Upper Extremities – Elbow

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 elbow. 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 Elbow Impairment

The elbow provides essential hand and wrist positioning and upper extremity functionality. The most significant function of the elbow joint is hand positioning, either elbow extension (moving the hand away from the body) or supination/pronation (precise hand movement).

We must objectively determine if the patient has permanent residual physical deficits due to an injury through a physical examination or appropriate diagnostic testing.

Permanent Elbow 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, we use the time of MMI, including physical bone, muscle, cartilage, tendon, nerve, blood vessel, or other tissue damage.

Elbow Range of Motion

The normal elbow range of motion is 0-150°

Flexion: We measure the angle between the extension and full flexion position of the forearm by beginning at maximum extension. Normal elbow flexion is 150 degrees.

Figure: Elbow Flexion

Figure: Elbow Flexion

Extension: We measure the angle between the forearm’s flexion and full extension position by beginning at maximum flexion. The normal elbow extension is zero degrees.

Figure: Elbow Extension

Figure: Elbow Extension

Calculating Loss of Use of the Elbow

We will begin to assess any special considerations to determine the overall schedule loss of use of the elbow. If there are no special considerations, we calculate the schedule loss of use of the elbow by adding any noted extension and flexion deficits.

The maximum loss of the use of the elbow must not exceed ankylosis when evaluating based on the range of motion.

Table: Elbow: Percent Loss of Use of Elbow

To determine deficits, we add A+B. The maximum loss of the use of the elbow must not exceed ankylosis. We proportionally adjust the schedule loss of use percentages for the range of motion values.

Special Considerations for the Elbow

We utilize the special considerations when evaluating enumerated schedule loss of use values or without a provided schedule value. The maximum schedule loss of use value must not exceed the ankylosis value.

  1. We use a 10% loss of use of the arm for the loss of the radius head and add for mobility deficits.

     

  2. We utilize a 10-15% arm use loss with elbow laxity during hyperextension deficit.

     

  3. We provide a schedule for medial and lateral epicondylitis. Then, we will consider classification if the condition becomes chronic, severe, or disabling.

     

  4. The schedule is dependent on residual deficits when evaluating olecranon fracture or bursitis.

     

  5. We use a 10% loss of use of the arm for bone loss and olecranon excision and add for mobility deficits.

Arm Amputation

Table: Percent Loss of Use of the Arm: Amputation at Different Levels

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

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