When a worker has both grip loss and atrophy in the hand, which approach best reflects the rating?

When a worker has both grip loss and atrophy in the hand, which approach best reflects the rating?

• A. Consider only the greater impairment
• B. Consider only the lesser impairment
• C. Combine the ratings
• D. Include both grip loss and the atrophy

Answer: (D)

When there are multiple impairments in the same hand, you account for each deficit rather than picking just one. Grip loss and atrophy are separate impairments that both contribute to overall hand disability, so the rating should include both and be combined to reflect the total functional loss. This approach prevents underestimating disability by ignoring one impairment and follows the standard combining method used in impairment ratings (often via the AMA Guides' Combined Values Chart). For example, if grip loss is rated at 20% and atrophy at 10%, the combined hand impairment is about 28% using the standard method: 0.20 + 0.10 × (1 − 0.20) = 0.28. The final rating is greater than either impairment alone but not simply the sum, accurately representing the hand’s overall impairment.

When there are multiple impairments in the same hand, you account for each deficit rather than picking just one. Grip loss and atrophy are separate impairments that both contribute to overall hand disability, so the rating should include both and be combined to reflect the total functional loss. This approach prevents underestimating disability by ignoring one impairment and follows the standard combining method used in impairment ratings (often via the AMA Guides' Combined Values Chart). For example, if grip loss is rated at 20% and atrophy at 10%, the combined hand impairment is about 28% using the standard method: 0.20 + 0.10 × (1 − 0.20) = 0.28. The final rating is greater than either impairment alone but not simply the sum, accurately representing the hand’s overall impairment.