Workers compensation Scheduled Loss of
Use for Upper Extremities – Thumb and Fingers

If you were injured your thumb and fingers at work and you are looking to see what is involved in “Scheduled Loss of Use” (SLU), you’re in the right place! You may be eligible for a compensation payment that is calculated according to the Workers’ Compensation Board’s standards.

Our report will state that because of your job-related injury, you have lost function in your thumb and hand that will never return. We follow Workers’ Compensation Guidelines for Determining Impairment. This post is based on New York state workers compensation guidelines.

We’ll go over how we evaluate you for SLU for your injured thumb and fingers.

Objectives for Determining Thumb and Finger Impairment

The objective is to precisely determine the long-term physical deficit that you experienced as a result of their accident. We will evaluate the damage as a result of a permanent physical impairment brought on by job accidents. The assessment is based on factual information gleaned from the history and physical examination, as well as any relevant diagnostic test results.

Techniques for Evaluating Permanent Impairment

When medical improvement has reached its limit and no further improvement is anticipated, it is necessary to assess the level of permanent residual physical impairment. Maximum medical improvement should be assessed in light of the clinical course of treatment’s results, the medical provider’s experience, and any additional treatment alternatives the patient may have. The consequent detrimental effect of injury to the hand may have substantial effect on the quality of life.

We take into account the contralateral extremity and expected/normal values when assessing the degree of permanent residual physical deficiency. 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 damage has little bearing on how severe the permanent residual physical deficiency 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.

Workers’ Compensation guidelines for Maximum Rating of Body Part

Workers’ Compensation guidelines are followed by us when assessing any permanent physical deficits in the thumb and fingers. The loss or impairment of a single digit must be assessed solely on the digit and not on the hand as a whole. If more than one joint is afflicted, the overall range of motion cannot be greater than the digit’s maximum value.

The overall impairment cannot be greater than 100% of the next largest significant member when multiple digit impairments are taken into account in a single comprehensive rating. Hence the loss of multiple digits, resulting in conversion to a hand impairment, may not exceed 100% schedule loss of the hand.

These pictures show the joints of the hand and their range of motion.


Joints of Thumb. IP is interphalangeal joint. MCP is Metacarpophaleangeal joint. CMC is carpometacarpal joint

Degrees of motion of the interphaangeal joint (IP joint)

Degrees of motion of the Metacarpopalangeal joint (MCP Joint)

CMC Joint Position Measurement

The carpometacarpal joints of the fingers are synovial plane joints that act as the point of contact for the bases of the metacarpal bones and function as the articulation between the carpals and the metacarpals. There are a total of five CMC joints, with the thumb’s carpometacarpal joint being the most specialized and flexible.

Flexion/Adduction/Opposition of the fingers

The majority of the hand’s functions are carried out by these motions (flexion, adduction, and opposition). They enable pinching, prehension, and object manipulation by tip-to-tip contact.

Here’s how it’s measured:

The hand is held flat and facing up, the thumb rotates as it is extended as far over the palm as it can go. This is apparent as the thumbnail location varies. When more rotational degrees are applied in this action, the thumb tip contacts the MCP joints, making the change from full flexion to opposition obvious.

When there is complete opposition, the MCP of the pinky or little finger makes contact with the tip of the thumb (4th finger).

– The pinky’s MCP does not make touch with the tip of the thumb in a slight deficiency (1), but it does so with the ring finger’s MCP. In a medium deficiency (2), the MCP of the middle finger (2nd finger) makes contact with the tip of the thumb, but not the MCP of the ring finger.

When there is a significant deficit (3), just the MCP of the index finger is made touch by the tip of the thumb (the first finger).

Degrees of motion of the carpometacarpal joint (CMC Joint)


Measurement Position for Radial Abduction

Degrees of motion for Radial Abduction

Degrees of motion for Isolated Opposition

Calculating Loss of Use of Thumb

We examine whether any unusual circumstances exist before calculating the total schedule loss of thumb use. If not, we measure each joint separately and sum any deficit values (found in the table below) to determine the schedule loss of thumb function. The lower number is applicable when only one motion deficit (flexion or extension) is present. When flexion and extension are both present, the larger number is used.

Range of motion can be reduced to the sum of two major values when calculating schedule loss of use, and the overall schedule loss of use of the thumb cannot be greater than the value of ankylosis.

Percent Loss of Use of Thumb
Instructions: To the extent there are deficits, add A+B unless a reduction
to the sum of two major values is in order.
Maximum value cannot exceed the value for ankylosis.
Schedule loss of use percentages for ranges of motion values above/below
those depicted here should be adjusted proportionally











If no other deficit exists:

  • A mild impairment of thumb adduction corresponds to a 71.2 percent loss of thumb function.
  • A mild impairment of thumb opposition results in a 10% loss of thumb function.
  • A mild impairment of the radial abduction is equivalent to a 10% loss of thumb function.
  • A higher schedule may be given for more significant impairments in adduction, opposition, or abduction.

Thumb Special Considerations

The following things should be taken into account while making the last adjustment to the fingers.

  1. Loss of active flexion or ankylosis at the CMC joint results in a complete loss of thumb function and is typically accompanied by a wrist deficit, in which case a hand schedule is created.
  2. The CMC joint is primarily the site of the thumb’s abduction and opposition, with potential deficits at the MCP and IP joints. This results in a slight, moderate, or severe reduction of the hand’s pinch and grasp strength. A hand schedule is provided for such circumstances.


DIP Joint

Measuring Proximal Interphalangeal Joint (PIP) Position (Normal range of motion is 100 degrees)

3. Measurement Position for Metacarpophalangeal Joint (MCP) (Normal range of motion is 90 degrees)

MCP Joint

Calculating Loss of Use of Finger

First, evaluate whether any special circumstances need to be taken into account before calculating the overall schedule loss of finger use. If not, each joint should be measured separately and the values (found in the table below) summed to determine the schedule loss of use of the finger. The lower number is applicable when only one motion deficit (flexion or extension) is present. When flexion and extension are both present, the larger number is used.

For losses in all three joints, a reduction to the sum of two major values may be necessary when determining schedule loss of use, and the total schedule loss of use of the finger cannot be greater than the value of ankylosis.

Percent Loss of Use of Finger
Instructions: To the extent there are deficits, add A+B+C unless a reduction
to the sum of two major values is in order.
Maximum value cannot exceed the value for ankylosis.
Schedule loss of use percentages for ranges of motion values above/below
those depicted here should be adjusted proportionally

*Use lower figure for one deficit and higher figure when both are affected







Inquire with your doctor about your development and whether you have reached MMI. A medical report stating that you have reached MMI must be submitted to the Board by your doctor when they make that determination. The report must include an examination of the damaged bodily part and a breakdown of the percentage of functionality that has been irrevocably lost.

The report can indicate, for instance, that you function 50 percent less than you did prior to your accident. Schedule loss of use. The table shows of range of motion in different joints in the finger depending on severity and loss of use

Finger Special Considerations

Special considerations with enumerated schedule loss of use values include the following. When specified, other deficits may be introduced. However, unless special consideration number 5 below applies, the maximum schedule loss of use value cannot be greater than the value of ankylosis.

  1. Mallet deformity: Depending on degree, finger loss might reach 331.3 percent.
  2. Loss of up to 331.3 percent of the trigger finger. If the thumb or index finger is affected, choose the highest value (331.3%).
  3. Flail DIP joint: finger loss of 50%.
  4. A 50% loss of finger function results from the loss of half or more of the distal phalanx.
  5. Dupuytren’s contracture – Prior to schedule examination, there must be an ODNCR and/or ANCR for the condition. The accident or occupational sickness should be the only scheduled loss of use. If an impairment is identified in only one finger, there is a loss of hand function. If there are two or three, a larger schedule may be provided.
    The involvement of the fingers compromises hand functionality, such as grasp strength. It is acknowledged that this may go beyond the worth of the affected finger’s ankylosis.


When multiple digits are affected, loading is the amount that is added to a schedule to account for grasp weakness or other significant loss of function. Convert multiple digit loss to an overall hand schedule when stated. Schedules with one or two digits less than 50% remain in the digits.

To calculate the overall loading value:

  1. To calculate the number of weeks per digit, multiply the percentage of use lost per digit by the statutory maximum number of weeks allowed per digit.
  2. Add the weeks for each digit together to get the “total digit weeks.”
  3. Multiply the “total digit weeks” by the appropriate loading percentage2, then add that amount to the “total digit weeks.”
  4. Divide this figure by the hand’s maximum statutory weeks (2441). To find the percentage of the hand that was lost, multiply the quotient by 100.

Example: a 50% loss of use of the index finger and a 60% loss of use of the thumb is given a 60% load and converted to a hand schedule (Scenario C below).

  1. (A) 50% Loss of Index 23 weeks (50% of 46 weeks)
  2. (B) 60% Loss of Thumb 45 weeks (60% of 75 weeks)
  3. Total Digit Weeks (A plus B) 68 weeks (23 + 45)
  4. Total Weeks including 60% load 108.8 weeks ((68 x 60%)+68)
  5. Converted to Hand Schedule 44.6% ((108.8/244) x 100)

Loading when two digits are affected





The scenarios are compared in the table when there are four different possibilities. Accidents are unplanned events, and as a result, they have varying effects on the finger depending on the type of event.
Per table above:

  • Scenario A – No load is given when one digit has 50% loss of use and another has less than 50% loss of use; instead a separate percentage is given for each finger.
  • Scenario B – The load is 60% and converted to a hand schedule when one digit has 100% loss of use and another digit has 50% loss of use.
  • Scenario C – Schedules of 50% or more in two digits are loaded 60% and converted to a hand schedule.
  • Scenario D – The load is 60% and converted to a hand schedule when there is a 100% bone loss in either the thumb or index finger and a second digit has less than 50% loss of use.

Loading when three or more digits are affected





The table contrasts the circumstances where there are two separate possibilities. Accidents are unplanned events, and as a result, they have various effects according on the type of event; the finger will therefore be impacted in various ways.

Per table above:

  • Scenario A – In cases of loss of three fingers with less than 50% loss of use in each finger, are given a 30% load and converted to a hand schedule.
  • Scenario B – Schedules of 50% or more loss in two or more digits are loaded 60% and converted to a hand schedule.

Loading for Amputations











It can be incredibly devastating to have a work-related injury that necessitates the amputation of a finger or thumb. This can have severe long-term effects on the wounded person’s life. A finger amputation injury can be extremely painful, make it difficult for you to perform daily tasks, and in some cases, require the victim to change their line of work if they are unable to perform their job.

You might be entitled to file a finger amputation at work claim for compensation if an accident at work caused you to suffer a finger injury that required amputation.


The level of amputation determines the residual disability and functional loss. It may be misleading to rely just on initial x-rays or reports. To achieve appropriate closure or improved function, the operative amputation is typically carried out at a higher level. To determine the level of bone loss and the precise level of amputation, additional post-operative x-rays are required if there is any uncertainty.

The schedule loss computation will require this information. In the worst scenarios, a finger, a portion of a finger, or multiple fingers/thumbs may need to be amputated, which would have an immediate impact on your ability to return to work since the majority of jobs require some sort of input from the hand or fingers.

Schedule Loss of Use of the Fingers Due to an Amputation

  1. Complete loss of hand function results from the loss of all fingers at the proximal phalanges.
  2. Loss of the distal phalanx’s tuft tip (combined with bone loss) results in a 15% to 20% reduction in finger function. Add percentage for mobility deficit at the DIP joint if present.
  3. A loss through the base of the tuft results in a 33 ⅓% loss of finger function.
  4. A finger loses 50% of its function if the distal phalanx, or all of it, is lost (no additional values added for mobility impairment at the DIP joint).
  5. Amputation via the DIP joint results in a 50% loss of finger function.
  6. Complete loss of finger function results from the removal of any part of the middle phalanx.
  7. Any damage to the proximal phalanx results in complete loss of finger function.
  8. 75 weeks are equal to a thumb that is completely useless. A load of 120% and a hand regimen are used in situations of amputation close to the MCP joint.
  9. A loss affecting the entire finger and any portion of the ray (metacarpal) results in a 100% loss of digit function, is loaded at a rate of 120%, and is converted to a hand schedule.
  10. In cases where 100% was given for a member, additional schedules may be given for subsequent injuries under certain circumstances, e.g., amputation above the elbow receives 100% loss 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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I had an extremely friendly and personalized medical consult with Dr Karkare. Dr Karkare was very knowledgeable and very professional. His communication skills was extremely good and explained my medical condition in very simple words. The office visit was very helpful in understanding my medical condition. Thank you Dr Karkare
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20:49 25 Sep 23
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22:46 07 Sep 23
Dr Vedant Vaksha had done emergency surgery in 2020 after a traumatic injury.His office at Complete Orthopedics handled the continued care thereafter.Dr V and his staff had been Professional and friendly throughout the process, taking the time to explain all the questions on how to proceed and what to expect.Whenever I needed to speak with Dr V or the office they were a phone call away, without waiting or calling several numbers like in so many other medical offices.The office was accommodating to scheduling to my needs at all times. Dr Vedant Vaksha earned the following5 out of 5 stars, highly recommended.
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20:58 05 Sep 23
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22:30 02 Aug 23
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17:48 14 Jul 23
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14:41 30 Jun 23
Dr. Nakul Karkare is awesome! And patriotic! Thank you, Dr. Karkare for displaying the American Flag in your waiting room, honoring and mourning our military personnel, this Memorial Day, who died while serving in the United States Armed Forces.
00:52 30 May 23
Excellent and skilled orthopedic practice specializing in joint replacements. Dr Karkare was trained at the Hospital for Special Surgery and has excellent results, as do his associates!! Would gladly refer family members to the practice!!
00:24 30 May 23
I had such a wonderful experience with Complete Orthopedics in Stony Brook. Not only did Dr. Kuo fix my broken wrist with such kindness and care, but the office staff, including Billing, Reception and the X-Ray Technician, was always so helpful, going out of their way to ensure that each patient felt welcome, answering any questions with a smile, and ensuring any issues with insurance/billing were handled with the utmost professionalism. I highly recommend their practice!
Victoria DeMatteo
19:49 10 May 23
I'm very happy St. Catherine's sent me to this office for treatment after I broke my collar bone! Unfortunately the break was too severe to repair on its own and I had to have it rebuilt a week after the injury. Dr. Vaksha did a great job fixing it. I'm three months out, and I have full use of the arm and shoulder. The whole office staff is very professional, accommodating, and welcoming. I hope to not need orthopedic services again, but Dr. Vaksha will be my number one choice if I or anyone in family suffers such am injury.
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20:42 08 May 23
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15:02 02 Mar 23
Dr. Kuo knowledgeable and competent surgeon- very good experience and more importantly great result.
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21:23 25 Feb 23
Dr Vaksha was so kind and helpful. He took extra time with us and explained things so thoroughly. Highly recommend. Office very clean.
Susan Bosinius
20:20 19 Feb 23
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.
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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
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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.
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❤️🙏🏼
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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.
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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
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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
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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.
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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