We use these guidelines if you received a work-related injury and are curious about the effect of “Scheduled Loss of Use (SLU) on your ankle and foot. Then, you could be eligible for a compensation payment determined by the Workers’ Compensation Board’s regulations.
Our SLU report will conclude that you have permanently lost function in the injured body part due to your work-related accident. The determination of impairment is based on New York state Workers’ Compensation guidelines.
Objectives for Determining Ankle and Foot Impairment
The distal tibia and fibula create the ankle, a mortise joint to provide lower limb stability and promote foot movement. The foot absorbs shock during heel strike and rigid platform during toe-off of the gait cycle. Climbing and descending stairs require dorsiflexion, while plantarflexion helps elevate the body and vehicle or machinery pedal depression.
We must objectively assess a patient’s permanent residual physical deficit due to an injury by evaluating history and physical examination and interpreting diagnostic testing.
Permanent Ankle and Foot Impairment Assessment Methods
We evaluate the degree of permanent residual physical deficit when not expecting further healing during maximum medical improvement (MMI). Therefore, we must determine the MMI based on the clinical treatment course outcome, expertise, and other additional treatment options.
In addition, we will consider the contralateral extremity and expected values when assessing the level of permanent residual physical deficit. Typically, one year from the injury or the last surgery is required to determine the time from the injury to MMI.
We must not assess the permanent residual physical deficit severity of the mechanism of injury. Instead, use the time of MMI, including physical bone, muscle, cartilage, tendon, nerve, blood vessel, or other tissue damage.
Range of Motion of the Ankle
Figure: Percent Loss of Use of the Foot: Flexion Deficits of the Ankle
Figure: Subtalar Joint Motion
Figure: Plantar Motion
Calculating Loss of Use of the Foot
We will assess whether special considerations apply when determining the overall schedule loss of the foot. If no special circumstances exist, add plantar and dorsi flexion deficits. Then, we use the following chart to evaluate other deficits.
First, the maximum loss of the use of the foot must not exceed ankylosis. Then, we adjust the schedule loss of use percentages for the range of motion values.
Table: Foot: Percent Loss of Use of Foot
To determine deficits, we use the following chart to select a deficit and add A + B. Marked deficits must not exceed 50-55%. Then, proportionally adjust the schedule loss of use percentages for the range of motion values.
Table: Other deficits
Table: Complete Loss
Special Considerations for the Foot
We utilize the special considerations when evaluating enumerated schedule loss of use values and add other deficits when specified. However, the maximum schedule loss of use value must not exceed the ankylosis value except when applying for special consideration numbers three and four.
- Substantiate schedule losses by determining permanent residual deficits, including tissue loss, mobility deficits, sensory and motor loss, and impaired function.
- We use a 33 1⁄3-40% loss of use of the foot for os calcis fracture and depending on residual mobility deficits. Then, we allow a leg schedule if heel height loss causes leg shortening.
- We utilize a 75% loss of the use of the foot with ankle fusion. This value exceeds the 60% ankylosis value if the patient presents with other toe deficits.
- We will determine a 66 2⁄3% loss of use of the foot for a complete foot drop and a 20- 331⁄3% loss for a partial foot drop.
- We will consider a higher schedule for a severe residual neurological deficit.
- We use an average 20-25% loss for Achilles tendon rupture.
- We utilize an average 20-30% loss of the foot for malleolar (bimalleolar or trimalleolar) fractures.
Ankle Amputation
We use a 75% loss of leg use for an amputation at the ankle joint.
Please refer to your state’s Workers’ Compensation Board website or speak with your Workers’ Compensation attorney for more information.
