| (4) |
For the loss of: Number of Weeks
| (a) |
Upper extremity
| (i) |
Arm
| (A) |
Arm and shoulder (forequarter amputation) ......................................... 218
|
| (B) |
Arm at shoulder joint, or above deltoid insertion ................................. 187
|
| (C) |
Arm between deltoid insertion and elbow joint, at elbow joint, or below elbow joint proximal to insertion of biceps tendon ....................................... 178
|
| (D) |
Forearm below elbow joint distal to insertion of biceps tendon ........... 168
|
|
| (ii) |
Hand
| (A) |
At wrist or midcarpal or midmetacarpal amputation ............................ 168
|
| (B) |
All fingers except thumb at metacarpophalangeal joints ...................... 101
|
|
| (iii) |
Thumb
| (A) |
At metacarpophalangeal joint or with resection of carpometacarpal bone................................................................................................ 67
|
| (B) |
At interphalangeal joint .......................................................................... 50
|
|
| (iv) |
Index finger
| (A) |
At metacarpophalangeal joint or with resection of metacarpal bone ...... 42
|
| (B) |
At proximal interphalangeal joint ........................................................... 34
|
| (C) |
At distal interphalangeal joint ................................................................ 18
|
|
| (v) |
Middle finger
| (A) |
At metacarpophalangeal joint or with resection of metacarpal bone ...... 34
|
| (B) |
At proximal interphalangeal joint ........................................................... 27
|
| (C) |
At distal interphalangeal joint ................................................................. 15
|
|
| (vi) |
Ring finger
| (A) |
At metacarpophalangeal joint or with resection of metacarpal bone ...... 17
|
| (B) |
At proximal interphalangeal joint ........................................................... 13
|
| (C) |
At distal interphalangeal joint ................................................................... 8
|
|
| (vii) |
Little finger
| (A) |
At metacarpophalangeal joint or with resection of metacarpal bone ........ 8
|
| (B) |
At proximal interphalangeal joint ............................................................. 6
|
| (C) |
At distal interphalangeal joint ................................................................... 4
|
|
|
| (b) |
Lower extremity
| (i) |
Leg
| (A) |
Hemipelvectomy (leg, hip and pelvis) .................................................. 156
|
| (B) |
Leg at hip joint or three inches or less below tuberosity of ischium ...... 125
|
| (C) |
Leg above knee with functional stump, at knee joint or Gritti-Stokes amputation or below knee with short stump (three inches or less below intercondylar notch).................................................................................................. 112
|
| (D) |
Leg below knee with functional stump ................................................... 88
|
|
| (ii) |
Foot
| (A) |
Foot at ankle ........................................................................................... 88
|
| (B) |
Foot partial amputation (Chopart's) ........................................................ 66
|
| (C) |
Foot midmetatarsal amputation ............................................................... 44
|
|
| (iii) |
Toes
| (A) |
Great toe
| (I) |
With resection of metatarsal bone ............................................................ 26
|
| (II) |
At metatarsophalangeal joint ................................................................... 16
|
| (III) |
At interphalangeal joint .......................................................................... 12
|
|
| (B) |
Lesser toe (2nd -- 5th)
| (I) |
With resection of metatarsal bone .............................................................. 4
|
| (II) |
At metatarsophalangeal joint ..................................................................... 3
|
| (III) |
At proximal interphalangeal joint ............................................................ 2
|
| (IV) |
At distal interphalangeal joint ................................................................. 1
|
|
| (C) |
All toes at metatarsophalangeal joints .................................................... 26
|
|
| (iv) |
Miscellaneous
| (A) |
One eye by enucleation ......................................................................... 120
|
| (B) |
Total blindness of one eye ..................................................................... 100
|
| (C) |
Total loss of binaural hearing ............................................................... 109
|
|
|
|