Rothermel & Wilson, PLLC offers free tools for doctors who perform a schedule loss of use evaluation in a New York workers’ compensation case. The tools follow the Workers’ Compensation Board’s 2018 Guidelines for Determining Impairment.
Schedule Loss of Use Examination Walkthrough Tool (beta)
The walkthrough takes you through a schedule loss of use evaluation one step at a time. It covers the history, the contralateral baseline, three measurements of each motion, special considerations, and the totals by member. Each step quotes and links the section of the Guidelines it applies.
Who it is for
It is for treating physicians and consultants who complete Form C-4.3 for a schedule loss of use. The tool is free, and it needs no account or sign-in. In addition, you can stop at any point, save your work, and finish the evaluation later.
What it prepares
- A worksheet (Word) that you can attach to your report or copy into it.
- A completed Attachment A on the Board’s Form C-4.3 (PDF).
- An exam-room sheet for recording your measurements.
Body parts covered in a schedule loss of use evaluation
The shoulder, elbow, wrist, thumb and fingers, hip, knee, ankle and foot, and toes. It also handles joint replacements, loading of the digits and toes, and high-value schedules.
Nothing you enter leaves your computer. Instead, evaluations are saved as files on your own computer, not on our system.
Open the Schedule Loss of Use Examination Walkthrough Tool · Notes on the law behind it
Proportional SLU calculations
How high-value schedules can be combined in proportion to the function that remains. Proportional SLU calculations
Questions or comments: [email protected]. These tools provide general information, not legal or medical advice. The findings and opinions in any report are the physician’s own.