I was just afraid. When I had no choice and could barely walk , it was recommended I see Dr. Karkare. We set up a consultation and my wife and I left his office feeling totally confident and comfortable with moving ahead with the surgery. He explained everything to us, and the office staff set everything up for us and made the process easy. So about one month after our initial meeting I had the first knee done. I was up walking mere hours after the surgery, and on the workout machines the next morning. I went home two days after the surgery, and yes walked my daughter down the aisle at her wedding only one week after the surgery without even a cane! Three months later I had the other knee done and went home the very next day. Dr. Karkare put my fears to rest . I would highly recommend him. His expertise gave me my life back. Thank you Dr. Karkare.SincerelyVito Congro
Ethel Congo
23:58 12 Aug 20
Dr Rhodin really cares for his patients. When I see him he makes sure to review my progress in detail.
Micki Cahill
15:03 08 Feb 20
My mom had a total hip replacement by dr karkare. He is the BEST orthopedic doctor.Her incision is almost invisable.She is going back for her other hip next week. The office staff is the best, love Andrea.You wont find a better doctor.
Ryan Brigandi
21:06 13 Jul 18
There is no better Orthopedic doctor you will find. Broke my ankle three places on a Saturday. Called Dr. Karkare. He had is team ready at the hospital and operated on me within 6 hours after my injury. Now After 3 months of great care by him and his staff, I am walking to normalcy.
Spacecom Tel
04:13 23 Mar 18
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