Visual System, Auditory System, Facial Scars, and Disfigurement

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 visual system, auditory system, facial scar, or disfigurement. 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.

Introduction to the Visual System

We aim to evaluate permanent impairment criteria due to visual system dysfunction, including the eyes, ocular adnexa, and visual pathways. In addition, we use a quantifying visual impairment due to a work-related injury and translate it into a payment schedule.

We utilize the following parameters to evaluate visual impairment:

  • The loss of uncorrected or corrected visual acuity of objects at a distance 
  • Visual field loss 
  • Diplopia

Vision is imperfect without the coordinated function of all parameters.

We will schedule a case-by-case basis when evaluating a visible eye and facial deformity. We use the following equipment during eye function assessment:

  1. Distance visual acuity testing charts include the Snellen chart with letters and numbers, the illiterate E chart, and Landolt’s broken-ring chart. 
  2. A Goldmann type or automated perimeter of the visual field extent and recorded in degrees 
  3. Refraction equipment or a report detailing recent refraction or a prescription for glasses 
  4. A handheld light with red glass 
  5. Slit lamp 
  6. Ophthalmoscope

Criteria and Methods for Evaluating Permanent Central Visual Acuity Impairment

We will ensure the chart or reflecting surface is not dirty or discolored. A far-distance test will stimulate infinity at 6 m (20 ft) or at least 4 m (13 ft 1 in).

We measure central vision and record distance with and without prescription glasses. Irregular astigmatism due to corneal injury or disease may improve reduced vision by wearing contact lenses. However, contact lenses are acceptable methods of visual acuity correction without contraindications.

We will record distance visual acuity in Snellen notation with a fraction. The numerator equals the testing distance of feet or meters. The denominator determines the length of where the patient can read the smallest letter with five minutes of arc. The fraction notation does not imply visual acuity percentage.

Use the following procedure to determine central vision loss in one eye.

  1. We measure and record the best central distance visual acuity with and without prescription glasses or contact lenses. 
  2. We use the following table to schedule for uncorrected or corrected visual loss within an injured eye, whichever is more significant.

Table: Visual Loss

Visual Fields

We determine the extent of the visual field by using a perimetric method and a white target. Using the Goldmann 30 cm radius bowl, employ the III/4 e-target in the kinetic mode.

Determining Loss of Visual Field

We utilize the following steps to determine the visual field loss.

  1. We will use eight principal meridians of a visual field chart to plot the visual field extent. 
  2. We evaluate the schedule based on percentage loss.

Figure: Example of Perimetric Charts

We use the perimetric charts to plot the extent of the visual field on the eight principal meridians, separated by 45-degree intervals.

Table: Visual Field Loss

The sum of the eight principal radii fields totals 420, equalling 100% of the industrial visual field efficiency. Next, we will calculate the visual field loss by adding the eight principal meridians of the patient’s peripheral field (x).

x/420 = % Efficiency (y)
100-y% = % Loss to Schedule for Eye

Determining Schedule for Diplopia

To determine the schedule for diplopia, we use a red glass test, chart the magnitude within 30 degrees, and calculate using the table below. Then, we will schedule the loss of the injured eye. Finally, we will combine the diplopia percentage loss with the central vision loss schedule and visual field loss of the injured eye.

Table: Diplopia
We will consider using a 30-degree field.

Hearing Loss

We will wait at least three months from the date of injury or removal from harmful noise exposure (possibly via protective devices) for the patient to file a job-related hearing loss claim. We will consider the last day of the three months of removal of the patient’s date of disablement.

Occupational Hearing Loss

We measure the hearing ability of normal speech and use audiometric tone tests at various sound intensities conducted at frequency levels of 500, 1000, 2000, and 3000 Hertz (Hz).

We will average the results of the four frequency levels and determine the necessary threshold for the patient to hear sound at most 25 decibels (dB), equalling no hearing loss.

We will calculate the hearing loss for every decibel that a hearing ear exceeds 25 dB at 1.5% and upward to 100% at 92 dB. Therefore, a patient’s hearing level is at 41 dB. They have a hearing loss of 24% within that ear.

We will multiply the patient’s greater ear hearing loss by five and add to the percentage of the hearing loss of the reduced hearing ear. Then we will divide the total by six to represent the patient’s overall hearing loss percentage to award benefits.

Traumatic Hearing Loss

A forceful blow to the head and a strong blast of air into the ear may create traumatic hearing loss.

We will use a different method to determine the hearing loss degree due to trauma instead of occupational disease.

We utilize the scale of 250 cycles per second (CPS) to 4000 CPS to measure the hearing loss percentage.

The schedule is 150 weeks for complete hearing loss in both ears and 60 weeks in each ear. First, we calculate the hearing loss by taking the percentage of each ear’s loss, totaling it, and then dividing it by two.

For example:

25% in the right ear
40% in the left ear
= 65% total loss

As a result, we will divide 65% by 2, which equals 321⁄2%.

Facial Scars and Disfigurement

  1. We evaluate facial and neck permanent scars and disfigurement at least one-year post-injury or one year post-operative. 
  2. Limit scars and disfigurement of the neck to the region above the clavicle. 
  3. We use description parameters accurately, such as length, width, color, contour, and the precise location of the scar and disfigurement. 
  4. We utilize specific disfigurements of the eye, ear, nose, and mouth. 
    • Typical eye disfigurements include corneal scaring, iris deficits, and possible total loss of the eye with prosthetics. 
    • Typical nose disfigurements include nasal septal deviation, enlargement, and tissue loss. 
    • Typical lip disfigurements include soft tissue loss, enlargement, and standard lip contour alteration. 
    • Typical ear disfigurements include tissue loss and standard ear contour alteration. 
    • Consult the patient’s dental report if teeth are damaged.

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

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