- Permanent impairment {NEL} (degree of impairment) (neck)
- Permanent impairment {NEL} (rating schedule) (AMA Guides)
The worker received initial entitlement for a cervical strain arising from a January 2010 compensable accident and subsequently received a 14% NEL award for injuries to the cervical spine, including abnormal range of motion.
The worker's representative did not dispute the 10% rating for abnormal range of motion. The Vice-Chair confirmed the 10% rating for abnormal range of motion. The worker's representative argued that the worker was entitled to an additional 1% rating under Table 53 of the AMA guides, relying on a definition for "lesion" provided by the National Cancer Institute. The Vice-Chair found that "intervertebral disc or other soft-tissue lesions" under Table 53 of the AMA Guides refers to a disc "lesion," which includes herniated nucleus pulposus. The word "lesion" in Table 53 should not be interpreted based on the definition of the term "lesion" from the National Cancer Institute as that definition was intended to be applied to the field of oncology. Degenerative changes alone do not constitute an intervertebral disc or a soft-tissue lesion in the absence of a significant structural change, such as a herniated disc. The words "lesion" and "degenerative changes" under Table 53 are not synonymous. A disc lesion is not merely any degenerative change, but rather significant structural change to the spine relating to the compression of the nerve root. The Vice-Chair found that, reading Table 53 as a whole, an intervertebral disc or other soft-tissue lesion is more significant than degenerative change alone. In this appeal, the worker was awarded 4% under Table 53 which was consistent with the worker's cervical spine condition. There was no medical evidence of significance to support a higher rating given the absence of any evidence of an intervertebral or soft-tissue lesion. The Vice-Chair confirmed the 4% NEL award for the other injuries to the worker's cervical spine. The Vice-Chair confirmed the rating of the worker's NEL award of 14%.The appeal was dismissed.