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Chapter 19 - Back Disabilities

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19.01 - Back Disabilities - General Instructions

  1. Disabilities of the back (spine) shall be assessed in accordance with the tables to the following articles:
    1. 19.02 - Cervical Spine
    2. 19.03 - Dorsal Spine
    3. 19.04 - Lumbar Spine
  2. 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.
  3. 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.
  4. 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.
  5. Disability in the 7th cervical - 1st dorsal area shall be assessed as cervical.
  6. Disability in the 12th dorsal - 1st lumbar area shall be assessed as lumbar.
  7. Disability in the 5th lumbar - 1st sacral area shall be assessed as lumbar.
  8. The effects of non- pensioned conditions must be excluded.
  9. 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.

Table 1 to Article 19.02 Assessment of Disability of 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.
Table 2 to Article 19.02

Assessment of cervical spine disability following surgery:

  1. Following surgical treatment 30 to 40%
    (Compulsory Reassessment after 6 months)
  2. Ultimate minimum    10%

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.

Table 1 to Article 19.04 Assessment of 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.
Table 1.1 to Article 19.04 Assessment of Lumbar Spine
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.
Table 1.2 to Article 19.04 Assessment of Lumbar Spine
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).

Table 2 to Article 19.04
Assessment of lumbar spine disability following surgery:
  1. Following surgical treatment 40 to 50%
    (Mandatory review in six months)
  2. Ultimate minimum 15%
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