Key Benefits:
Bs. As., 24/6/96
VISTO Law No. 24.557, Resolutions M.T. and S.S. No. 341 dated 11 October 1995 and 423 dated 13 November 1995, the Act of the PERMANENT CONSULTIVE COMMITTEE No. 6 of 20 February 1996, the Award of the Minister of Labour and Social Security of the Nation No. 179 of 1 March 1996 and
CONSIDERING:
That the PERMANENT CONSULTIVE COMMITTEE created by article 40 of the LAW ON RISKS OF WORK and constituted by M.T. and S.S. Resolutions. No. 341/95 and 423/95 was convened on 20 February 1996 in order to issue opinions on the Labour Incapacity Assessment Table provided for in article 8, paragraph 3 of the above-mentioned Act.
That the governmental representation in the PERMANENT CONSULTIVE COMMITTEE presented a Table of Labour Incapacities with the application of weighting factors, among which the possibilities of job relocation and the age of the worker are considered the type of activity.
That the said taba or baremo is the result of a deep technical study in which they have participated, in previous stages, representatives of the organizations of employers and workers.
That the NATIONAL ADMINISTRATION OF SOCIAL SECURITY (ANSeS) 1994, the Evaluation Table for Permanent Labour Incapacities of the PANAMERICAN SALISTATION 1995 and the Standards for the Evaluation and Quantification of the Grade of Invalidities of the PUBLIC OF ENVIRONMENTS, 1994 have been considered for its preparation.
It should also be noted that this Labor Incapacity Assessment Table has been discussed and agreed within the scope of the PERMANENT CONSULTIVE COMMITTEE of the RISK OF WORK, having received the valuable contribution of the technicians of the parties represented in that Committee.
That government and trade union representations have given wide agreement to the Labor Incapacity Assessment Table presented to the PERMANENT CONSULTIVE COMMITTEE of the Law on RISKS OF WORK, therefore voting for its approval.
That the three members of the business representation voted favourably, making a reservation with regard to the weighting factors, while the representative of UNION INDUSTRIAL ARGENTINA abstained, objecting to the percentage incidence that could cause such factors.
That, however, abstention could be interpreted as a passive consent, in the face of reservations raised by the business sector, the mechanism provided for in article 40, paragraph 3, of the Law on RISKS OF WORK was used.
That, therefore, the Minister of Labour and Social Security, in his capacity as Chairman of the PERMANENT CONSULTIVE COMMITTEE created by Law No. 24.557, favourably commended the approval of the Labor Incapacity Assessment Table.
That the awards or opinions emanating from the PERMANENT CONSULTIVE COMMITTEE are intended to prepare the administrative will and, in particular, in the case of subparagraphs (b), (c), (d) and (f) of that article 40, to conform it in accordance with their conclusions, in accordance with the binding nature imposed by the same rule.
That the NATIONAL EXECUTIVE PODER deems it appropriate to approve the decisions of the PERMANENT CONSULTIVE COMMITTEE regarding the Labor Incapacity Assessment Table provided for in Act No. 24.557.
Having complied with the provisions of article 49 final provision 1 of the Law on RISKS OF WORK, it is appropriate, in order to confer the necessary legal certainty all interested parties, that the NATIONAL EXECUTIVE PODER establishes with certainty the date of entry into force of the Law.
That the present decree is issued on the basis of the powers conferred by article 99, paragraph 2, of the NATIONAL CONSTITUTION, and article 8, paragraph 3 of Act No. 24.557.
Therefore,
THE PRESIDENT OF THE ARGENTINA NATION
RIGHT:
Article 1 la Approve the Labor Incapacity Assessment Table that as ANEX I forms an integral part of the present. Art. 2o de Stay as the date of entry into force of the Labour Risks Act on 1 July 1996. Art. 3o . Communicate, publish, give to the National Directorate of the Official Register and archvese. . MENEM. . Jorge A. Rodriguez. . José A. Caro Figueroa. . Alberto J. Mazza.Annex I
TABLA
EVALUATION
OF LABORAL INCACITIES
LEY 24.557
PIELGeneral
THE PIEL LEMISSIONS TO BE ASSESSED, ARE THE PIEL LEVELS OF THE PROFESSIONAL ENVIRONMENTS FIGURED IN THE LISTED, DIAGNOSTICED AS PERMANENT OR SECUELS OF WORKING ACCIDENTS.
The evaluation of the same takes into account: the affected areas, the depth and extent of the injury, the functional impact and the degree of labor difficulty that they cause; depending on these factors, the degree of disability within the established range will be determined.
Elements useful for evaluation: Anamnesis, physical examination and specific complementary studies (slash test, biopsies, immunology, etc.).
| Diagnosis | % Inability |
| 1. C CRONICA DERMATITIS | |
| (by contact or hypersensitivity. With or without photosensitive component) | |
| Recurrent Chronicle with a referral of more than 50% to therapeutic measures and suspension of exposure to the agent, and regular recidiva to the agent's replacement. | |
| A. Any body area except face and hands: | 0-10 % |
| B. Cara: | 5-20 % |
| C. One hand: | 10-30 % |
| D. Two hands: | 15-40 % |
| Recurrent Chronicle with less than 50% remission to therapeutic measures and suspension of exposure to the agent, and regular recidiva to the agent's replacement. | |
| A. Any body area except face and hands: | 0-40 % |
| B. Cara: | 10-30 % |
| C. One hand: | 10-40 % |
| D. Two hands: | 20-60 % |
| 2. Y CRONIC ACTINICA DERMATITIS AND ACTINICO RETICULOIDE | |
| Any body area except face and hands: | 0-30 % |
| Just hands: | 10-30 % |
| Just face: | 10-40 % |
| : Hands and faces: | 20-60 % |
| 3. R RADIODERMATITIS | |
| (value functional commitment) | |
| A . No ulcerative lesions. | |
| B . With ulcerative lesions. | |
| Any body area except face and hands: | A: 0-20 % |
| B: 10-40 % | |
| Just hands: | A: 0-15 % |
| B. 20-50 % | |
| Just face: | A: 0-30 % |
| B: 20-60 % | |
| : Hands and faces: | A-10-40 % |
| B: 20-60 % | |
| 4. _ | |
| (Chronicles with less than 50% referral to therapeutic measures and suspension of labour exposure) | |
| Only plants (evaluate depending on the commitment to the standing station and the march): | 0-40 % |
| One hand (according to functional commitment): | 0-30 % |
| Two hands (according to functional commitment): | 10-50 % |
| 5. AC ACNE | |
| Cloracne: | |
| Commitment less than 50% of body surface: | 0-10 % |
| Commitment over 50% of body surface: | 10-20 % |
| Commitment less than 50% face surface: | 0-25 % |
| Commitment over 50% face surface: | 10-40 % |
| Oleoso: | |
| Commitment less than 50% of body surface: | 0-5 % |
| Commitment over 50% of body surface: | 5-10 % |
| Commitment less than 25% face surface: | 0-15 % |
| Commitment greater than 25 % face surface: | 10-20 % |
| 6. ACION CRONIC HIPOPIGMENT | |
| Commitment less than 50% of body surface | 0-15 % |
| Commitment over 50% of body surface | 5-25 % |
| Face commitment less than 25% | 0-15 % |
| Face commitment greater than 25% | 10-25 % |
| 7. : PORFIRIA CUTANEA TARDA: | |
| If sun exposure causes functional disorders: | 10-40 % |
| 8. _ | 0-20 % |
| 9. : INFECTIONS CRONICAS AND/or SECUELS: | 5-15 % |
| 10. ANAFILAXIA | 0-20 % |
| 11. ) DERMATITIS PRE-CANCEROSS MULTIPES (105) | 10-30 % |
| 12. _ | |
| No deformative sequelae: | 0-15 % |
| With deforming sequelae: | |
| In any body area except faces and hands: | 10-20 % |
| In hands: | 15-30 % |
| In the face: | 20-40 % |
| With partial loss of more than 20% of eyelids, nose or mouth surface: | 30-40 % |
| With loss of vision of one or two eyes by direct invasion (evaluate according to chapter Eyes). | |
| Metastasis: | 90 % |
13. C CICATRIES
The evaluation refers to the Chapters corresponding to the affected area.
14. You'll burn
Burns can be caused by physical, chemical or radiant elements.
Evaluation methods:
The superficial lesions that heal without leaving scars or sequelae, will not be a reason for evaluation.
To determine the degree of incapacity caused by a burn, we must take into account its extension, depth, commitment to joint mobility and aesthetic sequelae.
The evaluation of the loss of mobility must be carried out in accordance with the chapter on osteoarticular lesions.
To quantify the extent of the injury, the "Rule of Nine" will be applied, where 36 % of the body surface is assigned to the chest and back, 36 % to the two lower members, 18 % to both superior members, 9 % to the head and 1 % to the genitals (male or female).
The depth of burns is assessed as follows:
Type A (superficial or epidermal);
Type AB (epidermis and dermis);
Type B (demis to aponeurosis or bone)
The type "A" or first degree will be assigned 50% of the percentage of the extent of the injured body surface. In the case of the type "AB" or of the second degree, a percentage equal to the affected area will be set; finally, the type "B" or third degree will be assigned twice the extent of the complained sector.
Thus, for example, a burn from the previous part of the left arm, which involves the anterior side of the elbow and does not reach the hand of the type AB, will correspond to an inability according to the following detail:
| Functional limitation of elbow by retraction from 150a He's 70.a (flexo-extension) extension of the burn depth or type AB The summary gives us: 27% incapacity. | 20% 3.5 % 3.5 % |
Another example: the burn of the external genitals in a man with a retraction in the abduction between both lower and type AB members.
In this case it would correspond:
| Limitation on abduction in both lower members (similar anchilosis in abduction) Extension of burn Type of burn "AB" The summary gives us: 32% incapacity. | 30% % % |
Another example: the burn of the previous face of the inf member with limitation of the bending of knee, of type B.
In this case it would correspond:
| Limitation on knee extension (flexoextension from 150th to 20th) Extension of burn: Type of burn "B": The summary gives us: 47% incapacity. | 20% 9 % 18 % |
The commitment of structures located in the affected area (e.g., eyes), will be evaluated according to the relevant chapters.
15. S COMMISSIONS PRODUCTED BY ACTION OF ANIMALS PONZOÑOS
The local commitment will be valued, according to the item relating to Burns; for the functional limitation of the osteoarticular structures it refers to the corresponding Chapter.
The general manifestation of the toxic action of the venom of snakes and of the scorpions, will be valued according to the consolidated sequel, for which it is referred to the corresponding Cap.
OSTEOARTICULARGeneral
FOR THE EVALUATION OF OSTEOARTICULAR AFFECTIONS TO BE TAKEN IN ANATOMO-FUNCIONAL SECUELS DERIVED FROM A WORKING ACCIDENT OR A PROFESSIONAL ENFERMEDY.
For diagnosis, the clinic will be used primarily and in case of suspected simulation, support tests such as simple x-rays, electrophysiological studies, Computed Axial Tomography (TAC - scanner), Magnetic Nuclear Resonance, somatosensitive potentials, among others.
Fractures that consolidate well without leaving any sequel (muscular, neurological, etc.), will not be grounds for economic restitution and will be considered temporary incapacity.
Pure pain, not accompanied by objective signs of organicity, will not be the goal of permanent incapacity. In these cases, the use of support reviews will be indicated.
In patients affected by multiple invalidities of anatomical and/or futional lesions in the same body segment, the sum of all of them will be applied for the calculation of total invalidity. The final result will have as much the percentage of incapacity given by the complete loss (amputation of the studied segment).
If the worker previously submits, limitation of the movements of one or more joints, the remaining capacity of the joints will be taken as normal and the calculations of the new rigidity proportionally to the remaining capacity will be made.
| The segments to consider are: | 1. COLUMNA | VERTEBRAL |
| CERVICAL | ||
| DORSOLUMBAR | ||
| SACROCOXIS | ||
| 2. CA TORACIC CAJA | ||
| 3. _ | ||
| 4. MI MISBRO INFERIOR | ||
COLUMNA VERTEBRAL
(1) The limitation of the mobility and/or anchilosis of the spinal column to be evaluated for the purposes of this law is what results from the vicious consolidation or aftermath of industrial accidents.
(2) In cases of mobility limitation, when several movements are affected, the degree of disability of each of them is arithmetic.
(3) In cases in which the column is overwhelmed, the greatest value for anchilosis corresponds to the overall inability of the column.
(4) Anatomical alterations and limitations in the cervical and/dorsolumbar sectors combine with each other when they coexist.
(5) By "clinical" alterations is understood strength, tone, trophy and reflexes. The limitation of mobility is valued apart in arithmetic way.
6) If the eventual neurological commitment to the incapacity assessed by osteoarticular sequel is not contemplated, the same, determined in the corresponding Cap, will be combined with this.
Vicious Consolidation Fracture Sequelas
| Verbral body fracture, with stabbing, with no radicular lesion | 0-15 % |
| Indictment less than 30th | 15-30 % |
| Accusation over 30th | |
| Operated vertebral body fracture, with mild or moderate radicular lesion, electromographically corroborated | 10-15 % |
| Operated vertebral body fracture, with severe root injury, electromographically corroborated | 20-35 % |
| Verbral body fracture, operated, without sequelae | 5 % |
| Fracture of thorny apophysis without sequelae | 0 % |
| Fracture of transvera apophysis without sequelae | 0 % |
| Verbral body fracture, no sequelae | 0 % |
| Verbral body fracture, with mild to moderate radicular stabbing and injury, electromographically corroborated | 10-25 % |
| Verbral body fracture, with severe chesting and root injury, electronically corroborated | 15-40 % |
| Post-traumatic cervicobrachialgia, without clinical, radiographic or electromiographic alterations | 0 % |
| Post-traumatic cervicobrachialgia, with clinical, radiological and electromiographic alterations mild to moderate | 5-25 % |
| Hernia de disco operada, sin secuelas | 5 % |
| Inoperable disc hernia (according to medical criteria) | 20-30 % |
| Operated disk hernia, with clinical sequelae and mild electroriomiographic | 10-15 % |
| Operated disk hernia, with moderate clinical sequelae and electromiographic | 15-20 % |
| Operated disk hernia, with severe clinical sequelae and electromiographic | 20-40 % |
| Traumatic spondylolistis without electromographic impact | |
| Grade I: | 0-2 % |
| Grade II: | 2-4 % |
| Grade III: | 4-6 % |
| Grade IV: | 6-10 % |
| Traumatic spondylolistis, with mild to moderate electromographic impact | 10-15 % |
| Traumatic spondylolistis, with severe electromographic impact | 20-40 % |
| Traumatic spondylolistesis, operated, without electromographic sequel | 0 % |
| Traumatic spontaneous, operated, with mild to moderate electromographic sequel | 10-15 % |
| Traumatic spondylolistesis, operated, with severe electromyographic sequel | 20-40 % |
| Post-traumatic lumbalgia without clinical, radiographic or electromographic alterations | 0 % |
| Post-traumatic lumbalgia, with moderate clinical and radiographic alterations, without electromographic alterations | 0-5 % |
| Post-traumatic lumbalgia with severe clinical and radiographic alterations, without electromographic alterations | 5-10 % |
| Lumbociatalgia, without clinical, radiographic or electromiographic alterations | 0 % |
| Lumbociatalgia, with clinical and radiographic alterations and/or electromiographic, mild to moderate | 5-10 % |
Functional limitation
It will only be assessed on those resulting from industrial accidents.
The 0o is taken with the head and the trunk looking forward.
Cervical Column
Tour from 0o to:
| Extension | Rotation | Inclination | Flexion | |
| 0o | 4% | 2 % | 4% | 4% |
| 10th | 2 % | 2 % | 3 % | 3 % |
| 20th | % | % | % | % |
| 30th | 0 % | % | 0 % | 0 % |
| 40oa 70o | 0 % |
Column Dorsolumbar
Tour from 0o to:
| Rotation D.I. | Inclination D.I. | Flexion | Extension | |
| 0o | 5 % | 4% | 9 % | 3 % |
| 10th | 4% | 2 % | 8 % | 2 % |
| 20th | 2 % | 0 % | 7 % | % |
| 30th | 0 % | 6 % | 0 % | |
| 40o | 5 % | |||
| 50o | 4% | |||
| 60o | 3 % | |||
| 70o | 2 % | |||
| 80o | % | |||
| 90th | 0 % |
Limitation percentages are added arithmeticly when there are several affected movements.
Anquilosis
Anquilosis in:
Cervical Column
| Rotation | Inclination | Flexion | Extension | |
| 0o | 20% | 20% | 20% | 20% |
| 10th | 27 % | 25 % | 27 % | 27 % |
| 20th | 33 % | 30% | 33 % | 33 % |
| 30th | 40% | 35 % | 40% | 40% |
| 40o | 40% |
Column Dorsolumbar
| Rotation | Inclination | Flexion | Extension | |
| 0o | 30% | 30% | 30% | 30% |
| 10th | 40% | 45 % | 33 % | 40% |
| 20th | 50% | 60% | 37 % | 50% |
| 30th | 60% | 40% | 60% | |
| 40o | 43 % | |||
| 50o | 7% | |||
| 60o | 50% | |||
| 70o | 53 % | |||
| 80o | 57 % | |||
| 90th | 60% |
The total percentage per anchilosis is the one that corresponds to the highest figure for such a condition, the partial results are not added.
CAJA TORACICA
Victim Consolidation - Sequelas de fractures
| Sterno-clavicular luxury | without disability |
| sternum-costal luxury | without disability |
| Bilateral sternum-condral disarticulation, with paradoxal breathing and resp. insufficiency without therapeutic solution | up to 70% |
| Uncomplicated breast fracture | without disability |
| Fracture of complicated breast | according to sequels |
| Fracture of a rib | without disability |
| Multiple coastal fractures, with respiratory complication | according to sequels |
| Multiple coastal fractures, without complication | without disability |
_
In cases of anatomical and/or functional injury of the most skilled member, 5% of the calculated disability rate will be added. In the event that there are percentage ranges, the criterion to be followed for the determination of the percentage in the particular case will be based on the recovery of the functionality of the member and the prosthesis placed.
Amputations
| Interscapulotoric amputation | 70% |
| Smokeral scapular disarticulation | 66 % |
| Amputation at arm level | 66 % |
| Elbow disarticulation | 40-60 % |
| Amputation at the level of 1/3 above forearm | 40-60 % |
| Amputation at the level of 1/3 medium forearm | 40-60 % |
| Amputation at level of 1/3 inner forearm | 40-60 % |
| Amputation of both hands | 100% |
| Hand amputation | 40-60 % |
| Transmetacarpian hand amputation | 40-60 % |
| Amputation of the five fingers | 40-60 % |
| Amputation of the ten fingers | 100% |
| Amputation of the four fingers minus the thumb | 40% |
| Metacarpophalagic thumb amputation | 30% |
| Amputation at the level of the 1st thumb phalange | 25 % |
| Amputation at the level of the interfalagic thumb | 15% |
| Distal amputation of the last fallacious portion of the thumb | 8 % |
| Amputation at the level of metacarpophalagic index | 14 % |
| Amputation at the level of the proximal interphalagic index | 11 % |
| Amputation at the level of the distal interphalagical index | 9 % |
| Distal amputation of the last portion of the index | 6 % |
| Amputation at the level of the major metacarpophalagic | 11 % |
| Amputation at the level of the highest proximal interphalagic | 8 % |
| Amputation at the level of the most distal interfalangic | 6 % |
| Distal amputation of the last falange of the elder | 2 % |
| Amputation at the level of the metacarpofalángica del anular | 8 % |
| Amputation at the level of the proximal interphalagic of the annular | 6 % |
| Amputation at the level of the interfalángica distal of the anular | 5 % |
| Distal amputation of the last falange of the annular | 3 % |
| Amputation at the level of meñique metacarpofalángica | 5 % |
| Amputation at the level of the proximal interphalagic of the masquerade | 4% |
| Amputation at the level of the interfalángica distal del meñique | 3 % |
| Distal amputation of the last phalange of the little girl | % |
Sequels of fractures
These percentages will be added arithmeticly to those corresponding to the functional impact of peripheral nerve injury, not being able to be greater to the amputation of that segment.
Fractures that consolidate without complications will not be a cause of labor incapacity.
| Grape fracture with deformed callus, angulation and/or shortening | 10% |
| Scaphoid fracture with necrosis | 10-20 % |
| Scaphoid fracture with necrosis and arthrosis | 15% |
| Scaphoid fracture with pseudoartrosis | 15% |
| Scaphoid resection | 10-15 % |
| Consolidated semi-lunar fracture, with necrosis | 6-9 % |
| Semi-lunar fracture with necrosis and arthrosis | 6-9 % |
| Semi-lunar resection | 6-9 % |
Shoulder
Functional limitation
Abdo - Elevation
From 0o to:
| 0o | 10-20 % |
| 10th | 10-20 % |
| 20th | 8-15 % |
| 30th | 8-15 % |
| 40o | 7 % |
| 50o | 7 % |
| 60o | 6 % |
| 70o | 5 % |
| 80o | 5 % |
| 90th | 4% |
| 100o | 4% |
| 110o | 2 % |
| 120o | 2 % |
| 130o | % |
| 140o | % |
| 150o | 0 % |
Aduction
From 0o to:
| 0o | 6 % |
| 10th | 5 % |
| 20th | % |
| 30th | 0 % |
Previous elevation
From 0o to:
| 0o | 10% |
| 10th | 9 % |
| 20th | 8 % |
| 30th | 8 % |
| 40o | 7 % |
| 50o | 7 % |
| 60o | 5 % |
| 70o | 5 % |
| 80o | 4% |
| 90th | 4% |
| 100o | 3 % |
| 110o | 2 % |
| 120o | 2 % |
| 130o | % |
| 140o | % |
| 150o | 0 % |
Further lifting
From 0o to:
| 0o | 2 % |
| 10th | 2 % |
| 20th | % |
| 30th | % |
| 40o | 0 % |
Internal rotation
From 0o to:
| 0o | 4% |
| 10th | 3 % |
| 20th | 2 % |
| 30th | % |
| 40 to 80o | 0 % |
External rotation
From 0o to:
| 0o | 8 % |
| 10th | 7 % |
| 20th | 7 % |
| 30th | 5 % |
| 40o | 5 % |
| 50o | 4% |
| 60o | 3 % |
| 70o | 2 % |
| 80o | % |
| 90th | 0 % |
Anquilosis
Anquilosis in:
| Abdoeleva | Aduc. | Lift up. | Eleva post. | Rot. I. | Rot. E. | |
| 0o | 36 % | 36 % | 36 % | 36 % | 36 % | 36 % |
| 10th | 34 % | 44 % | 32 % | 42 % | 42 % | 30% |
| 20th | 31 % | 52 % | 28 % | 48 % | 48 % | 24 % |
| 30th | 28 % | 60% | 24 % | 54 % | 54 % | 29 % |
| 40o | 25 % | 27 % | 60% | 60% | 34 % | |
| 50o | 26 % | 30% | 40% | |||
| 60o | 29 % | 33 % | 44 % | |||
| 70o | 32 % | 36 % | 50% | |||
| 80o | 36 % | 39 % | 55 % | |||
| 90th | 40% | 42 % | 60% | |||
| 100o | 42 % | 45 % | ||||
| 110o | 46 % | 48 % | ||||
| 120o | 50% | 51 % | ||||
| 130o | 53 % | 54 % | ||||
| 140o | 56 % | 57 % | ||||
| 150o | 60% | 60% |
Cod
Functional limitation
Flexo extension
| Retained in: | % | From 150 to: | % |
| 0o | 60% | 0o | 0 % |
| 10th | 57 % | 10th | % |
| 20th | 55 % | 20th | 2 % |
| 30th | 50% | 30th | 4% |
| 40o | 50% | 40o | 5 % |
| 50o | 45 % | 50o | 10% |
| 60o | 40% | 60o | 15% |
| 70o | 35 % | 70o | 20% |
| 80o | 30% | 80o | 25 % |
| 90th | 25 % | 90th | 30% |
| 100o | 8 % | 100o | 35 % |
| 110o | 6 % | 110o | 40% |
| 120o | 5 % | 120o | 45 % |
| 130o | 3 % | 130o | 50% |
| 140o | 2 % | 140o | 55 % |
| 150o | 0 % | 150o | 60% |
Pronation or Supination
From 0o to:
| (for each side) | |
| 10 | 7 % |
| 20th | 6 % |
| 30th | 5 % |
| 40o | 4% |
| 50o | 3 % |
| 60o | 2 % |
| 70o | % |
| 80o | 0 % |
Anquilosis
Anquilosis in:
| 0o | 60% |
| 10th | 58 % |
| 20th | 55 % |
| 30th | 50% |
| 40o | 45 % |
| 50o | 43 % |
| 60o | 40% |
| 70o | 35 % |
| 80o | 32 % |
| 90th | 30% |
| 100o | 35 % |
| 110o | 40% |
| 120o | 45 % |
| 130o | 50% |
| 140o | 55 % |
| 150o | 60% |
Doll
Functional limitation
Dorsal flexibility
From 0o to:
| 0o | 8 % |
| 10th | 6 % |
| 20th | 5 % |
| 30th | 4% |
| 40o | 2 % |
| 50o | % |
| 60o | 0 % |
Palm flex
From 0o to:
| 0o | 9 % |
| 10th | 7 % |
| 20th | 6 % |
| 30th | 5 % |
| 40o | 3 % |
| 50o | 2 % |
| 60o | % |
| 70o | 0 % |
Radial deviation
From 0o to:
| 0o | 2 % |
| 10th | % |
| 20th | 0 % |
Cubital deviation
From 0o to:
| 0o | 3 % |
| 10th | 2 % |
| 20th | % |
| 30th | 0 % |
Anquilosis
Anquilosis in:
| Flexion | Extension | Desv. Radial | Desv. cubital | |
| 0o | 18 % | 18 % | 18 % | 18 % |
| 10th | 23 % | 17 % | 36 % | 30% |
| 20th | 28 % | 16 % | 54 % | 42 % |
| 30th | 34 % | 15% | 54 % | |
| 40o | 38 % | 23 % | ||
| 50o | 44 % | 41 % | ||
| 60o | 49 % | 54 % | ||
| 70o | 54 % |
Pulgar
Functional limitation
Carpo-metacarpiana (includes Aduction and Abduction):
| Flexion | Extension | ||
| From 0o to: | Global inability | From 0o to: | Global inability |
| 0o | 3 % | 0o | 3 % |
| 10th | % | 10th | 2 % |
| Fifteenth | 0 % | 20th | % |
| 30th | 0 % | ||
| Metacarpo-falángical Articulation | Interfalaneous marketing | ||
| Flexion | |||
| Mobility to | Global inability | Mobility to | Global inability |
| 0o | 14 % | 0o | 12 % |
| 10th | 12 % | 10th | 10% |
| 20th | 8 % | 20th | 8 % |
| 30th | 6 % | 30th | 6 % |
| 40o | 4% | 40o | 5 % |
| 50o | 2 % | 50o | 4% |
| 60o | 0 % | 60o | 2 % |
| 70o | % | ||
| 80o | 0 % | ||
Anquilosis: Carpo- metacarpiana
(Includes Induction and Abduction)
| In bending of: | Global inability | In Extension of: | Global inability |
| 0o | 7 % | 0o | 7 % |
| 10th | 12 % | 10th | 10% |
| 20th | 17 % | 20th | 14 % |
| 30th | 17 % |
Anchilosis: Metacarpo-Falángica
Busted in:
| Global inability | |
| 0o | 12 % |
| 10th | 10% |
| 20th | 9 % |
| 30th | 12 % |
| 40o | 13 % |
| 50o | 15% |
Inter-Falangic Anquilosis
Busted in:
| Global inability | |
| 0o | 10% |
| 10th | 9 % |
| 20th | 8 % |
| 30th | 8 % |
| 40o | 8 % |
| 50o | 10% |
Hand fingers minus the Pulgar
Functional limitation
Metacarpo-falángical Articulation
Flexion
From 0o to:
| Global inability | |
| 0o | 8 % |
| 10th | 7 % |
| 20th | 6 % |
| 30th | 5 % |
| 40o | 4% |
| 50o | 3 % |
| 50o | 3 % |
| 70o | 2 % |
| 80o | % |
| 90th | 0 % |
Proximal Interfalangic Articulation
Flexion
From 0o to:
| Global inability | |
| 0o | 8 % |
| 10th | 8 % |
| 20th | 7 % |
| 30th | 6 % |
| 40o | 5 % |
| 50o | 4% |
| 60o | 3 % |
| 70o | 3 % |
| 80o | 2 % |
| 90th | % |
| 100o | 0 % |
Distal Interfalangic Articulation:
Flexion
From 0o to:
| Global inability | |
| 0o | 6 % |
| 10th | 5 % |
| 20th | 4% |
| 30th | 4% |
| 40o | 3 % |
| 50o | 2 % |
| 60o | % |
| 70o | 0 % |
Anchilosis: Index and Major
Global inability
| Anquilosis: | M-F | I-F-P | I-F-D |
| 0° | 8 % | 8 % | 6 % |
| 10° | 8 % | 8 % | 5 % |
| 20° | 7 % | 8 % | 5 % |
| 30° | 6 % | 8 % | 5 % |
| 40° | 8 % | 7 % | 4% |
| 50° | 8 % | 8 % | 5 % |
| 60° | 10% | 8 % | 5 % |
| 70° | 11 % | 8 % | 6 % |
| 80° | 13 % | 10% | |
| 90° | 14 % | 10% | |
| 100° | 11 % |
Anquilosis: Anular and Meñique
| Metacarpo-falangic anchilosis | % global |
| Pseudoartrosis | |
| The following incapacities include loss by functional impact. | |
| Cluster | 2-4 % |
| Number | 15-30 % |
| Cúbito, diafisaria | 9-12 % |
| Cúbito, olecraneana | 12-15% |
| Cúbito, apophysis | 0-1%3 |
| Radio, diafisaria | 6-9% |
| Radio, apophysis | 0-2 % |
| Radio and Cúbito | 30-40 % |
| Scaphoids | 15-18 % |
| Semilunar | 15-18 % |
Joint inability
In the following incapacities is included loss due to functional repercussion, it will evaluate through stress or dynamic radiology.
| Shoulder: for loss of soft or bone parts | 25-35 % |
| Shoulder: recidivizing humeral scapular dislocation | 12-15 % |
| Codo: for loss of soft or bone parts | 20% |
| Doll: for loss of soft or bone parts | 15-20 % |
Muscle-tendinous injuries
The following incapacities include loss by functional impact.
| Detoid breakdown | 10-15 % |
| Triceps break | 9-12 % |
| Proximal breakdown of biceps | 5-8 % |
| Distal height of biceps | 6-9 % |
| Antebrazo or wrist flexor section | 5-10 % |
| Section of forearm or wrist extenders | 5-10 % |
| Volkman syndrome | 20-40 % |
The muscle-tendinous injuries of the hand will be evaluated according to the limitation of mobility.
MIEMBRO INFERIOR
| Amputations | |
| Interabdomino-pelvian amputation | 80% |
| Bilateral amputation | 100% |
| Coxofemoral disarticulation | 70% |
| Musle amputation, 1/3 proximal | 45-65 % |
| Amputation of thigh, 1/3 medium and distal | 40-60 % |
| Disarticulation of the knee | :40-60 % |
| Knee Amputation with Functional Muñón | 30-50 % |
| Amputation below the bilateral knee | 80% |
| ankle disarticulation (Syme) | 25-45 % |
| Standing amputation with calcáneo conservation (Ricard) | 20-40 % |
| Mediatarsian amputation (Chapart) | 20-40 % |
| Tarsometatarsian Amputation (Lisfranc) | 20-40 % |
| Amputation transmetatarsiana | 15% |
| Amputation of the 5 fingers | 10-20 % |
| Amputation of the 1st finger | 15% |
| Amputation of the 1st finger and its metatarsian | 17 % |
| Amputation of 5th finger and metatarsian | 12 % |
| Amputation of 2nd, 3rd or 4th fingers with your metatarsian | 12 % |
| Amputation of the hallux distal phalange | 6 % |
| Amputation of one of the 2nd fingers. 3rd or 4th. | 2 % |
| Amputation of the 5th finger | 2 % |
| Amputation of two phalanges of the 2nd fingers, 3rd or 4th. | 1.5 % |
| Amputation of two phalanges of the 5th finger | 1.5 % |
| Amputation of a phalange of the 2nd fingers, 3rd or 4th. | % |
| Amputation of a 5th finger phalange | % |
Hunter
Functional limitation
From 0° to:
| Flexion | Extension | Abduction | Aduction | Rot. Ext. | Rot. Int. | |
| 0° | 7 % | 2 % | 6 % | 3 % | 5 % | 5 % |
| 10° | 7 % | 2 % | 5 % | 2 % | 4% | 3 % |
| 20° | 6 % | % | 3 % | 0 % | 3 % | 2 % |
| 30° | 5 % | 0 % | 2 % | 2 % | % | |
| 40° | 4% | 0 % | % | 0 % | ||
| 50° | 4% | 0 % | ||||
| 60o | 3 % | |||||
| 70° | 3 % | |||||
| 80o | 2 % | |||||
| 90th | % | |||||
| 100o | 0 % |
Anquilosis
Anquilosis in:
| Flexion | Extension | Abduction | Aduction | Rot. Int. | Rot. Ext. | |
| 0o | 28 % | 28 % | 28 % | 28 % | 28 % | 28 % |
| 10th | 25 % | 32 % | 31 % | 34 % | 31 % | 30% |
| 20th | 22 % | 36 % | 34 % | 40% | 34 % | 33 % |
| Twenty-fifth | 20% | 38 % | 35 % | 35 % | 34 % | |
| 30th | 21 % | 40% | 37 % | 37 % | 35 % | |
| 40o | 24 % | 40% | 40% | 38 % | ||
| 50o | 27 % | 40% | ||||
| 60o | 29 % | |||||
| 70o | 32 % | |||||
| 80o | 35 % | |||||
| 90th | 37 % | |||||
| 100o | 40% |
Rodilla
Functional limitation
Flexion
From 0o to:
| 0° | 30% |
| 10° | 25 % |
| 20th | 20% |
| 30th | 17 % |
| 40o | 16 % |
| 50o | 14 % |
| 60o | 13 % |
| 70o | 11 % |
| 80o | 10% |
| 90th | 8 % |
| 100o | 7 % |
| 110o | 6 % |
| 120o | 4% |
| 130o | 3 % |
| 140o | 2 % |
| 150o | 0 % |
Extension
From 0° to:
| 0o | 0 % |
| 10th | 10% |
| 20th | 20% |
| 30th | 40% |
| 40o | 50% |
| 50 to 150o | 60% |
Anniquilosis
Anquilosis in:
| 0o | 30% |
| 10th | 35 % |
| 20th | 40% |
| 30th | 45 % |
| 40o | 50% |
| 50 to 150o | 65 % |
ankle
Functional limitation
Dorsal Flexion
From 0° to:
| 0o | 3 % |
| 10th | 2 % |
| 20th | 0 % |
Plant Flexion
From 0° to:
| 0o | 6 % |
| 10th | 4% |
| 20th | 3 % |
| 30th | 2 % |
| 40o | 0 % |
Investment
From 0o to:
| 0o | 2 % |
| 10th | 2 % |
| 20th | % |
| 30th | 0 % |
Eversion
From 0° to:
| 0o | 2 % |
| 10th | % |
| 20th | 0 % |
Anquilosis
Anquilosis in:
| Flex. dorsal | Plant flexibility | Investment | Eversion | |
| 0o | 12 % | 12 % | 12 % | 12 % |
| 10th | 20% | 16 % | 17 % | 20% |
| 20th | 28 % | 20% | 23 % | 28 % |
| 30th | 24 % | 28 % | ||
| 40o | 28 % |
Fingers of the Foot
Anquilosis or Functional Limitations
1st. finger
| (a) Inter-falangic coordination: | |
| Grade of bending | |
| 0° | 2 % |
| 10° | 3 % |
| 20° | 3 % |
| 30° | 4% |
| (b) Metataro-falangic Articulation: | |
| Grade of dorsal bending | |
| 0° | 3 % |
| 10° | 3 % |
| 20° | 4% |
| 30° | 4% |
| 40° | 5 % |
| 50° | 5 % |
| Grade of bending plantr | |
| 0° | 3 % |
| 10° | 4% |
| 20° | 4% |
| 30° | 5 % |
| Fingering of fingers | |
| (a) Proximal inter-falangic arrest | % |
| (b) Metatarsophageal Articulation | |
| From 0° to 20° | % |
| From 20 to 30° | 2 % |
| Shortening of the lower members | |
| 0 to 1.50 cm. | 2 % |
| From 1.50 to 2.50 cm. | 4% |
| From 2.50 to 4cm. | 6 % |
| 4 to 5 cm. | 8 % |
| More than 5 cm, | 10% |
Sequelas de Fracturas
| Punial diastasis with iliac sacral subluxation, with pelvic visceral complication, according to sequelae (unstable pelvis): | 20-40 % |
| Cotton fracture with acetabular protrusion | 12-20 % |
| Cotyl fracture with protrusion and femoral head necrosis | 20% |
| Traumatic hip luxation sequel, with marginal fracture and femoral head necrosis | 20% |
| Flour neck fracture sequel | 15-20 % |
| Partial or total hip prosthesis | 10-15 % |
| Infected or sequel prosthesis ( Girlestone rescue operation) | 40-60 % |
| The previous incapacity should not be added to the functional impact and shortening of the member. | |
| -Fracture femoral diaphysis consolidated in, discharge (angulated or rotated) | 15-20 % |
| Tibial saucer fracture with joint inconsistency | 15-20 % |
| Circle fracture with displacement | up to 6 % |
| Partial election | 3-6 % |
| Total election | 5-10 % |
| Partial or total knee prosthesis | 15-20 % |
| Partial or total knee prosthesis, with radiographic signs of loosening | 25-30 % |
| Partial or total knee prosthesis, infected or surgical rescue sequel | 40-50 % |
| The previous incapacity should not be added to the functional impact and shortening of the member. | |
| Diafisary fracture of tibia without displacement | 5-10 % |
| Diafisary fracture of butne without displacement | 3-5 % |
| Fracture of tibia and/or perone consolidated in axis | 5-15 % |
| Fracture of tibia and/or perone consolidated in discard (angulated or rotated). | 10-20 % |
| Unimaleolar ankle fracture | 3-6 % |
| Bimaleolar or ankle trimaleolar fracture, with joint congruence | 10-15 % |
| Bimaleolar or ankle trimaleolar fracture, with joint incongruity | 15-20 % |
| Bleb diastasis peronea | up to 6 % |
| Fracture of roasting with necrosis | 15% |
| Astragalectomy | 15% |
| Calcáneo fracture with crushing, subastragaline arthrosis | 20% |
| Fracture of both calcans with crushing, claudicant march and subastragaline arthrosis | 25-30 % |
| Tarsian scaphoid fracture with necrosis | 5-10 % |
| Multiple foot fractures, with edema, post-traumatic flat foot, | |
| Sudeck atrophy | 20-30 % |
| Multiple foot fracture, edema, post traumatic, bilateral plane foot | 30-40 % |
Menisco-ligamentary injuries
The following incapacities include the percentage by functional impact.
Rodilla
| Meniscal syndrome with subjective signs | 0 % |
| Meniscal syndrome with objective signs (hydrotrosis, muscle hypotrophy, blockage, manoeuvres) | 8-10 % |
| Meniscectomy without sequelae | 3-6 % |
| Meniscectomy with hydrotesis, muscle hypotrophy | 10-15 % |
| Chronic hidrartrosls | 5-8 % |
| Chronic sinovitis with objective signs | 5-8 % |
| Internal insufficiency without hypotrophy or hydrotesis due to internal lateral ligament injury | 10-15 % |
| Internal instable with atrophy, hydrosis and changes in the march | 15% |
| Previous or later insufficiency, without atrophy or hydrotesis, by previous or posterior ligamentary lesion | 10-15 % |
| Previous and later instability with atrophy, hydrosis and changes in the march | 15% |
| External insufficiency without hypotrophy or hydrotesis due to external lateral ligament injury | 10-15 % |
| External insufficiency with atrophy, hydrotesis and changes in the march | 15% |
| Combined reliability | 30% |
| Inability combined with hypotrophies and hydrotesis | 40% |
Muscle and tendinous injuries
They will be evaluated according to the functional limitation they produce.
Pseudoartrosis
The following incapacities include the percentage by functional impact.
| Femoral neck | 40-60 % |
| Fémur. | 40-60 % |
| Fémur, supracondile | 40-60 % |
| Tibia, proximal end as failed osteotomy sequel | 20-40 % |
| Diamond tibia | 20-40 % |
| Butné, diafisaria | 5-10 % |
| Tibia and Peroné | 20-40 % |
| Unimaleolar tibial | 6-9 % |
| Unimaleolar peronea, infrasindesmal | 3-6 % |
| Unimaleolar peronea, transindesmal | 6-9 % |
| Unimaleolar peronea, suprasindesmal | 9-12 % |
| Catch it | 10-25 % |
| Metartasian first | 3-6 % |
| Metatarsian, 2nd, 3rd, 4th, or 5th. | 0-2 % |
| Metatarsian, 5th base. | 0-2 % |
| Hallux, read. Falange | 0-2 % |
| Hallux, 2da. falange | 0-1 % |
Joint inability
In the following incapacities is included loss by functional impact.
Hunter
| Joint inability | 40-60 % |
Rodilla
| Internal inability, without hypotrophy or hydrorrhythrois | 5-15 % |
| Internal instable with atrophy, hydrosis and changes in the march | 15% |
| External instability, without hypotrophy or hydrotesis | 5-15 % |
| External insufficiency with atrophy, hydrotesis and changes in the march | 15% |
| Previous or later instability, without atrophy or hydrotrosis | 5-15 % |
| Previous and later instable, with atrophy, hydrosis and changes in the march | 15% |
| Combined unstables | 30% |
| Combined inability, with hypotrophy and hydrotesis | 40% |
ankle
| ankle instability with radiological corroboration | 5-10 % |
| Instability of both ankles with radiological corroboration | 15-30 % |
THE CABEZA AND ROSTRO LESIONS TO BE ASSESSED, ARE THE DERIENDS OF PROFESSIONAL ENVIRONMENTS UNDER THE LISTED, DIAGNOSTICADA AS PERMANENT OR SECUELS OF WORKING ACCIDENTS
For the evaluation of the lesions produced in the head and face will be taken into account: the affected area, the extent of the lesion, the depth of the lesion, the appearance, complications, color changes and the anatomical-functional commitment of the different organs there located. The aesthetic impact will also be valued.
The assessment of organ-functional incapacity will be added to the corresponding by aesthetic sequel.
CABEZA
Bone and neurological lesions are evaluated in the chapter corresponding to neurology. The lesions here assessed refer to the contusse wounds and/or cutters produced in the pilosa area.
| Dry contusa and/or cutter, in piloss area, with covered scar | 0 % |
| Dry contusa and/or cutter, in piloss area, with uncovered scar | 1-3 % |
| Scalp of scalp leather, in piloss area, with partial loss, with covered scar | - 1 % |
| Scalp of scalp leather, in piloss area, with partial loss of it, with uncovered scar | 1-3 % |
| Scalp of scalp, with definitive and partial hair loss: | |
| 0 to 5 cm in diameter | 1-5 % |
| 5 to 10 cm in diameter | 5-10 % |
| more than 10 cm in diameter | 10-20 % |
| Scalp of scalp, with definitive and total loss of all layers: | |
| 0 to 5 cm in diameter | 5-10 % |
| 5 to 10 cm in diameter | 10-20 % |
| more than 10 cm in diameter | 20-40 % |
ROSTRO
| Front | |
| Front scar, horizontal, over stork or wrinkle, less than 4 cm. | 0-2 % |
| Front, horizontal, over-sand or wrinkle scar, greater 4 cm. | 5-7 % |
| Front, cross or perpendicular scar, less than 4 cm. | 5-7 % |
| Front, cross or perpendicular scar, greater 4 cm. | 8-10 % |
| Front scar, star or surface, less 4 cm2. | 5-7 % |
| Front scar, star or surface, larger 4 cm2. | 8-15 % |
| Front scar, stellar or surface, with cutaneous graft, less than 4 cm2. 5-7 % | |
| Front scar, stellar or surface, with cutaneous graft, greater than 4 cm2. 8-15 % | |
| Uni or bilateral Frontal Seno outbreak, without complication | 5-10 % |
| Uni or bilateral border sine burst, with complication | According to sequels |
| Linear scar of Arc Superciliar | 0-2 % |
| Retractable scar of Arc Superciliar (note) | 1-3 % |
| Pómulo | |
| Linear scar, minus 5 cm. | 1-3 % |
| Linear scar, plus 5 cm. | 4-6 % |
| Surface scar, less 6 cm2. | 0-5 % |
| Surface scar, greater 6 cm2. | 6-10 % |
| Fistula salival, without treatment | 5-7 % |
| Orbita | |
| Borde Superior | |
| Alopecia de la ceja, unilateral | 3 % |
| Alopecia de la ceja, bilateral | 5 % |
| Fracture with depression of the area | 5-10 % |
| External orbital apophysis fracture, with displacement, (involved to the superior extremity of the Malar, without fracture of the same), without treatment | 10-15 % |
| Malar fracture, its orbital apophysis alone or associated with the Frontal orbital apophysis | 15-20 % |
| Borde Inferior | |
| Fracture of the orbital floor Horizontal lamina, with displacement, with diplopia | 45 % |
| Borde Interno | |
| Fracture with unguis displacement | 5-8 % |
| Borde Externo | |
| We must make special mention of the malare bones. In the major facial traumas, the malar is fractured, giving rise to a sequel that must be repaired immediately, due to the fall of the orbital floor and the overcoming diplopia. | |
| Orbit content and soft parts See eye. | |
| Nasal breasts See nose, throat, and ear. | |
| Lefort I Horizontal palate and does not compromise orbits | According to sequels |
| Lefort II Crosses the infraorbitant edge, the floor, the interposed wall of the orbit and the perpendicular Etmoid foil | Head fistulas etc. |
| Lefort III Added to the previous stroke the outer wall etc. of the orbit, orbital apophysis of the Frontal and Cigoma | |
| The visual and/or olfactory alterations and/or nasal ventilation will be added to the anatomical incapacity. | |
| Auricular Pavilion | |
| Total, unilateral loss | 12 % |
| Loss of atrial lobe | 4% |
| Partial, unilateral aesthetic alteration | 5-10 % |
| Partial aesthetic alteration, bilateral | 15% |
| The head pavilion injuries will be added to the inability for hearing and/or vestibular impact. | |
| Menton | |
| Linear scar, minus 4 cm. | 0-2 % |
| Linear scar, greater 4 cm. | 2-4 % |
| Labial Comisura | |
| Upper lip removal | 3 % |
| Labial comisura deviation | 5 % |
| Retraction of both lips | 12-15 % |
| Lower | |
| Includes upward branch, horizontal branch, Gonion, Coronoid Apophysis, Condilo-board area superior alveolar and Menton | According to sequel |
| Loss of the chess function | 70% |
| Extensive removals of bone and soft parts | 60-80 % |
| Fistula salival | 25-30 % |
| All head and face lesions will be evaluated after treatment and if they remain intratable sequelae. | |
General
THE OJOS LESIONS THAT ARE ASSESSED, ARE THE LAWS OF PROFESSIONAL ENVIRONMENTS FIGURED IN THE LISTED, DIAGNOSTICED AS PERMANENT OR SECUELS OF WORKING ACCIDENTS.
The sequel to a labor accident or alterations produced by a professional disease with an ophthalmological impact can produce the following commitment to visual function.
1. . Loss of visual acuity. By commitment to transparent means, the retina of the optical nerve, the optical pathway or the sensory cortex.
2. . Loss of the visual field, can be uni or bilateral.
3. ). Loss or commitment of the motor function of extraocular musculature (with or without diplopia).
4. ). Loss of eye alignment and position and/or palpebal mobility (ptosis, lakeftamos and other alterations).
5. . Lagrimal Way injuries.
6. . Miscellaneous alterations.
Useful Elements for Evaluation: Anamnesis, Ophthalmological Physical Test: Visual Acuteness, Visual Field, Eye Fund, Biomicroscopy (BMC), Retinofluoresceinography and/or Neurological.
The diagnosis will eventually be completed with: Rx, Eco, TC, RMN or Evoked Potentials.
Bilateral visual capacity will be evaluated in all cases.
1. Visual aggress
1.1 ). The visual acuity will be determined corrected if appropriate or without correction if the use of the conventional lens or contact lens is not bearable (intolerance, aniseiconia, non-corrigible defects of the eye surface).
When the contact lens is well tolerated, its correction shall be considered in the calculation of invalidity.
1.2 . The loss of the vision of an eye should be evaluated following the values provided by the Table of Sená, approved by the Argentine Council of Ophthalmology.
| AV.: Visual aggress | ENUC: Enucleation | ES/P: Enucleation s/prosthesis |
| AV | 1 | 0.9 | 0.8 | 0.7 | 0.6 | 0.5 | 0.4 | 0.3 | 0.2 | 0.1 | -0.1 | Enuc | s/P |
| 1 | 0 | 1 | 2 | 4 | 6 | 9 | 13 | 18 | 24 | 32 | 42 | 45 | 50 |
| 0.9 | 1 | 2 | 3 | 5 | 8 | 11 | 15 | 20 | 26 | 34 | 43 | 47 | 52 |
| 0.8 | 2 | 3 | 5 | 7 | 10 | 13 | 18 | 23 | 29 | 37 | 45 | 50 | 54 |
| 0.7 | 4 | 5 | 7 | 9 | 13 | 16 | 21 | 26 | 32 | 40 | 50 | 55 | 58 |
| 0.6 | 6 | 8 | 10 | 13 | 16 | 20 | 25 | 30 | 36 | 44 | 55 | 60 | 62 |
| 0.5 | 9 | 11 | 13 | 16 | 20 | 24 | 29 | 34 | 41 | 49 | 60 | 65 | 67 |
| 0.4 | 13 | 15 | 18 | 21 | 25 | 29 | 33 | 39 | 47 | 56 | 70 | 70 | 73 |
| 0.3 | 18 | 20 | 23 | 26 | 30 | 34 | 39 | 45 | 54 | 65 | 80 | 80 | 80 |
| 0.2 | 24 | 26 | 29 | 32 | 36 | 41 | 47 | 54 | 64 | 75 | 90 | 90 | 90 |
| 0.1 | 32 | 34 | 37 | 40 | 44 | 49 | 56 | 65 | 75 | 85 | 100 | 100 | 100 |
| -0.1 | 42 | 43 | 45 | 50 | 55 | 60 | 70 | 80 | 90 | 100 | 100 | 100 | 100 |
| Enuc | 45 | 47 | 50 | 55 | 60 | 65 | 70 | 80 | 90 | 100 | 100 | 100 | 100 |
| Es/P | 50 | 52 | 54 | 58 | 62 | 67 | 73 | 80 | 90 | 100 | 100 | 100 | 100 |
1.3 . Total loss of one eye's vision will be causal of a 42% disability. This value will refer to the calculation of the loss of vision and the visual field.
1.4 . According to Sena Tables the loss of the eyeball (enucleation) will give a 5% invalidity.
1.5 . If the worker is a single eye carrier, at the time of starting the working relationship, the vision commitment will be evaluated according to the table below. Visions should be assessed with correction of the vices of refraction that may exist.
| Visual Agudeza | 0.9 | 0.8 | 0.7 | 0.6 | 0.5 | 0.4 | 0.3 | 0.2 | 0.1 |
| % Invalidity | 5 | 10 | 20 | 35 | 50 | 70 | 80 | 90 | 100 |
1.6 If the commitment of the vision is bilateral will be evaluated according to the Table of Sená resulting in the percentage of the union of the horizontal line (the first eye) with the value of the vertical line (the second eye).
1.7 . There can be poor visual acuity by macular vision regarding peripheral vision. In this case, the office of the accident to evaluate the incapacity must be taken care of.
In general, the criterion of invalidity for the specific trade, for certain work or for all work should be addressed in this and in all cases (WHO legal framework).
1.8 . In the case of a corrected afáquic patient or a pseudophac patient with intraocular lens and with or without additional air correction, the remaining central vision will be considered as an incapacity index to which 30% will be added to the loss of the peripheral visual field.
If there are problems in the uninjured eye and this has increased with trauma, you will be given lenses.
When it is an eye without intraocular lens the AV determined according to the Sená table is divided by two (e.g.: 8/10 will be 4/10) for normal visual calculation.
1.9 . The inoperable cataract will be evaluated according to visual sharpness.
2. Loss of Visual Field
2.1 . The loss of the visual field must be determined once guaranteed as much visual acuity as possible, with correction, if necessary.
2.2. El The commitment of the visual field will be evaluated considering the following scheme as a normal visual field.
2.3 . For activities that demand a visual acuity without limitations, where the peripheral visual field is of capital importance (machinist, bus drivers, crane operators and heavy machinery, etc.) will be considered the visual field divided into 8 meridians of 60 degrees each which equals 500 degrees.
For activities that do not require such visual capacity (officialists, teachers, service activities), understanding that the lesions are monocular, the visual field will be considered divided into 8 meridians but of 40 central degrees, which is equivalent to 320 degrees.
2.4 . The field obtained with the Goldmann campimeter will be analyzed with Isoptera 1/IV for the periphery and 1/II for the central field, and the degrees committed in each meridian will be counted.
2.5 . Obtained the graphic of the countryside, the grades of the eight meridians are added and divided by 320 (total of degrees for the normal visual field for each eye), or 500 if it refers to special cases, obtaining the preserved visual field. The difference with unity will be the loss of the visual field of that eye.
The loss of unilateral visual capacity is multiplied by the 0.25 index to calculate the loss of global capacity.
2.6 . When it comes to the bilateral visual field, the loss of both eyes is calculated separately. Then they are added and the result is multiplied by factor 1.5, thus obtaining the total degree of incapacity for bilateral loss of the visual field.
2.7 ). When the visual sharpness is compromised, the percentage of loss of the visual field must be added to the one originated by the first (according to the remaining capacity).
3. Loss of the Function of Extraocular Musculature. Diplopia
3.1 . The loss of this function forces the patient to consult by diplopia and/or deviation from the head. Diplopia can also be caused by trauma of the base of the orbit, or monocular in special cases of corneal damage.
The evaluation of it will be considered the age and time of evolution, determining an incapacity that will fluctuate between 10 and 25%.
3.2 . It should be considered as a Residual Diplopia that which has been impossible to correct with the surgery and that it is also not possible to reduce with the use of Frenkel compensatory prisms in the post-operative period.
The worker may perform a profession under the same conditions as a monocular, having to use occlusion to carry out his activity.
4. Loss of Eye Alignment, Position or Palpebral Mobility and Miscellaneous
4.1 . The loss of eye alignment due to various causes (postoperative, traumatic, etc.) will cause invalidity.
| Affections | Percentage |
| Orbita: Bone injuries, refers to the chapter of Head and Face | |
| What a chronic, allergic or unilateral irritative conjunctivitis that does not refer to treatment | up to 5% |
| Burning conjunctivitis Chronic, allergic or irritative bilateral, which does not refer to treatment | up to 10% |
| Post-traumatic | 5 % |
| Unilateral Paralytic Midriasis | 5 % |
| Bilateral paralytic Midriasis | 10% |
| Post-traumatic midriasis due to unilateral iris injury | 5 % |
| Post-traumatic midriasis due to bilateral iris injury | 10% |
| Iridodialysis (with visual commitment) Unilateral | 5 % |
| Iridodialysis Bilateral | 10% |
| unilateral palpebral Ptosis with discovered pupil | 5 % |
| Bilateral palpebral Ptosis with covered pupil. Added to the functional disorders of vision | Variable |
| Monocular palpebral deformations | 5-10 % |
| Bilateral pallets | 10-20 % |
| Unilateral residual lakes | 5-10 % |
| Bilateral residual lakes | 10-20 % |
| Stress (muscular or nervous injury). According to visual sharpness | |
| Unilateral post-traumatic spirit | 5-10 % |
| Bilateral post-traumatic | 10-20 % |
| Enucleation with prosthesis | 45 % |
| Enucleation does not allow prosthesis | 50% |
| Bilateral Enucleation or Evisceration | 100% |
| Sympathetic ophthalmy, kidnapping or accidents in the other eye | 100% |
| blindness, post-traumatic, without deformation of the eyeball, unilateral | 42 % |
| Post-traumatic or atrophic blindness of the eyeball with unilateral deformation, which allows prosthesis | 45 % |
General
THE GARGANTA, NARIZ AND OIDO LESIONS TO BE ASSESSED, ARE THE LAWS OF THE PROFESSIONAL ENVIRONMENTS THAT FIGURE IN THE LISTADO, DIAGNOSTICADA AS PERMANENT OR SECUELS OF WORKING ACCIDENTS.
For the evaluation of labor damage, produced in Garganta,
The following elements are useful:
Clinical data: Anamnesis, Otorhinolaryngological, Neurological.
Diagnosis by images: Rx. corresponding to the affected areas, in the specific positions:
| 1 - Top Maxilar: | Mentonasoplaca (M.N.P.). |
| Frontonasoplaca (F.N.P.) |
2 - Cigomatic Arc: vertical subment position, M.N.P. and F.N.P.
3 - Nasal fractures: M.N.P., F.N.P. and profile.
4 - Peñasco: Stenvers, Schuller.
Computed Axial Tomography and Magnet Resonance. Nuc.
Electrophysiological Electronistagmography, Tonal Audiometry, Logoaudiometry.
Powerful Auditives.
Yes.S.I., Rinomanometry. Olphatometry.
OWO
Traumatic injuries
| Auricular Pavilion | |
| Otohematoma, uni or bilateral without complications | without disability |
| Otohematoma, uni or bilateral with complications | according to sequels |
| Condronecrosis | 5 % |
| Scars, see Head and Face Chapter | |
| Membrana del Tímpano | |
| Uni or bilateral, hearing and/or vestibular impact | |
| Dislocation of Eggs. According to hearing and/or vestibular impact |
Standards for the evaluation of hearing damage
Workers who have suffered hearing damage, whether from intoxication, acute or chronic overexposure to noise, or by encephalic contusion, will be subjected to hearing study consisting of otological evaluation and 3 audiometries, as well as other studies to verify the cochleal damage. These tests should be done after a minimum of 24 hours. hearing rest and between them there must be an interval not less than 7 days.
The averages of decibels, measured on the thresholds of the frequencies considered, in the three examinations, may not differ by more than 10 dB. If this requirement is not met in the 3 audiometries, others should be taken to achieve it.
If, as a result of acute trauma, the function of one ear is completely and irreversibly lost, the normality of the other remains, the inability to recognize will be 15%.
Total, traumatic or noise exposure hypoacusis will be evaluated with a 42% disability. Partial hypoaccusias will be evaluated according to tables.
Calculation of monoaural loss
The loss in airway decibels of the tones is added 500, 1,000, 2,000 and 4,000. The amount obtained is transferred to the table where it becomes a percentage of hearing loss.
| MONOAURAL AUDIT | |||
| SD | % | SD | % |
| 100 105 110 115 120 125 130 135 140 145 150 155 160 165 170 175 180 185. 190 195 200 205 210 215 220 225 230 235 | 0.0 1.9 3,8 5.6 7.5 9.4 11,2 13,1 15,0 16.9 18.8 20.6 22.5 24.4 26.2 28.1 30.0 31.9 33.8 35.6 37.5 39.4 41.2 43.1 45,0 46.9 48.9 50.6 | 240 245 250 255 260 265 270 275 280 285 290 295 300 305 310 315 320 325 330 335 340 345 350 355 360 365 370 or 한 | 52.5 54.4 56.2 58.1 60.0 61.9 63.8 65.6 67.5 69.3 71.2 73.1 75.0 76.9 78.8 80.6 82.5 84.4 86.2 88.1 90.0 90.9 93.8 95.6 97.5 99.4 100.0 |
Calculation of bilateral hearing loss
It adds the loss in airway decibels of the tones 500, 1,000, 2,000 and 4,000 of each ear and moves it to the Table of the A.M.A./84 - A.A.O. MAY./79.
In this Table the best ear and in its vertical axis the worst must be sought in its horizontal axis; from the intersection of both axis the bilateral hearing loss arises in percentages. This value multiplied by 0.42 results in the loss of % of the salary.
If you do not have the AMA Table, you can determine the value of the loss of the salary percentage, for uni or bilateral hearing injury, with the following formula:
| (% Hear better x 5) + (% Hear worse x 1) | x 0.42 = % of the Salary |
| 6 |
Evaluation of inability to alter balance due to injury of the vestibular branch.
The alteration of the vestibular branch of the auditory nerve can cause disturbances of balance. For the purposes of this rule, balance is defined as the ability to acquire, change or maintain a bodily attitude that allows the realization of a particular job.
The determination of deterioration will be based on objective signs, attributed to organic damage, in the labyrinth examination. The assessment of the deterioration will be established on the basis of the degree of balance disorder (by electronistagmogram, neurological examination, etc.) and not in relation to vertiginous symptoms. The determinations will be made after 6 months of suspension of exposure to the agent or the allegedly causal accident. The levels of deterioration to be considered with their respective incapacities are as follows:
| Grade I. Minimum deterioration. There is imbalance with abrupt changes in the position of the head or in certain positions of the head. Leves deviations and/or lateropulsions in the march with closed eyes. Target signs of organic damage in labyrinth and/or neurological examination. | Inability 10 % |
| Grade II. Mild deterior. There are disorders in the march and quick spins that are accentuated in doing so with closed eyes. It makes him stand with his eyes closed. There are objective signs in labyrinth and/or neurological examinations. | Inability 20% |
| Grade III. Moderate deterior. The march is only possible with cane support. Great difficulty in maintaining balance with closed eyes and impossibility of marching in those conditions. | Inability 40 % |
| Grade IV. Advanced deterior. There is great difficulty in making changes in position. Impossibility of maintaining a position to perform a task. | Inability 70 % |
| Grade V. Serious deterior. Impossibility of marching with open eyes. It requires third-party assistance for your transfer. | Inability 100% |
Peñasco, with complications, is evaluated
Mastoid apophysis, without complications, has no disability
Apophysis Styleids, without complications, has no disability
Styleid apophysis, with complications (See Crane Pairs)
Incapacity, if any, will be added for hearing and/or vestibular impact.
NARIZ AND PARANAL SENOS
Face deforming lesions such as bone displacement and complications will be evaluated after repairing surgery, reducing the percentages of incapacity, according to the success of the surgery.
NARIZ
| Pyramid Nasal | |
| Nasal amputation, total | up to 30% |
| Windows Nasales | |
| Unilateral marked deformity | up to 8 % |
| Bilateral marked deformity | up to 15% |
| Fracture of the own bones | |
| without displacement | without disability |
| with displacement | up to 6 % |
| Vertical Lamine Fracture of Ethmoids | |
| without displacement | without disability |
| with displacement and nasal obstruction | up to 6 % |
| (you will add the nasal obstruction) | |
| Vomer bone fracture | |
| without displacement | |
| with displacement and complications | |
| (you'll be added to your aftermath) | |
| Fracture of Cartylaginous Tabique | |
| without displacement | without disability |
| with displacement | up to 6 % |
| piercing of the Tabique | 0-5 % |
The anatomical lesion will be added to the respiratory functional impact (only in cases that have no therapeutic solution) according to the following parameters:
| Nasal obstruction | ||
| unilateral | % | total 5-10 % |
| bilateral | partial 5-10 % | total 25-30 % |
In addition, the aesthetic commitment as considered in the Chapter of Head and Face will be evaluated.
STANDARDS
The fracture of the Maxilar, Esphenoidal, Etmoidal or Frontal Breasts, which do not cause complications, will not be a cause of inability.
Bone movements and complications will then be evaluated for surgical and/or medical repairs.
| Breast sinking | 10-20 % |
| Displacement of the orbital floor entrapment of the lower rectum | 10-20 % |
| Deplopia (see Cap. Ojos) will join the existing incapacity | |
| Hypomy | 5 % |
| Anosmia | 10% |
| Hydrorrhea with therapeutic solution | 5-10 % |
| Hydrorrhea without therapeutic solution | 40-60 % |
| Malar bone fracture | |
| with displacement that involves its orbital apophysis | 10-20 % |
| associated with Frontal orbital apophysis | 15-20 % |
| Cigoma Fracture | |
| unique, with displacement | 5 % |
| associated with Malar | 10-20 % |
| associated with Malar and the orbital floor, with displacement | 10-20 % |
| Palatine bone fracture, with complications | according to sequel |
| Professional disease | |
| Early Ethmoid Cancer | |
| Local | 20% |
| Invasor (Orbita forfeiture, etc.) | 90 % |
LARINGE
| Traumatisms | |
| Paralysis Single Vocal Strings | 5 % |
| Paralysis Bilateral Vocal Strings | 10% |
| Laryngeal Straight, without dyspnea | 5 % |
| Laryngeal Straight, with dyspnea (see Cap. Respiratory) | |
| Laryngea Straight, with dysphony | 5-15 % |
| partial laryngectomy | 35 % |
| total laryngectomy | 50-70 % |
| Transitory tracheostomy (to be evaluated according to respiratory sequelae and fonation) | |
| Final tracheostomy | 50% |
| Professional diseases | |
| Irreversible functional dysphony | 15% |
| Nodules of vocal cords operated with irreversible sequelae | 20% |
| Irreversible chronic laryngitis | 20% |
General
The recommendations of the RESPIRATORY SYSTEM that will be evaluated are those that detract from the PROFESSIONAL ENVIRONMENTS that are used in the LISTED, DIAGNOSTICADA AS PERMANENT OR SECUELS OF WORKING ACCIDENTS.
The criteria for assessing respiratory incapacity caused by occupational diseases or occupational accident sequelae are mainly based on functional commitment.
Diagnostic Elements: Anamnesis, Medical Examination
specific laboratory: blood gases, baciloscopy
Diagnosis by image Rx, TC, ECO, Centellography
Functional tests: Spirometry, Dico (dissemination tests)
Endocopies and pulmonary biopsies, lymph nodes, etc.
Studies measuring the function will only have value if they were performed outside the acute or recent reactivation of the chronic process.
Table 1
| Alterations | CV | VR | VEF1/CVF | VEF/1 |
| ASMA BRONQUITIS Cr. NEUMOCONIOSIS ENFISEMA | No dism. Don't dismin. Dism. No dism. | No aum- Don't dism. Dism. Aum. | Dism Dism. N Dism. | Dism. Dism. No dism. Dism. |
The Spirometric study is of fundamental importance for the diagnosis of the type of lung pathology, especially in professional diseases. The functional normality criterion will be proposed by the American Thoracic Society.
With anamnesis (disnea, agent, type of work, etc.), Physical exam, spirometry, Rx, and eventually blood gases and pulmonary gas diffusion; the diagnosis of Professional Disease will be reached, and the worker will be placed within the following table to assess the degree of respiratory incapacity present.
RESPIRATORY INCAPACITY ASSESSMENT
Table 2
| Stadium I: | Absence of dyspnea Ex normal or sequel uni or bilateral less than the equivalent of one third of the right lung beach. Spirometric volumes over 80%. Normal blood gas | No disability |
| Stadium II: | Disnea to great efforts and/or Rx uni or bilateral lesions that do not exceed the equivalent of the third of the right lung beach Spirometric volumes between 65 and 80 %. Blood gases with O2 saturation greater than 85% | up to 30% |
| Stage III: | Disnea to medium efforts and/or Rx with uni or bilateral lesions that do not exceed the equivalent of the entire right lung beach Spirometric Volumes between 50 and 65 %. Blood gases with O2 saturation greater than 85% | 35 - 50 % |
| Stage IV: | Disposes mere efforts and/or rest and/or Rx uni or bilateral lesions that exceed the surface of the right lung beach Spirometric volumes less than 50%. Blood gases with saturation less than 85% | 55 - 70% |
| Stadium V: | Respiratory Insufficiency Terminal, with Cor-Pulmonare | 70 - 90 % |
PROFESSIONAL ENVIRONMENTS
1. S FIBROGENIC NEUMOCONIOSIS
The criteria for assessing respiratory incapacity caused by fibrogenic pneumoconiosis, such as those derived from exposure to silica, asbestos, etc., are mainly based on radiological and functional commitment. For radiological purposes, the standard of reading pneumoconiosis plates of the International Labour Organization (ILO) of 1980 is used, which sets out the criteria shown in the following table:
Table 1
| OPACITIES | ||
| SMALLS | GRANDES | |
| PROFUSION | 0 1 2 3 | A - Diameter, or the sum of diameters 3 mm and ≤ 50 mm. B - Diameter, or sum of diameters ≤ or = to the area of the 1/3 upper right lung C - Diameter, or sum of diameters to area of type B |
| REDONDEADAS | IRREGULRES | |
| P Diameter ≤ 1.5 mm Q QDiámetro 1.5 ≤ 3 mm R 3Diámetro 한 3 ≤ 10 mm | S Diameter ≤ 1.5 mm T 3Diameter 1.5 ≤ 3 mm U 3Diámetro 한 3 ≤ 10 mm | |
| PLEURAL OPACITIES | |||||||
| PARED COSTAL | DIAFRAGMA | COSTOFRENCH ANNEX | |||||
| CIRCUNSCRITAS OR DIFUSAS | Yes | NO | Yes | NO | |||
| ANCHO a<≤5 mm b5 limit5 ten mm c 10국 10 mm | EXTENSION 1 1/4 of the chest wall. 2 de preliminar1/2 of the chest wall 3 deδ1/2 of the chest wall | D E R E C H O | I Z Q U I E R D O | D E R E C H O | I Z Q U I E R D O | ||
| CALIFICATIONS | The lower limit to define the obliteration of the costphrenic angle is given by Rx. standard chest, category 1/1 - t/t | ||||||
| PARED | DIAFRAGMA | OTHER | |||||
| EXTENSION | |||||||
Pulmonary radiological alterations are sine qua non condition for the diagnosis of pneumoconiosis. In the case of workers exposed to asbestos fiber, the presence of pleural plaque, as an isolated sign, does not allow the diagnosis of asbestosis in the absence of parechymatous opacities.
To measure the functional commitment, spirometry will be used, which must be performed without bronchodilator, being the Vital Force (CVF) and the Residual Capacity (CR) the most altered parameters in this pathology, as shown in Table 1.
The measured volumes will be expressed in percentages of normality references.
Bearing in mind that fibrogenic pneumoconiosis, by the development of fibrosis, which destroys and replaces the lung tissue, give a fundamentally restrictive commitment, the value of the forced vital capacity (CVF), will be the item that will affect the worker's location in the Respiratory Incapacity Table.
2. C CRONQUITIS CRONICA OCUPACIONAL
Chronic exposure to irritating respiratory agents contributes to the development of chronic bronchitis. This entity is defined as the presence of cough and expectation for a minimum period of 3 months per year, at least for two consecutive years.
1. . Simple chronic bronchitis in which there is no permanent and irreversible obstruction of the airway.
Inability 0 %
2. . Chronic obstructive bronchitis. the inability will be determined on the basis of the ventilatory alterations that are demonstrated by the spirometry without the use of bronchodilatador, bearing in mind that for obstructive pathology, the indicators Enforced Spiratory Volume will be used in a second (VEF1), and the relationship between it and the Forced Vital Capacity or Tiffeneau Indice VEF1/CVF, as the most orientation of the worker's location.
If the result is less than 66 %, the permanent incapacity will be leveled by 66 % in cases where the measurements of resting blood gases show a PaO2 equal to or less than 85 % or a CO2 PA equal to or greater than 15 % of what is considered normal.
3. ASMA BRONQUIAL OCUPATIONAL
In cases of occupational asthma for the effects of disability, the following three categories shall be recognized:
A. . Asthma without Bronchial Hyperreactibility Unspecific. Once the person is permanently removed from the labor environment causing the asthma disappears. While there is no respiratory sequelae, there is an immune state that prevents him from continuing to perform his specific work.
Inability: 0-15 %.
B. . Asma with unspecific HRB. The person continues to suffer from asthma despite his definitive removal from the causative working environment, which makes it imperative to permanently treat maintenance and regular medical controls. With proper treatment, you can unravel relatively well in your daily life, with jobs that do not involve respiratory attacks of any kind, including smoking.
Inability: 15-30 %.
C. . Severe bronchial asthma, is associated with persistent bronchial obstruction, which does not significantly reverse with the use of bronchodilators, constitute a severe limiter for physical effort. Incapacity will be determined by spirometric tests, to classify it at the corresponding functional stage. The parameters to be taken into account are the same as obstructive chronic bronchitis, i.e. the Forged expiratory volume in 1 sec. (VEF1) and the VEF1/CVF ratio.
HRB should be objectivized only by the metacoline test. The response will be considered positive with a minimum drop in the VEF1 of 20%.
4. DEL OCUPATIONAL CANCER OF RESPIRATORY APARTMENT
Numerous epidemiological studies have established an association between respiratory cancer and exposure to certain labor inhalation risks. Such is the case of arsenic, asbestos and chromium which constitute some of the leading causative agents. Both bronchial cancer and pleural mesothelioma are of great malignity and, therefore, of poor prognosis. Bearing in mind the above, it is appropriate to assign to any of the aforementioned, cone without demonstration of metastasis, a disability between 66 and 90 %.
BIBLIOGRAPHICAL REFERENCES
1. . American Thoracic Society Criteria for Pulmonary Inpairment. Renzetti AD et al: Evaluation of Impairment Disability Secondary to Respiratory Disorders. Am Rev. Breathe. Dis. 1986; 133: 1205.
5. OCUPATIONAL PULMONIAL INFECTIONS
Occupational infections are temporary lesions that will be evaluated according to the sequelae that will be measurable by the Evaluation Table for Respiratory Inability.
| Pulmonary hypothesis | |
| Simple hydatidic cyst, with surgical resection without complications | without disability |
| Complicated hydiatid cyst: Rupture (symbra) | 70% |
| Recidive with generalized sowing | 80% |
POST TRAUMATIC LESIONS
Upper aerial paths: It is referred to the Chapters of Head and Face and Gorges, Nariz and Hear.
PARED TORACICA
Soft and bone parts: It is referred to the Osteoarticular Chapter.
Post-traumatic diaphragmatic hernia is referred to the Abdominal Wall Chapter.
PULMONS AND PLEURA
| Post-traumatic scar reactions and reactions, without functional respiratory commitment | without disability |
| Post-traumatic scar reactions and reactions, with functional respiratory commitment | according to table |
| Traumatic Post Surgical Interventions, No Sequelas | without disability |
| Toracoplasty without respiratory failure | without disability |
| Toracoplasty or post-traumatic sequelae, with respiratory insufficiency | according to table |
| Lobectomy or Segmentectomy, according to respiratory incapacity | according to table |
| Neumonectomy (you will add the degree of respiratory insufficiency) | 30% |
MEDIASTINO
| Esophageal perforation mediastinitis | (see Cap. esophagus) |
| Mediastinitis, good evolution c/trat. doctor or surgical | without disability |
| Mediastinitis, with retractable sequelae (dysphagia, etc.) | according to sequel |
General
THE CARDIOVASCULAR SYSTEM LAWS TO BE ASSESSED, ARE THE LAWS OF PROFESSIONAL ENVIRONMENTS UNDER THE LISTED, DIAGNOSTICADA AS PERMANENT OR SECUELS OF WORKING ACCIDENTS
The diagnostic elements to be used are: Anamnesis, Physical Test.
Laboratory: Total Colesterol, Colesterol HDL, Colesterol LDL. Kidney function, CPK, LDH, TGO, TGP.
Diagnosis by images: Rx, Eco, Gama House, Dopller, Hemodinamia.
Electrophysiological: Ecg, PEG, Holter, Presurometry.
Eye background.
| Affections | Percentage |
| 1. Coronary Cardiopathy | |
| 1.1 Anginous syndrome. | |
| 1.1.1 Chronic and stable breast angina. Tested with PEG and/or Talio and/or Positive Hemodynamy | 60% |
| 1.2 Myocardial infarction. | |
| 1.2.1. Myocardial infarction recovered, medically treated or surgically, without hemodynamic alterations and negative submaximum PEG | 20-30 % |
| 1.2.2. Myocardial infarction recovered, medically or surgically treated, with residual ischemia and/or hemodynamic disorders and/or PEG positive submaximum stress test | 80% |
| 2. Right cardiac insufficiency (complication of lung pathologies of labor origin), adds arithmetic form to the disease that gave birth | 30% |
| 3. Angioneurotic syndrome of the predominant hand of the index and middle fingers accompanied by hand cramps and decreased sensitivity (Professional disease). | |
| Commitment of one hand | 5 % |
| Bilateral commitment | 10% |
| 4. Permanent unilateral vascular commitment, with Raynaud phenomenon or ischemic manifestations of fingers. | 20% |
| 5. Disorders of the permanent circulation of fingers and feet. | |
| 5.1 Disorders of the circulation of fingers and feet without acroostheolisis | 15% |
| 5.2. Disorders of the circulation of hands and feet with acroostheolisis | 25 % |
| 6. Arterial hypertension (HTA) as sequelae of professional nephropathies: It will be taken into account, Rx, Eco, Camera range, Ecg, Eyes background | |
| de Stadium I: Diastolic pressure figures are repeatedly higher than 90 mm Hg, Electrocardiogram (ECG), Rx, Eco (without ventricular hypertrophy) and normal eye background, with no history of stroke injury | 5 % |
| s Stadium II: No history of vascular lesion by HTA, no sequelae at the time of evaluation, with evidence of left ventricular hypertrophy and eye background with HTA arterial alterations without bleeding or exudated | 20% |
| s Stage III: Left ventricular hypertrophy to ECG and ECO, chest Rx without signs of heart congestion, retinopathy with changes defined by HTA with bleeding and exudados | 40% |
| todo Stadium IV: All of the above is added to the Cardiac Insufficiency or Cerebrovascular Accidents by HTA or HTA Retinopathy with retinal or optical nerve damage | 70% |
| Post Traumatic anatomical lesions | |
| Pericardio | |
| Tap, operated, without functional sequel | without disability |
| Tap, operated, with functional sequel | 50 - 70% |
| Pericarditis: | |
| start, surgical drainage, without hemodynamic sequel | without disability |
| with hemodynamic sequel | 40 - 70% |
| constrictive, with hemodynamic impact | 70% |
| Heart | |
| Myocardial lesions | |
| Direct wound, requiring surgery | 40 - 70% |
| Great vases (which require surgery) | |
| Arterials: | |
| Pulmonary | 30% |
| Aorta, no sequel | 40% |
| with sequel | 70% |
| Subclavian, no sequel | 0 % |
| with sequel (by pass) | 50% |
| Abdominal aorta | |
| Operated, no sequel | 30% |
| Operated, with sequel, aneurysm or stenosis, which requires surgery | 70% |
| Peripheral arteries | |
| Operated, without sequels | without disability |
| Operated, with sequelae, requiring surgery | according to sequels |
| Venous: | |
| Upper Cava, no sequel | 0 % |
| with complications | according to sequel |
| Pulmonary | 30% |
| Subclavian | 30% |
| Vena Cava inferior | |
| Operated, no sequel | 0 % |
| Operated, with sequel | 40% |
| Lymphs: Torque conduct, quilothorax | 30% |
| (If there is pleural sequel, see Cap. Respiratory) | |
THE LESIONS OF THE DIGESTIVE APARTMENT AND ABDOMINAL PARED TO BE ASSESSED, ARE THE LAUGHS OF THE PROFESSIONAL ENVIRONMENTS THAT FIGURE IN THE LISTED, DIAGNOSTICED AS PERMANENT OR SECUELS OF WORKING ACCIDENTS.
Useful elements for evaluation:
Anamnesis, Physical exam, Laboratory, Endoscopying
Diagnosis by images: Rx simple, Rx with contrast, T.C., ECO, EMN,
Centellogram.
BUCAL CAVITY
Loss of soft parts (See Head and Face)
| Stomatitis | Inability |
| 1. de Mercurial stomatitis with loss of less than 1/3 of the teething pieces as sequel | 20% |
| Mercurial Stomatitis with Kidney Loss of 1/3 More | 40% |
| 2. de Traumatic loss of less than 1/3 of teething pieces | 20% |
| Traumatic loss of more than a third of the teething parts | 40% |
Note: With regard to loss of dental parts due to stomatitis, mercurial or traumatic secondary to industrial accidents, only the inability indicated in the event that such losses are not replaced by fixed prosthesis, i.e. bridges or titanium implants will be granted.
Language
| 1. Partial loss, without alteration of fonation and swallowing | 10-15 % |
| 2. Partial loss, with alteration of fonation and swallowing | 15 - 30% |
| 3. Total loss. | 50 - 60% |
ESOFAGO
Working accidents that cause injuries in the esophagus are exceptional. They may be caused at the neck and/or chest level as a result of the intake of caustic or penetrating wounds in those regions. The latter are usually accompanied by commitments in other bodies.
Sequelae are directly related to the injury that caused them or may be secondary to the treatment, which must have been performed.
In anamnesis you will have special interest in the evaluation of dysphagia, pain and vomiting.
The physical examination shall consider the nutritional status. The contribution of Clinical History will be required, with the diagnostic and therapeutic procedures performed.
Injuries
| 1. , Simple perforation, without neck and/or mediastinitis, without sequelae | without disability |
| 2. . Mild sequel: with intermittent dysphagia, with dyskinesia, without stenosis and without weighted commitment. | 2-10 % |
| 3. : Moderate sequel: | |
| s with stenosis and need for periodic dilations without weight loss or with loss less than 10% of the usual weight | 10-15 % |
| con with loss greater than 10% of the usual weight and with little commitment of the general state | 15% |
| . with loss greater than 10% of the usual weight and moderate commitment of the general state. | 30-50 % |
| Perforation of the thoracoabdominal esophagus solved by toracolaparotomy or thoracophotomy and closing of the gap with the gastric mollus (Op. of Thal) or similar | 70% |
| 4. : Secuela grave: Perforation in mediastinum, which requires surgical drainage or removal of the esophagus, replacement of the esophagus with stomach, colon or small intestine | 70% |
| Necrosis (caustic lesions), with surgical replacement of the esophagus | 70% |
| Total stenosis, which requires surgical replacement of esophagus | 70% |
| Any of these three sequelae, without the possibility of surgical repair, except feeding ostomy and/or parenteral feeding | 80 - 90 % |
_
The stomach and duodenum may be injured by violent contusions in the epigastric region and lower thorax area by abdominal penetrating wounds and also by caustic ingestion.
The duodenum can explode by being heavily crushed against the vertebral bodies and, when this happens, the pancreas is usually compromised.
In all these cases surgical intervention is imposed, where the treatment will be determined: from simple closure to wide resections. For this reason, it is important to require a copy of the surgical part, and the complementary studies performed.
_
Injuries
| 1. Laparotomy scout without sequel | 0 % |
| 2. Partial range: | |
| 2.1 with loss of less than 10% of the usual weight | 15-20 % |
| 2.2 with weight loss greater than 10% | 20% |
| 2.3. with post-surgical sequelae (Dumping Arse Syndrome) with a loss of less than 10% of the usual weight | 25-35 % |
| 2.4 with post surgical sec. (Dumping, etc.), with a loss of more than 10% of body weight | 35-40 % |
| 3. Total Gatectomy: No Weight Loss | 30% |
| 3.1. with loss of less than 10% of the usual weight | 30-35 % |
| 3.2 with loss of more than 10% of the usual weight and moderate commitment of the general state | 40-50 % |
| 3.3 with loss greater than 10% of the usual weight and important commitment of the general state, with or without reflux sequel | 70% |
DUODENO
| 1. : Duodenopancreatectomy: | |
| cephalica | 45 % |
| total | 70% |
| 2. Plain ligation with simple closure and gastroenteroanastomosis | 20-30 % |
INTESTINO DELGADO
Like all hollow viscera, it can be injured by abdominal trauma and/or penetrating wounds.
Injuries
| 1. , Laparotomy scout without sequel, for simple closure without resection | without disability |
| 2. : Resection: | |
| less than 60 cm. | 5-10 % |
| if it involves Treitz' angle | 15% |
| other than 60 cm (value nutritional status): | |
| with less than 10% of the usual weight, hypoalbuminemia, not less than 3 gr. | 25-30 % |
| with a loss of more than 10% of the usual weight, hypoalbuminemia, not less than 3 gr. and/or anemia | 30-40 % |
| with a loss of more than 10 % of usual weight, albuminemia less than 3 gr. and/or anemia or functional commitment small intestine type | 70% |
| 3. de In case of fistulas, permanent, which compromise the general state, add: | 25 % |
INTESTINO GRUESO
The causes of the lesions are similar to those referred to for Intestino Delgado.
Injuries
| 1. , Laparotomy scout, with simple closure, without colostomy | without disability |
| 2. La Laparotomy scout, with simple sierre, with transient colostomy, reconstructed transit at the time of evaluation | 5 % |
| 3. , Segmentary colectomy, without colostomy | 10-15 % |
| 4. de Segmentary colostomy, with transient colostomy, reconstructed transit at the time of evaluation | 10-15 % |
| 5. , Hemicolectomy, without colostomy | 10-15 % |
| 6. de Hemicolectomy, with transient colostomy, reconstructed transit at the time of evaluation | 10-15 % |
| 7. total Total panchoectomy | 50-70 % |
| 8. Final colostomy | 40-60 % |
If resection motivates functional disorders, which compromise the general state (weight loss, anemia, hypoalbuminemia, chronic diarrhea) incapacity will increase by 15%.
To evaluate the colectomy, Rx de Colón will be requested by enema and colonoscopy.
RECENT AND ANO
The lesions are usually the product of penetrating contus trauma.
| 1. de Perforation of rectum, extraperitoneal, with transient colostomy, reconstructed transit at the time of evaluation | 10-15 % |
| 2. de Perforation of rectum, intraperitoneal, with simple closure and transient colostomy, reconstructed transit at the time of evaluation | 10-15 % |
| 3. de Straight, intraperitoneal, with Hartmann Operation | 25-30 % |
| 4. de Perforation of rectum, with final colostomy | 40-60 % |
| Anal fistulas (post-traumatics or post-traumatic complications) without therapeutic solution: | |
| Subcutaneous | 1-3 % |
| Transesfinteriana | 10-20 % |
| Extrasfintern | 10-20 % |
| Fissures without a sphincter injury | 0-2 % |
| with sphincter injury | 2-5 % |
If a permanent functional disorder occurs on the occasion of resections or lesions: incontinence, defecatory obstruction by stenosis and/or nervous injury, the inability will increase by 30%.
PARED ABDOMINAL
| Vicious scars, retractiles, anfractures: | |
| less than 10 cm. | 2 % |
| over 10 cm. | 5 % |
| Reupture of the previous rectum, operated or not, cure without sequel | without disability |
HERNIA EVENTRACION OR EVISCERATION DIAFRAGMATICA
POST-TRAUMATICA
| No complications | without disability |
| With complications (respirat., digest., cardiopul.): | according to sequel |
| HERNIA | |
| Umbilical or Epigastric: | |
| operated, without sequels | without disability |
| operated with after surgical sequelae | 6 % |
| Inguinal or unilateral crural: | |
| operated, without sequels | without disability |
| operated with after surgical sequelae | 6 % |
| Inguinal or Bilateral Crural: | |
| operated, without sequels | without disability |
| operated with after surgical sequelae | 12 % |
| EVENTRATION | |
| less than 6 cm, no therapeutic solution | 6-12 % |
| greater than 6 cm. without therapeutic solution | 13-16 % |
| giant, more than 23 cm, not reparable | 40% |
If there are complications that require surgery and this will leave you some sequel, you will be added to the incapacity assessed the corresponding type of intervention performed. For this purpose it is referred to the corresponding item (e.g. bowel sections).
BILIARES
Working accidents that cause injuries at this level may be due to intake of toxics, bruising or penetrating wounds. The liver may also be affected by certain infectious agents (Hepatitis B, Hepatitis C, or others) or work with some toxic substances
Useful elements for evaluation:
Anamnesis, physical exam.
General Laboratory: Specific: Hepatogram, Proteinogram, Gamma GT.,
Study of hemostasis,
Serial hills, Arc 5,
Viral markers
Diagnosis by images: Rx, Eco, TC, RMN.
Damage caused by liver diffuse lesions will be assessed on the basis of functional commitment: clinical and laboratory signs. Biopsy is a valuable element.
In segmental or targeted anatomical lesions imaging is indispensable.
Evaluation of the liver function:
Child Index (Marker of Function in Chronic Hepatopathy)
| A | B | C | |
| Bilirrubinemia | ≥20 mg/L | 20 - 30 mg/l | ≥30 mg/L |
| Albuminemia | ▪35 g/l | 30-35 g/l | ≥30 mg/L |
| Protrombinemia | ▪70 % | 70-40 % | % |
| Ascites | No. | moderate | abundant |
| Encephalopathy | No. | easy. | important |
| Nutrition | Excellent. | correct | Bad. |
| % Inability | 10 - 30% | 30 - 60% | 70% |
Diffuse liver lesions, whatever their etiology, produced at work, will be evaluated according to the preceding parameters. The extreme values of incapacity of each stage are correlated with: Clinical History, the frequency of decompensations and the humoral data limits expressed.
Active chronic hepatitis, still compensated, diagnosed by biopsy, can reach an inability of 70%, depending on the degree of inflammatory histological activity, clinical parameters, alteration of humoral values and the type of work activity.
| Hepatic Angiosarcoma | 90 % |
Anatomical lesions
Liver
Traumatic liver lesions that cure without sequelae do not present incapacity.
Traumatic liver lesions that leave sequelae will be evaluated according to the same. For example: Hepatic insufficiency, synequia, etc.
| Simple hydatidic cyst, with surgical resection without complications | without disability |
| Complex hydatidic cyst: Rupture (peritoneal seed) | 70% |
| Recidiva with peritoneal sowing | 80% |
When it coexists with chest complication, the incapacities will be combined.
If there is a commitment to the post-resection hepatic function, it will be evaluated from the parameters mentioned in the corresponding item.
The lesions, produced by and during the work, which give rise to a liver transplant are valued at 90%.
| Vías Biliares | |
| Post-traumatic vesicle break | 10% |
| Extra liver biliary duct break: | |
| Partial Breakdown of Colédoco (drenage) | 15-20 % |
| Total break with repair of the bile pathway | 30-40 % |
| Post-surgical obstructive sequel | 70% |
| Fistula biliar, post-surgical, non-reparable | 70% |
| Pancreas | |
| Resection of Pancreas for trauma: | |
| Duodenopancreatectomy cephalic | 45 % |
| Corporal pancreatectomy | 50% |
| Total pancreatectomy | 70% |
| Total pancreatectomy plus splenectomy | 80% |
| Bazo | |
| Splenic suture, post-traumatic (without splenectomy) | without disability |
| Partial Splenectomy, Post Traumatic | 10% |
| Total splenectomy, post-traumatic | 25-30 % |
General
THE RELESIONS OF THE NEFOUROLOGICAL SYSTEM TO BE ASSESSED, ARE THE LAWS OF THE PROFESSIONAL ENVIRONMENTS THAT FIGURE IN THE LISTED, DIAGNOSTICED AS PERMANENT OR SECUELS OF WORKING ACCIDENTS.
The useful elements for the evaluation are: Anamnesis, Physical Review
Laboratory: Hemogram, uremia, creatininemia, Clearence of creatininemia or insulin, etc.
Diagnosis by Rx, Eco, TC, RNM, isotopian radiorrhaging and/or Gamma Camera (you can see the function of each kidney separately)
RIÑON
Renal insufficiency
Kidney pathology caused by any of the toxic agents that includes the law should be evaluated based on the renal function of the worker, regardless of the type of damage (tubular, interstitial, glomerular, with nephrotic syndrome, uremic syndrome etc.)
The amount of incapacity for this concept depends on the degree of renal insufficiency measured by the degrees of glomerular filtration (VFG) that is then detailed;
| VFG Degree | VFG. ml/min | Inability |
| Grade I | 70 - 50 | 10% |
| Grade II | 40 - 30 | 20% |
| Grade III | 20 5 | 70% |
| Grade IV | . | 90 % |
| Note: | Grade I | Asymptomatics |
| Grade II | Mild anemia, hypertension (HTA), possible. | |
| Grade III | Incentuation of the above + uremic syndrome. | |
| Grade IV | Clinical situation that requires dialysis or transplant. |
You will be added to the inability caused by nephrovascular hypertension that this pathology of origin (see Cardiovascular)
| Post-traumatic injuries | Inability |
| Loss of kidney for nephrectomy, with functional compensation of the remnant kidney | 20% |
If the remaining kidney has any degree of insufficiency, the incapacity assessment must be in line with the criteria mentioned above in the table.
As a diagnostic method to evaluate the function of each kidney separately, isotopian radiorrhaging and/or Gamma Camera will be used.
Post-traumatic lesions will be evaluated according to the sequelae and once the therapeutic resources are exhausted.
| Unilateral hydronephrosis, without functional impact, with normal contralateral kidney | 5 % |
| Unilateral hydronephrosis, with 1/3 functional annulment, with normal contralateral kidney | 10% |
| Unilateral hydronephrosis, with 2/3 functional annulment, with normal contralateral kidney | 15% |
| Unilateral hydronephrosis, with total functional annulment, with normal contralateral kidney | 20% |
| Unilateral hydronephrosis, with 1/3 functional annulment, total with decreased contralateral kidney | according to renal function |
| Unilateral hydronephrosis, with total functional annulation, with contralateral kidney without function | according to renal function |
| Bilateral hydronephrosis, with functional annulment of both kidneys | according to table |
| Unilateral renal ptosis, without functional impact, with normal contralateral kidney | 5 % |
| Unilateral renal Ptosis, with 1/3 functional annulment, with normal contralateral kidney | 10% |
| Unilateral renal Ptosis, with 2/3 functional annulment, with normal contralateral kidney | 15% |
| Unilateral renal Ptosis, with total functional annulment, with normal contralateral kidney | 20% |
| Unilateral renal Ptosis, with total functional annulment, with decreased contralateral kidney | according to renal function |
| Unilateral renal ptosis, with total functional annulation, with contralateral kidney without function | according to renal function |
| Bilateral renal Ptosis, without functional impact | 10% |
| Bilateral kidney disease | according to renal function |
| The presence of permanent infection will increase every picture | 10% |
URETER
| Post traumatic ureteral replacement | |
| Unilateral, without functional alterations, with normal contralateral kidney | without disability |
| Unilateral, with 1/3 functional annulment, with normal contralateral kidney | 10% |
| Unilateral, with 2/3 functional annulation, with normal contralateral kidney | 15% |
| Unilateral, with full functional annulment, with normal contralateral kidney | 20% |
| Unilateral, with total functional annulment, with decreased contralateral kidney | according to renal function |
| Bilateral, without functional alterations | without disability |
| Bilateral, with functional annulment | according to renal function |
| Ureterostomy | |
| Unilateral permanent cutanx | 40% |
| Bilateral permanent cutaneous | 70% |
VEJIGA
Evening cancer (by exposure to toxics)
The criterion for establishing the degree of physical incapacity of a bladder cancer and which most likely leads to the death of the worker has to do with the degree of lost function but also with the prognosis and possibility of survival of the same.
For such purposes, the following criteria are established:
| Stadium | Engagement Degree | Inability |
| 0 | Surface or in situ, mucosa | 10% |
| A | Surface, submucosa | 20% |
| B | Invasor, muscle | 40% |
| C | Invasor, perivesical fat | 60% |
| D1 | Metastatic, lymph nodes | 90 % |
| D2 | Metastatic, bones or viscera | 90 % |
Without prejudice to the foregoing, if within the 36 months extended to 60 that establishes the law as a period of provisional incapacity, an increase in the commitment of bladder cancer from grades A or B to grade C or above, the worker must be given a disability of 90%.
| Evening congestion with varicocele | 20% |
| Benign bladder tumor | 10% |
| Post-traumatic injuries | |
| Transitory cystomy | without disability |
| Final cystomy | 70% |
| Partial | 20-30 % |
| Total number of cases | 70% |
| Post-traumatic neurogenic bladder | 70% |
| Operable chronic retractable cystitis | according to sequels |
| Inoperable chronic retractable cystitis | 60% |
| Man-operable urine incontinence | according to sequels |
| Operable urine incontinence in women | according to sequels |
| Incontinence of permanent urine, inoperable in man | 70% |
| Incontinence of permanent urine, inoperable in women | 70% |
| Operable urinary fistula | according to sequels |
| Inoperable urinary fistula | 40-60 % |
URETRA
Uretral lesions, by accidents, labor will evaluate after surgical repairs, if appropriate, and according to sequelae.
| Uretral narrow, post permeable traumatic | 10-20 % |
| Uretral Straight, post-traumatic Infranqueable | 70% |
| Uretral fistula, definitive post traumatic | 70% |
GENITAL MASCULINE
| Castration | 40% |
| Total Penis Amputation | 40% |
| Partial Penis Amputation with Conserved Erectile Function | 25 % |
| Partial Penis Amputation without Erectile Function | 30% |
| Penis deforming penis lesion with deviation of the angulation or lesion of the cavernous bodies | 20% |
| unilateral testicular atrophy, by contusion (organized hematocele) | 10% |
| Bilateral testicular atrophy, by confusion (organized hematocele) up to 40 years | 40% |
| between 40-65 years | 30% |
| over 65 years | 20% |
| Sexual, post-traumatic dysfunction in erection and permanent ejaculation (organic) | 30% |
| Scrotum trauma, with partial skin loss | 5 % |
| Scrotum trauma, with total skin loss and without repair surgery | 30% |
| Post-traumatic bruising, no sequelae | without disability |
GENITAL FEMENINE
The female genital apparatus is divided into two anatomical zones: internal and external.
In the internal part, given its location, it is statistically difficult to observe injuries from work accidents, which originate sequela.
These, in addition to the local impact, can lead to reproductive incapacity.
On the outside, traumatic lesions are more frequent.
The lesions will be evaluated, after the corresponding treatments and if the sequelae remain.
Injuries
| Partial or total adhesions of vulva | 10-30 % |
| Partial or total adherence to larger or lesser lips | 10-30 % |
| The urinary commitment shall be considered | |
| Straight vagina or shortening | 20-30 % |
| Traumatic Clitoridectomy | 20% |
| Total or subtotal hysterectomy, fertile age | 40% |
| Total or subtotal hysterectomy, post-menopausia | 10% |
| Traumatic unilateral oophorectomy | 10% |
| Traumatic bilateral oophorectomy, fertile age | 40% |
| Traumatic bilateral oophorectomy, post-menopausia | 20% |
| Traumatic unilateral salpinguectomy | 10% |
| Traumatic bilateral salping, fertile age | 40% |
| Bilateral traumatic salping, post-menopausia | 10% |
| Perineum tear produced by accident, without spurious or sexual commitment | without disability |
| Incontinence is assessed according to incontinence. | |
| Straight-vaginal fistula without surgical solution | 30% |
| Breast wound or trauma, with unilateral partial destruction | 0-5 % |
| Breast wound or trauma, with total unilateral destruction | 10-15 % |
| Breast wound or trauma, with bilateral partial destruction | 10-15 % |
| Breast wound or trauma, with total bilateral destruction | 30% |
THE LESIONS OF THE HEMATOPOYETIC SYSTEM TO BE ASSESSED, ARE THE LAWS OF PROFESSIONAL ENVIRONMENTS UNDER THE LISTADO, DIAGNOSTICADA AS PERMANENT OR SECUELS OF WORKING ACCIDENTS.
1. S HEMATOLOGICAL ENVIRONMENTS OF TIPO HIPOPLASIA, APLASIA or DISPLASIA, which can be manifested by:
Anemia, leuconeutropenia, thrombocytopenia.
For the purposes of evaluating benzolism the following hematological parameters will be taken into account, according to complexity:
| Anemia: Tested according to hemoglobinemia | Inability | ||
| 9-7 g. of Hb. | 15% | ||
| 7-5 g. of Hb. | 40% | ||
| 5 g. of Hb. | 70% | ||
| Leucopenia: Less than 3,500 per mm3 | Inability | ||
| Leucopenia more absolute neutrophil count between 3,000 and 2,200 mm3 | 5 % | ||
| Leucopenia more absolute neutrophil count between 2,200 and 1,000 mm3 | 10% | ||
| Leucopenia more absolute neutrophil count less than 1,000 per mm3 without recurrent infections | 20% | ||
| Leucopenia more absolute count of neutrophils less than 1,000 per mm3 with recurrent bacterial infections (more than 4 episodes in the last 5 months prior to evaluation) | 70% | ||
| Leucopenia more absolute count of lymphocytes between 1,500 and 800 per mm3 | 5 % | ||
| Leucopenia more absolute count of lymphocytes less than 800 per mm3 | 10% | ||
| Trombocytopenia: | Percentage | ||
| 100,000 - 30,000 x mm3 | 5 % | ||
| 30,000 x mm3 | 10% | ||
| All of the above is not additive. | |||
| Hipoplasia and medular aplasia | |||
| (Medulular puncture and biopsy need) | |||
| Degree | Features | Inability | |
| Leve | Medullary suppression of 10% with normal peripheral blood | 0 % | |
| Moderate A | Medular depression from 11 to 40%, chronic anemia | 30% | |
| Moderate B | Medular depression from 41 to 70% | 60% | |
| Severa Medular suppression 70 % | 80% | ||
| Myelodysplasia with hyperleucocytosis and syndromes | Inability | ||
| Mieloprolifera | |||
| Leucemoides States | 40% | ||
2. . LEUCEMIAS more than 10 years, in general they evolve faster to death than cryptogenic forms and are usually resistant to various antimitotic treatments.
Leukemias of professional origin in decreasing order of presentation frequency are as follows:
Acute leukemia
Chronic myeloid leukemia
Chronic lymphoid leukemia
The percentage of incapacity is determined according to the number of referrals after having performed antimitotic treatment that stabilizes the patient.
| Acute myelogenous leukemia (AML) | Inability |
| First remission | 50% |
| Second remission | 70% |
| Third remission | 90 % |
| Acute lymphocytic leukemia (HLA) | |
| First remission | 50% |
| Second remission | 70% |
| Third remission | 90 % |
| Chronic myeloid leukemia (CLM) | 20-90 % |
The degree of incapacity will depend on factors such as, timing of diagnosis, age, if the treatment is performed with a brother's marrow transplant or another person with compatible HLA, later evolution etc.
Note: HLA - An acronym that by international convention designates the gene complex of human histocompatibility.
Chronic lymphoid leukemia (CLL)
The degree of incapacity will depend on the stage of the disease according to the international classification.
| Stadium | Features | Inability |
| A | Lymphocytes with clinical involvement of less than three lymph node groups; without anemia or thrombocytopenia | 20% |
| A(0) | No larger nodes | |
| A(I) | Increased Ganglios in size | |
| A(II) | Hepatomegalia or splenomegalia | |
| B | Over three lymph node groups are affected. Without anemia or thrombocytopenia | 40% |
| B(I) | Increased Ganglios in size | |
| B(II) | Hepatomegalia or splenomegalia | |
| C | Anemia or thrombocytopenia, regardless of the number of ganglia groups affected | 70% |
| C(III) | Anemia | |
| C(IV) | Trombocitopenia |
S.I.D.A.
For the diagnosis of the working nature of this infectious disease, the corresponding serological determinations (Elisa - IF) will be performed at the time of the suspicious cut-off injury. These reactions must be negative.
Semi-annual controls will then be made within one year to verify the Seroconversion
| Group I: Seroconversion | 0-10 % |
| Group II: Asymptomatic infection | 10-30 % |
| Group III: Generalized Adenopathies Persistent | 40-60 % |
| Group IV: Associated with other diseases | |
| With Subgroups A, B and C | 70-90 % |
General
NEUROLOGICAL LEMISSIONS TO BE ASSESSED, ARE THE DERIENDS OF THE PROFESSIONAL ENVIRONMENTS THAT FIGURE IN THE LISTADO, DIAGNOSTICADA COMMANENT OR SECUELS OF WORKING ACCIDENTS.
In this Chapter, lesions and neurological commitment are evaluated exclusively. In case of not being contemplated in the incapacity assessed by osteoarticular posttraumatic sequel, the neurological incapacity determined will be combined with the first.
| Useful elements for evaluation: | Anamnesis. Physical review |
| Ojo and Campimetric Fund | |
| Laboratory General Dosage of Anticonvulsants | |
| Diagnosis by Images | |
| Simple Rx of skull and spine | |
| Eco-Doppler carotide, vertebral and transcranean | |
| TC, RMN, | |
| Electrophysiological, audiometry | |
| Electronistagmography, | |
| EMG with driving speed, EEG | |
| Evoked potentials: Auditives, Visuals, | |
| Somatosensitivos, Radioisotopicos, | |
| Centellogram, Dynamics |
1. DE REMISSIONS OF CRANIAL COUNTRIES
They will be taken into account to assess the lesion of the cranial pairs: significant clinic, evoked P. and/or altered EMG.
| Nervio Olfatorio | |
| Fracture of Cribosa Lamina | |
| (a) No complications | 0 % |
| (b) With complications: | |
| Hypomy | 5 % |
| Anosmia | 10% |
| Optical nerve: See chapter of Ojos. | |
| Common Eye Motor Nerve: Diplopia, Potsis palpebral (See chapter of Eyes). | |
| Pathetic nerve: Diplopia (See Ojos chapter). | |
| Nervio Trigémino | |
| Ophthalmic nerve | |
| Unilateral | 5-10 % |
| Bilateral | 10-20 % |
| Max nerve. superior | |
| Unilateral | 5-10 % |
| Bilateral | 10-20 % |
| Max nerve. lower | |
| Unilateral | 5-10 % |
| Bilateral | 10-20 % |
| Neuralgia of the Trigem | |
| Unilateral | 3-10 % |
| Bilateral | 10-50 % |
| External Eye Motor Nerve: Diplopia (See chapter of Eyes). | |
| Facial | |
| Unilateral Central | 5-10 % |
| Unilateral peripheral | 10-15 % |
| Central bilateral | 15-20 % |
| Peripheral bilateral | 20-30 % |
| Auditive nerve: See chapter of Nariz, Garganta and Oído. | |
| Glosopharyngeal nerve | |
| With hypoesthesia or anesthesia of the later third of the tongue | 5-30 % |
| Liquid dysphagia | 10-15 % |
| Disphagia for solids | 15-30 % |
| Neumogastric nerve | 5-35 % |
| Bridal | 15-30 % |
| Nervio Hipogloso | |
| Unilateral | 5 % |
| Bilateral: | |
| with difficulty speaking | 5-30 % |
| with difficulty swallowing | |
| - liquid. | 10-15 % |
| - solid. | 15-30 % |
| - pipe feeding | 40-60 % |
2. COMMISSIONS OF PERIFERIC NERVOUS
They are the ones that can accompany the Osteoarticular lesions, manifested by the sensitive deficits and/or motors.
The percentages of incapacity correspond to complete injuries. In relation to partial injuries of pure motor or sensitive nerves, the percentage of incapacity will be calculated by percentage to the lost function. For these purposes, the scale proposed by the British Medical Research Council will be used to gradify M0 to M5 and Sensitivity in S0 to S5 ranges.
| M0: | 100% motor failure |
| M1 and M2: | 80% of motor incapacity |
| M3: | 60% motor failure |
| M4: | 30% motor incapacity |
| M5: | 0 % motor failure |
| Percentage of disability: | |
| M0: | Total paralysis |
| M1: | Contraction sketch (muscular fibers) |
| M2: | Contraction possible, eliminating the force of gravity |
| M3: | Contraction possible against the force of gravity |
| M4: | Contraction against some resistance |
| M5: | Contraction against major resistance |
| Sensitivity | |
| S0: | 100% sensitive disability |
| S1: | 80% of sensitive disability |
| S2: | 60 % of sensitive disability |
| S3: | 40 % of sensitive incapacity |
| S4: | 20% sensitive incapacity |
| S5: | 0 % of sensitive incapacity (full death) |
Mixed nerves are weighted by percentage as to the functional importance of their sensory and motor components, so partial lesions must finally be calculated according to this factor.
For example:
Partial injury of the medium nerve at wrist level:
Average M3 (60 % motor failure)
Average sensitivity S2 (60 % of sensitive disability)
Functional position of the medium nerve on the wrist:
(component motor 40%, and sensitive component 60%)
(higher functional importance has the sensitive component)
Complete injury of the medium nerve: 25% incapacity
Engine component: 25 x 0.40 = 10 % x 0.60 (M3) = 6 % (motor capacity)
Sensitive component: 25 x 0.60 = 15 % x 0.60 (M3) = 9 % (sensitive incapacity)
Total inability of the medium nerve: 15%
In the case of coexistence of the neurological lesion with joint stiffness and deformity, the sum of both incapacities will be carried out, having as a maximum the percentage of incapacity for the amputation of the segment in valuation.
Neurotendinous lesions will be evaluated by adding the incapacities resulting from neurological injury and the alteration of joint mobility that causes tendon lesion. In the same way, the amputation of the studied segment will have as a maximum degree of incapacity.
Radical lesions will be evaluated according to the partial or total impact they cause on the peripheral nerves that form.
| A. . Senior Member | Inability |
| 1.- Full reading of the Braqueal Plex | 60% |
| 2.- Nervio Supraescapular | 15% |
| 3.- Long Toraceae | 10% |
| 4.- Nerve Axilar | 20% |
| ( Functional power: 98 % sensory component 2 %) | |
| 5.- Radial nerve | 30% |
| ( Functional power: 90 % sensory component 10 %) | |
| 6.- Nerve Skin muscle | 20% |
| ( Functional power: 90 % sensory component 10 %) | |
| 7.- Nervio Interóseo posterior | 20% |
| 8.- Antebraqueal cutaneous medial | 30% |
| 9.- Medium nerve (proximal to 1/3 medium of AB) | 40% |
| ( Functional power: 40 % sensory component 30 %) | |
| 10.- Medium nerve (distal to 1/3 medium of AB) | 25 % |
| ( Functional power: 40 % sensory component 60 %) | |
| 11.- Previous | 10% |
| 12.- Cubital nerve (proximal to 1/3 medium of AB) | 35 % |
| ( Functional power: 70 % sensory component 30%) | |
| 13.- Cubital nerve (distal to 1/3 medium of AB) | 25 % |
| ( Functional power: 70 % sensory component 30%) | |
| 14.- Collateral IR | 5 % |
| 15.- Collateral IC | 7 % |
| 16.- Collateral IIR | 7 % |
| 17.- Collateral IVC | 7 % |
| 18.- Collateral challenge | 3 % |
| B. - Inferior Member | Inability |
| 1.- Full readability of the lumbar plexus | 40% |
| 2.- Full lesion of the sacral plexus | 60% |
| 3.- Rape Femoral nerve | 7 % |
| 4.- Nervio Femoral | 30% |
| ( Functional component: Engine component 95 % sensory component 5 %) | |
| 5.- Nerve Internal Obturator | 15% |
| ( Functional component: 96 % sensory component 5 %) | |
| 6.- Rest of the branches of the lumbar plex | 10% |
| 7.- Cyatic nerve (Proximal to popliteum bone) | 50% |
| ( Functional component: motor component 50 %, sensitive component 50 %) | |
| 8.- Later cutaneous nerve of the thigh | 5 % |
| 9.- Common Peroneous nerve | 25 % |
| ( Functional component: 70 % sensory component 30 %) | |
| 10.- Previous Tibial nerve (1/2 prox. leg) | 18 % |
| ( Functional component: Engine component 95 % sensory component 5 %) | |
| 11.- Previous Tibial nerve (1/2 leg distal) | 10% |
| ( Functional component: motor component 50 %, sensitive component 50 %) | |
| 12.- Surface sine | 7.5 % |
| 13.- Nervio Tibial | 35 % |
| ( Functional component: 60 % sensory component 60 %) | |
| 14.- posterior Tibial nerve (1/2 prox. leg) | 30% |
| ( Functional component: 60 % motor component, sensory component 40 %) | |
| 15.- posterior Tibial nerve (1/2 leg distal) | 20% |
| ( Functional component: Engine component 30%, sensitive component 70%) | |
| 16.- External or internal planting | 10% |
| ( Functional component: Engine component 30%, sensitive component 70%) | |
| 17.- Nervio Safeno | 5 % |
| 18.- Sural nerve | 5 % |
3. TRA TRAUMATISMOS RAQUIMEDULARES
The lesions will be classified according to the neurological level at which the spinal injury occurs, and if they cause a complete or incomplete deficit of the spinal function.
In the case of incomplete injuries, a range of incapacity is established, which will be assessed on the basis of the functional capacity of the patient.
| LEVEL | Complete | Incomplete |
| C4 | 100% | 50 to 100% |
| C5 | 100% | 50 to 100% |
| C6 | 100% | 50 to 100% |
| C7 | 100% | 50 to 100% |
| C8 | 100% | 50 to 100% |
| T1 | 100% | 50 to 100% |
| T2 | 100% | 50 to 100% |
| T3 | 100% | 50 to 100% |
| T4 | 100% | 50 to 100% |
| T5 | 100% | 50 to 100% |
| T6 | 100% | 50 to 100% |
| T7 | 90 % | 50 to 90 % |
| T8 | 90 % | 50 to 90 % |
| T9 | 90 % | 50 to 90 % |
| T10 | 90 % | 50 to 90 % |
| T11 | 90 % | 50 to 90 % |
| T12 | 90 % | 50 to 90 % |
| L1 | 90 % | 50 to 90 % |
| L2 | 90 % | 50 to 90 % |
| L3 | 90 % | 50 to 90 % |
| L4 | 80% | 30 to 80% |
| L5 | 60% | 30 to 60% |
| S1 | 50% | 30 to 50% |
| S2 | 20% | 5 to 20% |
| S3 | 10% | 5 to 9 % |
| S4 | 5 % | 2-4 % |
| S5 | 5 % | 2-4 % |
BIBLIOGRAPHY
1) Hoppenfeld, S.: Physical exploration of the spine and the extremities. Ed. The Manual Moderno S.A., Mexico S.A., Mexico D. F. 1979.
2) Zachary, R. B.: Results of nerve suture. En: Peripheral Nerve Injuries, De por J. H.: Seddon, London, her Majesty's Stationery Office, 1954.
4. S NEURO-PSIQUIATRICES PRODUCED BY CHEMIC AGENTS
I. - ENCEFALOPATIA TOXICA AGUDA
There are numerous chemicals of industrial, agricultural or drug use, present in various production processes that can produce a toxic Acute Encephalopathy, which can generate CEREBRAL ORGANIC DAMAGE, of varying degrees, depending on the severity of intoxication and the opportunity of treatment.
The damages produced are not related to specificity with the chemical agent that causes them and consequently the brain function is evaluated in its psychological and neurological aspects. In cases where there is a brain organic damage, such as a sequel to acute encephalopathy, it is evaluated with the usual methods of Psychiatry, considering the characteristics prior to the disease of the affected person (age, sex, years of exposure, intellectual level, among others).
Agents who can produce ENCEFALOPATIA TOXICA AGUDA:
Mercury and its compounds.
Arsenic and its mineral compounds.
Lead and its compounds.
Alcohols and Cetonas, used as industrial solvents,
Carbon monoxide
Methyl Bromide.
Carbon sulfide.
Sulfhydric acid
The sequelae of acute encephalopathies for occupational intoxication are assessed according to the criteria of CEREBRAL ORGAN DAMAGE, which express the ability of the person to perform globally.
2. - ENCEFALOPATIA TOXICA CRONICA
Long-term exposure, often inappearing, at low doses of various chemicals of industrial or agricultural use produces a CRONIC EARGE DAMAGE, irreversible in all cases and progressive in some of them that must be evaluated with the same instruments and criteria as the sequelae of a Acute toxic encephalopathy.
Agents that can produce ENCEFALOPATIA TOXICA CRONICA:
Mercury.
Lead.
Carbon sulfide.
Halogenated derivatives of Aliphatic hydrocarbons.
Tolueno and Xileno.
Both acute and chronic toxic encephalopathy are evaluated by the brain organic damage they produce and the evaluation is performed in the same way.
The evaluation of brain organic damage secondary to acute toxic encephalopathy should be done at least six months after the sequelae have been stabilized and in the case of chronic toxic encephalopathy, six months after the exposure to the toxic has ceased.
Table 1 shows the most used psychological tests in the measurement of brain organic damage.
TABLE No. 1
EVALUATION OF THE EVALUATION
| TEST | TIPO | AREAS THAT EXPLORE | IMPLEMENTATION |
| BENDER RORSCHARCH WESCHLER RAVEN | TEST VISOMOTOR PROJECT OF PERSONALITY | PERCEPTUAL ACTIVITY CONDUCTA GRAFICA MADUREZ MEMORIA MANUAL MOTOR HABILITY TEMPORO CONCEPTS SPACE INTEGRATION CAPACITY MAGNIFICATION SIMULATION PROJECT OF THE STRUCTURE OF PERSONALITY INTELECTUAL LEVEL DETERIO SIMULATION INTELIGENCE CAPACITY ADAPTATION PSICO-ORGANICO LEVE, MODERED OR SEVERED INTELECTUAL COUNTRICT | GLOBAL RETRANS MADURATION SINDROME CEREBRO ORGANIZATION PSICOSIS DEPRESION IN ALL TABLES IN ALL TABLES IN ALL TABLES |
Table 2 shows the inability generated by each of the degrees of commitment produced by brain organic damage.
TABLE 2
CEREBRAL ORGAN DAMAGE INCAPACITY
| CHARACTERISTICS | GRAND | INCAPACITY |
| CAN REALIZE THE MAYORY OF ACTIVITIES OF DIARY LIFE | I | 15% |
| SUPERVISION AND DIRECTION FOR THE ACTIVITIES OF DIARY LIFE | II | 40% |
| CONFINAMIENT | III | 70% |
| ASSISTANCE FOR THE | IV | 100% |
3. - IREVERSIBLE CRONIC DEPRESION
Agents:
Carbon sulfide.
Organophosphorus pesticides.
Inability: 70%.
4. - NEUROPATIAS PERIFERICAL
Polineuritis and neuritis, with neuroelectric conduction disorder in irreversible phase.
Agents:
Carbon sulfide.
Lead.
- Hexano.
Arsenic.
Ethylene oxide.
Pesticide phosphorated organ.
Metil butil cetona.
The residual damage in the enervation area of each nerve will be evaluated according to the same criteria for traumatic neurological lesions.
5. - NEURITIS OPTICA
Agents:
Lead.
- Hexano.
Halogenated derivatives of Alphatic hydrocarbons.
Inability:
unilateral: 40%.
Bilateral: 70%.
6. - NEURITIS TRIGEMINAL
Agent:
Halogenated derivatives of Alphatic hydrocarbons.
Inability: 50%.
7. - SINDROME NEUROLOGICO TIPO PARKINSONISMO
Agent:
Manganese.
Inability:
In irreversible phase with response to drug treatment: 40%.
No response to drug treatment: 70%.
8. - ATAXIA CEREBELOSA
Agent:
Mercury.
Inability:
With intentional tremor in irreversible phase 40 %.
With progress disorders 70%.
5. . CEREBRAL or MEDULAR NEUROLOGICAL DAY. BY FISIC AGENTS
Produced by consecutive thrombosis or by improper decompression accident.
1. - Brain or medulla damage caused by thrombosis due to inadequate decompression.
They will be evaluated with the criteria of neurological damage for cases of commitment of the motor and sensitive functions of the affected territories. Medullary lesions will be evaluated with the same criteria of raquimedular trauma.
2. - And the commitment of other brain functions according to the criterion of brain organic damage.
6. TRA TRAUMATISMO CRANEO-ENCEFALICO
Evaluation of Neurological Sequelas
| Calota sinking, operated | according to sequels |
| Motor officers: | |
| Hemiparesia: | |
| mild | 40% |
| moderate | 50% |
| severe | 60% |
| Hemiplegia | 70% |
| Monoparesis: | |
| mild | 20% |
| moderate | 30% |
| severe | 40% |
| Monoplegia | 60% |
| Brain atrophies: | |
| Focales | 50% |
| Hemispheric | 60% |
| Generalized | 70% |
| Aphasias: | |
| Expression | 50% |
| Understanding | 70% |
| Mixed | 70% |
| Post-traumatic, communicative or non-communicative hydrocephalus (treated and compensated) | 40% |
| Auditive Deficit: Refers to Cap. de Otorrinolaringología | |
| Deficit Visual Agudeza and Campimetrics: It is referred to the Cap. of Ophthalmology. | |
| Convulsants Focales or Jacksonianas: | |
| EEG neg. (to be taken into account H.C.L. and anti-convulsant dosage) | |
| No positive data | 0 % |
| Positive data | 10-20 % |
| Positive EEG | 25-35 % |
| Generalized-Mal Convulsants | 50% |
7. TRA DESORDEN MENTAL ORGANICO POST TRAUMATICO
It is secondary to cranial brain trauma and is evaluated once acute alimic manifestations are stabilized.
| GRAND | DEFINITION | INCAPACITY |
| I | Momentary functional disruption of consciousness caused by skull trauma with a history of shock, but not of laceration or contusion. No histologic alterations or clinical changes. There is memory of the moment of trauma and a few moments before it. The period of unconsciousness is momentary or short. Recovery is fast and complete. The clinical picture is characterized by headaches, dizziness, lack of concentration and memory. | 0 % (doesn't leave sequels) |
| II | Trauma causes a loss of consciousness from one to several hours. The patient may suddenly wake up or go through a period of obnubilation of consciousness and confusion. There's post-traumatic amnesia. The functional recovery of the symptoms is complete, often accompanied by a moderate personality disorder, which is called CONTUSIONAL POST SINDROME, or POST-CONTUSIONAL NEUROTICO STATE. The clinical picture is characterized by anguish, headache and vertigo, hypersensitivity to stimuli, apathy and sluggish. Neurological, tomographic and electroencephalographic explorations are not significant. Psychometric tests show moderate elements of organicity. The influence of serious personality disorders must be discarded. | 20% |
| III | The headache is intense and palpitating, aggravated by the horizontal position and exacerbated by physical, mental effort and excitement, and improves with rest and quietness. There are dizziness due to changes in position, sometimes momentary nebulae of the vision of syncopal character, heat intolerance, tobacco and alcohol. Disphase disorders appear in language, loss of thought hierarchy, perseverance. Defects in concentration, perception, understanding and memory. There is intolerance to noises, litigant, fearful, apprehensive, hypochondriac. Neurological, tomographic, electroencephalographic and psychometric explorations present in all cases French organic alterations. | 40% |
| IV | Affective changes, memory disorders, disorders of other intellectual functions, alteration of behavior. Permanent and non-regressive. Neurological, tomographic, electroencephalographic and psychometric explorations present in all cases severe, organic alterations. Other organic defects are: Post-traumatic Epilepsy and Subdural Chronic Hematoma, evaluated by Neurology. | 70% |
General
THE SIQUIATRICTIONS TO BE ASSESSED, ARE THE SHIPPING OF THE PROFESSIONAL ENVIRONMENTS THAT FIGURE IN THE LISTED, DIAGNOSTICADA COMMANENT OR SECUELS OF WORKING ACCIDENTS.
Psychopathological diseases will not cause economic restitution, as in almost all of these diseases they have a structural basis.
Side psychiatric disorders or accidents due to skull-encephalic and/or post-traumatic epilepsy traumatic trauma (such as Acquired Abnormal Personalities and Post-Traumatic Dementia, Organic Chronic Deliriums, etc.) will be evaluated only under the heading TRAUMATIC ORGANIC OR IV.
Only the REACTIONS or the DISORDINATION of these TRAUMATIC POSTs, the NEUROTICAL VIVENTIAL REACTIONS, the PARANOIDES and the PSICOTIC DEPRESION that have a specific causal link related to a labor accident will be recognized. It should be discarded first of all the causes outside this etiology, such as the predisponent personality, socio-economic, family factors, etc.
Partial psychiatric incapacities, if there is more than one diagnosis, will not be summarizing, but will be recognized only for the most incapacity.
1. RE REACTIONS OR DISORDENGES BY THIS TRAUMATIC POST
They will be recognized when they are directly related to relevant traumatic events that occur at work, either as accidents, or as a witness to it. They constitute a disease, officially recognized by DSM III, and CIE 10 (WHO), which has an etiology, a presentation and a course, as well as a prognosis and resolution.
In general they tend to adapt to their new reality, and the vast majority of patients improve after three to six months, without sequelae.
A smaller group of cases evolve into a TRAUMATIC POST NEUROSIS, which does determine some degree of inability for work.
They will be considered for evaluation as ANORMAL VIVENCE REACTIONS discussed below.
2. ) NEUROTICAL ANORMAL VIEW REACTIONS (NEUROSIS)
In abnormal neurotic living reactions, as a result of work accidents, the previous personality must be carefully evaluated.
Important features will be considered for evaluation: the subject's basic personality, biography, mourning episodes, affective response, frustrated labor expectations and personal relationships with the environment.
Grade I
Definition: They are related to daily situations, the magnitude is mild, does not interfere in the activities of daily life, nor the adaptation of its medium. No permanent treatment required.
INCAPACITY: 0 %
Grade II
Definition: The features of the base personality are accentuated, they do not present alterations in thought, concentration or memory. They sometimes need some type of medication or psychotherapeutic treatment.
INCAPACITY: 10%
Grade III
Definition: They require more intensive treatment. There is remission of the most acute symptoms before three months. Memory and concentration disorders are verified during psychiatric and psychodiagnosis examination. The forms of presentation are from depression, conversive crises, panic crises, phobias and obsessions. They are reversible with appropriate psychopharmamacological and psychotherapeutic treatment. The controls are ongoing every year.
INCAPACITY: 20%
Grade IV
Definition: They require permanent assistance from third parties. Fóbical Neurosis, hysterical conversions, are the most invalid clinical expressions in this type of reaction. Neurotic depressions can also be very invalidating.
INCAPACITY 30%.
SUMMARY OF INCAPACITY REACCION VIVENCIAL ANORMAL NEUROTICA R.V.A.N. WITH MANIFESTATION
| R.V.A.N. Depressive Grade I | 0 % |
| R.V.A.N. Depressive Degree II | 10% |
| R.V.A.N. Depressive Grade III | 20% |
| R.V.A.N. Depressive Degree IV | 30% |
SUMMARY OF INCAPACITY REACCION VIVENCIAL ANORMAL NEUROTICA R.V.A.N. CON MANIFESTATION
| R.V.A.N. Fóbica Grado I | 0 % |
| R.V.A.N. Fóbica Grade II | 10% |
| R.V.A.N. Fóbica Grade III | 20% |
| R.V.A.N. Fóbica Grade IV | 30% |
SUMMARY OF INCAPACITY REACCION VIVENCIAL ANORMAL NEUROTICA R.V.A.N. WITH COMPULTIVE OBSESTATION
| R.V.A.N. Obsessive-compulsive Grade I | 0 % |
| R.V.A.N. Obsessive-compulsive Grade II | 10% |
| R.V.A.N. Obsessive-compulsive Grade III | 20% |
| OBSEVO-COMPULSTIVE ENVIRONMENT IV (with personality impairment) | 40% |
| OBSEVO-COMPULSTIVE ENVIRONMENT IV (with psychotic evolution) | 70% |
SUMMARY OF INCAPACITY REACCION VIVENCIAL ANORMAL NEUROTICA R.V.A.N. PSICOSOMATIC MANIFESTATION
| R.V.A.N. Psychosomatic Degree I | 0 % |
| R.V.A.N. Psychosomatic Degree II | 10% |
| R.V.A.N. Psychosomatic Degree III | 20% |
| R.V.A.N. Psychosomatic Degree IV | 30% |
SUMMARY OF INCAPACITY REACCION VIVENCIAL ANORMAL NEUROTICA R.V.A.N. HISTERICAL MANIFESTATION
| R.V.A.N. Historical Conversion Grade I | 0 % |
| R.V.A.N. Grade II Historical Conversion | 10% |
| R.V.A.N. Historical Conversion Grade III | 20% |
| R.V.A.N. Historical Conversion Grade IV | 30% |
SUMMARY OF INCAPACITY REACCION VIVENCIAL ANORMAL NEUROTICA R.V.A.N. WITH MANIFESTATION
| R.V.A.N. Grade I | 0 % |
| R.V.A.N. Grade II | 10% |
| R.V.A.N. Hipocondríacas Grade III | 20% |
| R.V.A.N. Grade IV | 30% |
3. S PARANOID STATES
Paranoid reaction:
Abnormal living reaction of psychological origin, secondary to intensely lived experience. There is a vulnerable personality predisponent, such as the litigants and sensitives of K. Schneider. The duration is from weeks to months, without leaving sequelae.
INCAPACITY: There is no inability to work.
Paranoid Development or Paranoia.
Definition: Chronic, irreducible, incapacitating, irreversible, interpretative systematized delirium. (Only those originating in industrial accidents will be considered.)
INCAPACITY: Up to 50%
4. A PSICOTIC DEPRESION
Definition: When a reactive depressive picture has an evolution of melancholic psychotic characteristics that deviates from the motive that originated it, evolving into an affective psychosis, they are incapacitating while the phase lasts, which remits with ad-integrum restitution in most cases (only those that originate in occupational accidents will be considered).
In the event that more than a year is prolonged, or the age is aggravated by elements of involution with cerebral organicity, paranoid and organic sensoperceptive deliroid components, they are incapable of being irreversible.
INCAPACITY: up to 50%.
5. DE NEUROSIS OF RENTA
Definition: It is a mental state of some sinister or rugged individuals, of litigant personality, who unconsciously exaggerate functional impotence, abnormally prolong labor incapacity, accentuate objective sequelae, with other subjectives and undertake a growing PARANOIDE activity in search of maximum compensation.
Given the existence of a prior personality disorder before the damage, they do not give the right to incapacity assessment as a sequel to an accident at work.
NOTE: Due to the characteristics of these labour incapacity assessment examinations, it should be studied to rule out possible: Simulations, Metasimulations or perseverance and Oversimulation.
SIMULATION: Voluntary production of false or exaggerated mental or physical symptoms, motivated by the attainment of any objective, such as the obtaining of economic compensations.
METASIMULATION OR PERSEVERATION: Characterized by description of missing symptoms or already cured pathology.
ONSIMULATION: Exaggeration of subjective symptoms that may persist.
The foregoing leads medical experts on more than one occasion to make mistakes or deception, making the correct assessment of incapacity difficult.
PONDERATION FACTORS1. OS FUNDAMENTS
In order to comply with the provisions of article 8 (3) of the Labour Risks Act, which states that "The degree of permanent labour incapacity shall be determined by the medical commissions of this law, on the basis of the labour incapacity assessment table, which shall be prepared by the National Executive and shall, among other factors, ponder the age of the worker, the type of activity and the possibilities of job relocation", the instruction is attached for the application of the application.
The three factors that govern the incorporation of the Law are: age, type of activity and possibilities of employment relocation. Age is a perfectly determinable factor and does not need the generation of any additional variable in order to incorporate it as a weighting factor.
The same does not happen in the case of type of activity and the possibilities of job relocation, which is why it becomes necessary to generate determinable variables that allow us to approximate the state of these weighting factors.
In the case of the type of activity, the nearest indicator is the degree of difficulty that causes the individual's inability to perform his usual tasks. Some of the criteria adopted by the Integrated Pension and Pension System (SIJP) set out the following categories: performs the usual tasks without difficulty, performs them with minor difficulty, with intermediate difficulty or with high difficulty.
In the case of job relocation possibilities, it is considered that the variable that best approaches the possibilities of job relocation is the requalification of the individual. The categorization according to the requalification of the Individual is performed according to whether "merita" or "no amerita" requalification. The division in these categories is made to .los, In order to assimilate the "greater possibilities of job relocation" with the "do not deserve requalification" and the "lower possibilities of relocation" with the "requalification letter".
The weighting of these factors is a task to be addressed on a case-by-case basis, to determine whether it is appropriate to apply .according to the characteristics of the accident and injury, the possibilities of relocation, the affectation for the performance of their usual task, etc. estos these weighting factors and, if any, the range of them. To this end, one or more of the factors may be applied and not necessarily the maximum expected value.
2. PROCEDURES
Once the functional incapacity is determined according to the work incapacity assessment table, the weighting factors will be incorporated.
Percentages arising from the application of the work incapacity assessment table may be increased by the percentage (1) arising from the application of weighting factors as follows:
(1) When reference is made to increase the percentage of the table, it implies that the percentage of the table should be multiplied by (1+x%).
1. Activity type factor
This factor is incorporated into definitively dictating the degree of disability. The assessment of the degree of difficulty that the individual has to perform his or her usual task is carried out.
| Difficulty in performing the usual tasks | Factor value range |
| None Leve Intermedia High | 0 % 0-10 % 0-15 % 0-20 % |
2. Factor of job relocation possibilities.
In this case the incorporation of the factor depends on whether the individual ameritates or not requalification.
| Amerita Requalification | Factor value range |
| Don't lie Yes amerita | 0 % 10% |
This implies that in case the individual deserves to be requalified, the application of 10% as a weighting factor corresponds. This percentage will be reduced to 0% if the process ends in accordance with established guidelines. In case of not completing all stages of the process, such a reduction will not correspond. This process of modifying the value of the factor according to the result of requalification will cease once the incapacity acquires the definitive character.
3. Age factor.
The weight factor values according to the age of the injured party should be included in the intervals presented in the following table:
| Age of the survivor | Add to the percentages resulting from step 1 and 2 |
| less than 21 years from 21 to 30 years 31 and more years | 0-4 % 0-3 % 0-2 % |
4. Operation of Factors.
Once the values of each of the 3 weighting factors are determined, they will be added to each other, determining a unique value. This only value will be the percentage in which the value arising from the functional disability assessment will be increased according to the work incapacity assessment table.
The existence of ranges of values for each factor implies that it is at the discretion of the evaluator to apply a particular value based on the circumstances surrounding the survivor.
In the event that a permanent disability is partial by application of the work incapacity assessment table and that by the incorporation of the weighting factors, the maximum value of this incapacity will be 65%.
CRITERIA OF USE OF LABORAL INCAPACITY TABLESSUPPORTS
The inability that arises from a professional illness or a work accident will be measured in percentage of the total functional capacity of the individual.
In workers who, in the entrance examinations, have functional anatomical limitations, they must be settled in their personal legacy, being 100% of the worker's functional capacity, their remaining capacity.
This implies, therefore, that for the assessment of the inability of a worker affected by successive sinisters the criterion of the remaining capacity will be used. That is to say that the assessment of the deterioration will be made on the total remaining capacity.
In terms of the assessment of the inability of a large sinister, the product of a single accident will also be used the remaining capacity criterion, using that of greater magnitude to begin with the assessment and continue to be greater to less with the rest of the measurable incapacities.
CONCLUSION
The assessment of permanent incapacity for work accidents and occupational diseases requires the participation of:
The existence of an accident of work or a professional illness duly recognized in accordance with the existing standards.
The presence of, a definitive, irreversible and measurable anatomical or functional decrease that must be the consequence of the sinister labor indicated above.
The damage should be measured in accordance with the provisions of the labour incapacity tables provided for in article 8 of the LRT.
The degree of permanent work incapacity should be the result of the application of the above tables and of the weighting factors that allow for differences in case to case.
The weighting criteria should be specified so that their use is uniform on the part of all the Assessing Medical Commissions and placed on a scale that allows the flexibilisation of their application.
CONTENTS
Piel
Osteoarticular
Head and Face
Eyes
Garganta, Nariz and Oído
Respiratory system
Cardiovascular system
Digestive and Pared Abdominal
Nephroourological system
Hematopoietic system
Neurology
Psychiatry
Pondering factors
Use criteria
