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19.01 - Back Disabilities - General Instructions
- Disabilities of the back (spine) shall be assessed in accordance with the tables to the following articles:
- 19.02 - Cervical Spine
- 19.03 - Dorsal Spine
- 19.04 - Lumbar Spine
- When a disability of the spine is due to a pensioned systemic disease, all manifestations of the pensioned condition, e. g. - rheumatoid arthritis, tuberculosis, Reiter's disease, shall be taken into account when determining the assessment.
- When entitlement is held for disabilities of two or more areas of the spine, the disability in each of these areas shall be considered separately before determining the assessment.
- Entitlement for either disc disease or osteoarthritis is normally assumed to include entitlement for the other of these conditions if located in the same area of the spine, whether cervical, dorsal or lumbar.
- Disability in the 7th cervical - 1st dorsal area shall be assessed as cervical.
- Disability in the 12th dorsal - 1st lumbar area shall be assessed as lumbar.
- Disability in the 5th lumbar - 1st sacral area shall be assessed as lumbar.
- The effects of non- pensioned conditions must be excluded.
- Factors to be taken into consideration in assessing the disability include the symptoms and physical signs of disease resulting from the pensioned condition from time to time, the treatment required and other normal activities.
19.02 - Cervical Spine
The Tables to Article 19.02 are provided as a guide only as the various factors overlap and all elements must be taken into consideration in determining the assessment of disabilities of the cervical spine.
Assessments | Symptoms | Range of Motions | Reflexes | Sensation | Wasting | Medication | Cervical Collar or Traction |
0 to 10% | Recurrent mild neck pain and/ or nerve root symptoms | Loss of up to 30% motion | Normal | Normal | None | Essentially | Occasionally |
10 to 20% | Recurrent moderate to mild relatively persistent neck pain and/ or nerve root symptoms | Range of motion reduced 50% | Normal | Possibly impaired | Possibly minimal | Not continuous | Occasionally |
20 to 30% | Persistent neck pain and/ or nerve root symptoms | Marked reduction | Possibly altered | Possibly impaired | Possibly wasting | Regular medication | Relatively frequent |
Above 30% | 1. Nerve root involvement resulting in impairment or loss of function. 2. Fixation of cervical spine in abnormal position. |
Assessment of cervical spine disability following surgery:
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19.03 - Dorsal Spine
The dorsal spine has less mobility when compared to either the cervical or lumbar spines. Disability in the dorsal spine represents a significantly lesser disability than had the condition involved the cervical or lumbar spine.
Assessments generally fall in the range of Nil to 10%. Very rarely if ever should a dorsal spine disability be assessed at over 10%.
19.04 - Lumbar Spine
The tables to Article 19.04 are provided as a guide only as the various factors overlap and all elements must be taken into consideration in determining the assessment of disabilities of the lumbar spine.
Assessment | Symptoms (see note) | Posture | Range of Motion | Straight Leg Raising | Reflexes and/ or | Wasting | Toe & Heel Walking | Medication | Back Brace |
0 to 10% | Occasional mild pain | Little loss of lumbar lordosis | Nearly full range of motion | 90 degrees essentially painless | Normal | None | No impairment | Essentially nil | No |
10 to 20% | Recurrent mild pain | Slight flattening of lumbar lordosis | Decreased by at least 20% | 60 to 90 degrees back and buttock discomfort | Normal | None | No impairment | Minimal not continuous | No |
20 to 30% | Recurrent moderate or mild continuous pain | Loss of lumbar lordosis and/ or scoliosis | Decreased 30- to 50% alteration of rhythm | Less than 75 degrees radiation beyond buttock | Present may be diminished | Wasting Minimal | No impairment | Mild regular medication | May be worn |
30 to 40% | Moderate relatively constant pain | As for 20 to 30% | Decreased 50% minimal lumbar movement | As for 20 to 30% | Reflex and/ or sensory change probably present | Wasting moderate | Possible alteration | Moderate regular medication | May be worn |
Above 40% | Unusual complications such as alteration of bodily function or intractable pain. |
Assessment | Symptoms (see note) | Posture | Range of Motion | Straight Leg Raising |
0 to 10% | Occasional mild pain | Little loss of lumbar lordosis | Nearly full range of motion | 90 degrees essentially painless |
10 to 20% | Recurrent mild pain | Slight flattening of lumbar lordosis | Decreased by at least 20% | 60 to 90 degrees back and buttock discomfort |
20 to 30% | Recurrent moderate or mild continuous pain | Loss of lumbar lordosis and/ or scoliosis | Decreased 30- to 50% alteration of rhythm | Less than 75 degrees radiation beyond buttock |
30 to 40% | Moderate relatively constant pain | As for 20 to 30% | Decreased 50% minimal lumbar movement | As for 20 to 30% |
Above 40% | Unusual complications such as alteration of bodily function or intractable pain. |
Assessment | Reflexes and/ or | Wasting | Toe & Heel Walking | Medication | Back Brace |
0 to 10% | Normal | None | No impairment | Essentially nil | No |
10 to 20% | Normal | None | No impairment | Minimal not continuous | No |
20 to 30% | Present may be diminished | Wasting Minimal | No impairment | Mild regular medication | May be worn |
30 to 40% | Reflex and/ or sensory change probably present | Wasting moderate | Possible alteration | Moderate regular medication | May be worn |
Above 40% | Unusual complications such as alteration of bodily function or intractable pain. |
(Note: Pain may be lumbar and/ or referred due to nerve root pressure).
Assessment of lumbar spine disability following surgery:
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