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Rule 11 – Permanent Loss of Physical Functions – Injuries prior to 4/1/95

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11.1000    In addition to the scheduled compensation set forth in 21 V.S.A. § 648, the following compensation is adopted under 21 V.S.A. § 648(18) and (20):

 

11.1100    Teeth.  In the event of injury resulting in the loss of teeth, the employer shall pay as permanent partial disability compensation, in addition to the cost of acquisition of artificial teeth, the following number of weeks for each lost tooth:

 

Each of the eight incisors 4 weeks
Each of the four canine or eye teeth 6 weeks
Each of the four first bicuspids 8 weeks
Each of the four second bicuspids 8 weeks
Each of the twelve molars 8 weeks

 

11.1200    Certain Organs.  In the event of injury resulting in the loss of one of the following organs the employer shall pay as permanent partial disability compensation the following number of weeks:

 

Kidney 100 weeks
Spleen 100 weeks
Single testicle  30 weeks

 

11.1300    Fingers.  In the event of injury resulting in multiple finger loss or loss of use or fractional multiple losses, the employer shall pay as permanent partial disability compensation the following number of weeks:

 

Thumb 62.949 weeks
Index Finger 40.287 weeks
Middle Finger 31.473 weeks
Ring Finger 25.180 weeks
Little Finger 15.107 weeks

 

Compensation for loss of less than one‑half of the first phalange shall be for one‑fourth the period of payment specified for loss of the whole finger. Any Permanent Partial Disability Agreement (Form 22) involving the fractional or total loss or loss of use of one or more fingers or a thumb on the same hand shall be accompanied by a dismemberment chart diagramming the extent of the loss.

 

11.1400    The Back or Spine.  In the event of injury resulting in impairment to the back or spine, not amounting to permanent total disability under 21 V.S.A. § 644, the employer shall pay that percentage of 330 weeks of compensation representing the percentage of permanent partial loss of function to the back or spine.  Any whole person impairment rating derived from the AMA Guides to the Evaluation of Permanent Impairment which is referable to an injury to the back or spine shall be converted to a spinal impairment rating in accordance with the following conversion table:

 

 IMPAIRMENT OF WHOLE

SPINE   PERSON

 IMPAIRMENT OF
WHOLE

SPINE   PERSON

 IMPAIRMENT OF WHOLE

SPINE   PERSON

0%  =    0%

35%   =   21%

70%    =   42%

1%   =    1%

36%   =   22%

71%    =   43%

2%   =    1%

37%   =   22%

72%    =   43%

3%   =    2%

38%   =   23%

73%    =   44%

4%   =    2%

39%   =   23%

74%    =   44%

5%   =    3%

40%   =   24%

75%    =   45%

6%   =    4%

41%   =   25%

76%    =   46%

7%   =    4%

42%   =   25%

77%    =   46%

8%   =    5%

43%   =   26%

78%    =   47%

9%   =    5%

44%   =   26%

79%    =   47%

10%   =    6%

45%   =   27%

80%    =   48%

11%   =    7%

46%   =   28%

81%    =   49%

12%   =    7%

47%   =   28%

82%    =   49%

13%   =    8%

48%   =   29%

83%    =   50%

14%   =    8%

49%   =   29%

84%    =   50%

15%   =    9%

50%   =   30%

85%    =   51%

16%   =   10%

51%   =   31%

86%    =   52%

17%   =   10%

52%   =   31%

87%    =   52%

18%   =   11%

53%   =   32%

88%    =   53%

19%   =   11%

54%   =   32%

89%    =   53%

20%   =   12%

55%   =   33%

90%    =   54%

21%   =   13%

56%   =   34%

91%    =   55%

22%   =   13%

57%   =   34%

92%    =   55%

23%   =   14%

58%   =   35%

93%    =   56%

24%   =   14%

59%   =   35%

94%    =   56%

25%   =   15%

60%   =   36%

95%    =   57%

26%   =   16%

61%   =   37%

96%    =   58%

27%   =   16%

62%   =   37%

97%    =   58%

28%   =   17%

63%   =   38%

98%    =   59%

29%   =   17%

64%   =   38%

99%    =   59%

30%   =   18%

65%   =   39%

100%   =   60%

31%   =   19%

66%   =   40%

 

32%   =   19%

67%   =   40%

 

33%   =   20%

68%   =   41%

 

34%   =   20%

69%   =   41%

 

 

11.1500    Cardiovascular, Respiratory, Hematopoietic, Psychological or Nervous System.  In the event of injury resulting in impairment to the cardiovascular, respiratory, hematopoietic, psychological or nervous system, not amounting to permanent total disability under 21 V.S.A. § 644, the employer shall pay that percentage of 330 weeks of compensation representing the percentage of permanent partial loss of function to that system.

 

11.1510    The injuries and compensation set forth in part 11.1000 of this Rule shall not limit the commissioner’s authority under 21 V.S.A. § 648 (20) to determine compensation for permanent loss to other physical functions not specified in the Act.

 

11.1520    In resolving disputes about degrees of impairment to specific body parts, the Guides to the Evaluation of Permanent Impairment of the American Medical Association and similar recognized and accepted treatises may serve as authority in appropriate cases.

 

11.1530    It shall be the employer’s responsibility to pay for at least one permanency examination and impairment rating from the claimant’s treating physician, notwithstanding its decision to obtain a rating from an independent medical examiner as well if it so desires.  All impairment ratings received by the employer shall be copied to the claimant or his or her attorney.