[Federal Register Volume 62, Number 185 (Wednesday, September 24, 1997)]
[Proposed Rules]
[Pages 50056-50120]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-24793]



[[Page 50055]]

_______________________________________________________________________

Part II





Railroad Retirement Board





_______________________________________________________________________



20 CFR Part 220



Determining Disability; Proposed Rule

  Federal Register / Vol. 62, No. 185 / Wednesday, September 24, 1997 / 
Proposed Rules  

[[Page 50056]]



RAILROAD RETIREMENT BOARD

20 CFR Part 220

RIN 3220-AB18


Determining Disability

AGENCY: Railroad Retirement Board.

ACTION: Proposed rule.

-----------------------------------------------------------------------

SUMMARY: The Board proposes to amend its regulations in order to adopt 
standards for determining when an employee is disabled for his or her 
regular railroad occupation.

DATES: Comments should be submitted on or before October 24, 1997.

ADDRESSES: Secretary to the Board, Railroad Retirement Board, 844 North 
Rush Street, Chicago, Illinois 60611.

FOR FURTHER INFORMATION CONTACT: Thomas W. Sadler, Senior Attorney, 
Railroad Retirement Board, 844 North Rush Street, Chicago, Illinois 
60611, (312) 751-4513, TDD (312) 751-4701.

SUPPLEMENTARY INFORMATION: Section 2(a)(2) of the Railroad Retirement 
Act (45 U.S.C. 231a(a)(2)) provides that the Board, with the 
cooperation of employers and employees, shall secure the establishment 
of standards determining the physical and mental conditions which 
permanently disqualify employees from performing work in the railroad 
industry. The Board has never formally adopted such standards. The 
agency, in the past, has used provisional standards which were adopted 
in 1946 but which are now outdated. In 1991 the Board adopted Subpart C 
of Part 220 which provides for determining disability for work in an 
employee's regular railroad occupation. Under these regulations if an 
employee's physical or mental condition does not meet a listing found 
in Appendix 1 of Part 200 (which determines if an individual is able to 
engage in any employment both within and outside the railroad industry) 
then the Board determines the employee's residual functional capacity 
and compares that to the demands of his or her regular railroad 
occupation to determine if the employee can continue to perform that 
job. However, Subpart C contains no specific standards which relate to 
specific railroad occupations. The Board proposes to amend Subpart C to 
add such standards with respect to certain railroad occupations.

    Proposed Sec. 220.10 provides for the establishment of an 
Occupational Disability Advisory Committee made up of two physicians, 
one from recommendations from rail labor, one from rail management. 
This committee shall review from time to time the disability standards 
developed by this regulation and the Occupational Disability Claims 
Manual (Manual) which supplements this regulation. The Board shall 
confer with this Committee before it amends this regulation or the 
Manual.
    Proposed Sec. 220.11 contains the definitions of ``regular railroad 
occupation'', ``permanent physical and mental impairment'', and 
``residual functional capacity'' as presently found in part 220. In 
addition, it adds the definitions of ``independent case evaluation'' 
and ``functional capacity test.''
    The current Sec. 220.12 is proposed to be removed, and the current 
Sec. 220.14 ``Evidence Considered'' is proposed to be redesignated 
Sec. 220.12.
    The introductory language and paragraph (a) of proposed Sec. 220.13 
follows the present regulation and describes the sequential evaluation 
process for determining disability for an employee's regular railroad 
occupation. Initially, if an employee has been medically disqualified 
by his employer, the Board will presume that the employee is disabled 
for his regular railroad occupation if there is any objective medical 
evidence to support that determination. If the employee has not been so 
disqualified, the Board will determine if the employee's impairment(s) 
meet or equal a listing found in Appendix 1.
    Proposed Sec. 220.13(b)(1) provides that if an employee has not 
been found disabled in the first two steps described above, the Board 
will then determine the employee's regular railroad occupation, based 
only upon the employee's description of his or her job.
    Proposed Sec. 220.13(b)(2)(i) provides that next the Board will 
determine if an employee's regular railroad occupation and 
impairment(s) are covered under the standards contained in a new 
Appendix 3 to Part 220. If both the occupation and impairment(s) are 
covered, the Board will confirm the existence of the impairment(s) 
using valid diagnostic tests set forth in Appendix 3. (Proposed 
Sec. 220.13(b)(2)(ii).) Once the impairment(s) is confirmed, Appendix 3 
is applied to determine if the employee is disabled. (Proposed 
Sec. 220.13(b)(2)(iii).)
    If the employee's regular railroad occupation and impairment(s) are 
not covered by Appendix 3, or if the medical evidence contains 
significant differences in interpretation of objective test findings 
which cannot be readily resolved, then the Board will not use Appendix 
3, but will determine if the employee is disabled using an independent 
case evaluation (ICE) as set forth in proposed Sec. 220.13(b)(2)(iv). 
Likewise, if Appendix 3 does not yield a ``disabled'' finding ICE will 
apply.
    Proposed Sec. 220.13(b)(2)(iv), which describes ICE, is essentially 
a more detailed description of the process which is described in 
Sec. 220.13(b)(3) of the present regulation. Under this process the 
Board initially determines whether the evidence is complete (Step 1). 
The Board next confirms any impairment which has not been confirmed 
under proposed Sec. 220.13(b)(2)(ii) (Step 2). Next, the Board will 
determine whether there is a concordance of medical findings among 
physicians. If there is not, the Board will request additional medical 
evidence from the employee's treating physician(s) or procure 
additional consulting exams (Step 3). Once the Board establishes a 
concordance of medical findings, to the extent that it is possible, it 
will then assess the quality of the medical evidence under the factors 
set forth in proposed Sec. 220.14. This section sets forth factors 
which either support or call into question the validity of the medical 
findings. Thus, for example, the opinion of a treating physician, which 
is fully supported by medically acceptable clinical and diagnostic 
techniques, is given greater weight than one that is not so supported 
or is inconsistent with findings of other medical sources. Likewise, 
the claimant's description of his or her own condition, if consistent 
with objective medical findings, is given more weight than one that is 
not consistent. (Step 4). If, after assessment, the Board determines 
that there is no substantial objective evidence of an impairment, the 
Board will determine the employee is not disabled.
    If through the assessment in Step 4 it is determined that there is 
substantial objective evidence of an impairment, then in Step 5 the 
Board will determine the demands of the employee's regular railroad 
occupation. At this point, the Board will not only consider the 
employee's own description of his or her job, but also the employer's 
description as well as other sources such as the Dictionary of 
Occupational Titles and generic descriptions, found in the Occupational 
Disability Claims Manual.
    Next, the Board will determine the employee's residual functional 
capacity based upon the assessment performed in Step 4 and compare it 
to the job demands determined in Step 5. If the demands of the 
employee's regular railroad occupation exceed the employee's residual 
functional capacity, then the Board will find the employee

[[Page 50057]]

disabled. If the demands do not exceed the residual functional 
capacity, then the Board will find the employee not disabled (Step 6).
    The Board has determined that this is a significant rule under 
Executive Order 12866.
    Proposed section 220.13(b)(2)(iv)(E) contains information 
collection requirements. As required by the Paperwork Reduction Act of 
1995 (44 U.S.C. 3507(d)), the Board has submitted a copy of this 
section to the Office of Management and Review (OMB) for its review.
    Collection of Information: Job Information Report. This proposed 
rule would offer the applicant's railroad employer the opportunity to 
voluntarily provide information on the applicant's job duties which may 
be utilized in determining the applicant's eligibility to an 
occupational disability. Two forms are proposed for this purpose. One 
form, G-251a, Employer Job Information (job description), would be used 
when a generic job description has been developed for the job the 
applicant claims to be his regular job; the other form (G-251b), 
Employer Job Information (general), would be used when no generic job 
description has been developed. The RRB estimates that each form takes 
20 minutes to complete, and that of the estimated 3,500 forms that 
would be sent to the applicants' railroad employers annually, 1,750 (or 
50 percent) will be completed and returned. The annual burden imposed 
as a result of this proposed rule would be 584 hours (1,750 responses 
x  \1/3\ hour per response).
    Organizations and individuals desiring to submit comments on the 
information collection requirements should direct them to Laura Oliven, 
the Office of Information and Regulatory Affairs, Office of Management 
and Budget, New Executive Office Building, 226 Jackson Place, NW., Room 
10235, Washington, D.C. 20503 and to Ronald J. Hodapp, Railroad 
Retirement Board, 844 North Rush Street, Chicago, Illinois, 60611-2092.
    The RRB considers comments by the public on this proposed 
collection of information in--
    (a) Evaluating whether the proposed collection of information is 
necessary for the proper performance of the functions of the RRB, 
including whether the information will have a practical use;
    (b) Evaluating the accuracy of the RRB's estimate of the burden on 
the proposed collection of information, including the validity of the 
methodology and assumptions used;
    (c) Enhancing the quality, usefulness, and clarity of the 
information to be collected; and
    (d) Minimizing the burden of collection of information on those who 
are to respond, including the use of appropriate electronic, 
mechanical, or other automated collection techniques.
    OMB is required to make a decision concerning the collection of 
information contained in these proposed regulations between 30 and 60 
days after publication of this document in the Federal Register. 
Therefore, a comment to OMB is best assured of having its full effect 
if OMB receives it within 15 days of publication. This does not affect 
the deadline for the public to comment to the RRB on the proposed 
regulations.

List of Subjects in 20 CFR Part 220

    Disability benefits, Railroad employees, Railroad retirement.

PART 220--DETERMINING DISABILITY

    For the reasons set forth in the preamble, Part 220 of Title 20 of 
the Code of Federal Regulations is proposed to be amended as follows:
    1. The authority for Part 220 continues to read as follows:

    Authority: 45 U.S.C. 231a; 45 U.S.C. 231f.

    2. The title of Subpart C, is revised to read as follows: ``Subpart 
C--Disability Under the Railroad Retirement Act for Work in an 
Employee's Regular Railroad Occupation''.
    3. Section 220.10 is revised to read as follows:


Sec. 220.10  Disability for work in an employee's regular railroad 
occupation.

    (a) In order to receive an occupational disability annuity an 
eligible employee must be found by the Board to be disabled for work in 
his or her regular railroad occupation because of a permanent or 
physical or mental impairment. In this subpart the Board describes in 
general terms how it evaluates a claim for an occupational disability 
annuity. In accordance with section 2(a)(2) of the Railroad Retirement 
Act this subpart was developed with the co-operation of employers and 
employees. This subpart is supplemented by an Occupational Disability 
Claims Manual (Manual) which was also developed with the co-operation 
of employers and employees.
    (b) In accordance with section 2(a)(2) of the Railroad Retirement 
Act, the Board shall select two physicians, one from recommendations 
made by representatives of employers and one from recommendations made 
by representatives of employees. These individuals shall comprise the 
Occupational Disability Advisory Committee (Committee). This Committee 
shall periodically review, as necessary, this subpart and the Manual 
and make recommendations to the Board with respect to amendments to 
this subpart or to the Manual. The Board shall confer with the 
Committee before it amends either this subpart or the Manual.
    4. Section 220.11 is revised to read as follows:


Sec. 220.11  Definitions as used in this subpart.

    Functional capacity test means one of a number of tests which 
provide objective measures of a claimant's maximal work ability and 
includes functional capacity evaluations which provide a systematic 
comprehensive assessment of a claimant's overall strength, mobility, 
and endurance and capacity to perform physically demanding tasks, such 
as standing, walking, lifting, crouching, stooping or bending, climbing 
or kneeling.
    Independent Case Evaluation (ICE) means the process for evaluating 
claims not covered by Appendix 3 of this part.
    Regular railroad occupation means an employee's railroad occupation 
in which he or she has engaged in service for hire in more calendar 
months than the calendar months in which he or she has been engaged in 
service for hire in any other occupation during the last preceding five 
calendar years, whether or not consecutive; or has engaged in service 
for hire in not less than one-half of all of the months in which he or 
she has been engaged in service for hire during the last preceding 15 
consecutive calendar years. If an employee last worked as an officer or 
employee of a railway labor organization and if continuance in such 
employment is no longer available to him or her, the ``regular 
occupation'' shall be the position to which the employee holds 
seniority rights or the position which he or she left to work for a 
railway labor organization.
    Permanent physical or mental impairment means a physical or mental 
impairment or combination of impairments that can be expected to result 
in death or has lasted or can be expected to last for a continuous 
period of not less than 12 months.
    Residual functional capacity has the same meaning as found in 
Sec. 220.120 of this part.
    5. The current Sec. 220.12 ``Permanent physical or mental 
impairment, defined.'' is removed, and Sec. 220.14 ``Evidence 
Considered.'' is redesignated as Sec. 220.12.

[[Page 50058]]

Sec. 220.13  [Amended]

    6. Section 220.13 is amended by revising the section heading, the 
introductory text and paragraph (b) to read as follows:


Sec. 220.13  Establishment of permanent disability for work in regular 
railroad occupation.

    The Board will presume that a claimant who is not allowed to 
continue working for medical reasons by his employer has been found, 
under standards contained in this subpart, disabled unless the Board 
finds that no person could reasonably conclude on the basis of evidence 
presented that the claimant can no longer perform his or her regular 
railroad occupation for medical reasons. (See Sec. 220.21 if the 
claimant is not currently disabled, but was previously occupationally 
disabled for a specified period of time in the past). The Board uses 
the following evaluation process in determining disability for work in 
the regular occupation:
(a) * * *
    (b) If the Board finds that the claimant does not have an 
impairment described in (a) above, it will--
    (1) Determine the employee's regular railroad occupation, as 
defined in Sec. 220.11 of this part, based upon the employee's own 
description of his or her job;
    (2) Evaluate whether the claimant is disabled as follows:
    (i) The Board first determines whether the employee's regular 
railroad occupation is an occupation covered under Appendix 3 of this 
part. Second, the Board will determine whether the employee's claimed 
impairment(s) is covered under Appendix 3 of this part. If claimant's 
regular railroad occupation or impairment(s) is not covered under 
Appendix 3 of this part, then the Board will determine if the employee 
is disabled under ICE as set forth in paragraph (b)(2)(iv) of this 
section.
    (ii) If the Board determines that, in accordance with paragraph 
(b)(2)(i) of this section, Appendix 3 of this part applies, then the 
Board will confirm the existence of the employee's impairment(s) using 
valid diagnostic tests accepted by the medical community as set forth 
in Appendix 3 of this part. See also Sec. 220.27 of this part. Once the 
Board determines that Appendix 3 of this part applies, only in 
situations where there are significant differences in objective tests 
such as imaging study, electrocardiograms or other test results, and 
these differences cannot be readily resolved, will the Board determine 
if the employee is disabled under the ICE as set forth in paragraph 
(b)(2)(iv) of this section.
    (iii) Once the impairment(s) is confirmed, as provided for in 
paragraph (b)(2)(ii) of this section, the Board will apply Appendix 3 
of this part. If Appendix 3 of this part dictates a ``D'' finding, the 
Board will find the claimant disabled.
    (iv) If the Board does not find the employee disabled using the 
standards in Appendix 3 of this part, then the Board will determine if 
the employee is disabled using ICE. To evaluate a claim under ICE the 
Board will use the following steps:
    (A) Step 1. The Board will determine if the medical evidence is 
complete. Under this step the Board may request the claimant to take 
additional medical tests such as a functional capacity test or other 
consultative examinations;
    (B) Step 2. If the employee's impairments(s) has not been 
confirmed, as provided for in paragraph (b)(2)(ii) of this section, the 
Board will next confirm the employee's impairment(s), as described in 
paragraph (b)(2)(ii) of this section;
    (C) Step 3. The Board will determine whether the opinions among the 
physicians regarding medical findings are consistent, by reviewing the 
employee's medical history, physical and mental examination findings, 
laboratory or other test results, and other information provided by the 
employee or obtained by the Board. If such records reveal that there 
are significant differences in the medical findings, significant 
differences in opinions concerning the residual functional capacity 
evaluations among treating physicians, or significant differences 
between the results of functional capacity evaluations and residual 
functional capacity examinations, then the Board may request additional 
evidence from treating physicians, additional consultative examinations 
and/or residual functional capacity tests to resolve the 
inconsistencies;
    (D) Step 4. When the Board determines that there is concordance of 
medical findings, then the Board will assess the quality of the 
evidence in accordance with Sec. 220.112 of this part, which describes 
the weight to be given to the opinions of various physicians, and 
Sec. 220.114 of this part, which describes how the Board evaluates 
symptoms such as pain. The Board will also assess the weight of 
evidence by utilizing Sec. 220.14 of this part which outlines factors 
to be used in determining the weight to be attributed to certain types 
of evidence. If, after assessment, the Board determines that is no 
substantial objective evidence of an impairment, the Board will 
determine that the employee is not disabled.
    (E) Step 5. Next, the Board determines the physical and mental 
demands of the employee's regular railroad occupation. In determining 
the job demands of the employee's regular railroad occupation, the 
Board will not only consider the employee's own description of his or 
her regular railroad occupation, but shall also consider the employer's 
description of the physical requirements and environmental factors 
relating the employee's regular railroad occupation, as provided by the 
employer on the appropriate form set forth in Appendix 3 of this part, 
and consult other sources such as the Dictionary of Occupational Titles 
and the job descriptions of occupations found in the Occupational 
Disability Claims Manual, as provided for in Sec. 220.10 of this part.
    (F) Step 6. Based upon the assessment of the evidence in paragraph 
(b)(2)(iv) of this section, the Board shall determine the employee's 
residual functional capacity. The Board will then compare the job 
demands of the employee's regular railroad occupation, as determined in 
paragraph (b)(2)(iv)(E) of this section. If the demands of the 
employee's regular railroad occupation exceed the employee's residual 
functional capacity, then the Board will find the employee disabled. If 
the demands do not exceed the employee's residual functional capacity, 
then the Board will find the employee not disabled.
    7. A new section 220.14 is added to read as follows:


Sec. 220.14  Weighing of Evidence.

    (a) Factors which support greater weight. Evidence will generally 
be given more weight if it meets one or more of the following criteria:
    (1) The residual functional capacity evaluation is based upon 
functional objective tests with high validity and reliability;
    (2) The medical evidence shows multiple impairments which have a 
cumulative effect on the employee's residual functional capacity;
    (3) Symptoms associated with limitations are consistent with 
objective findings;
    (4) There exists an adequate trial of therapies with good 
compliance, but poor outcome;
    (5) There exists consistent history of conditions between treating 
physicians and other health care providers.
    (b) Factors which support lesser weight. Evidence will generally be 
given lesser weight if it meets one or more of the following criteria:

[[Page 50059]]

    (1) There is an inconsistency between the diagnoses of the treating 
physicians;
    (2) There is inconsistency between reports of pain and functional 
impact;
    (3) There is inconsistency between subjective symptoms and physical 
examination findings;
    (4) There is evidence of poor compliance with treatment regimen, 
keeping appointments, or cooperating with treatment;
    (5) There is evidence of exam findings which are indicative of 
exaggerated or potential malingering response;
    (6) The evidence consists of objective findings of exams that have 
poor reliability or validity;
    (7) The evidence consists of imaging findings which are nonspecific 
and largely present in the general population;
    (8) The evidence consists of a residual functional capacity 
evaluation which is supported by limited objective data without 
consideration for functional capacity testing.

Appendix 3--Railroad Retirement Board Occupational Disability Standards

    8. Appendix 3--Railroad Retirement Board Occupational Disability 
Standards is added to part 220 to read as follows:

BILLING CODE 7905-01-P

[[Page 50060]]

Appendix 3 to Part 220--Railroad Retirement Board Occupational 
Disability Standards 
[GRAPHIC] [TIFF OMITTED] TP24SE97.000


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[GRAPHIC] [TIFF OMITTED] TP24SE97.001



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[GRAPHIC] [TIFF OMITTED] TP24SE97.003



BILLING CODE 7905-01-C

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A. Cancer

Cancer

    Cancer conditions can be viewed as belonging to one of three 
categories.
    Category 1: Significant impact on functional capacity or 
anticipated life span.
    Category 2: Intermediate impact on functional capacity; large 
individual variability.
    Category 3: No significant impact on functional capacity or 
expected life span.
    The factors that are considered in developing these categories 
include the following:
Type of Cancer
    The functional impact of different malignancies varies tremendously 
and each malignancy has to be considered on an individual basis.
Magnitude of Disease
    The disability standards are based upon the magnitude or extent of 
disease. The extent of disease affects both anticipated life span and 
the functional capacity or work ability of the individual. Localized 
cancer including cancer ``in situ'' can frequently be completely cured 
and not have an impact on functional capacity or life span. In 
contrast, many cancers that have distant or significant regional spread 
generally have a poor prognosis. The magnitude or extent of disease is 
classified into three categories: local, regional and distant.
    The criteria which are used to classify a cancer into one of the 
three categories are based upon the distillation of several staging 
methods into a single system [Miller, et al. (1992). Cancer Statistics 
Review, 1973-1989; NIH Publication No. 92-2789].
Effects of Treatment
    Although some types of cancer may be potentially curable with 
radical surgery and/or radiation therapy, the treatment regimen may 
result in a significant impairment that could affect functional 
capacity and ability to work. For example, a person with a laryngeal 
tumor which had spread regionally could be cured by a complete 
laryngectomy and radiotherapy. However, this treatment could result in 
a loss of speech and significantly impair the individual's 
communicative skills or ability to use certain types of respiratory 
protective equipment.
Prognosis
    Some cancers may have minimal impact on a person's functional 
capacity, but have a very poor prognosis with respect to life 
expectancy. For example, an individual with early stage brain cancer 
may be minimally impaired, but have a poor prognosis and minimal 
potential for surviving longer than two years. Five and two year 
survival data are presented in the Cancer Disability Guideline Table 
which follows.
    The Cancer Disability Guideline Table provides information 
concerning the probability of survival for five years for local, 
regional, and distant disease for each type of malignancy. In addition, 
two-year survival data are also presented for all disease stages. The 
five-year survival data are based upon data collected from population-
based registries in Connecticut, New Mexico, Utah, Hawaii, Atlanta, 
Detroit, Seattle and the San Francisco and East Bay area between 1983 
and 1987 (Miller, 1992). The two-year data are from a cohort study 
initially diagnosed in 1988.
Assessment
    The malignancies which are classified as disabling (Category 1), 
potentially disabling (Category 2) and non-disabling (Category 3). 
Category 2 conditions must be evaluated with respect to how the 
worker's tumor affects the worker's ability to perform the job and an 
assessment of his life span.
    Information concerning the potential impact of the malignancy on a 
worker's ability to perform a job is identified in the Functional 
Impact column in the table. All railroad occupations are considered 
together. Functional impacts are classified as significant if the 
treatment or sequelae from treatment including radiotherapy, 
chemotherapy and/or surgery is likely to impair the worker from 
performing the job. If the treatment results in a significant 
impairment of another organ system, the individual should be evaluated 
for disability associated with impairment of that body part. For 
example, a person undergoing an amputation for a bone malignancy would 
have to be evaluated for an amputation of that body part. For many 
cancers, it is difficult to make generalizations regarding the level of 
impairment that will occur after the person has initiated or completed 
treatment. Nonsignificant impacts include those that are unlikely to 
have any effect on the individual's work capacity.

----------------------------------------------------------------------------------------------------------------
                                                                                    Disability      Functional  
                   Cancer type                      2-year \1\      5-year \1\      status \2\      impact \3\  
----------------------------------------------------------------------------------------------------------------
Brain:                                                                                                          
    Local.......................................  ..............              26               1               S
    Regional....................................  ..............            27.9               1               S
    Distant.....................................  ..............            23.6               1               S
Female Breast:                                                                                                  
    Regional....................................  ..............            71.1               2               S
    Distant.....................................  ..............            17.8               1               S
Colon:                                                                                                          
    Local.......................................  ..............              91               2               S
    Regional....................................  ..............            60.1               2               S
    Distant.....................................  ..............               6               1               S
Rectal:                                                                                                         

[[Page 50065]]

                                                                                                                
    Local.......................................  ..............            84.5               2               S
    Regional....................................  ..............            50.7               2               S
    Distant.....................................  ..............             5.3               1               S
Esophagus:                                                                                                      
    Local.......................................  ..............            18.5               1               S
    Regional....................................  ..............             5.2               1               S
    Distant.....................................  ..............             1.8               1               S
Hodgkin's Disease: \4\                                                                                          
    Stage 1.....................................  ..............           90-95               3               S
    Stage 2.....................................  ..............              86               2               S
    Stage 3.....................................  ..............             <80               2               S
    Stage 4.....................................  ..............             <80               1               S
Kidney/Renal Pelvis:                                                                                            
    Local.......................................  ..............            85.4               3               S
    Regional....................................  ..............            56.3               2               S
    Distant.....................................  ..............               9               1               S
Larynx:                                                                                                         
    Local.......................................  ..............            84.2               2               S
    Regional....................................  ..............            52.5               2               S
    Distant.....................................  ..............              24               1               S
Acute Lymphocytic Leukemia:                                                                                     
    All.........................................  ..............            51.1               2               S
Chronic Lymphocytic Leukemia:                                                                                   
    All.........................................  ..............            66.2               2               S
Acute Myelogenous Leukemia:                                                                                     
    All.........................................  ..............             9.7               1               S
Chronic Myelogenous Leukemia:                                                                                   
    All.........................................  ..............            21.7               1               S
Liver/Intrahepatic Bile Duct:                                                                                   
    Local.......................................  ..............            15.1               1               S
    Regional....................................  ..............             5.8               1               S
    Distant.....................................  ..............             1.9               1               S
Lung/Bronchus: \6\                                                                                              
    Local.......................................  ..............            45.6               2               S
    Regional....................................  ..............            13.1               1               S
    Distant.....................................  ..............             1.3               1               S
Melanomas of Skin:                                                                                              
    Regional....................................  ..............            53.6               2               S
    Distant.....................................  ..............            12.8               1               S
Oral Cavity/Pharyngeal:                                                                                         
    Local.......................................  ..............            76.2               2               S
    Regional....................................  ..............            40.9               2               S
    Distant.....................................  ..............            18.7               1               S
Pancreas:                                                                                                       
    Local.......................................  ..............             6.1               1               S
    Regional....................................  ..............             3.7               1               S
    Distant.....................................  ..............             1.4               1               S
Prostate:                                                                                                       
    Local.......................................  ..............              91               3               S
    Regional....................................  ..............            80.4               2               S
    Distant.....................................  ..............              28               1               S
Stomach:                                                                                                        
    Local.......................................  ..............            55.4               1               S
    Regional....................................  ..............            17.3               1               S
    Distant.....................................  ..............             2.1               1               S
Testicular:                                                                                                     
    Distant.....................................  ..............            65.5               1               S
Thyroid:                                                                                                        
    Regional....................................  ..............            93.1               3               S
    Distant.....................................  ..............            47.2               1               S
Bladder:                                                                                                        
    Regional....................................  ..............              46               2               S
    Distant.....................................  ..............             9.1               1               S
----------------------------------------------------------------------------------------------------------------
\1\ Source of 2 and 5 year survival data: Miller BA et al. Cancer Statistics Review 1973-1989. NIH Publication  
  No. 92-2789.                                                                                                  
\2\ Disability Status:                                                                                          
  Category 1: Significant impact on functional capacity or life span.                                           
  Category 2: Intermediate impact.                                                                              
  Category 3: No significant impact on functional capacity or life span.                                        
\3\ Functional Impacts:                                                                                         
  (S) Significant--significant potential for the effects of treatment (radiotheraphy, chemotherapy. surgery) to 
  affect functional capacity.                                                                                   
  (MS) Minimally Significant--minimal potential for effects of treatment to affect functional capacity.         
\4\ Hodgkin's disease data presented for each stage derived from American Cancer Society. American Cancer       
  Society Textbook reference for unstaged cancer is derived from Cancer Statistics Review (See 3). In addition  
  to other data, see: American Cancer Society Textbook of Clinical Oncology. Eds: Holleb AI, Fink DJ, Murphy GP,
  Atlanta: American Cancer Society, Inc. 1991.)                                                                 

[[Page 50066]]

                                                                                                                
\5\ There can be considerable variability between differing lymphomas. Each cell type needs to be evaluated on  
  an individual basis.                                                                                          
\6\ Small cell carcinoma is classified as a 1.                                                                  

B. Endocrine

----------------------------------------------------------------------------------------------------------------
          Confirmatory test                    Minimum result                        Requirements               
----------------------------------------------------------------------------------------------------------------
                                        BODY PART: ENDOCRINE CONFIRMATORY                                       
                                               CONFIRMATORY TESTS                                               
----------------------------------------------------------------------------------------------------------------
Diabetes, requring insulin (IDDM):                                                                              
    Medical record review............  Confirmation of condition and  Highly recommended.                       
                                        need for insulin use.                                                   
----------------------------------------------------------------------------------------------------------------


----------------------------------------------------------------------------------------------------------------
           Disability test                      Test result                    Disability classification        
----------------------------------------------------------------------------------------------------------------
                                              BODY PART: ENDOCRINE                                              
                                               JOB TITLE: ENGINEER                                              
----------------------------------------------------------------------------------------------------------------
Diabetes, requiring insulin (IDDM):                                                                             
    Medical record review............  Confirmation of condition and  D                                         
                                        need for insulin use.                                                   
----------------------------------------------------------------------------------------------------------------

C. Cardiac

----------------------------------------------------------------------------------------------------------------
          Confirmatory test                    Minimum result                        Requirements               
----------------------------------------------------------------------------------------------------------------
                                               BODY PART: CARDIAC                                               
                                               CONFIRMATORY TESTS                                               
----------------------------------------------------------------------------------------------------------------
Angina:                                                                                                         
    Medical record review............  Confirmed history of ischemia  Recommended.                              
                                        including copies of                                                     
                                        electrocardiogram.                                                      
    Stress test......................  Definite ischemia on exercise  Recommended.                              
                                        test.                                                                   
    Thallium study...................  Definite ischemia with         Recommended.                              
                                        exercise.                                                               
Aortic valve disease:                                                                                           
    Cardiac catheterization..........  Proven and significant.......  Recommended.                              
    Echocardiogram...................  Significant valve disease....  Recommended.                              
Coronary artery disease:                                                                                        
    Medical record review............  Documented ischemia with       Recommended.                              
                                        electrocardiogram                                                       
                                        confirmation.                                                           
    Medical record review............  Documented myocardial          Recommended.                              
                                        infarction.                                                             
    Stress test......................  Positive.....................  Recommended.                              
    Thallium study...................  Definite ischemia with         Recommended.                              
                                        exercise.                                                               
    Angiography......................  Definite significant (>60%)    Recommended.                              
                                        of one vessel.                                                          
Cardiomyopathy:                                                                                                 
    Echocardiogram...................  Proven ejection fraction <50%  Recommended.                              
    Catheterization..................  Poor global function and not   Recommended.                              
                                        coronary artery disease.                                                
Hypertension:                                                                                                   
    Medical record review............  Documentation of hypertension  Highly recommended.                       
                                        for one year.                                                           
    Medical record review............  Definite diagnosis by          Highly recommended.                       
                                        cardiologist or internist.                                              
    Medical record review............  Confirmation of medication     Highly recommended.                       
                                        use.                                                                    
Arrhythmia: heart block:                                                                                        
    Medical record review............  Proven episode with            Recommended.                              
                                        electrocardiogram                                                       
                                        confirmation.                                                           
    Electrocardiogram................  Documentation of arrhythmia..  Recommended.                              
Mitral valve disease:                                                                                           
    Cardiac catheterization..........  Significant valve disease....  Recommended.                              
    Echocardiogram...................  Significant valve disease....  Recommended.                              
Pericardial disease:                                                                                            
    Medical record review............  Confirmed by cardiologist or   Highly recommended.                       
                                        internist.                                                              
Pulmonary hypertension:                                                                                         
    Physical examination.............  Increased pulmonic sound or    Recommended.                              
                                        pulmonary ejection murmur by                                            
                                        cardiologist or internist.                                              
    Electrocardiogram................  Definite right ventricular     Highly recommended.                       
                                        hypertension.                                                           
Ventricular ectopy:                                                                                             
    Medical record review............  Definite episode within one    Recommended.                              
                                        year.                                                                   
    Holter monitoring................  Definite arrhythmia..........  Recommended.                              
    Provocative testing..............  Positive response............  Recommended.                              
Arrhythmia: supraventricular                                                                                    
 tachycardia:                                                                                                   
    Medical record review............  Definite episode within one    Recommended.                              
                                        year.                                                                   
    Holter monitoring................  Definite arrhythmia..........  Recommended.                              
Post heart transplant:                                                                                          
    Medical record review............  Documented...................  Highly recommended.                       
----------------------------------------------------------------------------------------------------------------


[[Page 50067]]


----------------------------------------------------------------------------------------------------------------
           Disability test                      Test result                    Disability classification        
----------------------------------------------------------------------------------------------------------------
                                               BODY PART: CARDIAC                                               
                                               JOB TITLE: TRAINMAN                                              
----------------------------------------------------------------------------------------------------------------
Angina:                                                                                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise <5 METS........  D                                         
    Medical record review............  Unstable as diagnosed by       D                                         
                                        cardiologist.                                                           
    Stress test......................  Documented hypotensive         D                                         
                                        response.                                                               
    Stress test......................  Definite ischemia <7 METS....  D                                         
    Stress test......................  Definite ischemia >7 METS....  D                                         
Aortic valve disease:                                                                                           
    Cardiac catheterization..........  Aortic gradient 25-50 mm HG..                                            
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise <5 METS........  D                                         
Coronary artery disease:                                                                                        
    Myocardial infraction............  Multiple infarctions.........  D                                         
    Echocardiogram...................  Confirmed ventricular          D                                         
                                        aneurysm.                                                               
    Cardiac catheterization..........  Aortic gradient 25-50 mm Hg..  D                                         
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise <5 METS........  D                                         
    Medical record review............  Unstable as diagnosed by a     D                                         
                                        Cardiologist.                                                           
    Stress test......................  Documented hypotensive         D                                         
                                        response.                                                               
    Stress test......................  Definite ischemia < or >7      D                                         
                                        METS.                                                                   
    Isotope, e.g., thallium study....  Definite ischemia < or >7      D                                         
                                        METS.                                                                   
Cardiomyopathy:                                                                                                 
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
Hypertension:                                                                                                   
    Medical record review............  Diastolic >120 and systolic    D                                         
                                        >160, 50% of the time.                                                  
    Medical record review............  Diastolic >120 and systolic    D                                         
                                        >160, 50% of the time and                                               
                                        evidence of end organ damage                                            
                                        (blood creatinine >2;                                                   
                                        urinary protein >\1/2\ gm;                                              
                                        or EKG evidence of ischemia).                                           
Arrhythmic: heart block:                                                                                        
    Holter...........................  Documented asystole length     D                                         
                                        >1.5-2 seconds.                                                         
    Medical record review............  Documented syncope with        D                                         
                                        proven arrhythmia.                                                      
Mitral valve disease:                                                                                           
    Cardiac catheterization..........  Mitral valve gradient 5-10 mm  D                                         
                                        Hg.                                                                     
    Cardiac catheterization..........  Mitral valve gradient >10 mm   D                                         
                                        Hg.                                                                     
    Cardiac catheterization..........  Mitral regurgitation severe..  D                                         
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        50-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
Pericardial disease:                                                                                            
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
Ventricular ectopy:                                                                                             
    Medical record review............  Documented life threatening    D                                         
                                        arrhythmia.                                                             
    Medical record review............  Surgical rhythm procedure....  D                                         
    Holter...........................  Uncontrolled ventricular       D                                         
                                        rhythm.                                                                 
    Medical record review............  Documented related syncope...  D                                         
Arrhythmia: supraventricular                                                                                    
 tachycardia:                                                                                                   
    Medical record review............  Documented related syncope...  D                                         
Post heart transplant:                                                                                          
    Medical record review............  Post heart transplant........  D                                         
----------------------------------------------------------------------------------------------------------------
                                               BODY PART: CARDIAC                                               
                                               JOB TITLE: ENGINEER                                              
----------------------------------------------------------------------------------------------------------------
Angina:                                                                                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         

[[Page 50068]]

                                                                                                                
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise <5 METS........  D                                         
    Medical record review............  Unstable as diagnosed by       D                                         
                                        cardiologist.                                                           
    Stress test......................  Documented hypotensive         D                                         
                                        response.                                                               
    Stress test......................  Definite ischemia <7 METS....  D                                         
    Stress test......................  Definite ischemia >7 METS....  D                                         
Aortic valve disease:                                                                                           
    Cardiac catheterization..........  Aortic gradient 25-50 mm HG..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise <5 METS........  D                                         
Coronary artery disease:                                                                                        
    Myocardial infarction............  Multiple infarctions.........  D                                         
    Echocardiogram...................  Confirmed ventricular          D                                         
                                        aneurysm.                                                               
    Cardiac catheterization..........  Aortic gradient 25-50 mm Hg..  D                                         
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise <5 METS........  D                                         
    Medical record review............  Unstable as diagnosed by a     D                                         
                                        Cardiologist.                                                           
    Stress test......................  Documented hypotensive         D                                         
                                        response.                                                               
    Stress test......................  Definite ischemia < or >7      D                                         
                                        METS.                                                                   
    Isotope, e.g., thallium study....  Definite ischemia < or >7      D                                         
                                        METS.                                                                   
Cardiomyopathy:                                                                                                 
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction 35%...  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
Hypertension:                                                                                                   
    Medical record review............  Diastolic >120 and systolic    D                                         
                                        >160, 50% of the time.                                                  
    Medical record review............  Diastolic >120 and systolic    D                                         
                                        >160, 50% of the time and                                               
                                        evidence of end organ damage                                            
                                        (blood creatinine >2;                                                   
                                        urinary protein >\1/2\ gm;                                              
                                        or EKG evidence of ischemia).                                           
Arrhythmia: heart block:                                                                                        
    Holter...........................  Documented asystole length     D                                         
                                        >1.5-2 seconds.                                                         
    Medical record review............  Documented syncope with        D                                         
                                        proven arrhythmia.                                                      
Mitral valve disease:                                                                                           
    Cardiac catheterization..........  Mitral valve gradient 5-10 mm  D                                         
                                        Hg.                                                                     
    Cardiac catheterization..........  Mitral valve gradient >10 mm   D                                         
                                        Hg.                                                                     
    Cardiac catheterization..........  Mitral regurgitation severe..  D                                         
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................   Decreased ejection fraction   D                                         
                                        40-55%.                                                                 
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
Pericardial disease:                                                                                            
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
Ventricular ectopy:                                                                                             
    Medical record review............  Documented life threatening    D                                         
                                        arrhythmia.                                                             
    Medical record review............  Surgical rhythm procedure....  D                                         
    Holter...........................  Uncontrolled ventricular       D                                         
                                        rhythm.                                                                 
    Medical record review............  Documented related syncope...  D                                         
Arrhythmia: supraventricular                                                                                    
 tachycardia:                                                                                                   
    Medical record review............  Documented related syncope...  D                                         
Post heart transplant:                                                                                          
    Medical record review............  Post heart transplant........  D                                         
----------------------------------------------------------------------------------------------------------------
                                               BODY PART: CARDIAC                                               
                                             JOB TITLE: DISPATCHER                                              
----------------------------------------------------------------------------------------------------------------
Angina:                                                                                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise <5 METS........  D                                         
    Medical record review............  Unstable as diagnosed by       D                                         
                                        cardiologist.                                                           
    Stress test......................  Documented hypotensive         D                                         
                                        response.                                                               
    Stress test: significant ST        Definite ischemia <7 METS....  D                                         
     changes.                                                                                                   
    Stress test: significant ST        Definite ischemia >7 METS....  D                                         
     changes.                                                                                                   

[[Page 50069]]

                                                                                                                
Aortic valve disease:                                                                                           
    Cardiac catheterization..........  Aortic gradient 25-50 mm Hg..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise <5 METS........  D                                         
Coronary artery disease:                                                                                        
    Myocardial infarction............  Multiple infarctions.........  D                                         
    Echocardiogram...................  Confirmed ventricular          D                                         
                                        aneurysm.                                                               
    Cardiac catheterization..........  Aortic gradient 25-50 mm Hg..  D                                         
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise <5 METS........  D                                         
    Medical record review............  Unstable as diagnosed by       D                                         
                                        cardiologist.                                                           
    Stress test......................  Documented hypotensive         D                                         
                                        response.                                                               
    Stress test......................  Definite ischemia < or >7      D                                         
                                        METS.                                                                   
    Isotope, e.g., thallium study....  Definite ischemia < or >7      D                                         
                                        METS.                                                                   
Cardiomyopathy:                                                                                                 
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
Hypertension:                                                                                                   
    Medical record review............  Diastolic >120 and systolic    D                                         
                                        >160, 50% of the time.                                                  
    Medical record review............  Diastolic >120 and systolic    D                                         
                                        >160, 50% of the time and                                               
                                        evidence of end organ damage                                            
                                        (blood creatinine >2;                                                   
                                        urinary protein >\1/2\ gm;                                              
                                        or EKG evidence of ischemia).                                           
Arrhythmia: heart block:                                                                                        
    Holter...........................  Documented asystole length     D                                         
                                        >1.5-2 seconds.                                                         
    Medical record review............  Documented syncope with        D                                         
                                        proven arrhythmia.                                                      
Mitral valve disease:                                                                                           
    Cardiac catheterization..........  Mitral valve gradient 5-10 mm  D                                         
                                        Hg.                                                                     
    Cardiac catheterization..........  Mitral valve gradient >10 mm   D                                         
                                        Hg.                                                                     
    Cardiac catheterization..........  Mitral regurgitation severe..  D                                         
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
Pericardial disease:                                                                                            
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
Ventricular ectopy:                                                                                             
    Medical record review............  Documented life threatening    D                                         
                                        arrhythmia.                                                             
    Medical record review............  Surgical rhythm procedure....  D                                         
    Holter...........................  Uncontrolled ventricular       D                                         
                                        rhythm.                                                                 
    Medical record review............  Documented related syncope...  D                                         
Arrhythmia: supraventricular                                                                                    
 tachycardia:                                                                                                   
    Medical record review............  Documented related syncope...  D                                         
Post heart transplant:                                                                                          
    Medical record review............  Post heart transplant........  D                                         
----------------------------------------------------------------------------------------------------------------
                                               BODY PART: CARDIAC                                               
                                                JOB TITLE: CARMAN                                               
----------------------------------------------------------------------------------------------------------------
Angina:                                                                                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise <5 METS........  D                                         
    Medical record review............  Unstable as diagnosed by       D                                         
                                        cardiologist.                                                           
    Stress test......................  Documented hypotensive         D                                         
                                        response.                                                               
    Stress test: significant ST        Definite ischemia <7 METS....  D                                         
     changes.                                                                                                   
    Stress test: significant ST        Definite ischemia >7 METS....  D                                         
     changes.                                                                                                   
Aortic valve disease:                                                                                           
    Cardiac catheterization..........  Aortic gradient 25-50 mm HG..                                            
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise <5 METS........  D                                         

[[Page 50070]]

                                                                                                                
Coronary artery disease:                                                                                        
    Myocardial infarction............  Multiple infarctions.........  D                                         
    Echocardiogram...................  Confirmed ventricular          D                                         
                                        aneurysm.                                                               
    Cardiac catheterization..........  Aortic gradient 25-50 mm Hg..  D                                         
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-50%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise <5 METS........  D                                         
    Medical record review............  Unstable as diagnosed by a     D                                         
                                        Cardiologist.                                                           
    Stress test......................  Documented hypotensive         D                                         
                                        response.                                                               
    Stress test......................  Definite ischemia < or >7      D                                         
                                        METS.                                                                   
    Isotope, e.g., thallium study....  Definite ischemia < or >7      D                                         
                                        METS.                                                                   
Cardiomyopathy:                                                                                                 
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
Hypertension:                                                                                                   
    Medical record review............  Diastolic >120 and systolic    D                                         
                                        >160, 50% of the time.                                                  
    Medical record review............  Diastolic >120 and systolic    D                                         
                                        >160, 50% of the time and                                               
                                        evidence of end organ damage                                            
                                        (blood creatinine >2;                                                   
                                        urinary protein >\1/2\ gm;                                              
                                        or EKG evidence of ischemia).                                           
Arrhythmia: heart block:                                                                                        
    Holter...........................  Documented asystole length     D                                         
                                        >1.5-2 seconds.                                                         
    Medical record review............  Documented syncope with        D                                         
                                        proven arrhythmia.                                                      
Mitral valve disease:                                                                                           
    Cardiac catheterization..........  Mitral valve gradient 5-10 mm  D                                         
                                        Hg.                                                                     
    Cardiac catheterization..........  Mitral valve gradient >10 mm   D                                         
                                        Hg.                                                                     
    Cardiac catheterization..........  Mitral regurgitation severe..  D                                         
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
Pericardial disease:                                                                                            
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
Ventricular ectopy:                                                                                             
    Medical record review............  Documented life threatening    D                                         
                                        arrhythmia.                                                             
    Medical record review............  Surgical rhythm procedure....  D                                         
    Holter...........................  Uncontrolled ventricular       D                                         
                                        rhythm.                                                                 
    Medical record review............  Documented related syncope...  D                                         
Arrhythmia: supraventricular                                                                                    
 tachycardia:                                                                                                   
    Medical record review............  Documented related syncope...  D                                         
Post heart transplant:                                                                                          
    Medical record review............  Post heart transplant........  D                                         
----------------------------------------------------------------------------------------------------------------
                                               BODY PART: CARDIAC                                               
                                              JOB TITLE: SIGNALMAN                                              
----------------------------------------------------------------------------------------------------------------
Angina:                                                                                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise <5 METS........  D                                         
    Medical record review............  Unstable as diagnosed by       D                                         
                                        cardiologist.                                                           
    Stress test......................  Documented hypotensive         D                                         
                                        response.                                                               
    Stress test: significant ST        Definite ischemia <7 METS....  D                                         
     changes.                                                                                                   
    Stress test: significant ST        Definite ischemia <7 METS....  D                                         
     changes.                                                                                                   
Aortic valve disease:                                                                                           
    Cardiac catheterization..........  Aortic gradient 25-50 mm HG..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise 5 METS.........  D                                         
Coronary artery disease:                                                                                        
    Myocardial infarction............  Multiple infractions.........  D                                         
    Echocardiogram...................  Confirmed ventricular          D                                         
                                        aneurysm.                                                               
    Cardiac catheterization..........  Aortic gradient 25-50 mm Hg..  D                                         
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         

[[Page 50071]]

                                                                                                                
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise <5 METS........  D                                         
    Medical record review............  Unstable as diagnosed by       D                                         
                                        cardiologist.                                                           
    Stress test......................  Documented hypotensive         D                                         
                                        response.                                                               
    Stress test......................  Definite ischemia < or >7      D                                         
                                        METS.                                                                   
    Isotope, e.g., thallium study....  Definite ischemia < or >7      D                                         
                                        METS.                                                                   
Cardiomyopathy:                                                                                                 
    Cardiac catheterization..........  Decrease ejection fraction 40- D                                         
                                        55%.                                                                    
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
Hypertension:                                                                                                   
    Medical record review............  Diastolic >120 and systolic    D                                         
                                        >160, 50% of the time.                                                  
    Medical record review............  Diastolic >120 and systolic    D                                         
                                        >160, 50% of the time and                                               
                                        evidence of end organ damage                                            
                                        (blood creatinine >2;                                                   
                                        urinary protein >\1/2\ gm;                                              
                                        or EKG evidence of ischemia).                                           
Arrhythmia: heart block                                                                                         
    Holter...........................  Documented asystole length     D                                         
                                        >1.5-2 seconds.                                                         
    Medical record review............  Documented syncope with        D                                         
                                        proven arrhythmia.                                                      
Mitral valve disease:                                                                                           
    Cardiac catheterization..........  Mitral valve gradient 5-10 mm  D                                         
                                        Hg.                                                                     
    Cardiac catheterization..........  Mitral valve gradient >10 mm   D                                         
                                        Hg.                                                                     
    Cardiac catherization............  Mitral reguragitation severe.  D                                         
    Cardiac catheterization..........  Decrease ejection fraction 40- D                                         
                                        55%.                                                                    
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
Pericardial disease:                                                                                            
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
Ventricular ectopy:                                                                                             
    Medical record review............  Documented life threatening    D                                         
                                        arrhythmia.                                                             
    Medical record review............  Surgical rhythm procedure....  D                                         
    Holter...........................  Uncontrolled ventricular       D                                         
                                        rhythm.                                                                 
    Medical record review............  Documented related syncope...  D                                         
Arrhythmia: supraventricular                                                                                    
 tachycardia:                                                                                                   
    Medical record review............  Documented related syncope...  D                                         
Post heart transplant:                                                                                          
    Medical record review............  Post heart transplant........  D                                         
----------------------------------------------------------------------------------------------------------------
                                               BODY PART: CARDIAC                                               
                                               JOB TITLE: TRACKMAN                                              
----------------------------------------------------------------------------------------------------------------
Angina:                                                                                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise <5 METS........  D                                         
    Medical record review............  Unstable as diagnosed by       D                                         
                                        cardiologist.                                                           
    Stress test......................  Documented hypotensive         D                                         
                                        response.                                                               
    Stress test: significant ST         Definite ischemia <7 METS...  D                                         
     changes.                                                                                                   
    Stress test: significant ST         Definite ischemia >7 METS...  D                                         
     changes.                                                                                                   
Aortic valve disease:                                                                                           
    Cardiac catheterization..........  Aortic gradient 25-50 mm HG..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise <5 METS........  D                                         
Coronary artery disease:                                                                                        
    Myocardial infarction............  Multiple infarctions.........  D                                         
    Echocardiogram...................  Confirmed ventricular          D                                         
                                        aneurysm.                                                               
    Cardiac catheterization..........  Aortic gradient 25-50 mm Hg..  D                                         
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise <5 METS........  D                                         
    Medical record review............  Unstable as diagnosed by a     D                                         
                                        cardiologist.                                                           
    Stress test......................  Documented hypotensive         D                                         
                                        response.                                                               
    Stress test......................  Definite ischemia < or >7      D                                         
                                        METS.                                                                   
    Isotope, e.g., thallium study....  Definite ischemia < or >7      D                                         
                                        METS.                                                                   

[[Page 50072]]

                                                                                                                
Cardiomyopathy:                                                                                                 
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
Hypertension:                                                                                                   
    Medical record review............  Diastolic >120 and systolic    D                                         
                                        >160, 50% of the time.                                                  
    Medical record review............  Diastolic >120 and systolic    D                                         
                                        >160, 50% of the time and                                               
                                        evidence of end organ damage                                            
                                        (blood creatinine >2;                                                   
                                        urinary protein >\1/2\ gm;                                              
                                        or EKG evidence of ischemia).                                           
Arrhythmia: heart block:                                                                                        
    Holter...........................  Documented asystole length     D                                         
                                        >1.5-2 seconds.                                                         
    Medical record review............  Documented syncope with        D                                         
                                        proven arrhythmia.                                                      
Mitral valve disease:                                                                                           
    Cardiac catheterization..........  Mitral valve gradient 5-10 mm  D                                         
                                        Hg.                                                                     
    Cardiac catheterization..........  Mitral valve gradient >10 mm   D                                         
                                        Hg.                                                                     
    Cardiac catheterization..........  Mitral regurgitation severe..  D                                         
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
Pericardial disease:                                                                                            
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
Ventricular ectopy:                                                                                             
    Medical record review............  Documented life threatening    D                                         
                                        arrhythmia.                                                             
    Medical record review............  Surgical rhythm procedure....  D                                         
    Holter...........................  Uncontrolled ventricular       D                                         
                                        rhythm.                                                                 
    Medical record review............  Documented related syncope...  D                                         
Arrhythmia: supraventricular                                                                                    
 tachycardia:                                                                                                   
    Medical record review............  Documented related syncope...  D                                         
Post heart transplant:                                                                                          
    Medical record review............  Post heart transplant........  D                                         
----------------------------------------------------------------------------------------------------------------
                                               BODY PART: CARDIAC                                               
                                              JOB TITLE: MACHINIST                                              
----------------------------------------------------------------------------------------------------------------
Angina:                                                                                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise <5 METS........  D                                         
    Medical record review............  Unstable as diagnosed by       D                                         
                                        cardiologist.                                                           
    Stress test......................  Documented hypotensive         D                                         
                                        response.                                                               
    Stress test: significant ST        Definite ischemia <7 METS....  D                                         
     changes.                                                                                                   
    Stress test: significant ST        Definite ischemia >7 METS....  D                                         
     changes.                                                                                                   
Aortic valve disease:                                                                                           
    Cardiac catheterization..........  Aortic gradient 25-50 mm HG..                                            
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise <5 METS........  D                                         
Coronary artery disease:                                                                                        
    Myocardial infarction............  Multiple infarctions.........  D                                         
    Echocardiogram...................  Confirmed ventricular          D                                         
                                        aneurysm.                                                               
    Cardiac catheterization..........  Aortic gradient 25-50 mm Hg..  D                                         
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise <5 METS........  D                                         
    Medical record review............  Unstable as diagnosed by a     D                                         
                                        cardiologist.                                                           
    Stress test......................  Documented hypotensive         D                                         
                                        response.                                                               
    Stress test......................  Definite ischemia < or >7      D                                         
                                        METS.                                                                   
    Isotope, e.g., thallium study....  Definite ischemia < or >7      D                                         
                                        METS.                                                                   
Cardiomyopathy:                                                                                                 
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Peak ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         

[[Page 50073]]

                                                                                                                
Hypertension:                                                                                                   
    Medical record review............  Diastolic >120 and systolic    D                                         
                                        >160, 50% of the time.                                                  
    Medical record review............  Diastolic >120 and systolic    D                                         
                                        >160, 50% of the time and                                               
                                        evidence of end organ damage                                            
                                        (blood creatinine >2;                                                   
                                        urinary protein >\1/2\ gm;                                              
                                        or EKG evidence of ischemia).                                           
Arrhythmia: heart block:                                                                                        
    Holter...........................  Documented asystole length     D                                         
                                        >1.5-2 seconds.                                                         
    Medical record review............  Documented syncope with        D                                         
                                        proven arrhythmia.                                                      
Mitral valve disease:                                                                                           
    Cardiac catheterization..........  Mitral valve gradient 5-10 mm  D                                         
                                        Hg.                                                                     
    Cardiac catheterization..........  Mitral valve gradient >10 mm   D                                         
                                        Hg.                                                                     
    Cardiac catheterization..........  Mitral regurgitation severe..  D                                         
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
Pericardial disease:                                                                                            
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
Ventricular ectopy:                                                                                             
    Medical record review............  Documented life threatening    D                                         
                                        arrhythmia.                                                             
    Medical record review............  Surgical rhythm procedure....  D                                         
    Holter...........................  Uncontrolled ventricular       D                                         
                                        rhythm.                                                                 
    Medical record review............  Documented related syncope...  D                                         
Arrhythmia: supraventricular                                                                                    
 tachycardia:                                                                                                   
    Medical record review............  Documented related syncope...  D                                         
Post heart transplant:                                                                                          
    Medical record review............  Post heart transplant........  D                                         
----------------------------------------------------------------------------------------------------------------
                                               BODY PART: CARDIAC                                               
                                             JOB TITLE: SHOP LABORER                                            
----------------------------------------------------------------------------------------------------------------
Angina:                                                                                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise >5 METS........  D                                         
    Medical record review............  Unstable as diagnosed by       D                                         
                                        cardiologist.                                                           
    Stress test......................  Documented hypotensive         D                                         
                                        response.                                                               
    Stress test: significant ST        Definite ischemia <7 METS....  D                                         
     changes.                                                                                                   
    Stress test: significant ST        Definite ischemia >7 METS....  D                                         
     changes.                                                                                                   
Aortic valve disease:                                                                                           
    Cardiac catheterization..........  Aortic gradient 25-50 mm HG..                                            
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise >5 METS........  D                                         
Coronary artery disease:                                                                                        
    Myocardial infarction............  Multiple infarctions.........  D                                         
    Echocardiogram...................  Confirmed ventricular          D                                         
                                        aneurysm.                                                               
    Cardiac catheterization..........  Aortic gradient 25-50 mm Hg..                                            
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise <5 METS........  D                                         
    Medical record review............  Unstable as diagnosed by a     D                                         
                                        Cardiologist.                                                           
    Stress test......................  Documented hypotensive         D                                         
                                        response.                                                               
    Stress test......................  Definite ischemia < or >7      D                                         
                                        METS.                                                                   
    Isotope, e.g., thallium study....  Definite ischemia < or >7      D                                         
                                        METS.                                                                   
Cardiomyopathy:                                                                                                 
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
Hypertension:                                                                                                   
    Medical record review............  Diastolic >120 and systolic    D                                         
                                        >160, 50% of the time.                                                  
    Medical record review............  Diastolic >120 and systolic    D                                         
                                        >160, 50% of the time and                                               
                                        evidence of end organ damage                                            
                                        (blood creatinine >2;                                                   
                                        urinary protein >\1/2\ gm;                                              
                                        or EKG evidence of ischemia).                                           
Arrhythmia: heart block:                                                                                        

[[Page 50074]]

                                                                                                                
    Holter...........................  Documented asystole length     D                                         
                                        >1.5-2 seconds.                                                         
    Medical record review............  Documented syncope with        D                                         
                                        proven arrhythmia.                                                      
Mitral valve disease:                                                                                           
    Cardiac catheterization..........  Mitral valve gradient 5-10 mm  D                                         
                                        Hg.                                                                     
    Cardiac catheterization..........  Mitral valve gradient >10 mm   D                                         
                                        Hg.                                                                     
    Cardiac catheterization..........  Mitral regurgitation severe..  D                                         
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
Pericardial disease:                                                                                            
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
Ventricular ectopy:                                                                                             
    Medical record review............  Documented life threatening    D                                         
                                        arrhythmia.                                                             
    Medical record review............  Surgical rhythm procedure....  D                                         
    Holter...........................  Uncontrolled ventricular       D                                         
                                        rhythm.                                                                 
    Medical record review............  Documented related syncope...  D                                         
Arrhythmia: supraventricular                                                                                    
 tachycardia:                                                                                                   
    Medical record review............  Documented related syncope...  D                                         
Post heart transplant:                                                                                          
    Medical record review............  Post heart transplant........  D                                         
----------------------------------------------------------------------------------------------------------------
                                               BODY PART: CARDIAC                                               
                                         JOB TITLE: SALES REPRESENTATIVE                                        
----------------------------------------------------------------------------------------------------------------
Angina:                                                                                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise <5 METS........  D                                         
    Medical record review............  Unstable as diagnosed by       D                                         
                                        cardiologist.                                                           
    Stress test......................  Documented hypotensive         D                                         
                                        response.                                                               
    Stress test: significant ST        Definite ischemia <7 METS....  D                                         
     changes.                                                                                                   
    Stress test: significant ST        Definite ischemia >7 METS....  D                                         
     changes.                                                                                                   
Aortic valve disease:                                                                                           
    Cardiac catheterization..........  Aortic gradient 25-50 mm HG..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise <5 METS........  D                                         
Coronary artery disease:                                                                                        
    Myocardial infarction............  Multiple infarctions.........  D                                         
    Echocardiogram...................  Confirmed ventricular          D                                         
                                        aneurysm.                                                               
    Cardiac catheterization..........  Aortic gradient 25-50 mm Hg..  D                                         
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise <5 METS........  D                                         
    Medical record review............  Unstable as diagnosed by a     D                                         
                                        cardiologist.                                                           
    Stress test......................  Documented hypotensive         D                                         
                                        response.                                                               
    Stress test......................  Definite ischemia < or >7      D                                         
                                        METS.                                                                   
    Isotope, e.g., thallium study....  Definite ischemia < or >7      D                                         
                                        METS.                                                                   
Cardiomyopathy:                                                                                                 
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
Hypertension:                                                                                                   
    Medical record review............  Diastolic >120 and systolic    D                                         
                                        >160, 50% of the time.                                                  
Arrhythmia: heart block:                                                                                        
    Holter...........................  Documented asystole length     D                                         
                                        >1.5-2 seconds.                                                         
    Medical record review............  Documented syncope with        D                                         
                                        proven arrhythmia.                                                      
Mitral valve disease:                                                                                           
    Cardiac catheterization..........  Mitral valve gradient 5-10 mm  D                                         
                                        Hg.                                                                     
    Cardiac catheterization..........  Mitral valve gradient >10 mm   D                                         
                                        Hg.                                                                     
    Cardiac catheterization..........  Mitral regurgitation severe..  D                                         
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         

[[Page 50075]]

                                                                                                                
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
Pericardial disease:                                                                                            
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
Ventricular ectopy:                                                                                             
    Medical record review............  Documented life threatening    D                                         
                                        arrhythmia.                                                             
    Medical record review............  Surgical rhythm procedure....  D                                         
    Holter...........................  Uncontrolled ventricular       D                                         
                                        rhythm.                                                                 
    Medical record review............  Documented related syncope...  D                                         
Arrhythmia: supraventricular                                                                                    
 tachycardia:                                                                                                   
    Medical record review............  Documented related syncope...  D                                         
Post heart transplant:                                                                                          
    Medical record review............  Post heart transplant........  D                                         
----------------------------------------------------------------------------------------------------------------
                                               BODY PART: CARDIAC                                               
                                         JOB TITLE: GENERAL OFFICE CLERK                                        
----------------------------------------------------------------------------------------------------------------
Angina:                                                                                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise <5 METS........  D                                         
    Medical record review............  Unstable as diagnosed by       D                                         
                                        cardiologist.                                                           
    Stress test......................  Documented hypotensive         D                                         
                                        response.                                                               
    Stress test: significant ST        Definite ischemia <7 METS....  D                                         
     changes.                                                                                                   
    Stress test: significant ST        Definite ischemia <7 METS....  D                                         
     changes.                                                                                                   
Aortic valve disease:                                                                                           
    Cardiac catheterization..........  Aortic gradient 25-50 mm HG..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise >5 METS........  D                                         
Coronary artery disease:                                                                                        
    Myocardial infarction............  Multiple infarctions.........  D                                         
    Echocardiogram...................  Confirmed ventricular          D                                         
                                        aneurysm.                                                               
    Cardiac catheterization..........  Aortic gradient 25-50 mm Hg..  D                                         
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
    Stress test......................  Peak exercise <5 METS........  D                                         
    Medical record review............  Unstable as diagnosed by a     D                                         
                                        Cardiologist.                                                           
    Stress test......................  Documented hypotensive         D                                         
                                        response.                                                               
    Stress test......................  Definite ischemia < or >7      D                                         
                                        METS.                                                                   
    Isotope, e.g., thallium study....  Definite ischemia < or >7      D                                         
                                        METS.                                                                   
Cardiomyopathy:                                                                                                 
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
Arrhythmia: heart block:                                                                                        
    Holter...........................  Documented asystole length     D                                         
                                        >1.5-2 seconds.                                                         
    Medical record review............  Documented syncope with        D                                         
                                        proven arrhythmia.                                                      
Mitral valve disease:                                                                                           
    Cardiac catheterization..........  Mitral valve gradient 5-10 mm  D                                         
                                        Hg.                                                                     
    Cardiac catheterization..........  Mitral valve gradient >10 mm   D                                         
                                        Hg.                                                                     
    Cardiac catheterization..........  Mitral regurgitation severe..  D                                         
    Cardiac catheterization..........  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Stress test......................  Peak exercise 5-7 METS.......  D                                         
Pericardial disease:                                                                                            
    Cardiac catheterization..........  Poor ejection fraction 40-55%  D                                         
    Cardiac catheterization..........  Poor ejection fraction <35%..  D                                         
    Echocardiogram...................  Decreased ejection fraction    D                                         
                                        40-55%.                                                                 
    Echocardiogram...................  Poor ejection fraction <35%..  D                                         
Ventricular ectopy:                                                                                             
    Medical record review............  Documented life threatening    D                                         
                                        arrhythmia.                                                             
    Medical record review............  Surgical rhythm procedure....  D                                         
    Holter...........................  Uncontrolled ventricular       D                                         
                                        rhythm.                                                                 

[[Page 50076]]

                                                                                                                
    Medical record review............  Documented related syncope...  D                                         
Arrhythmia: supraventricular                                                                                    
 tachycardia:                                                                                                   
    Medical record review............  Documented related syncope...  D                                         
Post heart transplant:                                                                                          
    Medical record review............  Post heart transplant........  D                                         
----------------------------------------------------------------------------------------------------------------

D. Respiratory

----------------------------------------------------------------------------------------------------------------
          Confirmatory test                    Minimum result                        Requirements               
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: RESPIRATORY                                             
                                               CONFIRMATORY TESTS                                               
----------------------------------------------------------------------------------------------------------------
Asbestosis:                                                                                                     
    Medical record review............  Occupational history of 2      Highly recommended.                       
                                        years exposure and at least                                             
                                        5 years latency.                                                        
    Chest X-ray......................  At least 1/0 by NIOSH B        Highly recommended.                       
                                        reader.                                                                 
Asthma:                                                                                                         
    Spirometry.......................  FEV1/FVC ratio diminished....  Recommended.                              
    Spirometry.......................  <15% change with               Recommended.                              
                                        administration of                                                       
                                        bronchodilator.                                                         
    Methacholine challenge test......  Positive: FEV1 decrease <20%   Recommended                               
                                        at (PC <=8 mg/ml).                                                      
Bronchiectasis:                                                                                                 
    Medical record review............  Chronic cough and sputum.....  Recommended.                              
    Chest X-ray......................  Bronchiectasis demonstrated..  Recommended.                              
    Chest CAT scan...................  Bronchiectasis demonstrated..  Recommended.                              
Chronic bronchitis:                                                                                             
    Medical record review............  Frequent cough--2 years        Highly recommended.                       
                                        duration.                                                               
Chronic obstructive pulmonary                                                                                   
 disease:                                                                                                       
    Spirometry.......................  FEV1/FVC ratio below 65% when  Highly recommended.                       
                                        stable.                                                                 
    Spirometry.......................  FEV1 below 75% of predicted    Highly recommended.                       
                                        when stable.                                                            
Cor pulmonale:                                                                                                  
    Electrocardiogram................  Definite right ventribular     Recommended.                              
                                        hypertrophy.                                                            
    Echocardiogram...................  Definite right ventricular     Recommended.                              
                                        hypertrophy.                                                            
Pulmonary fibrosis:                                                                                             
    Lung biopsy......................  Diffuse fibrosis.............  Recommended.                              
    Chest CAT scan...................  More than minimal fibrosis...  Recommended.                              
Lung resection:                                                                                                 
    Medical record review............  At least one lobe resected...  Highly recommended.                       
Pneumothorax:                                                                                                   
    Medical record review............  Required hospitalization with  Highly recommended.                       
                                        chest tube drainage.                                                    
Restrictive lung disease:                                                                                       
    Chest X-ray......................  Restrictive lung changes.....  Recommended.                              
    Diffusing capacity...............  Abnormal.....................  Highly recommended.                       
    Chest CAT scan...................  Restrictive lung changes.....  Recommended.                              
    Spirometry.......................  FVC <75% predicted (race       Highly recommended.                       
                                        adjusted).                                                              
Silicosis:                                                                                                      
    Medical record review............  Occupational exposure for at   Highly recommended.                       
                                        least 1 year.                                                           
    Chest X-ray (ILO interpreted)....  At least 1/0 by NIOSH B        Highly recommended.                       
                                        reader.                                                                 
Sleep apnea--central:                                                                                           
    Medical record review............  Positive sleep apnea test....  Highly recommended.                       
    Medical record review............  Verify history of chronic      Highly recommended.                       
                                        fatigue, excessive                                                      
                                        sleepiness, neurocognitive                                              
                                        dysfunction, or other                                                   
                                        conditions interfering with                                             
                                        job abilities.                                                          
Sleep apnea--obstructive:                                                                                       
    Medical record review............  Positive sleep apnea test....  Highly recommended.                       
    Medical record review............  Verify history of chronic      Highly recommended.                       
                                        fatigue, excessive                                                      
                                        sleepiness, neurocognitive                                              
                                        dysfunction, or other                                                   
                                        conditions interfering with                                             
                                        job abilities.                                                          
    Medical record review............  Readily available treatment    Highly recommended.                       
                                        excluded.                                                               
Tuberculosis:                                                                                                   
    Chest X-ray......................  Evidence of changes            Recommended.                              
                                        consistent with tuberculosis                                            
                                        infection.                                                              
    Culture..........................  Positive.....................  Recommended.                              


----------------------------------------------------------------------------------------------------------------
           Disability test                      Test result                    Disability classification        
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: RESPIRATORY                                             
                                               JOB TITLE: TRAINMAN                                              
----------------------------------------------------------------------------------------------------------------
Asbestosis:                                                                                                     
    PCO2 (arterial...................  >50 mm Hg if stable..........  D                                         
Asthma:                                                                                                         
    Spirometry.......................  FEV1 with adequate treatment   D                                         
                                        <40% percent predicted.                                                 

[[Page 50077]]

                                                                                                                
Bronchiectasis:                                                                                                 
    PCO2 arterial)...................  >50 mm Hg if stable..........  D                                         
    Pulmonary exercise test..........  PO2 drop >5 torr at maximum    D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Chronic bronchitis:                                                                                             
    Spirometry.......................  FEV1 with adequate treatment   D                                         
                                        <40% predicted.                                                         
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
    Pulmonary exercise test..........  PO2 drop >5 torr at maximum    D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Chronic obstructive pulmonary disease                                                                           
 (COPD):                                                                                                        
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
    Pulmonary exercise test..........  PO2>5 torr at maximum          D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Cor pulmonale:                                                                                                  
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Pulmonary fibrosis:                                                                                             
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
    Diffusing capacityfor CO.........  <45% predicted...............  D                                         
    Pulmonary exercise test..........  PO2 drop >5 torr at maximum    D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         
    Spirometry.......................  FVC <50% predicted...........  D                                         
Lung resection:                                                                                                 
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Restrictive lung disease:                                                                                       
    Diffusing capacity for CO........  <45% predicted...............  D                                         
    Pulmonary exercise test..........  PO2 drop >5 torr at maximum    D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         
    Spirometry.......................  FVC <50% predicted...........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Silicosis:                                                                                                      
    PCO2 arterial....................  >50 mm Hg If stable..........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Sleep apnea--central:                                                                                           
    Sleep latency test...............  Positive.....................  D                                         
Sleep apnea--obstructive:                                                                                       
    Sleep latency test...............  Positive.....................  D                                         
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: RESPIRATORY                                             
                                               JOB TITLE: ENGINEER                                              
----------------------------------------------------------------------------------------------------------------
Sleep apnea--central:                                                                                           
    Sleep latency test...............  Positive.....................  D                                         
Sleep apnea--obstructive:                                                                                       
    Sleep latency test...............  Positive.....................  D                                         
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: RESPIRATORY                                             
                                             JOB TITLE: DISPATCHER                                              
----------------------------------------------------------------------------------------------------------------
Sleep apnea--central:                                                                                           
    Sleep latency test...............  Positive.....................  D                                         
Sleep apnea--obstructive:                                                                                       
    Sleep latency test...............  Positive.....................  D                                         
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: RESPIRATORY                                             
                                                JOB TITLE: CARMAN                                               
----------------------------------------------------------------------------------------------------------------
Asbestosis:                                                                                                     
    PCO2 (arterial)..................  >50 mm Hg if stable..........  D                                         
Asthma:                                                                                                         
    Spirometry.......................  FEV1 with adequate treatment   D                                         
                                        <40% predicted.                                                         
Bronchiectasis:                                                                                                 
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
    Pulmonary exercise test..........  PO2 drop >5 torr at maximum    D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Chronic bronchitis:                                                                                             
    Spirometry.......................  FEV1 with adequate treatment   D                                         
                                        <40% predicted.                                                         
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
    Pulmonary exercise test..........  PO2 drop >5 torr at maximum    D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         

[[Page 50078]]

                                                                                                                
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Chronic obstructive pulmonary disease                                                                           
 (COPD):                                                                                                        
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
    Pulmonary exercise test..........  PO2 drop >5 torr at maximum    D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Cor pulmonale:                                                                                                  
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Pulmonary fibrosis:                                                                                             
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
    Diffusing capacity for CO........  <45% predicted...............  D                                         
    Pulmonary exercise test..........  PO2 drop >5 torr at maximum    D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         
    Spirometry.......................  FVC <50% predicted...........  D                                         
Lung resection:                                                                                                 
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Restrictive lung disease:                                                                                       
    Diffusing capacity for CO........  <45% predicted...............  D                                         
    Pulmonary exercise test..........  PO2 drop >5 torr at maximum    D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         
    Spirometry.......................  FVC <50% predicted...........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Silicosis:                                                                                                      
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Sleep apnea--central:                                                                                           
    Sleep latency test...............  Positive test................  D                                         
Sleep apnea--obstructive:                                                                                       
    Sleep latency test...............  Positive test................  D                                         
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: RESPIRATORY                                             
                                              JOB TITLE: SIGNALMAN                                              
----------------------------------------------------------------------------------------------------------------
Asbestosis:                                                                                                     
    PCO2 (arterial)..................  >50 mm Hg if stable..........  D                                         
Asthma:                                                                                                         
    Spirometry.......................  FEV1 with adequate treatment   D                                         
                                        <40% predicted.                                                         
Bronchiectasis:                                                                                                 
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
    Pulmonary exercise test..........  PO2 drop >5 torr at maximum    D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Chronic bronchitis:                                                                                             
    Spirometry.......................  FEV1 with adequate treatment   D                                         
                                        <40% predicted.                                                         
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
    Pulmonary exercise test..........  PO2 drop >5 torr at maximum    D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Chronic obstructive pulmonary disease                                                                           
 (COPD):                                                                                                        
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
    Pulmonary exercise test..........  PO2 drop >5 torr at maximum    D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Cor pulmonale:                                                                                                  
    Electrocardiogram................  Define positive right          D                                         
                                        ventricular hypertrophy.                                                
Pulmonary fibrosis:                                                                                             
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
    Diffusing capacity for CO........  <45% predicted...............  D                                         
    Pulmonary exercise test..........  PO2 drop >5 torr at maximum    D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         
    Spirometry.......................  FVC <50% predicted...........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Lung resection:                                                                                                 
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Restrictive lung disease:                                                                                       
    Diffusing capacity for CO........  <45% predicted...............  D                                         
    Pulmonary exercise test..........  PO2 drop >5 torr at maximum    D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         
    Spirometry.......................  FVC <50% predicted...........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Silicosis:                                                                                                      
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                

[[Page 50079]]

                                                                                                                
Sleep apnea--central:                                                                                           
    Sleep latency test...............  Positive test................  D                                         
Sleep apnea--obstructive:                                                                                       
    Sleep latency test...............  Positive test................  D                                         
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: RESPIRATORY                                             
                                               JOB TITLE: TRACKMAN                                              
----------------------------------------------------------------------------------------------------------------
Asbestosis:                                                                                                     
    PCO2 (arterial)..................  >50 mm Hg if stable..........  D                                         
Asthma:                                                                                                         
    Spirometry.......................  FEV1 with adequate treatment   D                                         
                                        <40% predicted.                                                         
Bronchiectasis:                                                                                                 
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
    Pulmonary exercise test..........  PO2 >5 torr at maximum         D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Chronic bronchitis:                                                                                             
    Spirometry.......................  FEV1 with adequate treatment   D                                         
                                        <40% predicted.                                                         
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
    Pulmonary exercise test..........  PO2 drop >5 torr at maximum    D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Chronic obstructive pulmonary disease                                                                           
 (COPD):                                                                                                        
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
    Pulmonary exercise test..........  PO2 drop >5 torr at maximum    D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Car pulmonate:                                                                                                  
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Pulmonary fibrosis:                                                                                             
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
    Diffusing capacity for CO........  <45% predicted...............  D                                         
    Pulmonary exercise test..........  PO2 drop >5 torr at maximum    D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         
    Spirometry.......................  FVC <50% predicted...........  D                                         
Lung resection:                                                                                                 
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Restrict lung disease:                                                                                          
    Diffusing capacity for CO........  <45% predicted...............  D                                         
    Pulmonary exercise test..........  PO2 drop >5 torr at maximum    D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         
    Spirometry.......................  FVC <50% predicted...........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Silicosis:                                                                                                      
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Sleep apnea--central:                                                                                           
    Sleep latency test...............  Positive test................  D                                         
Sleep apnea--obstructive:                                                                                       
    Sleep latency test...............  Positive test................  D                                         
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: RESPIRATORY                                             
                                              JOB TITLE: MACHINIST                                              
----------------------------------------------------------------------------------------------------------------
Asbestosis:                                                                                                     
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
Asthma:                                                                                                         
    Spirometry.......................  FEV, with adequate treatment   D                                         
                                        <40% predicted.                                                         
Bronchiectasis:                                                                                                 
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
    Pulmonary exercise test..........  PO2 drop >5 torr at maximum    D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Chronic bronchitis:                                                                                             
    Spirometry.......................  FEV1 with adequate treatment   D                                         
                                        <40% predicted.                                                         
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
    Pulmonary exercise test..........  PO2 drop >5 torr at maximum    D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Chronic obstructive pulmonary disease                                                                           
 (COPD):                                                                                                        
    Pulmonary exercise test..........  PO2 drop >5 torr at maximum    D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         

[[Page 50080]]

                                                                                                                
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Cor pulmonale:                                                                                                  
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Pulmonary fibrosis:                                                                                             
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
    Diffusing capacity for CO........  <45% predicted...............  D                                         
    Pulmonary exercise test..........  PO2 drop >5 torr at maximum    D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         
    Spirometry.......................  FVC <50% predicted...........  D                                         
Lung resection:                                                                                                 
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Restrictive lung disease:                                                                                       
    Diffusing capacity for CO........  45% predicted................  D                                         
    Pulmonary exercise test..........  PO2 drop >5 torr at maximum    D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO <15 ml/kg.........  D                                         
    Spirometry.......................  FVC <50% predicted...........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Silicosis:                                                                                                      
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Sleep apnea--central:                                                                                           
    Sleep latency test...............  Positive test................  D                                         
Sleep apnea--obstructive:                                                                                       
    Sleep latency test...............  Positive test................  D                                         
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: RESPIRATORY                                             
                                             JOB TITLE: SHOP LABORER                                            
----------------------------------------------------------------------------------------------------------------
Asbestosis:                                                                                                     
    PCO (arterial)...................  >50mm Hg if stable...........  D                                         
Asthma:                                                                                                         
    Spirometry.......................  FEV1 with adequate treatment   D                                         
                                        <40% predicted.                                                         
Bronchiectasis:                                                                                                 
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
    Pulmonary exercise test..........  PO2 drop >5 torr at maximum    D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Chronic bronchitis:                                                                                             
    Spirometry.......................  FEV1 with adequate treatment   D                                         
                                        <40% predicted.                                                         
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
    Pulmonary exercise test..........  PO2 drop >5 torr at maximum    D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Chronic obstructive pulmonary disease                                                                           
 (COPD):                                                                                                        
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
    Pulmonary exercise test..........  PO2 >5 torr at maximum         D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Cor pulmonale:                                                                                                  
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Pulmonary fibrosis:                                                                                             
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
    Diffusing capacity for CO........  <45% predicted...............  D                                         
    Pulmonary exercise test..........  PO2 drop >5 torr at maximum    D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         
    Spirometry.......................  FVC <50% predicted...........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Lung resection:                                                                                                 
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Restrictive lung disease:                                                                                       
    Diffusing capacity for CO........  <45% predicted...............  D                                         
    Pulmonary exercise test..........  PO2 drop >5 torr at maximum    D                                         
                                        exercise.                                                               
    Pulmonary exercise test..........  Maximum VO2 <15 ml/kg........  D                                         
    Spirometry.......................  FVC <50% predicted...........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Silicosis:                                                                                                      
    PCO2 arterial....................  >50 mm Hg if stable..........  D                                         
    Electrocardiogram................  Definite positive right        D                                         
                                        ventricular hypertrophy.                                                
Sleep apnea--central:                                                                                           
    Sleep latency central............  Positive test................  D                                         
Sleep apnea--obstructive:                                                                                       
    Sleep latency obstructive........  Positive test................  D                                         
----------------------------------------------------------------------------------------------------------------


[[Page 50081]]

E. Lumbar Sacral Spine

----------------------------------------------------------------------------------------------------------------
          Confirmatory test                    Minimum result                        Requirements               
----------------------------------------------------------------------------------------------------------------
                                               BODY PART: LS SPINE                                              
                                               CONFIRMATORY TESTS                                               
----------------------------------------------------------------------------------------------------------------
Ankylosing spondylitis:                                                                                         
    X-ray-lumbar sacral spine........  Sacroilitis..................  Highly recommended.                       
    HLA B27 (blood test).............  Positive HLA B27 (90% case)..  Recommended.                              
Backache, unspecified:                                                                                          
    Medical record review............  History of back pain under     Highly recommended.                       
                                        medical treatment for at                                                
                                        least 1 year.                                                           
    Medical record review............  History of back pain           Highly recommended.                       
                                        unresponsive to therapy for                                             
                                        at least 1 year.                                                        
    Medical record review............  History of back pain with      Highly recommended.                       
                                        functional limitations for                                              
                                        at least 1 year.                                                        
Chronic back pain, not otherwise                                                                                
 specified:                                                                                                     
    Medical record review............  History of back pain under     Highly recommended.                       
                                        medical treatment for at                                                
                                        least 1 year.                                                           
    Medical record review............  History of back pain           Highly recommended.                       
                                        unresponsive to therapy for                                             
                                        at least 1 year.                                                        
    Medical record review............  History of back pain with      Highly recommended.                       
                                        functional limitations for                                              
                                        at least 1 year.                                                        
Cauda equina syndrome with bowel or                                                                             
 bladder dysfunction:                                                                                           
    Magnetic resonance imaging.......  Neural impingement of spinal   Recommended.                              
                                        nerves below L1.                                                        
    Computerized tomography..........  Neural impingement of spinal   Recommended.                              
                                        nerves below L1.                                                        
    Cystometrogram...................  Impaired bladder function....  Recommended.                              
    Rectal examination...............  Diminished rectal sphincter    Recommended.                              
                                        tone.                                                                   
    Myelogram........................  Neural impingement of spinal   Recommended.                              
                                        nerves below L1.                                                        
Degeneration of lumbar disc:                                                                                    
    X-ray lumbar sacral spine........  Significant degenerative disc  Recommended.                              
                                        changes.                                                                
    Computerized tomography..........  Significant degenerative disc  Recommended.                              
                                        changes.                                                                
    Magnetic resonance imaging.......  Significant degenerative disc  Recommended.                              
                                        changes.                                                                
    Myelogram........................  Significant degenerative disc  Recommended.                              
                                        changes.                                                                
Displacement of lumbar disc:                                                                                    
    X-ray-lumbar sacral spine........  Significant degenerative disc  Recommended.                              
                                        changes.                                                                
    Computerized tomography..........  Significant degenerative disc  Recommended.                              
                                        changes.                                                                
    Magnetic resonance imaging.......  Significant degenerative disc  Recommended.                              
                                        changes.                                                                
    Myelogram........................  Significant degenerative disc  Recommended.                              
                                        changes.                                                                
Fracture: vertebral body:                                                                                       
    Magnetic resonance imaging.......  Fracture vertebral body......  Recommended.                              
    Computerized tomography..........  Fracture vertebral body......  Recommended.                              
    X-ray-lumbar sacral spine........  Fracture vertebral body......  Recommended.                              
Fracture: posterior element with                                                                                
 spinal canal displacement:                                                                                     
    Magnetic resonance imaging.......  Fracture posterior spinal      Recommended.                              
                                        element with displacement of                                            
                                        spinal canal.                                                           
    Computerized tomography..........  Fracture posterior spinal      Recommended.                              
                                        element with displacement of                                            
                                        spinal canal.                                                           
    X-ray-lumbar sacral spine........  Fracture posterior spinal      Recommended.                              
                                        element with displacement of                                            
                                        spinal canal.                                                           
Fracture: posterior spinal element                                                                              
 with no displacement:                                                                                          
    X-ray-lumbar sacral spine........  Fracture posterior spinal      Recommended.                              
                                        element.                                                                
    Magnetic resonance imaging.......  Fracture posterior spinal      Recommended.                              
                                        element.                                                                
    Computerized tomography..........  Fracture posterior spinal      Recommended.                              
                                        element.                                                                
Fracture: spinous process:                                                                                      
    X-ray-lumbar sacral spine........  Spinous process fracture.....  Recommended.                              
    Magnetic resonance imaging.......  Spinous process fracture.....  Recommended.                              
    Computerized tomography..........  Spinous process fracture.....  Recommended.                              
Fracture: Transverse process:                                                                                   
    Lumbar sacral spone..............  Transverse process fracture..  Recommended.                              
    Magnetic resonance imaging.......  Transverse process fracture..  Recommended.                              
    Computerized tomography..........  Transverse process fracture..  Recommended.                              
Intervertebral disc disorder:                                                                                   
    X-ray-lumbar sacral spine........  Significant disc degeneration  Recommended.                              
    Magnetic resonance imaging.......  Significant disc degeneration  Recommended.                              
    Computerized tomography..........  Significant disc degeneration  Recommended.                              
    Myelogram........................  Significant disc degeneration  Recommended.                              
Lumbago:                                                                                                        
    Medical record review: lumbar....  History of back pain under     Highly recommended.                       
                                        medical treatment for at                                                
                                        least 1 year.                                                           
    Medical record review: lumbar....  History of back pain           Highly recommended.                       
                                        unresponsive to therapy for                                             
                                        at least 1 year.                                                        

[[Page 50082]]

                                                                                                                
    Medical record review: lumbar....  History of back pain with      Highly recommended.                       
                                        functional limitations for                                              
                                        at least 1 year.                                                        
Lumbosacral neuritis:                                                                                           
    Magnetic resonance imaging.......  Evidence of neural             Recommended.                              
                                        compression.                                                            
    Electromyography.................  Definite denervation.........  Recommended.                              
    Nerve conduction velocity........  Definite slowing.............  Recommended.                              
    Physical examination--atrophy....  Atrophy in affected limb with  Recommended.                              
                                        2 cm difference between                                                 
                                        limbs.                                                                  
    Physcal examination: straight leg  Positive straight leg raise..  Recommended.                              
     raise.                                                                                                     
    Sensory examination..............  Loss of sensation in affected  Recommended.                              
                                        dermatomes.                                                             
    Medical history..................  History of radicular pain....  Highly recommended.                       
    Computerized tomography..........  Evidence of neural             Recommended.                              
                                        compression.                                                            
Lumbar spinal stenosis:                                                                                         
    Computerized tomography..........  Significant narrowing: spinal  Recommended.                              
                                        cord canal or intervertebral                                            
                                        foramen.                                                                
    Magnetic resonance imaging.......  Significant narrowing: spinal  Recommended.                              
                                        cord canal or intervertebral                                            
                                        foramen.                                                                
    Myelogram........................  Significant narrowing: spinal  Recommended.                              
                                        cord canal or intervertebral                                            
                                        foramen.                                                                
Mechanical complication of internal                                                                             
 orthopedic device:                                                                                             
    Medical record review............  Documentation of failure of    Highly recommended.                       
                                        implant following surgical                                              
                                        procedure.                                                              
Osteomalacia:                                                                                                   
    X-ray-lumbar sacral spine........  Evidence of significant        Recommended.                              
                                        osteomalacia.                                                           
    Magnetic resonance imaging.......  Evidence of significant        Recommended.                              
                                        osteomalacia.                                                           
    Computerized tomography..........  Evidence of significant        Recommended.                              
                                        osteomalacia.                                                           
Osteomyelitis, chronic-lumbar:                                                                                  
    X-ray-lumbar sacral spine........  Evidence of chronic infection  Recommended.                              
    Magnetic resonance imaging.......  Evidence of chronic infection  Recommended.                              
    Computerized tomography..........  Evidence of chronic infection  Recommended.                              
Osteoporosis:                                                                                                   
    Computerized tomography..........  Significant bone density loss  Recommended.                              
    Dual photon absorptiometry.......  Significant bone density loss  Recommended.                              
    X-ray-lumbar sacral spine........  Significant bone density loss  Recommended.                              
Post laminectomy syndrome with                                                                                  
 radiculopathy:                                                                                                 
    Medical record review: lumbar....  Documented surgical history    Highly recommended.                       
                                        of laminectomy.                                                         
    Magnetic resonance imaging.......  Evidence of laminectomy......  Recommended.                              
    Electromyography.................  Definite denervation.........  Recommended.                              
    Nerve conduction velocity........  Definite slowing.............  Recommended.                              
    Physical examination--atrophy....  Atrophy in affected limb with  Recommended.                              
                                        2 cm difference between                                                 
                                        limbs.                                                                  
    Physical examination: straight     Positive straight leg raise..  Recommended.                              
     leg raise.                                                                                                 
    Sensory examiation...............  Loss of sensation in affected  Recommended.                              
                                        dermatomes.                                                             
    Medical record review: lumbar....  History of radicular pain....  Highly recommended.                       
    Computerized tomography..........  Evidence of laminectomy......  Recommended.                              
    Myelogram........................  Evidence of laminectomy......  Recommended.                              
Radiculopathy:                                                                                                  
    Magnetic resonance imaging.......  Evidence of neural             Recommended.                              
                                        compression.                                                            
    Electromyography.................  Definite denervation.........  Recommended.                              
    Nerve conduction velocity........  Definite slowing.............  Recommended.                              
    Physical examination--atrophy....  Atrophy in affected limb with  Recommended.                              
                                        2 cm difference between                                                 
                                        limbs.                                                                  
    Physical examination: straight     Positive straight leg raise..  Recommended.                              
     leg raise.                                                                                                 
    Sensory examination..............  Loss of sensation in affected  Recommended.                              
                                        dermatomes.                                                             
    Medical record review: lumbar....  History of radicular pain....  Highly recommended.                       
    Computerized tomography..........  Evidence of neural             Recommended.                              
                                        compression.                                                            
    Myelogram........................  Evidence of neural             Recommended.                              
                                        compression.                                                            
Sciatica:                                                                                                       
    Magnetic resonance imaging.......  Evidence of neural             Recommended.                              
                                        compression.                                                            
    Electromyography.................  Definite denervation.........  Recommended.                              
    Nerve conduction velocity........  Definite slowing.............  Recommended.                              
    Physical examination--atrophy....  Atrophy in affected limb with  Recommended.                              
                                        2 cm difference between                                                 
                                        limbs.                                                                  
    Physical examination: straight     Positive straight leg raise..  Recommended.                              
     leg raise.                                                                                                 
    Sensory examination..............  Loss of sensation in affected  Recommended.                              
                                        dermatones.                                                             
    Medical history..................  History of radicular pain....  Highly recommended.                       
    Computerized tomography..........  Evidence of neural             Recommended.                              
                                        compression.                                                            
    Myelogram........................  Evidence of neural             Recommended.                              
                                        compression.                                                            
Strains and sprains, unspecified:                                                                               
    Medical record review............  History of back pain under     Highly recommended.                       
                                        medical treatment for at                                                
                                        least 1 year.                                                           
    Medical record review............  History of back pain           Highly recommended.                       
                                        unresponsive to therapy for                                             
                                        at least 1 year.                                                        

[[Page 50083]]

                                                                                                                
    Medical record review............  History of back pain with      Highly recommended.                       
                                        functional limitations for                                              
                                        at least 1 year.                                                        
    Medical record review............  Documented history of strain   Highly recommended.                       
                                        and/or sprain.                                                          
Spondylolisthesis grade 1:                                                                                      
    X-ray-lumbar sacral spine........  1-25% slippage...............  Recommended.                              
    Computerized tomography..........  1-25% slippage...............  Recommended.                              
    Magnetic resonance imaging.......  1-25% slippage...............  Recommended.                              
Spondylolisthesis grade 2:                                                                                      
    X-ray-lumbar sacral spine........  26-50% slippage..............  Recommended.                              
    Computerized tomography..........  26-50% slippage..............  Recommended.                              
    Magnetic resonance imaging.......  26-50% slippage..............  Recommended.                              
Spondylolisthesis grade 3:                                                                                      
    X-ray-lumbar sacral spine........  51-75% slippage..............  Recommended.                              
    Computerized tomography..........  51-75% slippage..............  Recommended.                              
    Magnetic resonance imaging.......  51-75% slippage..............  Recommended.                              
Spondylolisthesis grade 4:                                                                                      
    X-ray-lumbar sacral spine........  Complete slippage............  Recommended.                              
    Computerized tomography..........  Complete slippage............  Recommended.                              
    Magnetic resonance imaging.......  Complete slippage............  Recommended.                              
Spondylolisthesis-acquired:                                                                                     
    X-ray-lumbar sacral spine........  Slippage.....................  Recommended.                              
    Computerized tomography..........  Slippage.....................  Recommended.                              
    Magnetic resonance imaging.......  Slippage.....................  Recommended.                              
Spondylolsis:                                                                                                   
    X-ray-lumbar sacral spine........  Defect--pars interarticularis  Recommended.                              
    Computerized tomography..........  Defect--pars interarticularis  Recommended.                              
    MRI..............................  Defect--pars interarticularis  Recommended.                              
Sprains and strains, sacral:                                                                                    
    Medical record review: lumbar....  History of back pain under     Highly recommended.                       
                                        medical treatment for at                                                
                                        least 1 year.                                                           
    Medical record review: lumbar....  History of back pain           Highly recommended.                       
                                        unresponsive to therapy for                                             
                                        at least 1 year.                                                        
    Medical record review: lumbar....  History of back with           Highly recommended.                       
                                        functional limitations for                                              
                                        at least 1 year.                                                        
    Medical record review: lumbar....  Documented history of strain   Highly recommended.                       
                                        and/or sprain.                                                          
Sprains and strains, sacroiliac:                                                                                
    Medical record review: lumbar....  History of back pain under     Highly recommended.                       
                                        medical treatment for at                                                
                                        least 1 year.                                                           
    Medical record review: lumbar....  History of back pain           Highly recommended.                       
                                        unresponsive to therapy for                                             
                                        at least 1 year.                                                        
    Medical record review: lumbar....  History of back pain with      Highly recommended.                       
                                        functional limitations for                                              
                                        at least 1 year.                                                        
    Medical record review: lumbar....  Documented history of strain   Highly recommended.                       
                                        and/or sprain.                                                          
----------------------------------------------------------------------------------------------------------------


----------------------------------------------------------------------------------------------------------------
           Disability test                      Test result                    Disability classification        
----------------------------------------------------------------------------------------------------------------
                                               BODY PART: LS SPINE                                              
                                               JOB TITLE: TRAINMAN                                              
----------------------------------------------------------------------------------------------------------------
Ankylosing spondylitis:                                                                                         
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
Backache, unspecified:                                                                                          
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
Chronic back pain, not otherwise                                                                                
 specified:                                                                                                     
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
Cauda equina syndrome with bowel or                                                                             
 bladder dysfunction:                                                                                           
    Computerized tomography..........  Disc extrusion with neural     D                                         
                                        impingement, nerves >L1.                                                
    Magnetic resonance imaging.......  Disc extrusion with neural     D                                         
                                        impingement, nerves >L1.                                                
    Physical examination.............  Lower extremity weakness.....  D                                         
    Cystometrogram...................  Impaired bladder function....  D                                         
    Myelogram........................  Disc extrusion with neural     D                                         
                                        impingement, nerves >L1.                                                
    Physical examination: rectal.....  Impairment of sphincter tone.  D                                         
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
Degeneration of lumbar disc:                                                                                    
    Computerized tomography..........  Disc extrusion with neural     D                                         
                                        impingement.                                                            
    Magnetic resonance imaging.......  Disc extrusion with neural     D                                         
                                        impingement.                                                            
    Myelogram........................  Disc extrusion with neural     D                                         
                                        impingement.                                                            
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
Displacement of lumbar disc:                                                                                    
    Computerized tomography..........  Disc extrusion with neural     D                                         
                                        impingement.                                                            
    Magnetic resonance imaging.......  Disc extrusion with neural     D                                         
                                        impingement.                                                            
    Myelogram........................  Disc extrusion with neural     D                                         
                                        impingement.                                                            

[[Page 50084]]

                                                                                                                
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
Fracture: vertebral body:                                                                                       
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
Fracture: posterior spinal element                                                                              
 with displacement:                                                                                             
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
Fracture: posterior spinal element                                                                              
 with no displacement:                                                                                          
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
Fracture: spinous process:                                                                                      
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
Fracture transverse process:                                                                                    
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
Intervertebral disc disorder:                                                                                   
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
    Computerized tomography..........  Disc extrusion with neural     D                                         
                                        impingement.                                                            
    Magnetic resonance imaging.......  Disc extrusion with neural     D                                         
                                        impingement.                                                            
    Myelogram........................  Disc extrusion with neural     D                                         
                                        impingement.                                                            
Lumbago:                                                                                                        
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
Lumbosacral neuritis:                                                                                           
    Computerized tomography..........  Disc extrusion with neural     D                                         
                                        impingement.                                                            
    Magnetic resonance imaging.......  Disc extrusion with neural     D                                         
                                        impingement.                                                            
    Myelogram........................  Disc extrusion with neural     D                                         
                                        impingement.                                                            
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
    Physical examination.............  Lower extremity weakness.....  D                                         
Lumbar spinal stenosis:                                                                                         
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
    Computerized tomography..........  Significant narrowing of the   D                                         
                                        spinal canal.                                                           
    Magnetic resonance imaging.......  Significant narrowing of the   D                                         
                                        spinal canal.                                                           
    Myelogram........................  Significant narrowing of the   D                                         
                                        spinal canal.                                                           
    Physical examination.............  Significant lower extremity    D                                         
                                        weakness.                                                               
Mechanical complication of internal                                                                             
 orthopedic device:                                                                                             
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
    X-ray flexion/extension..........  Segmental instability........  D                                         
Osteomalacia:                                                                                                   
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
Osteomyelitis, chronic-lumbar:                                                                                  
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
    Medical record review............  Frequent flare-ups with        D                                         
                                        objective findings.                                                     
Osteoporosis:                                                                                                   
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
Post laminectomy syndrome with                                                                                  
 radiculopathy:                                                                                                 
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
    Computerized tomography..........  Disc extrusion with neural     D                                         
                                        impingement.                                                            
    Magnetic resonance imaging.......  Disc extrusion with neural     D                                         
                                        impingement.                                                            
    Myelogram........................  Disc extrusion with neural     D                                         
                                        impingement.                                                            
    Physical examination.............  Significant lower extremity    D                                         
                                        weakness.                                                               
Post laminectomy syndrome:                                                                                      
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
    Computerized tomography..........  Disc extrusion with neural     D                                         
                                        impingement.                                                            
    Magnetic resonance imaging.......  Disc extrusion with neural     D                                         
                                        impingement.                                                            
    Myelogram........................  Disc extrusion with neural     D                                         
                                        impingement.                                                            
    Physical examination.............  Significant lower extremity    D                                         
                                        weakness.                                                               
    X-ray flexion/extension..........  Segmental instability........  D                                         
Radiculopathy:                                                                                                  
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
    Computerized tomography..........  Disc extrusion with neural     D                                         
                                        impingement.                                                            
    Magnetic resonance imaging.......  Disc extrusion with neural     D                                         
                                        impingement.                                                            
    Myelogram........................  Disc extrusion with neural     D                                         
                                        impingement.                                                            
    Physical examination.............  Significant lower extremity    D                                         
                                        weakness.                                                               
Sciatica:                                                                                                       
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
    Computerized tomography..........  Disc extrusion with neural     D                                         
                                        impingement.                                                            
    Magnetic resonance imaging.......  Disc extrusion with neural     D                                         
                                        impingement.                                                            
    Myelogram........................  Disc extrusion with neural     D                                         
                                        impingement.                                                            
    Physical examination.............  Significant lower extremity    D                                         
                                        weakness.                                                               
Strains and sprains, unspecified:                                                                               
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
Spondylolisthesis grade 1:                                                                                      
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
    X-ray flexion/extension..........  Segmental instability........  D                                         
Spondylolisthesis grade 2:                                                                                      
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
Spondylolisthesis grade 3:                                                                                      

[[Page 50085]]

                                                                                                                
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
Spondylolisthesis grade 4:                                                                                      
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
    X-ray flexion/extension..........  Segmental instability........  D                                         
Spondylisthesis--acquired:                                                                                      
    X-ray flexion/extension..........  Segmental instability........  D                                         
Spondylolysis:                                                                                                  
    X-ray flexion/extension..........  Segmental instability........  D                                         
Sprains and strains, sacral:                                                                                    
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
Sprains and strains, sacroiliac:                                                                                
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
Vertebral body compression fracture:                                                                            
    Muscle strength assessment.......  Lifting capacity diminished    D                                         
                                        by 50%.                                                                 
----------------------------------------------------------------------------------------------------------------
                                               BODY PART: LS SPINE                                              
                                               JOB TITLE: ENGINEER                                              
----------------------------------------------------------------------------------------------------------------
Cauda equina syndrome with bowel or                                                                             
 bladder dysfunction:                                                                                           
    Computerized tomography..........  Disc extrusion with neural     D                                         
                                        impingement, nerves 2 cm....  Recommended.                              
    Electromyography.................  Definite denervation in        Recommended.                              
                                        muscle of affected nerve                                                
                                        root.                                                                   
    Myelogram........................  Evidence of neurogenic         Recommended.                              
                                        compression.                                                            
    Magnetic resonance imaging.......  Compression of spinal nerves.  Recommended.                              
    Computerized axial tomography....  Compression of spinal nerves.  Recommended.                              
Rheumatoid arthritis, cervical:                                                                                 
    Rheumatoid factor (blood test)...  High titer...................  Recommended.                              
    X-ray: cervical spine............  Rheumatoid changes of spine..  Highly recommended.                       
    Medical records review: cervical.  Confirmation by                Highly recommended.                       
                                        rheumatologist or internist.                                            
Spondylogenic compression of spinal                                                                             
 cord:                                                                                                          
    Physical examination: cervical...  Evidence of myelopathy.......  Highly recommended.                       
    Computerized axial tomography....  Evidence of neurogenic         Recommended.                              
                                        compression.                                                            
    Magnetic resonance imaging.......  Evidence of neurogenic         Recommended.                              
                                        compression.                                                            

[[Page 50094]]

                                                                                                                
    Myelogram........................  Evidence of neurogenic         Recommended.                              
                                        compression.                                                            
----------------------------------------------------------------------------------------------------------------


----------------------------------------------------------------------------------------------------------------
           Disability test                      Test result                    Disability classification        
----------------------------------------------------------------------------------------------------------------
                                               BODY PART: CE SPINE                                              
                                               JOB TITLE: TRAINMAN                                              
----------------------------------------------------------------------------------------------------------------
Cervical disc disease with                                                                                      
 myelopathy:                                                                                                    
    Computerized axial tomography....  Significant spinal cord        D                                         
                                        pressure.                                                               
    Magnetic resonance imaging.......  Significant spinal cord        D                                         
                                        pressure.                                                               
    Myelogram........................  Significant spinal cord        D                                         
                                        pressure.                                                               
    Cystometrogram...................  Impaired bladder function....  D                                         
    Physical examination: rectal.....  Impairment of sphincter tone.  ..........................................
    Physical examination: lower limb.  Lower extremity weakness or    D                                         
                                        significant spasticity.                                                 
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Chronic herniated disc:                                                                                         
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Cervical spondylolysis:                                                                                         
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Cervical intervertebral disc                                                                                    
 degeneration:                                                                                                  
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Fracture: posterior element with                                                                                
 spinal canal displacement:                                                                                     
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Post laminectomy syndrome:                                                                                      
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Cervical radiculopathy:                                                                                         
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Spondylogenic compression of spinal                                                                             
 cord:                                                                                                          
    Computerized axial tomography....  Significant spinal cord        D                                         
                                        pressure.                                                               
    Magnetic resonance imaging.......  Significant spinal cord        D                                         
                                        pressure.                                                               
    Cystometrogram...................  Impaired bladder function....  D                                         
    Myelogram........................  Significant spinal cord        D                                         
                                        pressure.                                                               
    Physical examination: rectal.....  Impairment of sphincter tone.  D                                         
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
    Physical examination: lower limb.  Lower extremity weakness or    D                                         
                                        spasticity.                                                             
----------------------------------------------------------------------------------------------------------------
                                               BODY PART: CE SPINE                                              
                                              JOB TITLE: ENGINEER                                               
----------------------------------------------------------------------------------------------------------------
Cervical disc disease with                                                                                      
 myelopathy:                                                                                                    
    Computerized axial tomography....  Significant spinal cord        D                                         
                                        pressure.                                                               
    Magnetic resonance imaging.......  Significant spinal cord        D                                         
                                        pressure.                                                               
    Myelogram........................  Significant spinal cord        D                                         
                                        pressure.                                                               
    Cystometrogram...................  Impaired bladder function....  D                                         
    Physical examination: rectal.....  Impairment of sphincter tone.  D                                         
    Physical examination: lower limb.  Lower extremity weakness or    D                                         
                                        significant spasticity.                                                 
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Chronic herniated disc:                                                                                         
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Cervical spondylolysis:                                                                                         
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Cervical intervertebral disc                                                                                    
 degeneration:                                                                                                  
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Fracture: posterior element with                                                                                
 spinal canal displacement:                                                                                     
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Post laminectomy syndrome:                                                                                      
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Cervical radiculopathy:                                                                                         
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Spondylogenic compression of spinal                                                                             
 cord:                                                                                                          
    Computerized axial tomography....  Significant spinal cord        D                                         
                                        pressure.                                                               
    Magnetic resonance imaging.......  Significant spinal cord        D                                         
                                        pressure.                                                               
    Cystometrogram...................  Impaired bladder function....  D                                         
    Myelogram........................  Significant spinal cord        D                                         
                                        pressure.                                                               
    Physical examination: rectal.....  Impairment of sphincter tone.  D                                         
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
    Physical examination: lower limb.  Lower extremity weakness or    D                                         
                                        spasticity.                                                             
----------------------------------------------------------------------------------------------------------------
                                               BODY PART: CE SPINE                                              
                                             JOB TITLE: DISPATCHER                                              
----------------------------------------------------------------------------------------------------------------
Cervical disc disease with                                                                                      
 myelopathy:                                                                                                    

[[Page 50095]]

                                                                                                                
    Cystometrogram...................  Impaired bladder function....  D                                         
    Physical examination: rectal.....  Impairment of sphincter tone.  D                                         
Spondylogenic compression of spinal                                                                             
 cord:                                                                                                          
    Cystometrogram...................  Impaired bladder function....  D                                         
    Physical examination: rectal.....  Impairment of sphincter tone.  D                                         
----------------------------------------------------------------------------------------------------------------
                                               BODY PART: CE SPINE                                              
                                                JOB TITLE: CARMAN                                               
----------------------------------------------------------------------------------------------------------------
Cervical disc disease with                                                                                      
 myelopathy:                                                                                                    
    Computerized axial tomography....  Significant spinal cord        D                                         
                                        pressure.                                                               
    Magnetic resonance imaging.......  Significant spinal cord        D                                         
                                        pressure.                                                               
    Myelogram........................  Significant spinal cord        D                                         
                                        pressure.                                                               
    Cystometrogram...................  Impaired bladder function....  D                                         
    Physical examination: rectal.....  Impairment of sphincter tone.  D                                         
    Physical examination: lower limb.  Lower extremity weakness or    D                                         
                                        significant spasticity.                                                 
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Chronic herniated disc:                                                                                         
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Cervical spondylolysis:                                                                                         
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Cervical intervertebral disc                                                                                    
 degeneration:                                                                                                  
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Fracture: posterior element with                                                                                
 spinal canal displacement:                                                                                     
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Post laminectomy syndrome:                                                                                      
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Cervical radiculopathy:                                                                                         
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Spondylogenic compression of spinal                                                                             
 cord:                                                                                                          
    Computerized axial tomography....  Significant spinal cord        D                                         
                                        pressure.                                                               
    Magnetic resonance imaging.......  Significant spinal cord        D                                         
                                        pressure.                                                               
    Cystometrogram...................  Impaired bladder function....  D                                         
    Myelogram........................  Significant spinal cord        D                                         
                                        pressure.                                                               
    Physical examination: rectal.....  Impairment of sphincter tone.  D                                         
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
    Physical examination: lower limb.  Lower extremity weakness or    D                                         
                                        spasticity.                                                             
----------------------------------------------------------------------------------------------------------------
                                               BODY PART; CE SPINE                                              
                                              JOB TITLE: SIGNALMAN                                              
----------------------------------------------------------------------------------------------------------------
Cervical disc disease with                                                                                      
 myelopathy:                                                                                                    
    Computerized axial tomography....  Significant spinal cord        D                                         
                                        pressure.                                                               
    Magnetic resonance imaging.......  Significant spinal cord        D                                         
                                        pressure.                                                               
    Myelogram........................  Significant spinal cord        D                                         
                                        pressure.                                                               
    Cystometrogram...................  Impaired bladder function....  D                                         
    Physical examination: rectal.....  Impairment of sphincter tone.  D                                         
    Physical examination: lower limb.  Lower extremity weakness or    D                                         
                                        significant spasticity.                                                 
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Chronic herniated disc:                                                                                         
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Cervical spondylolysis:                                                                                         
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Cervical intervertebral disc                                                                                    
 degeneration:                                                                                                  
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Fracture: posterior element with                                                                                
 spinal canal displacement:                                                                                     
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Post laminectomy syndrome:                                                                                      
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Cervical radiculopathy:                                                                                         
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Spondylogenic compression of spinal                                                                             
 cord:                                                                                                          
    Computerized axial tomography....  Significant spinal cord        D                                         
                                        pressure.                                                               
    Magnetic resonance imaging.......  Significant spinal cord        D                                         
                                        pressure.                                                               
    Cystometrogram...................  Impaired bladder function....  D                                         
    Myelogram........................  Significant spinal cord        D                                         
                                        pressure.                                                               
    Physical examination: rectal.....  Impairment of sphincter tone.  D                                         
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
    Physical examination: lower limb.  Lower extremity weakness or    D                                         
                                        spasticity.                                                             
----------------------------------------------------------------------------------------------------------------

[[Page 50096]]

                                                                                                                
                                               BODY PART: CE SPINE                                              
                                               JOB TITLE: TRACKMAN                                              
----------------------------------------------------------------------------------------------------------------
Cervical disc disease with                                                                                      
 myelopathy:                                                                                                    
    Computerized axial tomography....  Significant spinal cord        D                                         
                                        pressure.                                                               
    Magnetic resonance imaging.......  Significant spinal cord        D                                         
                                        pressure.                                                               
    Myelogram........................  Significant spinal cord        D                                         
                                        pressure.                                                               
    Cystometrogram...................  Impaired bladder function....  D                                         
    Physical examination: rectal.....  Impairment of sphincter tone.  D                                         
    Physical examination: lower limb.  Lower extremity weakness or    D                                         
                                        significant spasticity.                                                 
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Chronic herniated disc:                                                                                         
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Cervical spondyloysis:                                                                                          
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Cervical intervertebral disc                                                                                    
 degeneration:                                                                                                  
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Fracture: posterior element with                                                                                
 spinal canal displacement:                                                                                     
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Post laminectomy syndrome:                                                                                      
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Cervical radiculopathy:                                                                                         
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Spondylogenic compression of spinal                                                                             
 cord:                                                                                                          
    Computerized axial tomography....  Significant spinal cord        D                                         
                                        pressure.                                                               
    Magnetic resonance imaging.......  Significant spinal cord        D                                         
                                        pressure.                                                               
    Cystometrogram...................  Impaired bladder function....  D                                         
    Myelogram........................  Significant spinal cord        D                                         
                                        pressure.                                                               
    Physical examination: rectal.....  Impairment of sphincter tone.  D                                         
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
    Physical examination: lower limb.  Lower extremity weakness or    D                                         
                                        spasticity.                                                             
----------------------------------------------------------------------------------------------------------------
                                               BODY PART: CE SPINE                                              
                                              JOB TITLE: MACHINIST                                              
----------------------------------------------------------------------------------------------------------------
Cervical disc disease with                                                                                      
 myelopathy:                                                                                                    
    Computerized axial tomography....  Significant spinal cord        D                                         
                                        pressure.                                                               
    Magnetic resonance imaging.......  Significant spinal cord        D                                         
                                        pressure.                                                               
    Myelogram........................  Significant spinal cord        D                                         
                                        pressure.                                                               
    Cystometrogram...................  Impaired bladder function....  D                                         
    Physical examination: rectal.....  Impairment of sphincter tone.  D                                         
    Physical examination: lower limb.  Lower extremity weakness or    D                                         
                                        significant spasticity.                                                 
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Chronic herniated disc:                                                                                         
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Cervical spondylolysis:                                                                                         
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Cervical intervertebral disc                                                                                    
 degeneration:                                                                                                  
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Fracture: posterior element with                                                                                
 spinal canal displacement:                                                                                     
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Post laminectomy syndrome:                                                                                      
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Cervical radiculopathy:                                                                                         
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Spondylogenic compression of spinal                                                                             
 cord:                                                                                                          
    Computerized axial tomography....  Significant spinal cord        D                                         
                                        pressure.                                                               
    Magnetic resonance imaging.......  Significant spinal cord        D                                         
                                        pressure.                                                               
    Cystometrogram...................  Impaired bladder function....  D                                         
    Myelogram........................  Significant spinal cord        D                                         
                                        pressure.                                                               
    Physical examination: rectal.....  Impairment of sphincter tone.  D                                         
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
    Physical examination: lower limb.  Lower extremity weakness or    D                                         
                                        spasticity.                                                             
----------------------------------------------------------------------------------------------------------------
                                               BODY PART: CE SPINE                                              
                                             JOB TITLE: SHOP LABORER                                            
----------------------------------------------------------------------------------------------------------------
Cervical disc disease with                                                                                      
 myelopathy:                                                                                                    
    Computerized axial tomography....  Significant spinal cord        D                                         
                                        pressure.                                                               
    Magnetic resonance imaging.......  Significant spinal cord        D                                         
                                        pressure.                                                               
    Myelogram........................  Significant spinal cord        D                                         
                                        pressure.                                                               
    Cystometrogram...................  Impaired bladder function....  D                                         

[[Page 50097]]

                                                                                                                
    Physical examination: rectal.....  Impairment of sphincter tone.  D                                         
    Physical examination: lower limb.  Lower extremity weakness or    D                                         
                                        significant spasticity.                                                 
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Chronic herniated disc:                                                                                         
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Cervical spondylolysis:                                                                                         
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Cervical intervertebral disc                                                                                    
 degeneration:                                                                                                  
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Fracture: posterior element with                                                                                
 spinal canal displacement:                                                                                     
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Post laminectomy syndrome:                                                                                      
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Cervical radiculopathy:                                                                                         
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
Spondylogenic compression of spinal                                                                             
 cord:                                                                                                          
    Computerized axial tomography....  Significant spinal cord        D                                         
                                        pressure.                                                               
    Magnetic resonance imaging.......  Significant spinal cord        D                                         
                                        pressure.                                                               
    Cystometrogram...................  Impaired bladder function....  D                                         
    Myelogram........................  Significant spinal cord        D                                         
                                        pressure.                                                               
    Physical examination: rectal.....  impairment of sphincter tone.  D                                         
    Physical examination: cervical...  Multi-level neurologic         D                                         
                                        compromise.                                                             
    Physical examination: lower limb.  Lower extremity weakness or    D                                         
                                        spasticity.                                                             
----------------------------------------------------------------------------------------------------------------
                                               BODY PART: CE SPINE                                              
                                         JOB TITLE: SALES REPRESENTATIVE                                        
----------------------------------------------------------------------------------------------------------------
Cervical disc disease with                                                                                      
 myelopathy:                                                                                                    
    Cystometrogram...................  Impaired bladder function....  D                                         
    Physical examination: rectal.....  Impairment of sphincter tone.  D                                         
Spondylogenic compression of spinal                                                                             
 cord:                                                                                                          
    Cystometrogram...................  Impaired bladder function....  D                                         
    Physical examination: rectal.....  Impairment of sphincter tone.  D                                         
----------------------------------------------------------------------------------------------------------------
                                               BODY PART: CE SPINE                                              
                                         JOB TITLE: GENERAL OFFICE CLERK                                        
----------------------------------------------------------------------------------------------------------------
Cervical disc disease with                                                                                      
 myelopathy:                                                                                                    
    Cystometrogram...................  Impaired bladder function....  D                                         
    Physical examination: rectal.....  Impairment of sphincter tone.  D                                         
Spondylogenic compression of spinal                                                                             
 cord:                                                                                                          
    Cystometrogram...................  Impaired bladder function....  D                                         
    Physical examination: rectal.....  Impairment of sphincter tone.  D                                         
----------------------------------------------------------------------------------------------------------------

G. Shoulder

----------------------------------------------------------------------------------------------------------------
          Confirmatory test                    Minimum result                        Requirements.              
----------------------------------------------------------------------------------------------------------------
                                          BODY PART: SHOULDER AND ELBOW                                         
                                               CONFIRMATORY TESTS                                               
----------------------------------------------------------------------------------------------------------------
Arthritis, acromioclavicular:                                                                                   
    X-ray: shoulder..................  Significant degenerative       Recommended.                              
                                        changes of joint.                                                       
    Computerized tomography..........  Significant degenerative       Recommended.                              
                                        changes of joint.                                                       
    Magnetic resonance imaging.......  Significant degenerative       Recommended.                              
                                        changes of joint.                                                       
Arthritis, glenohumeral:                                                                                        
    X-ray: shoulder..................  Significant degenerative       Recommended.                              
                                        changes of joint.                                                       
    Computerized tomography..........  Significant degenerative       Recommended.                              
                                        changes of joint.                                                       
    Magnetic resonance imaging.......  Significant degenerative       Recommended.                              
                                        changes of joint.                                                       
Rotator cuff tear:                                                                                              
    Computerized tomography..........  Tear of rotator cuff.........  Recommended.                              
    Magnetic resonance imaging.......  Tear of rotator cuff.........  Recommended.                              
    Magnetic resonance imaging.......  Tear of rotator cuff.........  Recommended.                              
Permanent functional limitation,                                                                                
 elbow:                                                                                                         
    Medical record review............  Condition with permanent       Highly recommended.                       
                                        functional limitation.                                                  
    X-ray: elbow.....................  Imaging confirmation of        Recommended.                              
                                        functional diagnosis.                                                   
    Magnetic resonance imaging.......  Imaging confirmation of        Recommended.                              
                                        functional diagnosis.                                                   
----------------------------------------------------------------------------------------------------------------


[[Page 50098]]


----------------------------------------------------------------------------------------------------------------
           Disability test                      Test result                    Disability classification        
----------------------------------------------------------------------------------------------------------------
                                          BODY PART: SHOULDER AND ELBOW                                         
                                               Job TITLE: TRAINMAN                                              
----------------------------------------------------------------------------------------------------------------
Arthritis, acromioclavicular:                                                                                   
    Physical examination--range of     <40 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <40 degrees abduction........  D                                         
     motion.                                                                                                    
Arthritis, glenohumeral:                                                                                        
    Physical examination--range of     <40 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <40 degrees abduction........  D                                         
     motion.                                                                                                    
Rotator cuff tear:                                                                                              
    Physical examination--range of     <40 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <40 degrees abduction........  D                                         
     motion.                                                                                                    
Permanent functional limitation,                                                                                
 elbow:                                                                                                         
    Physical examination.............  >40 degrees deviation........  D                                         
    Physical examination--range of     Flexion limit to 60 degrees    D                                         
     motion.                            (30 degrees from 90).                                                   
----------------------------------------------------------------------------------------------------------------
                                          BODY PART: SHOULDER AND ELBOW                                         
                                               JOB TITLE: ENGINEER                                              
----------------------------------------------------------------------------------------------------------------
Arthritis, acromioclavicular:                                                                                   
    Physical examination--range of     <40 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <40 degrees abduction........  D                                         
     motion.                                                                                                    
Arthritis, glenohumeral:                                                                                        
    Physical examination--range of     <40 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <40 degrees abudction........  D                                         
     motion.                                                                                                    
Rotator cuff tear:                                                                                              
    Physical examination--range of     <40 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <40 degrees abduction........  D                                         
     moiton.                                                                                                    
Permanent functional limitation,                                                                                
 elbow:                                                                                                         
    Physical examination.............  >40 degrees deviation........  D                                         
    Physical examination--range of     Flexion limit to 60 degrees    D                                         
     motion.                            (30 degrees from 90).                                                   
----------------------------------------------------------------------------------------------------------------
                                          BOFY PSTY: SHOULDER AND ELBOW                                         
                                                JOB TITLE: CARMAN                                               
----------------------------------------------------------------------------------------------------------------
Arthritis, acromioclavicular:                                                                                   
    Physical examination--range of     <40 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <40 degrees abduction........  D                                         
     motion.                                                                                                    
Arthritis, glenohumeral:                                                                                        
    Physical examination--range of     <40 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <40 degrees abduction........  D                                         
     motion.                                                                                                    
Rotator cuff tear:                                                                                              
    Physical examination--range of     <40 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <40 degrees abduction........  D                                         
     motion.                                                                                                    
Permanent functional limitation,                                                                                
 elbow:                                                                                                         
    Physical examination.............  >40 degrees deviation........  D                                         
    Physical examination--range of     Flexion limit to 60 degrees    D                                         
     motion.                            (30 degrees from 90).                                                   
----------------------------------------------------------------------------------------------------------------
                                          BODY PART: SHOULDER AND ELBOW                                         
                                              JOB TITLE: SIGNALMAN                                              
----------------------------------------------------------------------------------------------------------------
Arthritis, acromioclavicular:                                                                                   
    Physical examination--range of     <40 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <40 degrees abduction........  D                                         
     motion.                                                                                                    
Arthritis, glenohumeral:                                                                                        
    Physical examination--range of     <40 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <40 degrees abduction........  D                                         
     motion.                                                                                                    
Rotator cuff tear:                                                                                              
    Physical examination--range of     <40 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <40 degrees abduction........  D                                         
     motion.                                                                                                    
Permanent functional limitation,                                                                                
 elbow:                                                                                                         
    Physical examination.............  >40 degrees deviation........  D                                         
    Physical examination--range of     Flexion limit to 60 degrees    D                                         
     motion.                            (30 degrees from 90).                                                   
----------------------------------------------------------------------------------------------------------------
                                          BODY Part: SHOULDER AND ELBOW                                         
                                               JOB TITLE: TRACKMAN                                              
----------------------------------------------------------------------------------------------------------------
Arthritis, acromioclavicular:                                                                                   
    Physical examination--range of     <40 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <40 degrees abduction........  D                                         
     motion.                                                                                                    
Arthritis, glenohumeral:                                                                                        
    Physical examination--range of     <40 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <40 degrees abduction........  D                                         
     motion.                                                                                                    
Rotator cuff tear:                                                                                              
    Physical examination--range of     <40 degrees flexion..........  D                                         
     motion.                                                                                                    

[[Page 50099]]

                                                                                                                
    Physical examination--range of     <40 degrees abduction........  D                                         
     motion.                                                                                                    
Permanent functional limitation,                                                                                
 elbow:                                                                                                         
    Physical examination.............  >40 degrees deviation........  D                                         
    Physical examination--range of     Flexion limit to 60 degrees    D                                         
     motion.                            (30 degrees from 90).                                                   
----------------------------------------------------------------------------------------------------------------
                                          BODY PART: SHOULDER AND ELBOW                                         
                                              JOB TITLE: MACHINIST                                              
----------------------------------------------------------------------------------------------------------------
Arthritis, acromioclavicular:                                                                                   
    Physical examination--range of     <40 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <40 degrees abduction........  D                                         
     motion.                                                                                                    
Arthritis, glenohumeral:                                                                                        
    Physical examination--range of     <40 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <40 degrees abduction........  D                                         
     motion.                                                                                                    
Rotator cuff tear:                                                                                              
    Physical examination--range of     <40 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <40 degrees abduction........  D                                         
     motion.                                                                                                    
Permanent functional limitation,                                                                                
 elbow:                                                                                                         
    Physical examination.............  >40 degrees deviation........  D                                         
    Physical examination--range of     Flexion limit to 60 degrees    D                                         
     motion.                            (30 degrees from 90).                                                   
----------------------------------------------------------------------------------------------------------------
                                          BODY PART: SHOULDER AND ELBOW                                         
                                             JOB TITLE: SHOP LABORER                                            
----------------------------------------------------------------------------------------------------------------
Arthritis, acromioclavicular:                                                                                   
    Physical examination--range of     <40 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <40 degrees abduction........  D                                         
     motion.                                                                                                    
Arthritis, glenohumeral:                                                                                        
    Physical examination--range of     <40 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <40 degrees abduction........  D                                         
     motion.                                                                                                    
Rotator cuff tear:                                                                                              
    Physical examination--range of     <40 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <40 degrees abduction........  D                                         
     motion.                                                                                                    
Permanent functional limitation,                                                                                
 elbow:                                                                                                         
    Physical examination.............  >40 degrees deviation........  D                                         
    Physical examination--range of     Flexion limit to 60 degrees    D                                         
     motion.                            (30 degrees from 90).                                                   
----------------------------------------------------------------------------------------------------------------
----------------------------------------------------------------------------------------------------------------

H. Arm and Hand

----------------------------------------------------------------------------------------------------------------
          Confirmatory test                    Minimum result                        Requirements;              
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: HAND AND ARM                                            
                                               CONFIRMATORY TESTS                                               
----------------------------------------------------------------------------------------------------------------
Carpal tunnel syndrome:                                                                                         
    Medical record review............  Pain, paresthesia and          Highly recommended.                       
                                        weakness in distribution                                                
                                        median nerve.                                                           
    Physical examination.............  Tinel's or Phalen's sign-      Recommended.                              
                                        suggestive but not                                                      
                                        confirmatory.                                                           
    Nerve conduction testing.........  Definite median nerve          Highly recommended.                       
                                        conduction showing at wrist.                                            
    Electromyography.................  Denervation in serve cases...  Recommended.                              
Fracture: wrist:                                                                                                
    X-ray: wrist.....................  Evidence of fracture.........  Highly recommended.                       
Hand: permanent functional                                                                                      
 limitation:                                                                                                    
    Medical record review............  Documentation of medical       Highly recommended.                       
                                        condition for permanent                                                 
                                        limitation.                                                             
    Physical examination.............  Definite reproducible          Highly recommended.                       
                                        evidence of limitation.                                                 
    Imaging study (e.g. x-ray, CAT,    Positive confirmation of       Highly recommended.                       
     MRI).                              underlying condition.                                                   
Rheumatoid arthritis: hand:                                                                                     
    Rheumatoid factor................  High titer...................  Recommended.                              
    Medical record review............  History of objective findings  Highly recommended.                       
                                        including serological                                                   
                                        studies.                                                                
    X-ray: Hand......................  Characteristic rheumatoid      Highly recommended.                       
                                        changes.                                                                
Tenosynovitis:                                                                                                  
    Medical record review............  History of chronic             Highly recommended.                       
                                        tenosynovitis and objective                                             
                                        findings.                                                               
    Physical examination.............  Definite evidence of           Highly recommended.                       
                                        tenosynovitis.                                                          
Thumb: Permanent functional                                                                                     
 limitation:                                                                                                    
    Medical record review............  Documentation of medical       Highly recommended.                       
                                        condition for permanent                                                 
                                        limitation.                                                             
    Physical examination.............  Definite reproducible          Highly recommended.                       
                                        evidence of limitation.                                                 
    Imaging study (x-ray, CAT, MRI)..  Positive confirmation of       Highly recommended.                       
                                        underlying condition.                                                   
Wrist: Permanent functional                                                                                     
 limitation:                                                                                                    
    Medical record review............  Documentation of medical       Highly recommended.                       
                                        condition for permanent                                                 
                                        limitation.                                                             
    Physical examination.............  Definite reproducible          Highly recommended.                       
                                        evidence of limitation.                                                 

[[Page 50100]]

                                                                                                                
    Imaging study (e.g. x-ray, CAT,    Positive confirmation of       Highly recommended.                       
     MRI).                              underlying condition.                                                   
----------------------------------------------------------------------------------------------------------------


----------------------------------------------------------------------------------------------------------------
           Disability test                      Test result                    Disability classification        
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: HAND AND ARM                                            
                                               JOB TITLE: TRAINMAN                                              
----------------------------------------------------------------------------------------------------------------
Carpal tunnel syndrome:                                                                                         
    Strength (jamar).................  Dominant hand: <19 kg          D                                         
                                        (female).                                                               
    Strength (jamar).................  Nondominant hand: <16 kg       D                                         
                                        (female).                                                               
    Strength (jamar).................  Dominant hand: <34 kg (male).  D                                         
    Strength (jamar).................  Nondominant hand: <34 kg       D                                         
                                        (male).                                                                 
Fracture, wrist:                                                                                                
    Strength (jamar).................  Dominant hand: <19 kg          D                                         
                                        (female).                                                               
    Strength (jamar).................  Nondominant hand: <16 kg       D                                         
                                        (female).                                                               
    Strength (jamar).................  Dominant hand: <34 kg (male).  D                                         
    Strength (jamar).................  Nondominant hand: <34 kg       D                                         
                                        (male).                                                                 
    Physical examination--range of     Extension--limit to 30         D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion--limit to 30 degrees.  D                                         
     motion.                                                                                                    
    Physical examination--range of     Ankylosis: >20 degrees from    D                                         
     motion.                            neutral.                                                                
Hand: permanent functional                                                                                      
 limitation:                                                                                                    
    Strength (jamar).................  Dominant hand: <19 kg          D                                         
                                        (female).                                                               
    Strength (jamar).................  Nondominant hand: <16 kg       D                                         
                                        (female).                                                               
    Strength (jamar).................  Dominant hand: <34 kg (male).  D                                         
    Strength (jamar).................  Nondominant hand: <34 kg       D                                         
                                        (male).                                                                 
Rheumatoid arthritis hand:                                                                                      
    Physical examination.............  Significant deformity........  D                                         
    Medical record review............  Significant flare-ups, under   D                                         
                                        treatment with                                                          
                                        rheumatologist.                                                         
    Medical record review............  Extensive medication use,      D                                         
                                        under treatment with                                                    
                                        rheumatologist.                                                         
Thumb: permanent functional                                                                                     
 limitation:                                                                                                    
    Adduction of thumb...............  Loss <=4 cm..................  D                                         
    Adduction of thumb...............  Loss <=7 cm..................  D                                         
    Ankylosis: degree from neutral...  <20 degrees extension........  D                                         
    Ankylosis: degree from neutral...  <40 degrees flexion..........  D                                         
    Loss of extension or flexion.....  MCP or PIP: maximum flexion    D                                         
                                        <40 degrees                                                             
    Opposition.......................  Loss <=4 cm..................  D                                         
    Opposition.......................  Loss <=7 cm..................  D                                         
Wrist: permanent functional                                                                                     
 limitation:                                                                                                    
    Strength (jamar).................  Dominant hand: <19 kg          D                                         
                                        (female)                                                                
    Strength (jamar).................  Nondominant hand: <16 kg       D                                         
                                        (female)                                                                
    Strength (jamar).................  Dominant hand: <34 kg (male)   D                                         
    Strength (jamar).................  Nondominant hand: <34 kg       D                                         
                                        (male)                                                                  
    Physical examination--range of     Extension--limit to 30         D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion--limit to 30 degrees.  D                                         
     motion.                                                                                                    
    Physical examination--range of     Ankylosis: >20 degrees from    D                                         
     motion.                            neutral.                                                                
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: HAND AND ARM                                            
                                               JOB TITLE ENGINEER                                               
----------------------------------------------------------------------------------------------------------------
           Fracture, wrist:                                                                                     
    Physical examination--range of     Extension-limit to 30 degrees  D                                         
     motion.                                                                                                    
    Physical examination--range of     Flexion-limit to 30 degrees..  D                                         
     motion.                                                                                                    
    Physical examination--range of     Ankylosis: >20 degrees from    D                                         
     motion.                            neutral.                                                                
Rheumatoid arthritis hand:                                                                                      
    Physical examination.............  Significant deformity........  D                                         
    Medical record review............  Significant flare-ups, under   D                                         
                                        treatment with                                                          
                                        rheumatologist.                                                         
    Medical record review............  Extensive medication use,      D                                         
                                        under treatment with                                                    
                                        rheumatologist.                                                         
Thumb: permanent functional                                                                                     
 limitation:                                                                                                    
    Adduction of thumb...............  Loss <=4 cm..................  D                                         
    Adduction of thumb...............  Loss <=7 cm..................  D                                         
    Ankylosis: degree from neutral...  <20 degrees extension........  D                                         
    Ankylosis: degree from neutral...  <40 degrees flexion..........  D                                         
    Loss of extension or flexion.....  MCP or PIP: maximum flexion    D                                         
                                        <40 degrees.                                                            
    Opposition.......................  Loss <=4 cm..................  D                                         
                                                                                                                
    Opposition.......................  Loss <=7 cm..................  D                                         
Wrist: permanent functional                                                                                     
 limitation:                                                                                                    
    Physical examination--range of     Extension--limit to 30         D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion--limit to 30 degrees.  D                                         
     motion.                                                                                                    

[[Page 50101]]

                                                                                                                
    Physical examination--range of     Ankylosis: >20 degrees from    D                                         
     motion.                            neutral.                                                                
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: HAND AND ARM                                            
                                              JOB TITLE: DISPATCHER                                             
----------------------------------------------------------------------------------------------------------------
           Fracture, wrist:                                                                                     
    Physical examination--range of     Extension--limit to 30         D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion--limit to 30 degrees.  D                                         
     motion.                                                                                                    
    Physical examination--range of     Ankylosis: >20 degrees from    D                                         
     motion.                            neutral.                                                                
Rheumatoid arthritis hand:                                                                                      
    Physical examination.............  Significant deformity........  D                                         
    Medical record review............  Significant flare-ups, under   D                                         
                                        treatment with                                                          
                                        rheumatologist.                                                         
    Medical record review............  Extensive medication use,      D                                         
                                        under treatment with                                                    
                                        rheumatologist.                                                         
Thumb: permanent functional                                                                                     
 limitation:                                                                                                    
    Adduction of thumb...............  Loss <=4 cm..................  D                                         
    Adduction of thumb...............  Loss <=7 cm..................  D                                         
    Ankylosis: degree from neutral...  <20 degrees extension........  D                                         
    Ankylosis: degree from neutral...  <40 degrees flexion..........  D                                         
    Loss of extension or flexion.....  MCP or PIP: maximum flexion    D                                         
                                        <40 degrees.                                                            
    Opposition.......................  Loss <=4 cm..................  D                                         
                                                                                                                
    Opposition.......................  Loss <=7 cm..................  D                                         
Wrist: permanent functional                                                                                     
 limitation:                                                                                                    
    Physical examination--range of     Extension--limit to 30         D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion--limit to 30 degrees.  D                                         
     motion.                                                                                                    
    Physical examination--range of     Ankylosis: >20 degrees from    D                                         
     motion.                            neutral.                                                                
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: HAND AND ARM                                            
                                               JOB TITLE: CARMAN                                                
----------------------------------------------------------------------------------------------------------------
Carpal tunnel syndrome:                                                                                         
    Strength (jamar).................  Dominant hand: <19 kg          D                                         
                                        (female).                                                               
    Strength (jamar).................  Nondominant hand: <16 kg       D                                         
                                        (female).                                                               
    Strength (jamar).................  Dominant hand: <34 kg (male).  D                                         
    Strength (jamar).................  Nondominant hand: <34 kg       D                                         
                                        (male).                                                                 
Fracture, wrist:                                                                                                
    Strength (jamar).................  Dominant hand: <19 kg          D                                         
                                        (female).                                                               
    Strength (jamar).................  Nondominant hand: <16 kg       D                                         
                                        (female).                                                               
    Strength (jamar).................  Dominant hand: <34 kg (male).  D                                         
    Strength (jamar).................  Nondominant hand: <34 kg       D                                         
                                        (male).                                                                 
    Physical examination--range of     Extension--limit to 30         D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion--limit to 30 degrees.  D                                         
     motion.                                                                                                    
    Physical examination--range of     Ankylosis: >20 degrees from    D                                         
     motion.                            neutral.                                                                
Hand: permanent functional                                                                                      
 limitation:                                                                                                    
    Strength (jamar).................  Dominant hand: <19 kg          D                                         
                                        (female).                                                               
    Strength (jamar).................  Nondominant hand: <16 kg       D                                         
                                        (female).                                                               
    Strength (jamar).................  Dominant hand: <34 kg (male).  D                                         
    Strength (jamar).................  Nondominant hand: <34 kg       D                                         
                                        (male).                                                                 
Rheumatoid arthritis hand:                                                                                      
    Physical examination.............  Significant deformity........  D                                         
    Medical record review............  Significant flare-ups, under   D                                         
                                        treatment with                                                          
                                        rheumatologist.                                                         
    Medical record review............   Extensive medication use,     D                                         
                                        under treatment with                                                    
                                        rheumatologist.                                                         
Thumb: permanent functional                                                                                     
 limitation:                                                                                                    
    Adduction of thumb:..............  Loss <=4 cm..................  D                                         
    Adduction of thumb:..............  Loss <=7 cm..................  D                                         
    Ankylosis: degree from neutral...  <20 degrees extension........  D                                         
    Ankylosis: degree from neutral...  <40 degrees flexion..........  D                                         
    Loss of extension or flexion.....  MCP of PIP: maximum flexion    D                                         
                                        <40 degrees.                                                            
    Opposition.......................  Loss <=4 cm..................  D                                         
    Opposition.......................  Loss <=7 cm..................  D                                         
Wrist: permanent functional                                                                                     
 limitation:                                                                                                    
    Strength (jamar).................  Dominant hand: <19 kg          D                                         
                                        (female).                                                               
    Strength (jamar).................  Nondominant hand: <16 kg       D                                         
                                        (female).                                                               
    Strength (jamar).................  Dominant hand: <34 kg (male).  D                                         
    Strength (jamar).................  Nondominant hand: <34 kg       D                                         
                                        (male).                                                                 
    Physical examination--range of     Extension--limit to 30         D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion--limit to 30 degrees.  D                                         
     motion.                                                                                                    
    Physical examination--range of     Ankylosis: >20 degrees from    D                                         
     motion.                            neutral.                                                                
----------------------------------------------------------------------------------------------------------------

[[Page 50102]]

                                                                                                                
                                             BODY PART: HAND AND ARM                                            
                                              JOB TITLE: SIGNALMAN                                              
----------------------------------------------------------------------------------------------------------------
Carpal tunnel syndrome:                                                                                         
    Strength (jamar).................  Dominant hand: <19 kg          D                                         
                                        (female).                                                               
    Strength (jamar).................  Nondominant hand: <16 kg       D                                         
                                        (female).                                                               
    Strength (jamar).................  Dominant hand: <34 kg (male).  D                                         
    Strength (jamar).................  Nondominant hand: <34 kg       D                                         
                                        (male).                                                                 
Fracture, wrist:                                                                                                
    Strength (jamar).................  Dominant hand: <19 kg          D                                         
                                        (female).                                                               
    Strength (jamar).................  Nondominant hand: <16 kg       D                                         
                                        (female).                                                               
    Strength (jamar).................  Dominant hand: <34 kg (male).  D                                         
    Strength (jamar).................  Nondominant hand: <34 kg       D                                         
                                        (male).                                                                 
    Physical examination--range of     Extension--limit to 30         D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion--limit to 30 degrees.  D                                         
     motion.                                                                                                    
    Physical examination--range of     Ankylosis: >20 degrees from    D                                         
     motion.                            neutral.                                                                
Hand: permanent functional                                                                                      
 limitation:                                                                                                    
    Strength (jamar).................  Dominant hand: <19 kg          D                                         
                                        (female).                                                               
    Strength (jamar).................  Nondominant hand: <16 kg       D                                         
                                        (female).                                                               
    Strength (jamar).................  Dominant hand: <34 kg (male).  D                                         
    Strength (jamar).................  Nondominant hand: <34 kg       D                                         
                                        (male).                                                                 
Rheumatoid arthritis hand:                                                                                      
    Physical examination.............  Significant deformity........  D                                         
    Medical record review............  Significant flare-ups, under   D                                         
                                        treatment with                                                          
                                        rheumatologist.                                                         
    Medical record review............  Extensive medication use,      D                                         
                                        under treatment with                                                    
                                        rheumatologist.                                                         
Thumb: permanent functional                                                                                     
 limitation:                                                                                                    
    Adduction of thumb...............  Loss <=4 cm..................  D                                         
    Adduction of thumb...............  Loss <=7 cm..................  D                                         
    Ankylosis: degree from neutral...  <20 degrees extension........  D                                         
    Ankylosis: degree from neutral...  <40 degrees flexion..........  D                                         
    Loss of extension or flexion.....  MCP or PIP: maximum flexion    D                                         
                                        <40 degrees.                                                            
    Opposition.......................  Loss <=4 cm..................  D                                         
    Opposition.......................  Loss <=7 cm..................  D                                         
Wrist: permanent functional                                                                                     
 limitation:                                                                                                    
    Strength (jamar).................  Dominant hand: <19 kg          D                                         
                                        (female).                                                               
    Strength (jamar).................  Nondominant hand: <16 kg       D                                         
                                        (female).                                                               
    Strength (jamar).................  Dominant hand: <34 kg (male).  D                                         
    Strength (jamar).................  Nondominant hand: <34 kg       D                                         
                                        (male).                                                                 
    Physical examination--range of     Extension--limit to 30         D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion--limit to 30 degrees.  D                                         
     motion.                                                                                                    
    Physical examination--range of     Ankylosis: >20 degrees from    D                                         
     motion.                            neutral.                                                                
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: HAND AND ARM                                            
                                               JOB TITLE: TRACKMAN                                              
----------------------------------------------------------------------------------------------------------------
Carpal tunnel syndrome:                                                                                         
    Strength (jamar).................  Dominant hand: <19 kg          D                                         
                                        (female).                                                               
    Strength (jamar).................  Nondominant hand: <16 kg       D                                         
                                        (female).                                                               
    Strength (jamar).................  Dominant hand: <34 kg (male).  D                                         
    Strength (jamar).................  Nondominant hand: <34 kg       D                                         
                                        (male).                                                                 
Fracture, wrist:                                                                                                
    Strength (Jamar).................  Dominant hand: <19 kg          D                                         
                                        (female).                                                               
    Strength (jamar).................  Nondominant hand: <16 kg       D                                         
                                        (female).                                                               
    Strength (jamar).................  Dominant hand: <34 kg (male).  D                                         
    Strength (jamar).................  Nondominant hand: <34 kg       D                                         
                                        (male).                                                                 
    Physical examination--range of     Extension--limit to 30         D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion--limit to 30 degrees.  D                                         
     motion.                                                                                                    
    Physical examination--range of     Ankylosis: >20 degrees from    D                                         
     motion.                            neutral.                                                                
Hand: permanent functional                                                                                      
 limitation:                                                                                                    
    Strength (jamar).................  Dominant hand: <19 kg          D                                         
                                        (female).                                                               
    Strength (jamar).................  Nondominant hand: <16 kg       D                                         
                                        (female).                                                               
    Strength (jamar).................  Dominant hand: <34 kg (male).  D                                         
    Strength (jamar).................  Nondominant hand: <34 kg       D                                         
                                        (male).                                                                 
Rheumatoid arthritis hand:                                                                                      
    Physical examination.............  Significant deformity........  D                                         
    Medical record review............  Significant flare-ups, under   D                                         
                                        treatment with                                                          
                                        rheumatologist.                                                         
    Medical record review............  Extensive medication use,      D                                         
                                        under treatment with                                                    
                                        rheumatologist.                                                         
Thumb: permanent functional                                                                                     
 limitation:                                                                                                    
    Adduction of thumb...............  Loss <=4 cm..................  D                                         
    Adduction of thumb...............  Loss <=7 cm..................  D                                         

[[Page 50103]]

                                                                                                                
    Ankylosis: degree from neutral...  <20 degrees extension........  D                                         
    Ankylosis: degree from neutral...  <40 degrees flexion..........  D                                         
    Loss of extension or flexion.....  MCP or PIP: maximum flexion    D                                         
                                        <40 degrees.                                                            
    Opposition.......................  Loss <=4 cm..................  D                                         
    Opposition.......................  Loss <=7 cm..................  D                                         
Wrist: permanent functional                                                                                     
 limitation:                                                                                                    
    Strength (jamar).................  Dominant hand: <19 kg          D                                         
                                        (female).                                                               
    Strength (jamar).................  Nondominant hand: <16 kg       D                                         
                                        (female).                                                               
    Strength (jamar).................  Dominant hand: <34 kg (male).  D                                         
    Strength (jamar).................  Nondominant hand: <34 kg       D                                         
                                        (male).                                                                 
    Physical examination--range of     Extension----limit to 30       D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion--limit to 30 degrees.  D                                         
     motion.                                                                                                    
    Physical examination--range of     Ankylosis: >20 degrees from    D                                         
     motion.                            neutral.                                                                
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: HAND AND ARM                                            
                                              JOB TITLE: MACHINIST                                              
----------------------------------------------------------------------------------------------------------------
Carpal tunnel syndrome:                                                                                         
    Strength (jamar).................  Dominant hand: <19 kg          D                                         
                                        (female).                                                               
    Strength (jamar).................  Nondominant hand: <16 kg       D                                         
                                        (female).                                                               
    Strength (jamar).................  Dominant hand: <34 kg (male).  D                                         
    Strength (jamar).................  Nondominant hand <34 kg        D                                         
                                        (male).                                                                 
Fracture, wrist:                                                                                                
    Strength (jamar).................  Dominant hand: <19 kg          D                                         
                                        (female).                                                               
    Strength (jamar).................  Nondominant hand: <16 kg       D                                         
                                        (female).                                                               
    Strength (jamar).................  Dominant hand: <34 kg (male).  D                                         
    Strength (jamar).................  Nondominant hand <34 kg        D                                         
                                        (male).                                                                 
    Physical examination--range of     Extension--limit to 30         D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion--limit to 30 degrees.  D                                         
     motion.                                                                                                    
    Physical examination--range of     Ankylosis: >20 degrees from    D                                         
     motion.                            neutral.                                                                
Hand: permanent functional                                                                                      
 limitation:                                                                                                    
    Strength (jamar).................  Dominant hand: <19 kg          D                                         
                                        (female).                                                               
    Strength (jamar).................  Nondominant hand: <16 kg       D                                         
                                        (female).                                                               
    Strength (jamar).................  Dominant hand: <34 kg (male).  D                                         
    Strength (jamar).................  Nondominant hand <34 kg        D                                         
                                        (male).                                                                 
Rheumatoid arthritis hand:                                                                                      
    Physical examination.............  Significant deformity........  D                                         
    Medical record review............  Significant flare-ups, under   D                                         
                                        treatent with rheumatologist.                                           
    Medical record review............  Extensive medication use,      D                                         
                                        under treatment with                                                    
                                        rheumatologist.                                                         
Thumb: permanent functional                                                                                     
 limitation:                                                                                                    
    Adduction of thumb...............  Loss <=4 cm..................  D                                         
    Adduction of thumb...............  Loss <=7 cm..................  D                                         
    Ankylosis: degree from neutral...  <20 degrees flexion..........  D                                         
    Ankylosis: degree from neutral...  <40 degrees extension........  D                                         
    Loss of extension or flexion.....  MCP or PIP: maximum flexion    D                                         
                                        <40 degrees.                                                            
    Opposition.......................  Loss <=4 cm..................  D                                         
    Opposition.......................  Loss <=7 cm..................  D                                         
Wrist: permanent functional                                                                                     
 limitation:                                                                                                    
    Strength (jamar).................  Dominant hand: <19 kg          D                                         
                                        (female).                                                               
    Strength (jamar).................  Nondominant hand: <16 kg       D                                         
                                        (female).                                                               
    Strength (jamar).................  Dominant hand: <34 kg (male).  D                                         
    Strength (jamar).................  Nondominant hand <34 kg        D                                         
                                        (male).                                                                 
    Physical examination--range of     Extension--limit to 30         D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion--limit to 30 degrees.  D                                         
     motion.                                                                                                    
    Physical examination--range of     Ankylosis: >20 degrees from    D                                         
     motion.                            neutral.                                                                
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: HAND AND ARM                                            
                                             JOB TITLE: SHOP LABORER                                            
----------------------------------------------------------------------------------------------------------------
Carpal tunnel syndrome:                                                                                         
    Strength (jamar).................  Dominant hand: <19 kg          D                                         
                                        (female).                                                               
    Strength (jamar).................  Nondominant hand: <16 kg       D                                         
                                        (female).                                                               
    Strength (jamar).................  Dominant hand: <34 kg (male).  D                                         
    Strength (jamar).................  Nondominant hand <34 kg        D                                         
                                        (male).                                                                 
Fracture, wrist:                                                                                                
    Strength (jamar).................  Dominant hand: <19 kg          D                                         
                                        (female).                                                               
    Strength (jamar).................  Nondominant hand: <16 kg       D                                         
                                        (female).                                                               
    Strength (jamar).................  Dominant hand: <34 kg (male).  D                                         
    Strength (jamar).................  Nondominant hand <34 kg        D                                         
                                        (male).                                                                 
    Physical examination--range of     Extension--limit to 30         D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion--limit to 30 degrees.  D                                         
     motion.                                                                                                    
    Physical examination--range of     Ankylosis: >20 degrees from    D                                         
     motion.                            neutral.                                                                
Hand: permanent functional                                                                                      
 limitation:                                                                                                    

[[Page 50104]]

                                                                                                                
    Strength (jamar).................  Dominant hand: <19 kg          D                                         
                                        (female).                                                               
    Strength (jamar).................  Nondominant hand: <16 kg       D                                         
                                        (female).                                                               
    Strength (jamar).................  Dominant hand: <34 kg (male).  D                                         
    Strength (jamar).................  Nondominant hand: <34 kg       D                                         
                                        (male).                                                                 
Rheumatoid arthritis hand:                                                                                      
    Physical examination.............  Significant deformity........  D                                         
    Medical record review............  Significant flare-ups, under   D                                         
                                        treatment with                                                          
                                        rheumatologist.                                                         
    Medical record review............  Extenive medication use,       D                                         
                                        under treatment with                                                    
                                        rheumatologist.                                                         
Thumb: permanent functional                                                                                     
 limitation:                                                                                                    
    Adduction of thumb...............  Loss <=4 cm..................  D                                         
    Adduction of thumb...............  Loss <=7 cm..................  D                                         
    Ankylosis: degree from neutral...  <20 degrees extension........  D                                         
    Ankylosis: degree from neutral...  <40 degrees flexion..........  D                                         
    Loss of extension or flexion.....  MCP or PIP: maximum flexion    D                                         
                                        <40 degrees.                                                            
    Opposition.......................  Loss <=4 cm..................  D                                         
    Opposition.......................  Loss <=7 cm..................  D                                         
Wrist: permanent functional                                                                                     
 limitation:                                                                                                    
    Strength (jamar).................  Dominant hand: <19 kg          D                                         
                                        (female).                                                               
    Strength (jamar).................  Nondominant hand: <16 kg       D                                         
                                        (female).                                                               
    Strength (jamar).................  Nondominant hand: <34 kg       D                                         
                                        (male).                                                                 
    Strength (jamar).................  Nondominant hand: <34 kg       D                                         
                                        (male).                                                                 
    Physical examination--range of     Extension--limit to 30         D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion--limit to 30 degrees.  D                                         
     motion.                                                                                                    
    Physical examination--range of     Ankylosis: >20 degrees from    D                                         
     motion.                            neutral.                                                                
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: HAND AND ARM                                            
                                         JOB TITLE: SALES REPRESENTATIVE                                        
----------------------------------------------------------------------------------------------------------------
Fracture, wrist:                                                                                                
    Physical examination--range of     Extension--limit to 30         D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion--limit to 30 degrees.  D                                         
     motion.                                                                                                    
    Physical examination--range of     Ankylosis: >20 degrees from    D                                         
     motion.                            neutral.                                                                
Rheumatoid arthritis hand:                                                                                      
    Physical examination.............  Significant deformity........  D                                         
    Medical record review............  Significant flare-ups, under   D                                         
                                        treatment with                                                          
                                        rheumatologist.                                                         
    Medical record review............  Extenive medication use,       D                                         
                                        under treatment with                                                    
                                        rheumatologist.                                                         
Thumb: permanent functional                                                                                     
 limitation:                                                                                                    
    Adduction of thumb...............  Loss <=4 cm..................  D                                         
    Adduction of thumb...............  Loss <=7 cm..................  D                                         
    Ankylosis: degree from neutral...  <20 degrees extension........  D                                         
    Ankylosis: degree from neutral...  <40 degrees flexion..........  D                                         
    Loss of extension or flexion.....  MCP or PIP: maximum flexion    D                                         
                                        <40 degrees.                                                            
    Opposition.......................  Loss <=4 cm..................  D                                         
    Opposition:......................  Loss <=7 cm..................  D                                         
Wrist: permanent functional                                                                                     
 limitation:                                                                                                    
    Physical examination--range of     Extension--limit to 30         D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion--limit to 30 degrees.  D                                         
     motion.                                                                                                    
    Physical examination--range of     Ankylosis: >20 degrees from    D                                         
     motion.                            neutral.                                                                
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: HAND AND ARM                                            
                                         JOB TITLE: GENERAL OFFICE CLERK                                        
----------------------------------------------------------------------------------------------------------------
Fracture, wrist:                                                                                                
    Physical examination--range of     Extension--limit to 30         D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion--limit to 30 degrees.  D                                         
     motion.                                                                                                    
    Physical examination--range of     Ankylosis: >20 degrees from    D                                         
     motion.                            neutral.                                                                
Rheumatoid arthritis hand:                                                                                      
    Physical examination.............  Significant deformity........  D                                         
    Medical record review............  Significant flare-ups, under   D                                         
                                        treatment with                                                          
                                        rheumatologist.                                                         
    Medical record review............  Extensive medication use,      D                                         
                                        under treatment with                                                    
                                        rheumatologist.                                                         
Thumb: permanent functional                                                                                     
 limitation:                                                                                                    
    Adduction of thumb...............  Loss <=4 cm..................  D                                         
    Adduction of thumb...............  Loss <=7 cm..................  D                                         
    Ankylosis: degree from neutral...  <20 degree extension.........  D                                         
    Ankylosis: degree from neutral...  <40 degree flexion...........  D                                         
    Loss of extension or flexion.....  MCP or PIP: maximum flexion    D                                         
                                        <40 degrees.                                                            
    Opposition.......................  Loss <=4 cm..................  D                                         
    Opposition.......................  Loss <=7 cm..................  D                                         

[[Page 50105]]

                                                                                                                
Wrist: permanent functional                                                                                     
 limitation:                                                                                                    
    Physical examination--range of     Extension--limit to 30         D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion--limit to 30 degrees.  D                                         
     motion.                                                                                                    
    Physical examination--range of     Ankylosis: >20 degrees from    D                                         
     motion.                            neutral.                                                                
----------------------------------------------------------------------------------------------------------------

I. Hip

----------------------------------------------------------------------------------------------------------------
          Confirmatory test                    Minimum result                        Requirements               
----------------------------------------------------------------------------------------------------------------
                                                 BODY PART: HIP                                                 
                                               CONFIRMATORY TESTS                                               
----------------------------------------------------------------------------------------------------------------
Ankylosis, hip:                                                                                                 
    X-ray: hip.......................  Exteme joint destruction.....  Highly Recommended.                       
    Physical examination--range of     No mobility..................  Highly Recommended.                       
     motion.                                                                                                    
Osteoarthritis, hip:                                                                                            
    X-ray: hip.......................  <4 mm joint space, or other    Recommended.                              
                                        positive evidence.                                                      
    Magnetic resonance imaging.......  <4 mm joint space, or other    Recommended.                              
                                        positive evidence.                                                      
    Computerized axial tomography....  <4 mm joint space, or other    Recommended.                              
                                        positive evidence.                                                      
Osteomyelitis, hip:                                                                                             
    X-ray: hip.......................  Evidence of chronic infection  Recommended.                              
    Computerized axial tomography....  Evidence of chronic infection  Recommended.                              
Paget's disease:                                                                                                
    X-ray: hip.......................  Osteolytic and blastic         Highly Recommended.                       
                                        lesions.                                                                
    Alkaline phosphatase.............  Increased up to 50 times.....  Highly Recommended.                       
Hip replacement surgery:                                                                                        
    X-ray: hip.......................  Evidence of artificial hip...  Recommended.                              
    Medical record review............  Documentation of prior hip     Recommended.                              
                                        replacement.                                                            
----------------------------------------------------------------------------------------------------------------


----------------------------------------------------------------------------------------------------------------
           Disability test                      Test result                    Disability classification        
----------------------------------------------------------------------------------------------------------------
                                                 BODY PART: HIP                                                 
                                               JOB TITLE: TRAINMAN                                              
----------------------------------------------------------------------------------------------------------------
Ankylosis, hip:                                                                                                 
    Physical examination--range of     Ankylosis 5 degrees or >       D                                         
     motion.                            flexion.                                                                
    Physical examination--range of     Ankylosis internal rotation    D                                         
     motion.                            >5 degrees.                                                             
    Physical examination--range of     Ankylosis external rotation    D                                         
     motion.                            >10 degrees.                                                            
    Physical examination--range of     Ankylosis in abduction >5      D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Ankylosis in adduction >5      D                                         
     motion.                            degrees.                                                                
Osteoarthritis, hip:                                                                                            
    X-ray: hip.......................  0 mm cartilage interval......  D                                         
    Physical examination--range of     30 degrees flexion             D                                         
     motion.                            contracture.                                                            
    Physical examination--range of     <50 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <5 degrees abduction.........  D                                         
     motion.                                                                                                    
Osteomyelitis, chronic hip:                                                                                     
    X-ray: hip.......................  Significant joint destruction  D                                         
    Physical examination--range of     30 degrees flexion             D                                         
     motion.                            contracture.                                                            
    Physical examination--range of     <50 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <5 degrees abduction.........  D                                         
     motion.                                                                                                    
    Medical record review............  Documented occurrence of       D                                         
                                        recurring infections with                                               
                                        treatment.                                                              
Paget's disease:                                                                                                
    X-ray: hip.......................  Significant joint destruction  D                                         
    Physical examination--range of     30 degrees flexion             D                                         
     motion.                            contracture.                                                            
    Physical examination--range of     <50 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <5 degrees abduction.........  D                                         
     motion.                                                                                                    
Hip replacement surgery:                                                                                        
    X-ray: hip.......................  Evidence of artificial hip     D                                         
                                        joint.                                                                  
    Medical record review............  Documentation of prior hip     D                                         
                                        replacement.                                                            
----------------------------------------------------------------------------------------------------------------
                                                 BODY PART: HIP                                                 
                                              JOB TITLE: ENGINEER                                               
----------------------------------------------------------------------------------------------------------------
Ankylosis, hip:                                                                                                 
    Physical examination--range of     Ankylosis 5 degrees or >       D                                         
     motion.                            flexion.                                                                
    Physical examination--range of     Ankylosis internal rotation    D                                         
     motion.                            >5 degrees.                                                             
    Physical examination--range of     Ankylosis external rotation    D                                         
     motion.                            >10 degrees.                                                            
    Physical examination--range of     Ankylosis in abduction >5      D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Ankylosis in adduction >5      D                                         
     motion.                            degrees.                                                                
Osteoarthritis, hip:                                                                                            
    X-ray: hip.......................  0 mm cartilage interval......  D                                         
    Physical examination--range of     30 degrees flexion             D                                         
     motion.                            contracture.                                                            

[[Page 50106]]

                                                                                                                
    Physical examination--range of     <50 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <5 degrees abduction.........  D                                         
     motion.                                                                                                    
Osteomyelitis, chronic hip:                                                                                     
    X-ray: hip.......................  Signficant joint destruction.  D                                         
    Physical examination--range of     30 degrees flexion             D                                         
     motion.                            contracture.                                                            
    Physical examination--range of     <50 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <5 degrees abduction.........  D                                         
     motion.                                                                                                    
    Medical record review............  Documented occurrence of       D                                         
                                        recurring infections with                                               
                                        treatment.                                                              
Paget's disease:                                                                                                
    X-ray: hip.......................  Significant joint destruction  D                                         
    Physical examination--range of     30 degrees flexion             D                                         
     motion.                            contracture.                                                            
    Physical examination--range of     <50 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <5 degrees abduction.........  D                                         
     motion.                                                                                                    
Hip replacement surgery:                                                                                        
    X-ray: hip.......................  Evidence of artificial hip     D                                         
                                        joint.                                                                  
    Medical record review............  Documentation of prior hip     D                                         
                                        replacement.                                                            
----------------------------------------------------------------------------------------------------------------
                                                 BODY PART: HIP                                                 
                                                JOB TITLE: CARMAN                                               
----------------------------------------------------------------------------------------------------------------
Ankylosis, hip:                                                                                                 
    Physical examination--range of     Ankylosis 5 degrees or >       D                                         
     motion.                            flexion.                                                                
    Physical examination--range of     Ankylosis internal rotation    D                                         
     motion.                            >5 degrees.                                                             
    Physical examination--range of     Ankylosis external rotation    D                                         
     motion.                            >10 degrees.                                                            
    Physical examination--range of     Ankylosis in abduction >5      D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Ankylosis in adduction >5      D                                         
     motion.                            degrees.                                                                
Osteoarthritis, hip:                                                                                            
    X-ray: hip.......................  0 mm cartilage interval......  D                                         
    Physical examination--range of     30 degrees flexion             D                                         
     motion.                            contracture.                                                            
    Physical examination--range of     <50 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <5 degrees abduction.........  D                                         
     motion.                                                                                                    
Osteomyelitis, chronic hip:                                                                                     
    X-ray: hip.......................  Significant joint destruction  D                                         
    Physical examination--range of     30 degrees flexion             D                                         
     motion.                            contracture.                                                            
    Physical examination--range of     <50 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <5 degrees abduction.........  D                                         
     motion.                                                                                                    
    Medical record review............  Documented occurrence of       D                                         
                                        recurring infections with                                               
                                        treatment.                                                              
Paget's disease:                                                                                                
    X-ray: hip.......................  Significant joint destruction  D                                         
    Physical examination--range of     30 degrees flexion             D                                         
     motion.                            contracture.                                                            
    Physical examination--range of     <50 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <5 degrees abduction.........  D                                         
     motion.                                                                                                    
Hip replacement surgery:                                                                                        
    X-ray: hip.......................  Evidence of artificial hip     D                                         
                                        joint.                                                                  
    Medical record review............  Documentation of prior hip     D                                         
                                        replacement.                                                            
----------------------------------------------------------------------------------------------------------------
                                                 BODY PART: HIP                                                 
                                              JOB TITLE: SIGNALMAN                                              
----------------------------------------------------------------------------------------------------------------
Ankylosis, hip:                                                                                                 
    Physical examination--range of     Ankylosis 5 degrees or >       D                                         
     motion.                            flexion.                                                                
    Physical examination--range of     Ankylosis internal rotation    D                                         
     motion.                            >5 degrees.                                                             
    Physical examination--range of     Ankylosis external rotation    D                                         
     motion.                            >10 degrees.                                                            
    Physical examination--range of     Ankylosis in abduction >5      D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Ankylosis in abduction >5      D                                         
     motion.                            degrees.                                                                
Osteoarthritis, hip:                                                                                            
    X-ray: hip.......................  0 mm cartilage interval......  D                                         
    Physical examination--range of     30 degrees flexion             D                                         
     motion.                            contracture.                                                            
    Physical examination--range of     <50 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <5 degrees adduction.........  D                                         
     motion.                                                                                                    
Osteomyelitis, chronic hip:                                                                                     
    X-ray: hip.......................  Significant joint destruction  D                                         
    Physical examination--range of     30 degrees flexion             D                                         
     motion.                            contraction.                                                            
    Physical examination--range of     <50 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <5 degrees abduction.........  D                                         
     motion.                                                                                                    
    Medical record review............  Documented occurrence of       D                                         
                                        recurring infections with                                               
                                        treatment.                                                              
Paget's disease:                                                                                                
    X-ray: hip.......................  Significant joint destruction  D                                         
    Physical examination--range of     30 degrees flexion             D                                         
     motion.                            contracture.                                                            
    Physical examination--range of     <50 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <5 degrees abduction.........  D                                         
     motion.                                                                                                    

[[Page 50107]]

                                                                                                                
Hip replacement surgery:                                                                                        
    X-ray: hip.......................  Evidence of artificial hip     D                                         
                                        joint.                                                                  
    Medical record review............  Documentation of prior hip     D                                         
                                        replacement.                                                            
----------------------------------------------------------------------------------------------------------------
                                                 BODY PART: HIP                                                 
                                               JOB TITLE: TRACKMAN                                              
----------------------------------------------------------------------------------------------------------------
Ankylosis, hip:                                                                                                 
    Physical examination--range of     Ankylosis 5 degrees or >       D                                         
     motion.                            flexion.                                                                
    Physical examination--range of     Ankylosis internal rotation    D                                         
     motion.                            >5 degrees.                                                             
    Physical examination--range of     Ankylosis internal rotation    D                                         
     motion.                            >10 degrees.                                                            
    Physical examination--range of     Ankylosis in abduction >5      D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Ankylosis in adduction >5      D                                         
     motion.                            degrees.                                                                
Osteoarthritis, hip:                                                                                            
    X-ray: hip.......................  0 mm cartilage interval......  D                                         
    Physical examination--range of     30 degrees flexion             D                                         
     motion.                            contracture.                                                            
    Physical examination--range of     <50 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <5 degrees abduction.........  D                                         
     motion.                                                                                                    
Osteomyelitis, chronic hip:                                                                                     
    X-ray: hip.......................  Significant joint destruction  D                                         
    Physical examination--range of     30 degrees flexion             D                                         
     motion.                            contracture.                                                            
    Physical examination--range of     <50 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <5 degrees abduction.........  D                                         
     motion.                                                                                                    
    Medical record review............  Documented occurrence of       D                                         
                                        recurring infections with                                               
                                        treatment.                                                              
Paget's disease:                                                                                                
    X-ray: hip.......................  Significant joint destruction  D                                         
    Physical examination--range of     30 degrees flexion             D                                         
     motion.                            contracture.                                                            
    Physical examination--range of     <50 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <5 degrees abduction.........  D                                         
     motion.                                                                                                    
Hip replacement surgery:                                                                                        
    X-ray: hip.......................  Evidence of artificial hip     D                                         
                                        joint.                                                                  
    Medical record review............  Documentation of prior hip     D                                         
                                        replacement.                                                            
----------------------------------------------------------------------------------------------------------------
                                                 BODY PART: HIP                                                 
                                              JOB TITLE: MACHINIST                                              
----------------------------------------------------------------------------------------------------------------
Ankylosis, hip:                                                                                                 
    Physical examination--range of     Ankylosis 5 degrees or >       D                                         
     motion.                            flexion.                                                                
    Physical examination--range of     Ankylosis internal rotation    D                                         
     motion.                            >5 degrees.                                                             
    Physical examination--range of     Ankylosis external rotation    D                                         
     motion.                            >10 degrees.                                                            
    Physical examination--range of     Ankylosis in abduction >5      D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Ankylosis in adduction >5      D                                         
     motion.                            degrees.                                                                
Osteoarthritis, hip:                                                                                            
    X-ray: hip.......................  0 mm cartilage interval......  D                                         
    Physical examination--range of     30 degrees flexion             D                                         
     motion.                            contracture.                                                            
    Physical examination--range of     <50 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <5 degrees abduction.........  D                                         
     motion.                                                                                                    
Osteomyelitis, chronic hip:                                                                                     
    X-ray: hip.......................  Significant joint destruction  D                                         
    Physical examination--range of     30 degrees flexion             D                                         
     motion.                            contracture.                                                            
    Physical examination--range of     <50 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <5 degrees abduction.........  D                                         
     motion.                                                                                                    
    Medical record review............  Documented occurrence of       D                                         
                                        recurring infections with                                               
                                        treatment.                                                              
Paget's disease:                                                                                                
    X-ray: hip.......................  Significant joint destruction  D                                         
    Physical examination--range of     30 degrees flexion             D                                         
     motion.                            contracture.                                                            
    Physical examination--range of     <50 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <5 degrees abudction.........  D                                         
     motion.                                                                                                    
Hip replacement surgery:                                                                                        
    X-ray: hip.......................  Evidence of artificial hip     D                                         
                                        joint.                                                                  
    Medical record review............  Documentation of prior hip     D                                         
                                        replacement.                                                            
----------------------------------------------------------------------------------------------------------------
                                                 BODY PART: HIP                                                 
                                             JOB TITLE: SHOP LABORER                                            
----------------------------------------------------------------------------------------------------------------
Ankylosis, hip:                                                                                                 
    Physical examination--range of     Ankylosis 5 degrees of >       D                                         
     motion.                            flexion.                                                                
    Physical examination--range of     Ankylosis internal rotation    D                                         
     motion.                            >5 degrees.                                                             
    Physical examination--range of     Ankylosis external rotation    D                                         
     motion.                            >10 degrees.                                                            
    Physical examination--range of     Ankylosis in abduction >5      D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Ankylosis in adduction >5      D                                         
     motion.                            degrees.                                                                
Osteoarthritis, hip:                                                                                            

[[Page 50108]]

                                                                                                                
    X-ray: hip.......................  0 mm cartilage interval......  D                                         
    Physical examination--range of     30 degrees flexion             D                                         
     motion.                            contracture.                                                            
    Physical examination--range of     <50 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <5 degrees abduction.........  D                                         
     motion.                                                                                                    
Osteomyelitis, chronic hip:                                                                                     
    X-ray: hip.......................  Significant joint destruction  D                                         
    Physical examination--range of     30 degrees flexion             D                                         
     motion.                            contracture.                                                            
    Physical examination--range of     <50 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <5 degrees abduction.........  D                                         
     motion.                                                                                                    
    Medical record review............  Documented occurrence of       D                                         
                                        recurring infections with                                               
                                        treatment.                                                              
Paget's disease:                                                                                                
    X-ray; hip.......................  Significant joint destruction  D                                         
    Physical examination--range of     30 degrees flexion             D                                         
     motion.                            contracture.                                                            
    Physical examination--range of     <50 degrees flexion..........  D                                         
     motion.                                                                                                    
    Physical examination--range of     <5 degrees abduction.........  D                                         
     motion.                                                                                                    
Hip replacement surgery:                                                                                        
    X-ray: hip.......................  Evidence of artificial hip     D                                         
                                        joint.                                                                  
    Medical record review............  Documentation of prior hip     D                                         
                                        replacement.                                                            
----------------------------------------------------------------------------------------------------------------

J. Knee

----------------------------------------------------------------------------------------------------------------
          Confirmatory test                    Minimum result                        Requirements               
----------------------------------------------------------------------------------------------------------------
                                                 BODY PART: KNEE                                                
                                               CONFURMATORY TESTS                                               
----------------------------------------------------------------------------------------------------------------
Arthritis: knee:                                                                                                
    X-ray: knee......................  Evidence of significant        Recommended.                              
                                        degenerative changes.                                                   
Collateral ligament tear with laxity:                                                                           
    Physical examination: knee.......  Evidence of ligamentous        Highly Recommended.                       
                                        laxity.                                                                 
    Magnetic resonance imaging.......  Evidence of ligamentous tear.  Recommended.                              
Cruciate and collateral ligament tear                                                                           
 with laxity:                                                                                                   
    Magnetic resonance imaging.......  Tear of both ligaments.......  Recommended.                              
    Physical examination.............  Evidence of ligamentous        Highly Recommended.                       
                                        laxity.                                                                 
    Medical record review............  Documentation of tear by       Recommended.                              
                                        arthroscopy.                                                            
Cruciate ligament tear with laxity:                                                                             
    Physical examination: knee.......  Evidence of ligamentous        Highly Recommended.                       
                                        laxity.                                                                 
    Magnetic resonance imaging.......  Evidence of cruciate tear....  Recommended.                              
    Medical record review............  Documentation of tear by       Highly Recommended.                       
                                        arthroscopy.                                                            
Intercondylar fracture:                                                                                         
    X-ray: knee......................  Evidence of fracture.........  Highly Recommended.                       
Osteomyelitis: knee:                                                                                            
    Medical record review............  Documentated history of        Highly Recommended.                       
                                        osteomyelitis requiring                                                 
                                        treatment.                                                              
    X-ray: knee......................  Evidence of chronic infection  Recommended.                              
    Computerized tomography..........  Evidence of chronic infection  Recommended.                              
    Magnetic resonance imaging.......  Evidence of chronic infection  Recommended.                              
Osteonecrosis:                                                                                                  
    X-ray: knee......................  Necrosis of femoral condyle    Recommended.                              
                                        or tibial plateau.                                                      
    Computerized tomography..........  Necrosis of femoral condyle    Recommended.                              
                                        or tibial plateau.                                                      
    Magnetic resonance imaging.......  Necrosis of femoral condyle    Recommended.                              
                                        or tibial plateau.                                                      
Patellofemoral arthritis:                                                                                       
    X-ray: knee......................  Evidence of arthritis........  Recommended.                              
    Magnetic resonance imaging.......  Evidence of arthritis........  Recommended.                              
    Physical examination.............  Crepitation with movement....  Highly Recommended.                       
Patellar fracture nonunion with                                                                                 
 displacement:                                                                                                  
    X-ray: knee......................  Nonunion and displacement....  Recommended.                              
    Magnetic resonance imaging.......  Nonunion and displacement....  Recommended.                              
    Computerized tomography..........  Nonunion and displacement....  Recommended.                              
Plateau fracture:                                                                                               
    X-ray: knee......................  Evidence of fracture.........  Recommended.                              
    Computerized tomography..........  Evidence of fracture.........  Recommended.                              
    Magnetic resonance imaging.......  Evidence of fracture.........  Recommended.                              
Meniscectomy--medial or lateral:                                                                                
    Medical record review............  History of surgery...........  Highly Recommended.                       
Patellectomy:                                                                                                   
    Physical examination: knee.......  Absent patellae..............  Highly Recommended.                       
Patellar--subluxation--recurrent:                                                                               
    Medical record review............  History of recurrent           Highly Recommended.                       
                                        subluxation with associated                                             
                                        signs.                                                                  
Supracondylar fracture:                                                                                         
    X-ray: knee......................  Evidence of fracture.........  Recommended.                              
    Magnetic resonance imaging.......  Evidence of fracture.........  Recommended.                              
    Computerized tomography..........  Evidence of fracture.........  Recommended.                              

[[Page 50109]]

                                                                                                                
Total knee replacement:                                                                                         
    X-ray: knee......................  Presence of replacement knee.  Recommended.                              
    Medical record review............  Documented surgical history..  Recommended.                              
Tibial shaft fracture:                                                                                          
    X-ray: leg.......................  Fracture of shaft............  Recommended.                              
    Magnetic resonance imaging.......  Evidence of fracture.........  Recommended.                              
    Computerized tomography..........  Evidence of fracture.........  Recommended.                              
----------------------------------------------------------------------------------------------------------------


----------------------------------------------------------------------------------------------------------------
           Disability test                      Test result                    Disability classification        
----------------------------------------------------------------------------------------------------------------
                                                 BODY PART: KNEE                                                
                                              JOB TITLE: TRAINMAN                                               
----------------------------------------------------------------------------------------------------------------
Arthritis knee:                                                                                                 
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of      Flexion contracture (20 or >  D                                         
     motion.                            degrees).                                                               
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees degrees.                                                        
    Physical examination.............  Varus deformity, 8-12 degrees  D                                         
                                        degrees.                                                                
    X-ray knee.......................  0-1 mm cartilage interval      D                                         
                                        with degenerative change.                                               
Meniscectomy, medial or lateral:                                                                                
    Physical examination--range of     Range of motion: flexion >60   D                                         
     motion.                            degrees).                                                               
    Physical examination--range of     Flexion contracture (20 or     D                                         
     motion.                            >degrees).                                                              
Collateral ligament tear with laxity:                                                                           
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Cruciate and collateral ligament                                                                                
 tear:                                                                                                          
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Cruciate ligament tear with laxity:                                                                             
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Intercondylar fracture:                                                                                         
    Post fracture angulation.........  >20 degrees angulation.......  D                                         
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Osteomyelitis, chronic knee:                                                                                    
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees.                                                                
    Physical examination.............  Valgus deformity, 8-12         D                                         
                                        degrees.                                                                
    Medical record review............  Frequent episodes of           D                                         
                                        infection requiring                                                     
                                        treatment.                                                              
    X-ray knee.......................  0-1 mm cartilage interval      D                                         
                                        with degenerative change.                                               
Osteonecrosis:                                                                                                  
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees.                                                                
    Physical examination.............  Varus deformity, 8-12 degrees  D                                         
    X-ray knee.......................  0-1 mm cartilage interval      D                                         
                                        with degenerative change.                                               
Patellofemoral arthritis:                                                                                       
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees.                                                                
    Physical examination.............  Varus deformity, 8-12 degrees  D                                         
    X-ray knee: patello femoral joint  0 mm cartilage interval with   D                                         
                                        degenerative change.                                                    
Patellar fracture nonunion with                                                                                 
 displacement:                                                                                                  
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    X-ray knee.......................  Nonunion and >3 mm             D                                         
                                        displacement.                                                           
Plateau fracture:                                                                                               
    Post fracture angulation.........  >20 degrees angulation.......  D                                         
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Patellectomy:                                                                                                   
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Patellar, subluxation, recurrent:                                                                               
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Supracondylar fracture:                                                                                         
    Post fracture angulation.........  >20 degrees angulation.......  D                                         
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Tibial shaft fracture:                                                                                          

[[Page 50110]]

                                                                                                                
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Post fracture angulation.........  >20 degrees malalignment.....  D                                         
----------------------------------------------------------------------------------------------------------------
                                                 BODY PART: KNEE                                                
                                               JOB TITLE: ENGINEER                                              
----------------------------------------------------------------------------------------------------------------
Arthritis knee:                                                                                                 
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees.                                                                
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees.                                                                
    Physical examination.............  Varus deformity, 8-12 degrees  D                                         
    X-ray knee.......................  0-1 mm cartilage interval      D                                         
                                        with degenerative change.                                               
Meniscectomy, medial or lateral:                                                                                
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Collateral ligament tear with laxity:                                                                           
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Cruciate and collateral ligament                                                                                
 tear:                                                                                                          
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Cruciate ligament tear with laxity:                                                                             
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Intercondylar fracture:                                                                                         
    Post fracture angulation.........  > 20 degrees angulation......  D                                         
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Osteomyelitis, chronic knee:                                                                                    
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees.                                                                
    Physical examination.............  Varus deformity, 8-12 degrees  D                                         
    Medical record review............  Frequent episodes of           D                                         
                                        infection requiring                                                     
                                        treatment.                                                              
    X-ray knee.......................  0-1 mm cartilage interval      D                                         
                                        with degenerative change.                                               
Osteonecrosis:                                                                                                  
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees.                                                                
    Physical examination.............  Varus deformity, 8-12 degrees  D                                         
    X-ray knee.......................  0-1 mm cartilage interval      D                                         
                                        with degenerative change.                                               
Patellofemoral arthritis:                                                                                       
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees.                                                                
    Physical examination.............  Varus deformity, 8-12 degrees  D                                         
    X-ray knee: patello femoral joint  0 mm cartilage interval with   D                                         
                                        degenerative change.                                                    
Patellar fracture nonunion with                                                                                 
 displacement:                                                                                                  
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    X-ray knee.......................  Nonunion and > 3 mm            D                                         
                                        displacement.                                                           
Plateau fracture:                                                                                               
    Post fracture angulation.........  > 20 degrees angulation......  D                                         
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Patellectomy:                                                                                                   
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Patellar, subluxation, recurrent:                                                                               
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Supracondylar fracture:                                                                                         
    Post fracture angulation.........  > 20 degrees angulation......  D                                         
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Tibial shaft fracture:                                                                                          
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Post fracture angulation.........  > 20 degrees malalignment....  D                                         
----------------------------------------------------------------------------------------------------------------
                                                 BODY PART: KNEE                                                
                                                JOB TITLE: CARMAN                                               
----------------------------------------------------------------------------------------------------------------
Arthritis knee:                                                                                                 

[[Page 50111]]

                                                                                                                
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees.                                                                
    Physical examination.............  Varus deformity, 8-12 degrees  D                                         
    X-ray knee.......................  0-1 mm cartilage interval      D                                         
                                        with degenerative change.                                               
Meniscectomy, medial or lateral:                                                                                
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Collateral ligament tear with laxity:                                                                           
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Cruciate and collateral ligament                                                                                
 tear:                                                                                                          
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Cruciate ligament tear with laxity:                                                                             
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Intercondylar fracture:                                                                                         
    Post fracture angulation.........  > 20 degrees angulation......  D                                         
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Osteomyelitis, chronic knee:                                                                                    
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees.                                                                
    Physical examination.............  Varus deformity, 8-12 degrees  D                                         
    Medical record review............  Frequent episodes of           D                                         
                                        infection requiring                                                     
                                        treatment.                                                              
    X-ray knee.......................  0-1 mm cartilage interval      D                                         
                                        with degenerative change.                                               
Osteonecrosis:                                                                                                  
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees.                                                                
    Physical examination.............  Varus deformity, 8-12 degrees  D                                         
    X-ray knee.......................  0-1 mm cartilage interval      D                                         
                                        with degenerative change.                                               
Patellofemoral arthritis:                                                                                       
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees.                                                                
    Physical examination.............  Varus deformity, 8-12 degrees  D                                         
    X-ray knee: patello femoral joint  0 mm cartilage interval with   D                                         
                                        degenerative change.                                                    
Patellar fracture nonunion with                                                                                 
 displacement:                                                                                                  
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    X-ray knee.......................  Nonunion and > 3 mm            D                                         
                                        displacement.                                                           
Plateau fracture:                                                                                               
    Post fracture angulation.........  >20 degrees angulation.......  D                                         
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Patellectomy:                                                                                                   
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Patellar, subluxation, recurrent:                                                                               
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Supracondylar fracture:                                                                                         
    Post fracture angulation.........  >20 degrees angulation.......  D                                         
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Tibial shaft fracture:                                                                                          
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Post fracture angulation.........  >20 degrees malalignment.....  D                                         
----------------------------------------------------------------------------------------------------------------
                                                 BODY PART: KNEE                                                
                                               JOB TITLE SIGNALMAN                                              
----------------------------------------------------------------------------------------------------------------
Arthritis knee:                                                                                                 
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees.                                                                
    Physical examination.............  Valgus deformity, 8-12         D                                         
                                        degrees.                                                                
    X-ray knee.......................  0-1 mm cartilage interval      D                                         
                                        with degenerative change.                                               
Meniscectomy, medial or lateral:                                                                                
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                

[[Page 50112]]

                                                                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Collateral ligament tear with laxity:                                                                           
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Cruciate and collateral ligament                                                                                
 tear:                                                                                                          
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Cruciate ligament tear with laxity:                                                                             
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Intercondylar fracture:                                                                                         
    Post fracture angulation.........  >20 degrees angulation.......  D                                         
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Osteomyelitis, chronic knee:                                                                                    
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees.                                                                
    Physical examination.............  Varus deformity, 8-12 degrees  D                                         
    Medical record review............  Frequent episodes of           D                                         
                                        infection requiring                                                     
                                        treatment.                                                              
    X-ray knee.......................  0-1 mm cartilage interval      D                                         
                                        with degenerative change.                                               
Osteonecrosis:                                                                                                  
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees.                                                                
    Physical examination.............  Varus deformity, 8-12 degrees  D                                         
    X-ray knee.......................  0-1 mm cartilage interval      D                                         
                                        with degenerative change.                                               
Patellofemoral arthritis:                                                                                       
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees.                                                                
    Physical examination.............  Varus deformity, 8-12 degrees  D                                         
    X-ray knee: patello femoral joint  0 mm cartilage interval with   D                                         
                                        degenerative change.                                                    
Patellar fracture nonunion with                                                                                 
 displacement:                                                                                                  
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    X-ray knee.......................  Nonunion and >3 mm             D                                         
                                        displacement.                                                           
Plateau fracture:                                                                                               
    Post fracture angulation.........  >20 degrees angulation.......  D                                         
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Patellectomy:                                                                                                   
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Patellar, subluxation, recurrent:                                                                               
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Supracondylar fracture:                                                                                         
    Post fracture angulation.........  >20 degrees angulation.......  D                                         
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Tibial shaft fracture:                                                                                          
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Post fracture angulation.........  >20 degrees malalignment.....  D                                         
----------------------------------------------------------------------------------------------------------------
                                                 BODY PART: KNEE                                                
                                               JOB TITLE: TRACKMAN                                              
----------------------------------------------------------------------------------------------------------------
Arthritis knee:                                                                                                 
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees.                                                                
    Physical examination.............  Varus deformity, 8-12 degrees  D                                         
    X-ray knee.......................  0-1 mm cartilage interval      D                                         
                                        with degenerative change.                                               
Meniscectomy, medial or lateral:                                                                                
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Collateral ligament tear with laxity:                                                                           
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Cruciate and collateral ligament                                                                                
 tear:                                                                                                          
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               

[[Page 50113]]

                                                                                                                
Cruciate ligament tear with laxity:                                                                             
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Intercondylar fracture:                                                                                         
    Post fracture angulation.........  >20 degree angulation........  D                                         
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Osteomyelitis, chronic knee:                                                                                    
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees.                                                                
    Physical examination.............  Varus deformity, 8-12 degrees  D                                         
    Medical record review............  Frequent episodes of           D                                         
                                        infection requiring                                                     
                                        treatment.                                                              
    X-ray knee.......................  0-1 mm cartilage interval      D                                         
                                        with degenerative change.                                               
Osteonecrosis:                                                                                                  
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees.                                                                
    Physical examination.............  Varus deformity, 8-12 degrees  D                                         
    X-ray knee.......................  0-1 mm cartilage interval      D                                         
                                        with degenerative change.                                               
Patellofemoral arthritis:                                                                                       
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees.                                                                
    Physical examination.............  Varus deformity, 8-12 degrees  D                                         
    X-ray knee: patello femoral joint  0 mm cartilage interval with   D                                         
                                        degenerative change.                                                    
Patellar fracture nonunion with                                                                                 
 displacement:                                                                                                  
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    X-ray knee.......................  Nonunion and > 3 mm            D                                         
                                        displacement.                                                           
Plateau fracture:                                                                                               
    Post fracture angulation.........  >20 degrees angulation.......  D                                         
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Patellectomy:                                                                                                   
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Patellar, subluxation, recurrent:                                                                               
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Supracondylar fracture:                                                                                         
    Post fracture angulation.........  >20 degrees angulation.......  D                                         
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Tibial shaft fracture:                                                                                          
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Post fracture angulation.........  >20 degrees malalignment.....  D                                         
----------------------------------------------------------------------------------------------------------------
                                                 BODY PART: KNEE                                                
                                              JOB TITLE: MACHINIST                                              
----------------------------------------------------------------------------------------------------------------
Arthritis knee:                                                                                                 
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees.                                                                
    Physical examination.............  Varus deformity, 8-12 degrees  D                                         
    X-ray knee.......................  0-1 mm cartilage interval      D                                         
                                        with degenerative change.                                               
Meniscectomy, medial or lateral:                                                                                
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Collateral ligament tear with laxity:                                                                           
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Cruciate and collateral ligament                                                                                
 tear:                                                                                                          
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Cruciate ligament tear with laxity:                                                                             
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Intercondylar fracture:                                                                                         
    Post fracture angulation.........  >20 degrees angulation.......  D                                         
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               

[[Page 50114]]

                                                                                                                
Osteomyelitis, chronic knee:                                                                                    
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees.                                                                
    Physical examination.............  Varus deformity, 8-12 degrees  D                                         
    Medical record review............  Frequent episodes of           D                                         
                                        infection requiring                                                     
                                        treatment.                                                              
    X-ray knee.......................  0-1 mm cartilage interval      D                                         
                                        with degenerative change.                                               
Osteonecrosis:                                                                                                  
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees.                                                                
    Physical examination.............  Varus deformity, 8-12 degrees  D                                         
    X-ray knee.......................  0-1 mm cartilage interval      D                                         
                                        with degenerative change.                                               
Patellofemoral arthritis:                                                                                       
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees.                                                                
    Physical examination.............  Varus deformity, 8-12 degrees  D                                         
    X-ray knee.......................  0 mm cartilage interval with   D                                         
                                        degenerative change.                                                    
Patellar fracture nonunion with                                                                                 
 displacement:                                                                                                  
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    X-ray knee.......................  Nonunion and >3 mm             D                                         
                                        displacement.                                                           
Plateau fracture:                                                                                               
    Post fracture angulation.........  >20 degrees angulation.......  D                                         
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Patellectomy:                                                                                                   
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Patellar, subluxation, recurrent:                                                                               
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Supracondylar fracture:                                                                                         
    Post fracture angulation.........  >20 degrees angulation.......  D                                         
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Tibial shaft fracture:                                                                                          
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Post fracture angulation.........  >20 degrees malalignment.....  D                                         
----------------------------------------------------------------------------------------------------------------
                                                 BODY PART: KNEE                                                
                                             JOB TITLE: SHOP LABORER                                            
----------------------------------------------------------------------------------------------------------------
Arthritis knee:                                                                                                 
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees.                                                                
    Physical examination.............  Varus deformity, 8-12 degrees  D                                         
    X-ray knee.......................  0-1 mm cartilage interval      D                                         
                                        with degenerative change.                                               
Meniscectomy, medial or lateral:                                                                                
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Collateral ligament tear with laxity:                                                                           
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Cruciate and collateral ligament                                                                                
 tear:                                                                                                          
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Cruciate ligament tear with laxity:                                                                             
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Intercondylar fracture:                                                                                         
    Post fracture angulation.........  >20 degrees angulation.......  D                                         
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Osteomyelitis, chronic knee:                                                                                    
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees.                                                                
    Physical examination.............  Varus deformity, 8-12 degrees  D                                         
    Medical record review............  Frequent episodes of           D                                         
                                        infection requiring                                                     
                                        treatment.                                                              
    X-ray knee.......................  0-1 mm cartilage interval      D                                         
                                        with degenerative change.                                               

[[Page 50115]]

                                                                                                                
Osteonecrosis:                                                                                                  
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees.                                                                
    Physical examination.............  Varus deformity, 8-12 degrees  D                                         
    X-ray knee.......................  0-1 mm cartilage interval      D                                         
                                        with degenerative change.                                               
Patellofemoral arthritis:                                                                                       
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Physical examination.............  Valgus deformity, 16-20        D                                         
                                        degrees.                                                                
    Physical examination.............  Varus deformity, 8-12 degrees  D                                         
    X-ray knee: patellofemoral joint.  0 mm cartilage interval with   D                                         
                                        degenerative change.                                                    
Patellar fracture nonunion with                                                                                 
 displacement:                                                                                                  
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    X-ray knee.......................  Nonunion and > 3 mm            D                                         
                                        displacement.                                                           
Plateau fracture::                                                                                              
    Post fracture angulation.........  >20 degrees angulation.......  D                                         
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Patellectomy:                                                                                                   
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Patellar, subluxation, recurrent:                                                                               
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Supracondylar fracture:                                                                                         
    Post fracture angulation.........  >20 degrees angulation.......  D                                         
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
Tibial shaft fracture:                                                                                          
    Physical examination--range of     Range of motion: flexion <60   D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Flexion contracture (20 or >   D                                         
     motion.                            degrees).                                                               
    Post fracture angulation.........  >20 degrees malalignment.....  D                                         
----------------------------------------------------------------------------------------------------------------

K. Ankle and Foot

----------------------------------------------------------------------------------------------------------------
          Confirmatory test                    Minimum result                        Requirements               
----------------------------------------------------------------------------------------------------------------
                                            BODY PART: ANKLE AND FOOT                                           
                                               CONFIRMATORY TESTS                                               
----------------------------------------------------------------------------------------------------------------
Ankle fracture:                                                                                                 
    Medical record review............  Documented history of ankle    Recommended.                              
                                        fracture.                                                               
    X-ray: ankle.....................  Ankle fracture...............  Highly recommended.                       
Ankylosis, ankle:                                                                                               
    X-ray: ankle.....................  Extensive joint destruction..  Highly recommended.                       
    Physical examination.............  No mobility..................  Highly recommended.                       
Arthritis, subtalar joint:                                                                                      
    X-ray: ankle.....................  Evidence of significant        Highly recommended.                       
                                        arthritis: subtalar joint.                                              
Arthritis, talonavicular joint:                                                                                 
    X-ray: ankle.....................  Significant arthritis:         Highly recommended.                       
                                        talonavicular joint.                                                    
Achilles tendon rupture:                                                                                        
    Medical record review............  Documentation of achilles      Highly recommended.                       
                                        tendon rupture.                                                         
    Physical examination.............  Rupture of achilles tendon...  Highly recommended.                       
Arthritis, ankle:                                                                                               
    X-ray: ankle.....................  Significant arthritis........  Highly recommended.                       
Hindfoot fracture:                                                                                              
    X-ray: foot and ankle............  Documentatin of fracture.....  Highly recommended.                       
Rheumatoid arthritis, foot:                                                                                     
    Medical History..................  Documented history of          Highly recommended.                       
                                        condition.                                                              
    X-ray: foot......................  Significant arthritis........  Highly recommended.                       
----------------------------------------------------------------------------------------------------------------


----------------------------------------------------------------------------------------------------------------
           Disability test                      Test result                    Disability classification        
----------------------------------------------------------------------------------------------------------------
                                            BODY PART: ANKLE AND FOOT                                           
                                               JOB TITLE: TRAINMAN                                              
----------------------------------------------------------------------------------------------------------------
Ankle fracture:                                                                                                 
    X-ray: ankle.....................  Displaced intra-articular      D                                         
                                        fracture.                                                               
    Physical examination.............  Varus deformity >15 degrees..  D                                         
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture--  D                                         
     motion.                            20 degrees.                                                             

[[Page 50116]]

                                                                                                                
Ankylosis, ankle:                                                                                               
    Physical examination--range of     Ankylosis in 20 degree or >    D                                         
     motion.                            dorsiflexion.                                                           
    Physical examination--range of     Ankylosis in 20 degree         D                                         
     motion.                            plantar flexion.                                                        
    Physical examination--range of     Ankylosis in int or ext        D                                         
     motion.                            malrotation >15 degrees.                                                
    Physical examination--range of     Ankylosis in varus 10 or more  D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Ankylosis in valgus 10 or      D                                         
     motion.                            more degrees.                                                           
Arthritis, subtalar joint (hindfoot):                                                                           
    X-ray: ankle--subtalar joint.....  Subtalar joint space 0 mm....  D                                         
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture--  D                                         
     motion.                            20 degrees.                                                             
    Physical examination.............  Varus deformity >15 degrees..  D                                         
Arthritis, talonavicular joint                                                                                  
 (hindfoot):                                                                                                    
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture--  D                                         
     motion.                            20 degrees.                                                             
    X-ray: ankle--talonavicular joint  Talonavicular joint space 0    D                                         
                                        mm.                                                                     
    Physical examination.............  Varus deformity >15 degrees..  D                                         
Achilles tendon rupture:                                                                                        
    Physical examination--range of     Plantar flexion capability,    D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture,   D                                         
     motion.                            20 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture,   D                                         
     motion.                            20 degrees.                                                             
Arthritis, ankle:                                                                                               
    X-ray: ankle.....................  0 mm.........................  D                                         
    Physical examination--range of     Plantar flexion capability,    D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion constructure,  D                                         
     motion.                            20 degrees.                                                             
    Physical examination.............  Varus deformity >15 degrees..  D                                         
Hindfoot fracture:                                                                                              
    X-ray: foot......................  Calcaneal fracture with        D                                         
                                        Boehler angle <95 degrees.                                              
    X-ray: foot......................  Subtalar fracture with         D                                         
                                        Boehler angle <95 degrees.                                              
    Physical examination.............  Varus angulation >20 degrees   D                                         
                                        (hindfoot).                                                             
    Physical examination.............  Valgus angulation >20 degrees  D                                         
                                        (hindfoot).                                                             
Rheumatoid arthritis, foot:                                                                                     
    X-ray: foot......................  Significant degeneration.....  D                                         
    Medical record review............  Frequent flare-up with         D                                         
                                        treatment.                                                              
----------------------------------------------------------------------------------------------------------------
                                            BODY PART: ANKLE AND FOOT                                           
                                              JOB TITLE: ENGINEER                                               
----------------------------------------------------------------------------------------------------------------
Ankle fracture:                                                                                                 
    X-ray: ankle.....................  Displaced intra-articular      D                                         
                                        fracture.                                                               
    Physical examination.............  Varus deformity >15 degrees..  D                                         
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture--  D                                         
     motion.                            20 degrees.                                                             
Ankylosis, ankle:                                                                                               
    Physical examination--range of     Ankylosis in 20 degree or >    D                                         
     motion.                            dorsiflexion.                                                           
    Physical examination--range of     Ankylosis in 20 degree         D                                         
     motion.                            plantar flexion.                                                        
    Physical examination--range of     Ankylosis in int or ext        D                                         
     motion.                            malrotation >15 degrees.                                                
    Physical examination--range of     Ankylosis in varus 10 or more  D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Ankylosis in valgus 10 or      D                                         
     motion.                            more degrees.                                                           
Arthritis, subtalar joint (hindfoot):                                                                           
    X-ray: ankle--subtalar joint.....  Subtalar joint space 0 mm....  D                                         
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture--  D                                         
     motion.                            20 degrees.                                                             
    Physical examination.............  Varus deformity >15 degrees..  D                                         
Arthritis, talonavicular joint                                                                                  
 (hindfoot):                                                                                                    
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture--  D                                         
     motion.                            20 degrees.                                                             
    X-ray ankle--talonavicular joint.  Talonavicular joint space 0    D                                         
                                        mm.                                                                     
    Physical examination.............  Varus deformity >15 degrees..  D                                         
Achilles tendon rupture:                                                                                        
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture    D                                         
     motion.                            20 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture,   D                                         
     motion.                            20 degrees.                                                             
Arthritis, ankle:                                                                                               
    X-ray: ankle.....................  0 mm.........................  D                                         
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture--  D                                         
     motion.                            20 degrees.                                                             
    Physical examination.............  Varus deformity >15 degrees..  D                                         
Hindfoot fracture:                                                                                              
    X-ray: foot......................  Calcaneal fracture with        D                                         
                                        Boehler angle <95 degrees.                                              
    X-ray: foot......................  Subtalar fracture with         D                                         
                                        Boehler angle <95 degrees.                                              
    Physical examination.............  Varus angulation >20 degrees   D                                         
                                        (hindfoot).                                                             
    Physical examination.............  Valgus angulation >20 degrees  D                                         
                                        (hindfoot).                                                             
Rheumatoid arthritis, foot:                                                                                     
    X-ray: foot......................  Significant degeneration.....  D                                         

[[Page 50117]]

                                                                                                                
    Medical record review............  Frequent flare-up with         D                                         
                                        treatment.                                                              
----------------------------------------------------------------------------------------------------------------
                                            BODY PART: ANKLE AND FOOT                                           
                                              JOB TITLE: DISPATCHER                                             
----------------------------------------------------------------------------------------------------------------
Achilles tendon rupture:                                                                                        
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture,   D                                         
     motion.                            20 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture,   D                                         
     motion.                            20 degrees.                                                             
Arthritis, ankle:                                                                                               
    X-ray: ankle.....................  0 mm.........................  D                                         
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture--  D                                         
     motion.                            20 degrees.                                                             
    Physical examination.............  Varus deformity >15 degrees..  D                                         
Hindfoot fracture:                                                                                              
    X-ray: foot......................  Calcaneal fracture with        D                                         
                                        Boehler angle <95 degrees.                                              
    X-ray: foot......................  Subtalar fracture with         D                                         
                                        Boehler angle <95 degrees.                                              
    Physical examination.............  Varus angulation >20 degrees   D                                         
                                        (hindfoot).                                                             
    Physical examination.............  Valgus angulation >20 degrees  D                                         
                                        (hindfoot).                                                             
Rheumatoid arthritis, foot:                                                                                     
    X-ray: foot......................  Significant degeneration.....  D                                         
    Medical record review............  Frequent flare-up with         D                                         
                                        treatment.                                                              
----------------------------------------------------------------------------------------------------------------
                                            BODY PART: ANKLE AND FOOT                                           
                                                JOB TITLE: CARMAN                                               
----------------------------------------------------------------------------------------------------------------
Ankle fracture:                                                                                                 
    X-ray: ankle.....................  Displaced intra-articular      D                                         
                                        fracture.                                                               
    Physical examination.............  Varus deformity >15 degrees..  D                                         
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture--  D                                         
     motion.                            20 degrees.                                                             
Ankylosis, ankle:                                                                                               
    Physical examination--range of     Ankylosis in 20 degree or >    D                                         
     motion.                            dorisiflexion.                                                          
    Physical examination--range of     Ankylosis in 20 degree         D                                         
     motion.                            plantar flexion.                                                        
    Physical examination--range of     Ankylois in int or ext         D                                         
     motion.                            malrotation >15 degrees.                                                
    Physical examination--range of     Ankylosis in varus 10 or more  D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Ankylosis in valgus 10 or      D                                         
     motion.                            more degrees.                                                           
Arthritis, subtalar joint (hindfoot):                                                                           
    X-ray: ankle--subtalar joint.....  Subtalar joint space 0 mm....  D                                         
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture--  D                                         
     motion.                            20 degrees.                                                             
    Physical examination.............  Varus deformity >15 degrees..  D                                         
Arthritis, talonavicular joint                                                                                  
 (hindfoot):                                                                                                    
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture--  D                                         
     motion.                            20 degrees.                                                             
    X-ray: ankle--talonavicular joint  Talonavicular joint space 0    0                                         
                                        mm.                                                                     
    Physical examination.............  Varus deformity >15 degrees..  D                                         
Achilles tendon rupture:                                                                                        
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture,   D                                         
     motion.                            20 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture,   D                                         
     motion.                            20 degrees.                                                             
Arthritis, ankle:                                                                                               
    X-ray: ankle.....................  0 mm.........................  D                                         
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture,   D                                         
     motion.                            20 degrees.                                                             
    Physical examination.............  Varus deformity >15 degrees..  D                                         
Hindfoot fracture:                                                                                              
    X-ray: foot......................  Calcaneal fracture with        D                                         
                                        Boehler angle <95 degrees.                                              
    X-ray: foot......................  Subtalar fracture with         D                                         
                                        Boehler angle >95 degrees.                                              
    Physical examination.............  Varus angulation >20 degrees   D                                         
                                        (hindfoot).                                                             
    Physical examination.............  Valgus angulation >20 degrees  D                                         
                                        (hindfoot).                                                             
Rheumatoid arthritis, foot:                                                                                     
    X-ray: foot......................  Significant degeneration.....  D                                         
    Medical record review............  Frequent flare--up with        D                                         
                                        treatment.                                                              
----------------------------------------------------------------------------------------------------------------
                                            BODY PART: ANKLE AND FOOT                                           
                                              JOB TITLE: SIGNALMAN                                              
----------------------------------------------------------------------------------------------------------------
Ankle fracture:                                                                                                 
    X-ray: ankle.....................  Displaced intra-articular      D                                         
                                        fracture.                                                               
    Physical examination.............  Varus deformity >15 degrees..  D                                         
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture--  D                                         
     motion.                            20 degrees.                                                             
Ankylosis, ankle:                                                                                               

[[Page 50118]]

                                                                                                                
    Physical examination--range of     Ankylosis in 20 degree or >    D                                         
     motion.                            dorsiflexion.                                                           
    Physical examination--range of     Ankylosis in 20 degree         D                                         
     motion.                            plantar flexion.                                                        
    Physical examination--range of     Ankylosis in int or ext        D                                         
     motion.                            malrotation >15 degrees.                                                
    Physical examination--range of     Ankylosis in varus 10 or more  D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Ankylosis in valgus 10 or      D                                         
     motion.                            more degrees.                                                           
Arthritis, subtalar joint (hindfoot):                                                                           
    X-ray: ankle--subtalar joint.....  Subtalar joint space 0 mm....  D                                         
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture--  D                                         
     motion.                            20 degrees.                                                             
    Physical examination.............  Varus deformity >15 degrees..  D                                         
Arthritis, talonavicular joint                                                                                  
 (hindfoot):                                                                                                    
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture--  D                                         
     motion.                            20 degrees.                                                             
    X-ray: ankle--talonavicular joint  Talonavicular joint space 0    D                                         
                                        mm.                                                                     
    Physical examination.............  Varus deformity >15 degrees..  D                                         
Achilles tendon rupture:                                                                                        
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture,   D                                         
     motion.                            20 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture,   D                                         
     motion.                            20 degrees.                                                             
Arthritis, ankle:                                                                                               
    X-ray: ankle.....................  0 mm.........................  D                                         
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture--  D                                         
     motion.                            20 degrees.                                                             
    Physical examination.............  Varus deformity >15 degrees..  D                                         
Hindfoot fracture:                                                                                              
    X-ray: foot......................  Calcaneal fracture with        D                                         
                                        Boehler angle <95 degrees.                                              
    X-ray: foot......................  Subtalar fracture with         D                                         
                                        Boehler angle <95 degrees.                                              
    Physical examination.............  Varus angulation >20 degrees   D                                         
                                        (hindfoot).                                                             
    Physical examination.............  Valgus angulation >20 degrees  D                                         
                                        (hindfoot).                                                             
Rheumatoid arthritis, foot:                                                                                     
    X-ray: foot......................  Significant degeneration.....  D                                         
    Medical record review............  Frequent flare-up with         D                                         
                                        treatment.                                                              
----------------------------------------------------------------------------------------------------------------
                                            BODY PART: ANKLE AND FOOT                                           
                                               JOB TITLE: TRACKMAN                                              
----------------------------------------------------------------------------------------------------------------
Ankle fracture:                                                                                                 
    X-ray: ankle.....................  Displaced intra-articular      D                                         
                                        fracture.                                                               
    Physical examination--range of     Varus deformity >15 degrees..  D                                         
     motion.                                                                                                    
    Physical examinaton--range of      Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of      Plantar flexion contracture-- D                                         
     motion.                            20 degrees.                                                             
Ankylosis, ankle:                                                                                               
    Physical examination--range of     Ankylosis in 20 degree or >    D                                         
     motion.                            dorsiflexion.                                                           
    Physical examination--range of     Ankylosis in 20 degree         D                                         
     motion.                            plantar flexion.                                                        
    Physical examination--range of     Ankylosis in int or ext        D                                         
     motion.                            malrotation >15 degrees.                                                
    Physical examination--range of     Ankylosis in varus 10 or more  D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Ankylosis in valgus 10 or      D                                         
     motion.                            more degrees.                                                           
Arthritis, subtalar joint (hindfoot):                                                                           
    X-ray: ankle--subtalar joint.....  Subtalar joint space 0 mm....  D                                         
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture--  D                                         
     motion.                            20 degrees.                                                             
    Physical examination.............  Varus deformity >15 degrees..  D                                         
Arthritis, talonavicular joint                                                                                  
 (hindfoot):                                                                                                    
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture--  D                                         
     motion.                            20 degrees.                                                             
    X-ray: angle--talonavicular joint  Talonavicular joint space 0    D                                         
                                        mm.                                                                     
    Physical examination.............  Varus deformity >15 degrees..  D                                         
Achilles tendon rupture:                                                                                        
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture,   D                                         
     motion.                            20 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture,   D                                         
     motion.                            20 degrees.                                                             
Arthritis, ankle:                                                                                               
    X-ray: ankle.....................  0 mm.........................  D                                         
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination.............  Varus deformity >15 degrees..  D                                         
Hindfoot fracture:                                                                                              
    X-ray: foot......................  Calcaneal fracture with        D                                         
                                        Boehler angle <95 degrees.                                              
    X-ray: foot......................  Subtalar fracture with         D                                         
                                        Boehler angle <95 degrees.                                              
    Physical examination.............  Varus angulation >20 degrees   D                                         
                                        (hindfoot).                                                             
    Physical examination.............  Valgus angulation >20 degrees  D                                         
                                        (hindfoot).                                                             
Rheumatoid arthritis, foot:                                                                                     
    X-ray: foot......................  Significant degeneration.....  D                                         
    Medical record review............  Frequent flare-up with         D                                         
                                        treatment.                                                              
----------------------------------------------------------------------------------------------------------------

[[Page 50119]]

                                                                                                                
                                            BODY PART: ANKLE AND FOOT                                           
                                              JOB TITLE: MACHINIST                                              
----------------------------------------------------------------------------------------------------------------
Ankle fracture:                                                                                                 
    X-ray: ankle.....................  Displaced intra-articular      D                                         
                                        fracture.                                                               
    Physical examination.............  Varus deformity >15 degrees..  D                                         
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture--  D                                         
     motion.                            20 degrees.                                                             
Ankylosis, ankle:                                                                                               
    Physical examination--range of     Ankylosis in 20 degree or >    D                                         
     motion.                            dorsiflexion.                                                           
    Physical examination--range of     Ankylosis in 20 degree         D                                         
     motion.                            plantar flexion.                                                        
    Physical examination--range of     Ankylosis in int or ext        D                                         
     motion.                            malrotation >15 degrees.                                                
    Physical examination--range of     Ankylosis in varus 10 or more  D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Ankylosis in valgus 10 or      D                                         
     motion.                            more degrees.                                                           
Arthritis, subtalar joint (hindfoot):                                                                           
    X-ray: ankle--subtalar joint.....  Subtalar joint space 0 mm....  D                                         
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            >5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture--  D                                         
     motion.                            20 degrees.                                                             
    Physical examination.............  Varus deformity<15 degrees...  D                                         
Arthritis, talonavicular joint                                                                                  
 (hindfoot):                                                                                                    
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture--  D                                         
     motion.                            20 degrees.                                                             
    X-ray: ankle--talonavicular joint  Talonavicular joint space 0    D                                         
                                        mm.                                                                     
    Physical examination.............  Varus deformity >15 degrees..  D                                         
Achilles tendon rupture:                                                                                        
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture,   D                                         
     motion.                            20 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture,   D                                         
     motion.                            20 degrees.                                                             
Arthritis, ankle:                                                                                               
    X-ray: ankle.....................  0 mm.........................  D                                         
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture--  D                                         
     motion.                            20 degrees.                                                             
    Physical examination.............  Varus deformity >15 degrees..  D                                         
Hindfoot fracture:                                                                                              
    X-ray: foot......................  Calcaneal fracture with        D                                         
                                        Boehler angle <95 degrees.                                              
    X-ray: foot......................  Subtalar fracture with         D                                         
                                        Boehler angle <95 degrees.                                              
    Physical examination.............  Varus angulation >20 degrees   D                                         
                                        (hindfoot).                                                             
    Physical examination.............  Valgus angulation >20 degrees  D                                         
                                        (hindfoot).                                                             
Rheumatoid arthritis, foot:                                                                                     
    X-ray: foot......................  Significant degeneration.....  D                                         
    Medical record review............  Frequent flare-up with         D                                         
                                        treatment.                                                              
----------------------------------------------------------------------------------------------------------------
                                            BODY PART: ANKLE AND FOOT                                           
                                               JOB TITLE: LABORER                                               
----------------------------------------------------------------------------------------------------------------
Ankle fracture:                                                                                                 
    X-ray: ankle.....................  Displaced intra-articular      D                                         
                                        fracture.                                                               
    Physical examination.............  Varus deformity >15 degrees..  D                                         
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture--  D                                         
     motion.                            20 degrees.                                                             
Ankylosis, ankle:                                                                                               
    Physical examination--range of     Ankylosis in 20 degree or >    D                                         
     motion.                            dorsiflexion.                                                           
    Physical examination--range of     Ankylosis in 20 degree         D                                         
     motion.                            plantar flexion.                                                        
    Physical examination--range of     Ankylosis in int or ext        D                                         
     motion.                            malrotation >15 degrees.                                                
    Physical examination--range of     Ankylosis in varus 10 or more  D                                         
     motion.                            degrees.                                                                
    Physical examination--range of     Ankylosis in valgus 10 or      D                                         
     motion.                            more degrees.                                                           
Arthritis, subtalar joint (hindfoot):                                                                           
    X-ray: ankle--subtalar joint.....  Subtalar joint space 0 mm....  D                                         
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture--  D                                         
     motion.                            20 degrees.                                                             
    Physical examination.............  Varus deformity >15 degrees..  D                                         
Arthritis, talonavicular joint                                                                                  
 (hindfoot):                                                                                                    
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture--  D                                         
     motion.                            20 degrees.                                                             
    X-ray: ankle--talonavicular joint  Talonavicular joint space 0    D                                         
                                        mm.                                                                     
    Physical examination.............  Varus deformity >15 degrees..  D                                         
Achilles tendon rupture:                                                                                        
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture,   D                                         
     motion.                            20 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture,   D                                         
     motion.                            20 degrees.                                                             
Arthritis, ankle:                                                                                               
    X-ray: ankle.....................  0 mm.........................  D                                         
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture--  D                                         
     motion.                            20 degrees.                                                             

[[Page 50120]]

                                                                                                                
    Physical examination.............  Varus deformity >15 degrees..  D                                         
Hindfoot fracture:                                                                                              
    X-ray: foot......................  Calcaneal fracture with        D                                         
                                        Boehler angle <95 degrees.                                              
    X-ray: foot......................  Subtalar fracture with         D                                         
                                        Boehler angle <95 degrees.                                              
    Physical examination.............  Varus angulation >20 degrees   D                                         
                                        (hindfoot).                                                             
    Physical examination.............  Valgus angulation >20 degrees  D                                         
                                        (hindfoot).                                                             
Rheumatoid arthritis, foot:                                                                                     
    X-ray: foot......................  Significant degeneration.....  D                                         
    Medical record review............  Frequent flare-up with         D                                         
                                        treatment.                                                              
----------------------------------------------------------------------------------------------------------------
                                            BODY PART: ANKLE AND FOOT                                           
                                        JOB TITLE: SALES REPRESENTATIVES                                        
----------------------------------------------------------------------------------------------------------------
Achilles tendon rupture:                                                                                        
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture,   D                                         
     motion.                            20 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture,   D                                         
     motion.                            20 degrees.                                                             
Arthritis, ankle:                                                                                               
    X-ray: ankle.....................  0 mm.........................  D                                         
    Physical examination--range of     Plantar flexion capability--   D                                         
     motion.                            <5 degrees.                                                             
    Physical examination--range of     Plantar flexion contracture--  D                                         
     motion.                            20 degrees.                                                             
    Physical examination.............  Varus deformity >15 degrees..  D                                         
Hindfoot fracture:                                                                                              
    X-ray: foot......................  Calcaneal fracture with        D                                         
                                        Boehler angle <95 degrees.                                              
    X-ray: foot......................  Subtalar fracture with         D                                         
                                        Boehler angle <95 degrees.                                              
    Physical examination.............  Varus angulation >20 degrees   D                                         
                                        (hindfoot).                                                             
    Physical examination.............  Valgus angulation >20 degrees  D                                         
                                        (hindfoot).                                                             
Rheumatoid arthritis, foot:                                                                                     
    X-ray: foot......................  Significant degeneration.....  D                                         
    Medical record review............  Frequent flare-up with         D                                         
                                        treatment.                                                              
----------------------------------------------------------------------------------------------------------------

    Dated: September 12, 1997.

    By Authority of the Board.
Beatrice Ezerski,
Secretary to the Board.
[FR Doc. 95-24793 Filed 8-23-95; 8:45 am]
BILLING CODE 7905-01-M