These notes are general information for physicians completing a schedule loss of use (SLU) evaluation under the New York State Workers’ Compensation Board’s 2018 Impairment Guidelines. They are not legal advice. The physician’s findings and opinions are the physician’s own; the Workers’ Compensation Law Judge and the Board decide the award.
The Guidelines tell the examiner to “first assess whether any special considerations apply” (§5.4, p. 30). Section 5.5 then says:
“The following are special considerations that have enumerated schedule loss of use values. Other deficits may be added when specified or when no schedule value is provided. However, the maximum schedule loss of use value cannot exceed the value of ankylosis.”2018 Guidelines §5.5, p. 32
Read literally, a special consideration could cap the SLU even where the loss of motion is worth more. The Appellate Division and the Board have rejected that result in several situations. The decisions fall into three groups.
In Matter of Blue v New York State Off. of Children & Family Servs., 206 AD3d 1126 [6/2/22], the claimant had chondromalacia patella (special consideration 4, 7½–10%) and a meniscal tear whose range-of-motion deficits both doctors valued at 50%. The Board capped the award at 10%. The court held that result irrational, because a claimant with only the meniscal tear could receive far more than a claimant with the same tear plus chondromalacia, and sent the case back for an SLU value for the impairment from the other diagnosis. The court also noted that the Guidelines “only provide useful criteria that need not be slavishly followed” (id. at 1132 n 5).
In Matter of Garrow v Lowe’s Home Ctrs. Inc., 227 AD3d 1242 [5/16/24], the court held that Blue “is not limited solely to knee impairments” and applies “where a claimant alleges a shoulder impairment due to both a condition encompassed by a special consideration and a diagnosis that is not governed by the special consideration at issue” — there, a biceps rupture (special consideration 6) and a rotator cuff tear.
The Board has added the two values where a separate diagnosis causes loss of motion:
Where the loss of motion and the special consideration arise from the same condition, the Board has awarded the higher of the two values rather than their sum.
One reading of Blue and Garrow is that they require exactly this: the special consideration may not leave the claimant with less than the motion loss alone would give. Note that in Albany Marble the Board took the greater value even though a rotator cuff tear was present; a physician who believes the values should be added should say which deficits come from which diagnosis.
In Matter of Zuhlke v Lake George Cent. Sch. Dist., 220 AD3d 1028 [10/12/23], the Board credited a consultant who testified that the knee motion loss came solely from a tibial plateau fracture, and the court upheld a 15% award under special consideration 7. The court distinguished Blue because there was no separate diagnosis. The later Board decisions in group 2 have awarded the higher range-of-motion value even where the fracture or rupture was the only diagnosis, so the outcome turns on the medical opinion the Board credits.
Two shoulder special considerations build motion into their own text. Special consideration 6 provides that, “taking into consideration mobility and muscle weakness, the schedule can vary up to 33⅓% loss of use of the arm.” Special consideration 5 provides that after the value for resection of the clavicle, the examiner should “add for mobility deficits of the single most notable in relation to functional deficit if present.” Both support adding motion loss to the base value.
The worksheet suggests the greater of the two values, following Albany Marble, with two exceptions. For a clavicle resection it suggests adding, because special consideration 5 says to add the mobility deficit. For a biceps rupture it suggests adding the motion loss to the rupture value up to 33⅓%, because special consideration 6 builds “mobility and muscle weakness” into a value of up to 33⅓%, or the range-of-motion value if that is greater. When you indicate that no diagnosis other than the special consideration causes the motion loss, the worksheet also offers the special-consideration value alone, as in Zuhlke, with your explanation. You choose, and your choice and explanation appear on the worksheet. If you add values because a separate diagnosis causes part of the motion loss, say which deficits come from which diagnosis; that is the fact the Board decides.
Board decisions without a link are cited by employer, WCB case number and filing date. They are available through the Board and commercial legal research services.
“Non-surgical rupture of the long head of the biceps muscle is equal to 10-15% loss of use of the arm. Rupture at distal point of insertion of the biceps is equal to 20% loss of use of the arm. Taking into consideration mobility and muscle weakness, the schedule can vary up to 33 1/3% loss of use of the arm depending on degree of impairment found.”2018 Guidelines §5.5, special consideration 6, p. 32
The Board reads “non-surgical” narrowly. After the Full Board rescinded a panel decision on its own motion, the new panel held that “a ‘non-surgical rupture,’ as that term is used in the Impairment Guidelines, means a biceps tear that was not surgically treated,” that special consideration 6 does not apply where the tear was surgically repaired, and it expressly disavowed earlier panel decisions to the contrary (Moog Inc., WCB G1358839 [3/7/23]). Later panels follow it:
One recent panel applied special consideration 6 after shoulder surgery because the biceps tear itself was not treated. In Brockport State College, WCB G3466099 [2/9/26], the claimant’s surgery included a distal clavicle coplaning, but the long head biceps tear “was not reattached.” The panel found “a 10% schedule loss of use under Special Consideration #6 for the claimant’s non-surgical rupture of the long head of the biceps muscle,” added to the clavicle resection value under special consideration 5, for a 54% schedule loss of use of the arm. The decision does not discuss Moog. Aspire, decided a month later, reached the opposite result where the surgeon debrided the remnants of the biceps tendon, so the operative report matters: say what, if anything, was done to the biceps.
The tool leaves the choice to you. If you apply special consideration 6 to a tear that was operated on, explain why in your report.
The Guidelines limit range-of-motion values to the value of ankylosis (80% of the arm at the shoulder) and say that “the maximum schedule loss of use value cannot exceed the value of ankylosis” (§5.4, p. 30; §5.5, p. 32). Section 1.3 adds:
“When determining the value of a schedule loss of use, the total value of several range of motion deficits should not exceed the value of full ankylosis of the joint. The sum of multiple ankylosed joints of a major member cannot exceed the value of amputation.”2018 Guidelines §1.3(7), p. 7
Special consideration 8 for the shoulder addresses a “high schedule”:
“The schedule given is focused on the highest valued part of the extremity. In case of a high schedule for one given part of the extremity calculate first for the major loss in part involved. For example, amputation at the wrist equals 100% loss of use of the hand or equals 80% loss of use of the arm. If there are additional deficits of the elbow and/or shoulder add 10% to the 80% loss of use of the arm and the final schedule would be 90% loss of use of the arm.”2018 Guidelines §5.5, special consideration 8, p. 32
Under the 1996 Guidelines, which had the same provision, the Board likewise held that it applies only to a high schedule (Nassau County General, WCB 2010 6928 [4/25/08]), and it affirmed a leg schedule found by adding a 23% hip and a 22.5% knee (Cablevision Systems Corp., WCB G0192828 [3/30/12]).
These decisions combine the shoulder with other parts of the arm (elbow, wrist). We have not found a decision that applies special consideration 8, or any other formula, to combine two large values within the shoulder itself, such as motion loss plus a special consideration. Simple addition can approach or pass 100% of the arm; ignoring the smaller value understates the loss.
Start with the highest value. Each further value applies only to the function that is left.
| Example | Simple addition | Proportional reduction |
|---|---|---|
| 60% hip and 50% knee of the same leg | 110% | 60% + (50% × 40%) = 80% |
| 75% elbow and 49% shoulder of the same arm | 124% | 75% + (49% × 25%) = 87.25% |
| 61.33% shoulder motion and 20% biceps rupture | 81.33% | 61.33% + (20% × 38.67%) = 69.06% |
The worksheet offers this method when the values are being added and their sum is 50% or more, the level the Board has described as a “high” schedule for purposes of special consideration 8 (Sunmount DDSO; DOCCS Wende Correctional Facility). It is one objective approach; the Board has not adopted it. In the decisions above the Board instead added a judgment amount for the other parts (10% in Bell and Wende, 15% in BlueLinx, 20% for each elbow in Sunmount); by the proportional reduction, BlueLinx would have been 72.5% (50% + 45% × 50%) rather than 65%.
The step on the worksheet. For each body part, the step “High values and the ankylosis limit” appears when the values add to 50% or more, or when the total exceeds the value of ankylosis. The physician chooses simple addition, the proportional reduction (suggested), 50% when the reduction comes out below 50%, the value of ankylosis when the total is over it, or the physician’s own value with an explanation. Range of motion is not limited to the value of ankylosis automatically; the limit is offered as a choice. The same choices (other than the ankylosis limit) are offered on the “Totals by member” step when several parts of one arm or leg are evaluated.
The Guidelines guide the physician’s opinion but do not replace it. The Appellate Division has repeatedly said that the Guidelines “only provide useful criteria that need not be slavishly followed” (Blue, 206 AD3d at 1132 n 5). In Matter of Ward v NYC Tr. Auth., 214 AD3d 1277 [3/30/23], a physician who “did not believe that a pro forma application of the SLU percentages set forth in the guidelines was warranted” gave lower percentages, and the Board was free to accept that opinion. The same principle lets a physician explain why a value should be higher.
In Matter of Semrau v Coca-Cola Refreshments USA Inc., 189 AD3d 1873 [12/17/20], the claimant had a large hamstring tear. The Guidelines have no provision for the hamstring. The treating orthopedist relied on the special consideration for a quadriceps rupture as the closest match and found a 25% SLU of the leg. The Board awarded nothing because no special consideration applied. The court reversed: the Guidelines expressly allow an SLU for permanent physical damage to muscles and tendons, and “neither the governing statute nor the 2018 guidelines supports the conclusion that a claimant who sustains an otherwise qualifying permanent impairment to a body part of a statutorily enumerated member is not entitled to an SLU merely because that particular body part is not specifically referenced in a special consideration.”
When the Guidelines are silent, identify the most comparable provision and explain the comparison. Examples:
“Deficits should be measured by comparing to the baseline reading of the contralateral member, if appropriate. Using the contralateral is not appropriate where the opposite side has been previously injured or is not otherwise available for comparison.”2018 Guidelines §1.3(3)(b), p. 7
The opposite side is not a proper baseline where it was previously injured, even if that injury left no permanent impairment (Matter of Brooks v New York City Tr. Auth., 234 AD3d 1072 [1/9/25]).
When the opposite shoulder is the baseline and has less than normal motion, there are two ways to account for it:
Which method applies to a given claim is a legal question for the judge. The worksheet can report both. When the opposite shoulder has full motion, the methods give the same result and the worksheet shows one. More: Proportional SLU calculations.
“Instructions: To the extent there are defects select one from the table below. Maximum value cannot exceed the value for ankylosis (70%). Schedule loss of use percentages for ranges of motion values above/below those depicted here should be adjusted proportionally.”2018 Guidelines, Table 7.4, p. 42
Table 7.4 gives flexion values of 10% at 120°, 40% at 90° and 55% at 45°, with ankylosis at 0° equal to 70% of the leg. Figure 7.3(1) prints more points: 110° = 20%, 60° = 50% and 25° = 65%. The worksheet prorates between all of them. Row B gives 7½–10% for an extension deficit of 10–25°, and Figure 7.3(2) shows 10° = 7½–10% and 25° = 10%. The worksheet uses 7½% at 10° and 10% at 25°, prorates in between and from 0° to 10°, and continues at the same rate (1/6% per degree) beyond 25°.
In Matter of Wright v Elmer W. Davis Inc., 231 AD3d 1225 [10/3/24], the Appellate Division agreed that a physician’s proportional adjustment of rows A and B was correct: 85° of flexion = 41.67% and a 30° extension deficit = 10.83%. The worksheet reproduces both figures.
Wright rejected adding the row A and row B values. The court held that row C “does not contain any values for cumulative range of motion deficits that could be adjusted proportionally”: the combined loss is classified as mild (10–15%), moderate (40–45%) or marked (66⅔%) and the row C value for that category is used. There, a moderate flexion loss and a moderate extension loss supported the Board’s 45% award.
The worksheet’s suggestion uses the table proportionally: the larger of the row A (flexion) and row B (extension) values is increased by one half of the smaller when flexion is 90° or better, rising to the full smaller value at 45° (a marked flexion loss). For example, 135° of flexion (2.50%) with a 30° extension deficit (10.83%) gives 10.83% + 1.25% = 12.08%. In Wright, 85° of flexion and a 25° extension deficit — a moderate loss in both — give a value near the Board’s 45% award. The physician may instead classify the combined loss under row C (mild, moderate or marked, lower or higher figure) or enter a value with an explanation. Because the table says to “select one,” the worksheet suggests whichever of row A, row B or row C gives the highest value.
The worksheet follows the same approach as for the shoulder: it suggests the greater of the special-consideration value and the range-of-motion value (Albany Marble Inc.; Frederick H. Wollin), with exceptions where the Guidelines text points the other way. Special consideration 1 (patella excision) says to “add for mobility defects and atrophy of muscles,” and special consideration 9 (ligament laxity) gives no schedule value, while §7.5 allows other defects to be added “when specified or when no schedule value is provided”; for those, adding is suggested. Special consideration 4 sets the chondromalacia value “depending on the defects of motion and atrophy of muscles found”; as with a biceps rupture, the worksheet suggests adding the motion loss up to the top of the range (10%), or the range-of-motion value if it is greater.
The knee cases are the core of this area of law: Blue (chondromalacia with a meniscus tear), Van Trans LLC (10% for chondromalacia plus 20% for motion), Zuhlke (tibial plateau fracture capped at 15% where the motion loss came only from the fracture), and Wollin and Gold Star Feed and Grain LLC (tibial plateau fracture; the Board awarded the higher range-of-motion value). See Special considerations and range of motion.
A good outcome is 35%. Range of motion adds up to 10% (fair: flexion 90° or an extension deficit of 15°) or up to 30% (poor: flexion 30°); the worksheet prorates from 105° of flexion (no addition) and from a 10° extension deficit (no addition), and uses the greater of the two. The table prints “E: < 20°” for a poor result, which the worksheet reads as an extension deficit of 20° or more. Position (alignment, medial/lateral laxity, anteroposterior motion or leg length) adds up to 5% or 10% for the greatest defect, atrophy at mid-thigh adds up to 5% (1.5–2.5 inches) or 10% (more than 3 inches), and chronic complications add up to 10%, to a maximum of 80%. The Guidelines’ example, flexion limited to 30° with 15° of malalignment, gives 35% + 30% + 5% = 70%, and the worksheet reproduces it.
“Instructions: To the extent there are defects add A+B+C; for other defect values see notes. Maximum value cannot exceed the value for ankylosis.”2018 Guidelines, Table 6.4, p. 37
Paired motions. Abduction/adduction (row A) and internal/external rotation (row B) carry the instruction “use lower figure for one defect and higher figure when both are affected.” The worksheet uses the lower figure when only one motion of the pair is limited and the higher figure when both are, prorates between the columns, and below the marked column prorates toward the notes’ values for complete loss of both (33⅓% for abduction and adduction; 30% for both rotations). The table gives one value for each pair, so the greater of the two motions’ values is used. Flexion (row C) is prorated between 90° (10%), 45° (33⅓%) and 25° (66⅔%), and toward ankylosis (80%) below 25°.
Posterior extension. The notes say only that “defects in posterior extension equals 7½-10% loss of use of the leg.” As with the shoulder, a mild defect is taken as a loss of 25% of the normal 30°, with moderate, marked and complete loss at two, three and four times the 7½% or 10% figure; the physician chooses the scale.
Special considerations. Excision of the femoral head and neck (50%) and quadriceps rupture (15–20%) direct adding for mobility defects, so adding is suggested. Quadriceps rupture also appears in the knee chapter at 10–15%; both worksheets let the physician choose which chapter’s value applies. Leg length is prorated at 10% per inch (½ inch = 5%, ¾ inch = 7½%, 1 inch = 10%). The worksheet warns when synovitis or bursitis, a pelvic fracture or a hip fracture is evaluated sooner than two years after the injury, or sooner than six months after hardware removal.
Hip replacement (Table 6.5). A good outcome is 35%. Flexion adds 0 at 90° or better, 10% at 45° and 35% at 25° or less, prorated. Position (leg length discrepancy or mal-rotation, whichever is greater) adds up to 5% for a fair result and 10% for a poor one; atrophy and chronic complications are handled as in Table 7.5; the maximum is 80%. The Guidelines’ example — flexion to 45° and 20° of mal-rotation — gives 35% + 10% + 10% = 55%, and the worksheet reproduces it.
Plantar flexion (40° normal) and dorsiflexion (20° normal) are added under Table 8.4(a) and prorated between the printed points, and below the marked column toward the complete-loss values in Table 8.4(c) (35% each). Where both are marked, Table 8.4(b) gives 40% for “marked defects of both plantar and dorsi flexion”; the worksheet suggests the addition and offers 40% as an alternative. The worksheet warns when the range-of-motion values exceed 50%, because Table 8.4(a) states that “marked defects in all cannot exceed 50-55%,” and limits them to the 60% ankylosis value.
Inversion and eversion. Table 8.4(b) and (c) give values by grade only (mild inversion or eversion alone 7½%; both mild 10%, moderate 17½%, marked 25%; complete loss of inversion 20%, eversion 10%, both 35%). The worksheet takes a mild defect as a loss of 25% of normal (inversion 30°, eversion 20°), moderate 50%, marked 75% and complete 100%, prorates, and adds the result to plantar flexion and dorsiflexion. The physician may instead choose a grade or enter a value.
Values above ankylosis and other members. Ankle fusion (75% where toe defects are also present) and complete foot drop (66⅔%) may exceed 60%. An os calcis fracture is 33⅓–40% “depending on residual mobility defects,” so the worksheet adds the motion loss up to 40%, or uses the range-of-motion value if it is greater; where loss of heel height shortens the leg, the value is given to the leg. Amputation at the ankle is 75% of the leg. Tarsal tunnel syndrome and Morton’s neuroma (Chapter 10) have no values; the physician enters one with the findings.
Extension (row A) is read as the loss of extension: an extension deficit (flexion contracture) of 45° = 25%, 90° = 50% and 125° = 85%. Flexion (row B) is 7½% at 125°, 33⅓% at 90° and 66⅔% at 45°. Both are prorated, toward 90% at complete loss, added, and limited to 90% (ankylosis at 0°). Loss of the radial head and olecranon excision direct adding for mobility defects. Cubital tunnel syndrome is given to the arm when accompanied by defects at the elbow and to the hand when the defects are confined to the hand and fingers (§10.3(B)).
Forearm rotation. Pronation and supination are valued in the wrist table (Table 3.4 row C, a schedule of the hand), though they are measured with the elbow at 90°. By default the elbow worksheet rates them to the hand; the physician may rate them to the arm with an explanation. When the wrist on the same side is also evaluated, they are rated only there.
Palmar flexion (row A), dorsiflexion (row B) and pronation/supination (row C, lower figure for one defect and higher when both are affected) are prorated, below the marked column toward the complete-loss notes (25%, 33⅓% and 35%), and added. The total is limited to 55% where marked defects are present in all wrist motions and otherwise to 60% (ankylosis in a position of function). When the total is 50% or more the worksheet also offers the proportional reduction of high value schedules, or the physician’s own value.
Radial and ulnar deviation. These “may be separately considered if other findings in the wrist are normal,” with no values given. Where the other wrist motions are normal, the physician enters a value. Where they are limited, the worksheet recommends no additional value for radial and ulnar deviation; the physician may still enter one with an explanation.
Special considerations. The Darrach procedure (10%) and resection of the proximal row (20%) direct adding for mobility defects. For carpal tunnel syndrome (10–20% of the hand) the greater of the carpal tunnel and range-of-motion values is suggested; where a separate diagnosis such as a TFCC tear also limits motion, the Board has added them (Verizon, WCB G3556180 [10/24/25]; Daily Pita Bread Bakery Ltd., WCB G2717858 [3/19/25]). De Quervain’s disease is a thumb schedule (7½–20%) unless there is a residual wrist defect with impaired grip, when it is given to the hand. Complete wrist drop (66⅔%) may exceed the ankylosis value.
Measuring. Each joint is recorded as flexion and the extension deficit (the degrees the joint stays short of full extension), three readings each. The arc of motion is flexion minus the deficit. The tables say to “use lower figure for one defect and higher figure when both are affected (flexion/extension)” (Tables 2.4(B), 2.5(B), 9.4(A), 9.5(A)(1)), so the worksheet uses the lower figure when only flexion or only extension is limited and the higher figure when both are.
Fingers (Table 2.5(B)). The DIP, PIP and MCP values are prorated between the degrees in the table and added. Below the marked point the DIP is prorated toward its ankylosis value, 50%. The table gives no ankylosis value for the PIP or MCP alone; the worksheet suggests 75% and 100%, by analogy to Table 9.5(A)(2), which rates the corresponding toe joints 75% and 90–100% and which §9.5 says follow the finger values, and the physician may use another value with an explanation. Where all three joints have values, “a reduction to the sum of two major values may be in order”; the physician chooses between adding all three and the two major values, and the proportional reduction is also offered.
Thumb (Table 2.4(B)). Row A is “select one”: the IP, the MCP, or, when both are limited, the “Both (IP and MCP)” row, which is given only by grade. The worksheet grades it by the average loss of the two joints (as it does for inversion and eversion of the ankle), with the more limited joint and the physician’s own value as alternatives. Row B, CMC flexion and opposition, is graded by the finger the thumb tip reaches; the low figure of the range is suggested. Adduction, opposition and radial abduction are valued only “if no other defects exist.” The amputation levels for the thumb follow WCL §15(3)(n): the loss of the first phalange is one-half of the digit, and more than one phalange is the whole digit; the tip-of-the-tuft value is taken from the finger values in Figure 2.7.
Toes (Chapter 9). The great toe is “select one” from the IP, the MTP, or both joints. The MTP has separate scales for flexion (0–45°) and extension (0–70°); when both are limited the worksheet averages the two losses, with the larger value as an alternative. The smaller toes have no degrees in Table 9.5(A)(1), so each joint is graded on examination (mild, moderate, marked, or total loss of active motion), or measured and valued on the finger scale.
Loading. When several digits of a hand are affected, §2.6 adds a load and converts them to a hand schedule: each digit’s percentage is multiplied by its statutory weeks (thumb 75, index 46, middle 30, ring 25, little 15), the total is loaded (Tables 2.6(a)–(c)), and divided by the 244 weeks of the hand. The Guidelines’ own example, a 50% index finger and a 60% thumb loaded 60%, equals 44.6% of the hand. Where the tables leave gaps (three or more digits with exactly one at 50% or more, or four digits all under 50%), the worksheet suggests the 30% load. Toes are loaded under §9.6 by the same weeks method (great toe 38 weeks, other toes 16, the foot 205): 50% for amputations of two or more toes, 100% of each toe with bone loss through the metatarsals, and 25% when three or more toes have defects. WCL §15(3)(q) provides that two or more digits “may be proportioned to the loss of use of the hand or foot,” so the physician chooses whether to convert. A converted value is combined with the hand and wrist (or ankle and foot) under the hand (or foot).
Where more than one part of the same member is evaluated (for example the shoulder and elbow of one arm, or the hip and knee of one leg), the worksheet adds each part’s final value and, when the total is 50% or more, offers the proportional reduction of high value schedules across all of the values, highest first, with each step of the arithmetic written out; the physician may instead apply a reduction of his or her own with an explanation. The hand, thumb and foot are separate members from the arm and leg, and the worksheet reports them separately. A value is converted to another member only where the Guidelines direct it (for example, losses of several fingers loaded into a hand), using the statutory weeks for each member.
Attachment A of Form C-4.3 asks the physician to state, where there was a prior schedule award to the same body part, the percentage of loss of use attributable solely to the injury being evaluated and the percentage attributable to the prior injury. Whether a prior award is credited is decided by the judge:
Last updated October 17, 2026.
Rothermel & Wilson, PLLC · 48 Dietz Street, Suite E, Oneonta, NY 13820 · This page is general information, not legal advice.