Or. Admin. Code § 436-035-0390 - Cranial Nerves/Brain
(1)
Impairment of the first cranial nerve (olfactory) resulting in either complete
inability to detect odors or alteration of the sense of smell is 3%
impairment.
(2) Ratings given for
impairment of the second cranial nerve (optic) are rated based on their effects
on vision under OAR 436-035-0260.
(3) Ratings given for impairment in the third
cranial nerve (oculomotor), fourth cranial nerve (trochlear), and sixth cranial
nerve (abducens) are rated based on their effects on ocular motility under OAR
436-035-0260.
(4) Ratings given for impairment of the fifth
cranial nerve (trigeminal) are as follows:
(a) For loss or alteration of sensation in
the trigeminal distribution on one side: 10%; on both sides: 35%.
(b) The rating given for loss of motor
function for each trigeminal Nerve is 5%.
(c) The rating given for loss of motor
function of both trigeminal Nerves is determined under OAR
436-035-0385 and
436-035-0420.
(5) Ratings given for impairment of the sixth
cranial nerve (abducens) are described in section (3) of this rule.
(6) Ratings given for impairment of the
seventh cranial nerve (facial) are as follows:
(a) No rating is given for loss of sensation
from impairment of one or both facial nerves.
(b) If impairment of one or both facial
nerves results in loss or alteration of the sense of taste, the rating is
3%.
(c) Motor loss on one side of
the face due to impairment of the facial nerve is rated at 15% for a complete
loss, or 5% for a partial loss.
(d)
Motor loss on both sides of the face due to impairment of the facial nerve is
rated at 45% for a complete loss, or 20% for a partial loss.
(7) Ratings given for impairment
of the eighth cranial nerve (auditory) are determined according to their
effects on hearing under OAR
436-035-0250. Other ratings for
loss of function most commonly associated with this nerve include the
following:
(a) For permanent disturbances
resulting in disequilibrium which limits activities the impairment is rated
under the following:
(A) Class 1: 8% when
signs of disequilibrium are present with supporting objective findings and the
usual activities of daily living (ADL) are performed without
assistance.
(B) Class 2: 23% when
signs of disequilibrium are present with supporting objective findings and the
usual activities of daily living can be performed without assistance, and the
worker is unable to operate a motor vehicle.
(C) Class 3: 48% when signs of disequilibrium
are present with supporting objective findings and the usual ADL cannot be
performed without assistance.
(D)
Class 4: 80% when signs of disequilibrium are present with supporting objective
findings and the usual ADL cannot be performed without assistance, and
confinement to the home or other facility is necessary.
(b) Tinnitus which by a preponderance of
medical opinion requires job modification is valued at 5%. No additional
impairment value is allowed for "bilateral" tinnitus.
(8) Ratings given for impairment of the ninth
cranial nerve (glossopharyngeal), tenth cranial nerve (vagus), and eleventh
cranial nerve (cranial accessory) are as follows:
(a) Impairment of swallowing due to damage to
the ninth, tenth, or eleventh cranial nerve is determined under OAR
436-035-0420.
(b) Speech impairment due to damage to the
ninth, tenth, or eleventh cranial nerve is rated under the classifications in
OAR 436-035-0385(8).
(9) Ratings given for impairment of the
twelfth cranial nerve (hypoglossal) are as follows:
(a) No rating is allowed for loss on one
side.
(b) Bilateral loss is rated
as in section (8) of this rule.
(10) Impairment for injuries to the brain or
head is determined based upon a preponderance of medical opinion which applies
or describes the following criteria.
(a) The
existence and severity of the claimed residuals and impairments must be
objectively determined by observation or examination or a preponderance of
evidence, and must be within the range reasonably considered to be possible,
given the nature of the original injury, based upon a preponderance of medical
opinion.
(b) Emotional disturbances
which are reactive to other residuals, but which are not directly related to
the brain or head injury, such as frustration or depressed mood about memory
deficits or work limitations, are not included under these criteria and must be
addressed separately.
(c) The
distinctions between classes are intended to reflect, at their most fundamental
level, the impact of the residuals on two domains: impairment of ADL, and
impairment of employment capacity.
(d) Where the residuals from the accepted
condition and any direct medical sequelae place the worker between one or more
classes, the worker is entitled to be placed in the highest class that
describes the worker's impairment. There is no averaging of impairment values
when a worker falls between classes.
(e) As used in these rules, episodic
neurologic disorder refers to and includes any of the following:
(A) Any type of seizure disorder;
(B) Vestibular disorder, including
disturbances of balance or sensorimotor integration;
(C) Neuro-ophthalmologic or oculomotor visual
disorder, such as diplopia;
(D)
Headaches. [Ratings not included. See ED. NOTE.]
(11) For the purpose of section (10) of this
rule, the Rancho Los Amigos-Revised levels are based upon the "Eight States
Levels of Cognitive Recovery" developed at the Rancho Los Amigos Hospital and
co-authored by Chris Hagen, PhD, Danese Malkumus, M.A., and Patricia Durham,
M.S., in 1972. These levels were revised by Danese Malkumus, M.A., and Kathryn
Standenip, O.T.R., in 1974, revised by Chris Hagen, PhD, in 1999 to include ten
levels, referred to as Rancho-R.
(12) For brain or head injuries that have
resulted in the loss of use or function of any upper or lower extremities, a
value may be allowed for the affected body part(s). Refer to the appropriate
section of these standards for that determination.
(13) Headaches that are not a direct result
of a brain or head injury (e.g., cervicogenic, sensory input issues, etc.) are
given a value of 10% when they interfere with the activities of daily living,
affect the worker's ability to regularly perform work, and require continued
prescription medication or therapy. If a value for headaches is granted under
section (10) of this rule, the value in this section is not granted because it
is included in the impairment value for the episodic neurological
disorder.
Notes
Ratings referenced are available from the agency.
Publications: Publications referenced are available from the agency.
Statutory/Other Authority: ORS 656.726
Statutes/Other Implemented: ORS 656.005, 656.214, 656.268 & 656.726
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