[Federal Register Volume 63, Number 30 (Friday, February 13, 1998)]
[Rules and Regulations]
[Pages 7538-7602]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 98-2026]



[[Page 7537]]

_______________________________________________________________________

Part V





Railroad Retirement Board





_______________________________________________________________________



20 CFR Part 220



Determining Disability; Final Rule

  Federal Register / Vol. 63, No. 30 / Friday, February 13, 1998 / 
Rules and Regulations  

[[Page 7538]]



RAILROAD RETIREMENT BOARD

20 CFR Part 220

RIN 3220-AB18


Determining Disability

AGENCY: Railroad Retirement Board.

ACTION: Final rule.

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

SUMMARY: The Railroad Retirement Board hereby amends its regulations 
with respect to determining when an employee is disabled for his or her 
regular railroad occupation. This final rule gives effect to an 
agreement between railroad labor and railroad management consistent 
with section 2(a)(2) of the Railroad Retirement Act which provides that 
labor and management shall cooperate with the Board in developing 
standards for determining when an employee's physical or mental 
condition disables him or her for work in his or her regular railroad 
occupation and thus there exists good cause not to delay its 
effectiveness beyond date of publication.

DATES: Effective date: This rule is effective February 13, 1998.
    Applicability date: This rule shall be applicable February 13, 
1998, but only with respect to applications for a disability annuity 
filed on or after January 1, 1998.

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 their regular 
occupation 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 this regulation if an employee's physical or mental 
condition does not meet a listing found in Appendix 1 of Part 220 
(which determines if an individual is able to engage in any employment 
both within and outside the railroad industry), 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 amends Subpart C to add such standards with respect to 
certain railroad occupations.
    Section 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 recommendations of 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. It should be noted that the Board is not an 
agency subject to the Federal Advisory Committee Act. Accordingly, the 
Occupational Disability Advisory Committee will not be subject to that 
Act.
    Section 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 removed, and the current Sec. 220.14 
``Evidence Considered'' is redesignated Sec. 220.12.
    The introductory language and paragraph (a) of section 220.13 
follow the present regulation and describe 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.
    Section 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 upon 
the employee's description of his or her job.
    Section 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) by using the tests listed in 
Appendix 3 or by other valid diagnostic tests which could be used to 
establish an impairment as provided for in Sec. 220.27 of this part. 
(Section 220.13(b)(2)(ii) of the proposed rule has been revised to 
clarify how an impairment is confirmed and that if an employee's 
impairment(s) cannot be confirmed, as provided for in this section, the 
employee will be found not disabled.) Once the impairment(s) is 
confirmed, Appendix 3 is applied to determine if the employee is 
disabled. (Section 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 Sec. 220.13(b)(2)(iv). Likewise, 
if Appendix 3 does not yield a ``disabled'' finding, ICE will apply.
    Section 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 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 
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

[[Page 7539]]

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 that 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 disabled. If 
the demands do not exceed the residual functional capacity, then the 
Board will find the employee not disabled (Step 6).
    The Board published this regulation as a proposed rule on September 
24, 1997 (62 FR 50056), and invited comments by October 24, 1997. Two 
comments were received. One commentator suggested that the Board adopt 
the vision and hearing acuity requirements found in 49 CFR 240.121, 
which have been adopted by the Federal Railroad Administration for 
certification of locomotive engineers. However, the Board does not feel 
such a change is needed since an engineer who is disqualified by his 
employer for failure to meet the requirements of 49 CFR 240.121 would 
ordinarily be presumed disabled under the first paragraph of 
Sec. 220.13. Another commentator expressed support for the regulation 
because it was in accord with an agreement reached in July 1997 between 
representatives of rail labor and rail management concerning 
occupational disability.
    The final rule contains an Introduction to Appendix 3 which 
explains how to use the Appendix. In addition, the Board has corrected 
typographical errors in Appendix 3, and made the following substantive 
changes in Appendix 3 based upon advice from physicians representing 
rail labor and rail management:

A. Cancer

     62 FR 50064--Under Assessment, second paragraph, second 
line, the phrase ``in the Tables'' was inserted after ``All railroad 
occupations.''
     62 FR 50065--Footnote 3, Functional Impacts, the reference 
to ``(MS) Minimally Significant'' was deleted.
     62 FR 50066--Footnote 5 was deleted and footnote 6 was 
redesignated footnote 5.

C. Cardiac

     62 FR 50066--The confirmatory test for coronary artery 
disease, angiography,''Definite significant (>60%) of one vessel,'' was 
changed to ``Definite occlusion (>60%) of one vessel.''
     62 FR 50067 through 50075--The disability tests, test 
results and disability classifications for ``Echocardiogram'' and 
``Cardiac catheterization'' with results of ``Decreased ejection 
fraction 40-55%'' were deleted for all job titles. These tests were 
found in the proposed rule under the listings Angina, Aortic valve 
disease, Cardiomyopathy, Mitral valve disease, and Pericardial disease.
     62 FR 50067 through 50075--The disability tests for 
``Echocardiogram'' and ``Cardiac catheterization'' with results of 
``Poor ejection fraction <35%'' were revised to read ``Poor ejection 
fraction 35%'' for all job titles. These tests were found in 
the proposed rule under the listings Angina, Aortic valve disease, 
Cardiomyopathy, Mitral valve disease, and Pericardial disease.
     62 FR 50067, 50071 and 50072--In the proposed rule one of 
the disability tests for ``Mitral valve disease'' for trainman, 
signalman and trackman was ``Cardiac catheterization'' with a test 
result of ``Mitral valve gradient >10mm Hg.'' This disability test, and 
its test result and disability classification was deleted. Another test 
result under ``Mitral valve disease'' for ``Cardiac catheterization'' 
was ``Mitral valve gradient 5-10mm Hg.'' This test result was changed 
to ``Mitral valve gradient 5mm Hg.''
     62 FR 50068, 50069, 50070, 50073, 50074, 50075--One of the 
disability tests for ``Mitral valve disease'' for engineer, dispatcher, 
carman, machinist, shop laborer, sales representative, and general 
office clerk was ``Cardiac catheterization'' with a test result of 
``Mitral valve gradient 5-10mm Hg.'' This disability test, and its test 
result and disability classification was deleted. Another test result 
under ``Mitral valve disease'' for ``Cardiac catheterization'' was 
``Mitral valve gradient >10mm Hg.'' This result was changed to ``Mitral 
valve gradient 10mm Hg.''
     62 FR 50067, 50070, 50071, 50072--For job titles trainman, 
signalman, and trackman the disability tests were revised as follows:
Angina
--Stress test with a result of ``Peak exercise 5-7 METS'' the 
disability test, test result, and disability classification were 
deleted.
--Stress test with a result of ``Peak exercise <5 METS'' was revised to 
read ``Stress test--Peak exercise 7 METS.''
--Stress test with a result of ``Definite ischemia <7 METS'' was 
revised to read ``Stress test: Significant ST changes--Definite 
ischemia 7 METS.''
--Stress test with a result of ``Definite ischemia >7 METS'': the 
disability test, test result, and disability classification were 
deleted.
Aortic Valve Disease
--Stress test with a result of ``Peak exercise 5-7 METS'': the 
disability test, test result, and disability classification were 
deleted.
--Stress test with a result of ``Peak exercise <5 METS'' was revised to 
read: ``Peak exercise 7 METS.''
Coronary Artery Disease
--Stress test with a result of ``Peak exercise 5-7 METS'': the 
disability test, test result, and disability classification were 
deleted.
--Stress test with a result of ``Peak exercise <5 METS'' was revised to 
read: ``Stress test --Peak exercise 7 METS.''
--Stress test with a result of ``Definite ischemia < or >7 METS'' was 
revised to read: ``Stress test--Definite ischemia 7 METS.''
--Isotope, e.g., thallium study with a result of ``Definite ischemia < 
or >7 METS'' was revised to read: ``Isotope, e.g., thallium study--
definite ischemia 7 METS.''
Cardiomyopathy
--Stress test with a result of ``Peak exercise 5-7 METS'' was revised 
to read: ``Stress test--Peak exercise 7 METS.''
Mitral Valve Disease
--Stress test with a result of ``Peak exercise 5-7 METS'' was revised 
to read: to ``Peak exercise 7 METS.''

     62 FR 50067, 50068, 50069, 50070, 50072, 50073, 50074, 
50075--For job titles engineer, dispatcher, carman, machinist, shop 
laborer, sales representative, and general office clerk

[[Page 7540]]

the disability tests were revised as follows:
Angina
--Stress test with a result of ``Peak exercise 5-7 METS'' the 
disability test, test result and disability classification were 
deleted.
--Stress test with a result of ``Peak exercise <5 METS'' was revised to 
read: ``Stress test--Peak exercise 5 METS.''
--Stress test: significant ST changes with a result of ``Definite 
ischemia <7 METS'' was revised to read: ``Stress test--Definite 
ischemia 5 METS.''
--Stress test: significant ST changes with a result of ``Definite 
ischemia >7 METS'': the disability test, test result, and disability 
classification were deleted.
Aortic Valve Disease
--Stress test with a result of ``Peak exercise 5-7 METS'': the 
disability test, test result, and disability classification were 
deleted.
--Stress test with a result of ``Peak exercise <5 METS'' was revised to 
read: ``Stress test--Peak exercise 5 METS.''
Coronary Artery Disease
--Stress test with a result of ``Peak exercise 5-7 METS'': the 
disability test, test result, and disability classification were 
deleted.
--Stress test with a result of ``Peak exercise <5 METS'' was revised to 
read: ``Stress test--Peak exercise 5 METS.''
--Stress test with a result of ``Definite ischemia < or >7 METS'' was 
revised to read: ``Stress test--Definite ischemia 5 METS.''
--Isotope, e.g., thallium study with a result of ``Definite ischemia < 
or >7 METS'' was revised to read: ``Isotope, e.g., thallium study--
Definite ischemia 5 METS.''
Cardiomyopathy
--Stress test with a result of ``Peak exercise 5-7 METS'' was revised 
to read: ``Stress test--Peak exercise 5 METS.''
Mitral Valve Disease
--Stress test with a result of ``Peak exercise 5-7 METS'' was revised 
to read: ``Stress test--Peak exercise 5 METS.''

     62 FR 50067 through 50074--For job titles trainman, 
engineer, dispatcher, carman, signalman, trackman, machinist, and shop 
laborer, under the listing of ``Hypertension,'' the disability test of 
``Medical record review'' with a result of ``Diastolic >120 and 
systolic >160, 50% of the time''; the disability test, test result, and 
disability classification were deleted. For sales representative, under 
the listing ``Hypertension,'' the disability test of ``Medical record 
review'' with a result of ``Diastolic >120 and systolic >160, 50% of 
the time'': the following was added: ``and evidence of end organ damage 
(blood creatinine >2; urinary protein >\1/2\ gm; or EKG evidence of 
ischemia).''
     62 FR 50067 through 50075--For all job titles, under 
``Ventricular ectopy,'' the disability test of ``Medical record 
review'' with a result of ``Surgical rhythm procedure'' and the 
disability classification were deleted.

D. Respiratory

     62 FR 50076 through 50080--The listing ``Asbestosis'' was 
removed and, consequently, the designated confirmatory tests for this 
condition were also removed.
     62 FR 50076 through 50080--The listing ``Sleep Apnea'' was 
removed and, consequently, the designated confirmatory tests for this 
condition were also removed.
     62 FR 50076--The confirmatory tests for ``Silicosis,'' 
``Chest X-ray (ILO interpreted)'' with a minimum result of ``At least 
1/0 by NIOSH B reader,'' was removed.
     62 FR 50076--The confirmatory test for ``Restrictive lung 
disease'' designated ``Diffusing capacity'' was changed to read: 
``DLCO.''
     62 FR 50076--The parenthetical ``(race adjusted)'' in the 
confirmatory test ``Spirometry'' for ``Restrictive lung disease'' was 
removed.
     62 FR 50077 through 50080--The disability test for 
``Pulmonary fibrosis'' and ``Restrictive lung disease'' for trainman, 
carman, signalman, trackman, machinist, and shop laborer designated 
``Diffusing capacity for CO'' was changed to read: ``DLCO.''
     62 FR 50076 through 50080--The disability test for 
``Asthma'' and ``Chronic bronchitis'' for trainman, carman, signalman, 
trackman, machinist, and shop laborer designated ``Spirometry'' has an 
accompanying test result of ``FEV1 with adequate treatment <40% 
predicted.'' The test result was changed to: ``Repeated spirometry FEV1 
<40% over a 12-month period.''
     62 FR 50077 through 50080--Under the listing 
Bronchiectasis, Chronic Bronchitis, Chronic Obstructive Pulmonary 
Disease (COPD), Pulmonary Fibrosis, and Silicosis for the job titles 
trainman, carman, signalman, trackman, machinist, and shop laborer the 
disability test ``PCO2 arterial'' was changed to read: ``Resting ABG,'' 
and its accompanying test result was revised to read: ``PCO2 arterial 
>50mm Hg if stable.''
     62 FR 50077 through 50080--Under the listings 
Bronchiectasis, Chronic Bronchitis, Chronic Obstructive Pulmonary 
Disease (COPD), and Pulmonary Fibrosis for the job titles trainman, 
carman, signalman, trackman, machinist, and shop laborer the disability 
test ``Pulmonary exercise test'' with a test result of ``PO2 drop >5 
torr at maximum exercise'' was changed to read ``Pulmonary exercise 
test or exercise ABG.''

F. CE Spine

     62 FR 50093--Under the listing ``Rheumatoid arthritis: 
cervical'' the minimum result under the confirmatory test of 
``Rheumatoid factor (blood test)'' was changed from ``High titer'' to 
``Titer of rheumatoid factor.''
     62 FR 50094 through 50097--The disability test for 
``Spondylogenic compression of spinal cord:'' for trainman, engineer, 
carman, signalman, trackman, machinist, and shop laborer designated 
``Physical examination: lower limb'' has an accompanying test result of 
``Lower extremity weakness or spasticity.'' The test result was changed 
to: ``Lower extremity weakness or significant spasticity.''
     62 FR 50094 through 50097--The disability test for 
trainman, engineer, carman, signalman, trackman, machinist, and shop 
laborer designated ``Physical examination: cervical'' was changed to 
read ``Physical examination.'' This disability test can be found under 
the listings Cervical disc disease with myelopathy, Chronic herniated 
disc, Cervical spondylolysis, Cervical intervertebral disc 
degeneration, Fracture: posterior element with spinal canal 
displacement, Post-laminectomy syndrome, Cervical radiculopathy, and 
Spondylogenic compression of spinal cord.

G. Shoulder

     62 FR 50097--The confirmatory test ``Permanent functional 
limitation, elbow:'' was changed to ``Medical diagnosis leading to a 
permanent functional limitation of the elbow.''
     62 FR 50098 through 50099--The disability test for 
trainman, engineer, carman, signalman, trackman, machinist, and shop 
laborer under the listing ``Permanent functional limitation, elbow:'' 
was ``Physical examination--range of motion.'' Its accompanying test 
result ``Flexion limit to 60 degrees (30 degrees from 90)'' was changed 
to ``Flexion limited to 60 degrees.''

[[Page 7541]]

H. Hand and Arm

     62 FR 50099--The confirmatory tests for ``Carpal tunnel 
syndrome'' designated ``Physical examination'' with a minimum result of 
``Tinel's or Phalen's sign suggestive but not confirming'' was removed.
     62 FR 50099--One of the confirmatory tests for 
``Rheumatoid arthritis: hand'' is ``Rheumatoid factor.'' The minimum 
result for this test was changed from ``High titer'' to ``Titer of 
rheumatoid factor.''
     62 FR 50100 through 50104--A disability test for trainman, 
carman, signalman, trackman, machinist, and shop laborer was ``Strength 
(jamar)'' with a test result for dominant and non-dominant hands for 
female and male. All references to these tests, their results and 
disability classifications were deleted. These disability tests were 
found in the proposed rule under the listings: Carpal tunnel syndrome, 
Fracture wrist, Hand permanent functional limitation, and Wrist 
permanent functional limitation.
     62 FR 50100 through 50104--Two of the disability tests for 
the listing ``Thumb: permanent functional limitation'' were ``Adduction 
of thumb'' and ``Opposition'' with a result of ``Loss <=7 cm.'' These 
disability tests, test results, and disability classifications were 
removed for all job titles.

I. Hip

     62 FR 50105--One of the confirmatory tests for ``Paget's 
disease'' is ``X-ray: hip.'' The minimum result for this test was 
changed from ``Osteolytic and blastic lesions'' to ``Osteolytic or 
blastic lesions.''

J. Knee

     62 FR 50108--The confirmatory test for ``Patellar-7 
subluxation-recurrent'' is a ``Medical record review.'' The minimum 
result for this testing in the proposed rule was ``History of recurrent 
subluxation with associated signs.'' The phrase ``with associated 
signs'' was removed.

K. Ankle and Foot

     62 FR 50116 through 50120--One of the disability tests for 
the listing ``Rheumatoid arthritis, foot:'' is a ``Medical record 
review.'' Its accompanying test result in the proposed rule was 
``Frequent flare-up with treatment.'' This test result was changed to 
``Chronic flare-up with treatment.''
    The Board has determined that this is a significant rule under 
Executive Order 12866. The Office of Management and Budget has approved 
the information collection (Job Information Report, RRB Forms G-251a 
and G-251b found in Appendix 3 of this part) associated with this rule 
and assigned it OMB control number 3220-0193.

List of Subjects in 20 CFR Part 220

    Disability benefits, Railroad employees, Railroad retirement, 
Reporting and recordkeeping requirements.

    For the reasons set forth in the preamble, part 220 of title 20 of 
the Code of Federal Regulations is amended as follows:

PART 220--DETERMINING DISABILITY

    1. The authority citation for part 220 continues to read as 
follows:

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

    2. The heading 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 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 cooperation of employers and employees. 
This subpart is supplemented by an Occupational Disability Claims 
Manual (Manual) 1  which was also developed with the 
cooperation of employers and employees.
---------------------------------------------------------------------------

    \1\ The Manual may be obtained from the Board's headquarters at 
844 North Rush Street, Chicago, IL 60611.
---------------------------------------------------------------------------

    (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, 
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.
    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.
    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.
    Residual functional capacity has the same meaning as found in 
Sec. 220.120.


Sec. 220.12  [Removed]


Sec. 220.14  [Redesignated as Sec. 220.12]

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

[[Page 7542]]

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:
* * * * *
    (b) If the Board finds that the claimant does not have an 
impairment described in paragraph (a) of this section, it will--
    (1) Determine the employee's regular railroad occupation, as 
defined in Sec. 220.11, 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)(A) 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--
    (1) The ``highly recommended'' and ``recommended'' tests set forth 
in Appendix 3 of this part that relate to the body part affected by the 
claimant's impairment(s); or
    (2) By using valid diagnostic tests accepted by the medical 
community as described in Sec. 220.27.
    (B) If the employee's impairment(s) cannot be confirmed because 
there are significant differences in objective tests such as imaging 
study, electrocardiograms or other test results, and these differences 
cannot be readily resolved, the Board will determine if the employee is 
disabled under ICE as set forth in paragraph (b)(2)(iv) of this 
section. However, if the employee's impairment(s) cannot be confirmed, 
and there are no significant differences in objective medical tests 
which cannot be readily resolved, then the employee will be found not 
disabled.
    (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'' (disabled) 
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 impairment(s) has not been confirmed, 
as provided for in paragraph (b)(2)(ii)(A)(2) of this section, the 
Board will next confirm the employee's impairment(s), as described in 
paragraph (b)(2)(ii)(A)(2) 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, which describes the weight to 
be given to the opinions of various physicians, and Sec. 220.114, which 
describes how the Board evaluates symptoms such as pain. The Board will 
also assess the weight of evidence by utilizing Sec. 220.14, 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 there 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 to 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;
    (F) Step 6. Based upon the assessment of the evidence in paragraph 
(b)(2)(iv)(D) 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.

[[Page 7543]]

    (b) Factors which support lesser weight. Evidence will generally be 
given lesser weight if it meets one or more of the following criteria:
    (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 is 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.
    8. Appendix 3--Railroad Retirement Board Occupational Disability 
Standards is added to part 220 to read as follows:

Appendix 3--Railroad Retirement Board Occupational Disability Standards

1. Introduction

    1.01  The Board uses this appendix to adjudicate the 
occupational disability claims of employees with medical conditions 
and job titles covered by the Tables in this appendix. The Tables 
are divided into ``Body Parts'', with each Body Part further divided 
by job title. Under each job title there is a list of impairments 
and tests with accompanying test results which establish a finding 
of ``D'' (disabled). The use of these Tables is a three-step 
process. In the first step we determine whether the employee's 
regular railroad occupation is covered by the Tables; next we 
establish the existence of an impairment covered by the Tables; 
finally, we reach a disability determination. If we do not find an 
employee disabled under these Tables, the employee may still be 
found disabled using Independent Case Evaluation (ICE), as explained 
in subpart C of this part.
    1.02  The Cancer Tables are treated in a different way than 
other body systems. Different types of cancer and their treatments 
have different functional impacts. In the Cancer Tables the impact 
of the impairment is seen as being significant or not significant. 
Therefore, these tables contain an ``S'' (significant) which is 
equivalent to a ``D'' rating. A detailed explanation of how to use 
those tables is in that section. The steps to use the remaining 
Tables are explained below:

2. Confirming the Impairment

    2.01  Once we determine that the employee's regular railroad 
occupation is covered by the Job Titles in the Tables, we must 
determine the existence of an impairment covered by the Tables. This 
is done through the use of Confirmatory Tests. These tests can 
include information from medical records, surgical or operative 
reports, or specific diagnostic test results. Confirmatory Tests are 
listed in the initial section regarding each Body Part covered in 
the Tables. If an impairment cannot be confirmed because of 
inconsistent medical information, ICE may be required.
    2.02  There are two types of Confirmatory Tests as follows.
    2.03  ``Highly Recommended'' Tests--The designation of a 
confirmatory test as being ``highly recommended'' means that the 
test is almost always performed to confirm the existence of the 
impairment. For many conditions, only one ``highly recommended'' 
test finding is suggested to confirm the impairment. However, there 
may be times when that test is not available or is negative, but 
other more detailed testing confirms the impairment.
    2.04  Example A: To confirm the condition of pulmonary 
hypertension, the Tables under Body Part C., Cardiac, designate as 
``highly recommended'': an electrocardiogram which indicates 
definite right ventricular hypertrophy. However, the impairment may 
also be confirmed by insertion of a Swan-Ganz catheter into the 
pulmonary artery and the pulmonary artery pressure measured 
directly.
    2.05  There may be some conditions for which several ``highly 
recommended'' tests are suggested to confirm an impairment. In these 
circumstances, we will use all ``highly recommended'' tests to 
establish the existence of the impairment.
    2.06  Example B: Under Body Part E., Lumbar Sacral Spine, three 
highly recommended medical findings are identified for the diagnosis 
of chronic back pain, not otherwise specified. These findings 
include:
    A. A history of back pain under medical treatment for at least 
one year, and
    B. A history of back pain unresponsive to therapy for at least 
one year, and
    C. A history of back pain with functional limitations for at 
least one year.
    2.07  All three of these criteria must be satisfied to confirm 
the existence of chronic back pain.
    2.08  Sometimes the employee may have undergone detailed testing 
which is as reliable as one of the ``highly recommended'' tests 
listed in the Tables. In cases where an impairment has not been 
confirmed by one of the designated ``highly recommended'' tests, the 
impairment may still be confirmed by ``recommended'' tests (see 
below) or by evidence acceptable under section 220.27 of this part.
    2.09  Recommended Tests--The designation of a confirmatory test 
as ``recommended'' means that the test need not be performed, or be 
positive, to confirm the impairment. However, a positive test 
provides significant support for confirming the impairment. If there 
are no ``highly recommended'' tests for confirming the impairment, 
at least one of the ``recommended'' tests should be positive.
    2.10  There are two categories of recommended tests which are 
described below.
    A. Imaging studies--These studies can include MRI, CAT scan, 
myelogram, or plain film x-rays. For conditions where several of 
these imaging studies are identified as ``recommended'' tests, at 
least one of the test results should be positive and meet the 
confirmatory test criteria. For some conditions, such as 
degenerative disc condition, there are several equivalent imaging 
methods to confirm a diagnosis.
    B. Other tests--This category of tests refers to non-imaging 
studies.
    2.11  If there are no ``highly recommended'' confirmatory tests 
designated to confirm an impairment and the ``recommended'' 
confirmatory tests only include non-imaging procedures, at least one 
of these tests should be positive to confirm the impairment. The 
greater the number of tests that are positive, the greater the 
confidence that the correct diagnosis has been established.
    2.12  Example: Under Body Part C., Cardiac, the diagnostic 
confirmatory tests for ventricular ectopy, a cardiac arrhythmia, 
include the following ``recommended'' tests:
    A. Medical record review, i.e., a review of the claimant's 
medical records, or
    B. Holter monitoring, or
    C. Provocative testing producing a definite arrhythmia.
    2.13  In this situation, only one of the ``recommended'' 
confirmatory tests need be positive to confirm the impairment. 
However, the more tests that are positive, the stronger the support 
for the diagnosis.
    2.14  In no circumstance will the Board require that an invasive 
test be performed to confirm an impairment. Several of the 
Confirmatory Tests which are described in the Tables are invasive 
and it is not the intention of the Board to suggest that these be 
performed. The inclusion of invasive tests in the Tables 
Confirmatory Tests section is intended to help the Board evaluate 
the significance of findings from such tests that may have already 
been performed and which are part of the submitted medical record.
    2.15  If an employee's impairment(s) cannot be confirmed by use 
of the confirmatory tests listed in the Tables, it still may be 
confirmed by medical evidence described in section 220.27 of this 
part. However, if a claimant's impairment(s) cannot be confirmed 
through use of the Tables or under section 220.27, and the medical 
evidence is complete and in concordance, the claimant will be found 
not disabled.

3. Disability Determination

    3.01  Once the Board determines that the employee's regular 
railroad occupation is covered by one of the Job Titles in the 
Tables and that his or her alleged impairment fits into a Body Part 
covered by the Tables and can be confirmed, we examine the results 
of any of the disability tests listed under the impairment. If the 
results from any of these tests indicate a ``D'' finding, the 
employee is found disabled. If none of the test results

[[Page 7544]]

indicate a ``D'' finding, then the employee's claim is evaluated 
using ICE.
    3.02  Example: A trainman has angina as confirmed by the 
recommended tests under Body Part A: Cardiac--Angina. An 
echocardiogram shows that he has poor ejection fraction 
35%. The employee is rated disabled. If none of the 
results of the listed disability tests match the results required 
for a ``D'' finding, then the employee's claim is evaluated under 
ICE.

Tables

    A. Cancer
    B. Endocrine
    C. Cardiac
    D. Respiratory
    E. Lumbar Sacral Spine
    F. Cervical Spine
    G. Shoulder and Elbow
    H. Hand and Arm
    I. Hip
    J. Knee
    K. Ankle and Foot

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 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 in the Tables 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:                                                                                                         
  Local..........................  ....................               84.5                  2                  S
  Regional.......................  ....................               50.7                  2                  S

[[Page 7545]]

                                                                                                                
  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:\5\                                                                                               
  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.                                                                                   
\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.)                                                                          
\5\Small cell carcinoma is classified as a 1.                                                                   


[[Page 7546]]


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


                                                   C. Cardiac                                                   
----------------------------------------------------------------------------------------------------------------
          Confirmatory test                    Minimum result                        Requirements               
----------------------------------------------------------------------------------------------------------------
                                               BODY PART: CARDIAC                                               
                                               CONFIRMATORY TESTS                                               
----------------------------------------------------------------------------------------------------------------
Angina:                                                                                                         
  Medical record review..............   Confirmed history of           Recommended.                             
                                        ischemia including copies of                                            
                                        electrocardiogram.                                                      
  Stress test........................   Definite ischemia on           Recommended.                             
                                        exercise 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 occlusion (>60%) of   Recommended.                             
                                        one vessel.                                                             
Cardiomyopathy:                                                                                                 
  Echocardiogram.....................   Proven ejection fraction 35%   Recommended.                             
  Catheterization....................   Poor global function and not   Recommended.                             
                                        coronary artery disease.                                                
Hypertension:                                                                                                   
  Medical record review..............   Documentation of               Highly recommended.                      
                                        hypertension 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 7547]]


----------------------------------------------------------------------------------------------------------------
           Disability test                      Test result                    Disability classification        
----------------------------------------------------------------------------------------------------------------
                                               BODY PART: CARDIAC                                               
                                               JOB TITLE: TRAINMAN                                              
----------------------------------------------------------------------------------------------------------------
Angina:                                                                                                         
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 7 METS........   D                                        
  Medical record review..............   Unstable as diagnosed by       D                                        
                                        cardiologist.                                                           
  Stress test........................   Documented hypotensive         D                                        
                                        response.                                                               
  Stress test: significant ST changes   Definite ischemia 7 METS....   D                                        
Aortic valve disease:                                                                                           
  Cardiac catheterization............   Aortic gradient 25 - 50 mm                                              
                                        HG.                                                                     
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 7 METS........   D                                        
Coronary artery disease:                                                                                        
  Myocardial infarction..............   Multiple infarctions........   D                                        
  Echocardiogram.....................   Confirmed ventricular          D                                        
                                        aneurysm.                                                               
  Cardiac catheterization............   Aortic gradient 25 - 50 mm     D                                        
                                        Hg.                                                                     
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 7 METS........   D                                        
  Medical record review..............   Unstable as diagnosed by a     D                                        
                                        Cardiologist.                                                           
  Stress test........................   Documented hypotensive         D                                        
                                        response.                                                               
  Stress test........................   Definite ischemia  7 METS...   D                                        
  Isotope, e.g., thallium study......   Definite ischemia  7 METS...   D                                        
Cardiomyopathy:                                                                                                 
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 7 METS........   D                                        
Hypertension:                                                                                                   
  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 mm     D                                        
                                        Hg.                                                                     
  Cardiac catheterization............   Mitral regurgitation severe.   D                                        
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 7 METS........   D                                        
Pericardial disease:                                                                                            
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
Ventricular ectopy:                                                                                             
  Medical record review..............   Documented life threatening    D                                        
                                        arrhythmia.                                                             
  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.....................   Poor ejection fraction 35%..   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 changes   Definite ischemia 5 METS....   D                                        
Aortic valve disease:                                                                                           
  Cardiac catheterization............   Aortic gradient 25 - 50 mm     D                                        
                                        HG.                                                                     
  Echocardiogram.....................   Poor ejection fraction 35%..   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     D                                        
                                        Hg.                                                                     
  Cardiac catheterization............   Poor ejection fraction 35%..   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 5 METS....   D                                        

[[Page 7548]]

                                                                                                                
  Isotope, e.g., thallium study......   Definite ischemia 5 METS....   D                                        
Cardiomyopathy:                                                                                                 
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 5 METS........   D                                        
Hypertension:                                                                                                   
  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 10 mm    D                                        
                                        Hg.                                                                     
  Cardiac catheterization............   Mitral regurgitation severe.   D                                        
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 5 METS........   D                                        
Pericardial disease:                                                                                            
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
Ventricular ectopy:                                                                                             
  Medical record review..............   Documented life threatening    D                                        
                                        arrhythmia.                                                             
  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.....................   Poor ejection fraction 35%..   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 changes   Definite ischemia 5 METS....   D                                        
Aortic valve disease:                                                                                           
  Cardiac catheterization............   Aortic gradient 25 - 50 mm     D                                        
                                        Hg.                                                                     
  Echocardiogram.....................   Poor ejection fraction 35%..   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     D                                        
                                        Hg.                                                                     
  Cardiac catheterization............   Poor ejection fraction 35%..   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 5 METS....   D                                        
  Isotope, e.g., thallium study......   Definite ischemia 5 METS....   D                                        
Cardiomyopathy:                                                                                                 
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 5 METS........   D                                        
Hypertension:                                                                                                   
  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 10 mm    D                                        
                                        Hg.                                                                     
  Cardiac catheterization............   Mitral regurgitation severe.   D                                        
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 5 METS........   D                                        
Pericardial disease:                                                                                            
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
Ventricular ectopy:                                                                                             
  Medical record review..............   Documented life threatening    D                                        
                                        arrhythmia.                                                             

[[Page 7549]]

                                                                                                                
  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.....................   Poor ejection fraction 35%..   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 changes   Definite ischemia 5 METS....   D                                        
Aortic valve disease:                                                                                           
  Cardiac catheterization............   Aortic gradient 25 - 50 mm                                              
                                        HG.                                                                     
  Echocardiogram.....................   Poor ejection fraction 35%..   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     D                                        
                                        Hg.                                                                     
  Cardiac catheterization............   Poor ejection fraction 35%..   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  5 METS...   D                                        
  Isotope, e.g., thallium study......   Definite ischemia  5 METS...   D                                        
Cardiomyopathy:                                                                                                 
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 5 METS........   D                                        
Hypertension:                                                                                                   
  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 10 mm    D                                        
                                        Hg.                                                                     
  Cardiac catheterization............   Mitral regurgitation severe.   D                                        
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 5 METS........   D                                        
Pericardial disease:                                                                                            
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
Ventricular ectopy:                                                                                             
  Medical record review..............   Documented life threatening    D                                        
                                        arrhythmia.                                                             
  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.....................   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 7 METS........   D                                        
  Medical record review..............   Unstable as diagnosed by       D                                        
                                        cardiologist.                                                           
  Stress test........................   Documented hypotensive         D                                        
                                        response.                                                               
  Stress test: significant ST changes   Definite ischemia 7 METS....   D                                        
Aortic valve disease:                                                                                           
  Cardiac catheterization............   Aortic gradient 25 - 50 mm     D                                        
                                        HG.                                                                     
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 7 METS........   D                                        
Coronary artery disease:                                                                                        
  Myocardial infarction..............   Multiple infractions........   D                                        

[[Page 7550]]

                                                                                                                
  Echocardiogram.....................   Confirmed ventricular          D                                        
                                        aneurysm.                                                               
  Cardiac catheterization............   Aortic gradient 25 - 50 mm     D                                        
                                        Hg.                                                                     
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 7 METS........   D                                        
  Medical record review..............   Unstable as diagnosed by       D                                        
                                        cardiologist.                                                           
  Stress test........................   Documented hypotensive         D                                        
                                        response.                                                               
  Stress test........................   Definite ischemia 7 METS....   D                                        
  Isotope, e.g., thallium study......   Definite ischemia 7 METS....   D                                        
Cardiomyopathy:                                                                                                 
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 7 METS........   D                                        
Hypertension:                                                                                                   
  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 mm     D                                        
                                        Hg.                                                                     
  Cardiac catherization..............   Mitral regurgitation severe.   D                                        
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 7 METS........   D                                        
Pericardial disease:                                                                                            
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
Ventricular ectopy:                                                                                             
  Medical record review..............   Documented life threatening    D                                        
                                        arrhythmia.                                                             
  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.....................   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 7 METS........   D                                        
  Medical record review..............   Unstable as diagnosed by       D                                        
                                        cardiologist.                                                           
  Stress test........................   Documented hypotensive         D                                        
                                        response.                                                               
  Stress test: significant ST changes   Definite ischemia 7 METS....   D                                        
Aortic valve disease:                                                                                           
  Cardiac catheterization............   Aortic gradient 25 - 50 mm     D                                        
                                        HG.                                                                     
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 7 METS........   D                                        
Coronary artery disease:                                                                                        
  Myocardial infarction..............   Multiple infarctions........   D                                        
  Echocardiogram.....................   Confirmed ventricular          D                                        
                                        aneurysm.                                                               
  Cardiac catheterization............   Aortic gradient 25 - 50 mm     D                                        
                                        Hg.                                                                     
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 7 METS........   D                                        
  Medical record review..............   Unstable as diagnosed by a     D                                        
                                        cardiologist.                                                           
  Stress test........................   Documented hypotensive         D                                        
                                        response.                                                               
  Stress test........................   Definite ischemia 7 METS....   D                                        
  Isotope, e.g., thallium study......   Definite ischemia 7 METS....   D                                        
Cardiomyopathy:                                                                                                 
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 7 METS........   D                                        
Hypertension:                                                                                                   
  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 mm     D                                        
                                        Hg.                                                                     
  Cardiac catheterization............   Mitral regurgitation severe.   D                                        

[[Page 7551]]

                                                                                                                
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 7 METS........   D                                        
Pericardial disease:                                                                                            
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
Ventricular ectopy:                                                                                             
  Medical record review..............   Documented life threatening    D                                        
                                        arrhythmia.                                                             
  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.....................   Poor ejection fraction 35%..   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 changes   Definite ischemia 5 METS....   D                                        
Aortic valve disease:                                                                                           
  Cardiac catheterization............   Aortic gradient 25 - 50 mm                                              
                                        HG.                                                                     
  Echocardiogram.....................   Poor ejection fraction 35%..   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     D                                        
                                        Hg.                                                                     
  Cardiac catheterization............   Poor ejection fraction 35%..   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 5 METS....   D                                        
  Isotope, e.g., thallium study......   Definite ischemia 5 METS....   D                                        
Cardiomyopathy:                                                                                                 
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 5 METS........   D                                        
Hypertension:                                                                                                   
  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 10 mm    D                                        
                                        Hg.                                                                     
  Cardiac catheterization............   Mitral regurgitation severe.   D                                        
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 5 METS........   D                                        
Pericardial disease:                                                                                            
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
Ventricular ectopy:                                                                                             
  Medical record review..............   Documented life threatening    D                                        
                                        arrhythmia.                                                             
  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.....................   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 5 METS........   D                                        
  Medical record review..............   Unstable as diagnosed by       D                                        
                                        cardiologist.                                                           

[[Page 7552]]

                                                                                                                
  Stress test........................   Documented hypotensive         D                                        
                                        response.                                                               
  Stress test: significant ST changes   Definite ischemia 5 METS....   D                                        
Aortic valve disease:                                                                                           
  Cardiac catheterization............   Aortic gradient 25 - 50 mm                                              
                                        HG.                                                                     
  Echocardiogram.....................   Poor ejection fraction 35%..   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............   Poor ejection fraction 35%..   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 5 METS....   D                                        
  Isotope, e.g., thallium study......   Definite ischemia 5 METS....   D                                        
Cardiomyopathy:                                                                                                 
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 5 METS........   D                                        
Hypertension:                                                                                                   
  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 10 mm    D                                        
                                        Hg.                                                                     
  Cardiac catheterization............   Mitral regurgitation severe.   D                                        
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 5 METS........   D                                        
Pericardial disease:                                                                                            
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
Ventricular ectopy:                                                                                             
  Medical record review..............   Documented life threatening    D                                        
                                        arrhythmia.                                                             
  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.....................   Poor ejection fraction 35%..   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 changes   Definite ischemia 5 METS....   D                                        
Aortic valve disease:                                                                                           
  Cardiac catheterization............   Aortic gradient 25 - 50 mm     D                                        
                                        HG.                                                                     
  Echocardiogram.....................   Poor ejection fraction 35%..   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     D                                        
                                        Hg.                                                                     
  Cardiac catheterization............   Poor ejection fraction 35%..   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 5 METS....   D                                        
  Isotope, e.g., thallium study......   Definite ischemia 5 METS....   D                                        
Cardiomyopathy:                                                                                                 
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 5 METS........   D                                        

[[Page 7553]]

                                                                                                                
Hypertension:                                                                                                   
  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 10 mm    D                                        
                                        Hg.                                                                     
  Cardiac catheterization............   Mitral regurgitation severe.   D                                        
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 5 METS........   D                                        
Pericardial disease:                                                                                            
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
Ventricular ectopy:                                                                                             
  Medical record review..............   Documented life threatening    D                                        
                                        arrhythmia.                                                             
  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.....................   Poor ejection fraction 35%..   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 changes   Definite ischemia 5 METS....   D                                        
Aortic valve disease:                                                                                           
  Cardiac catheterization............   Aortic gradient 25 - 50 mm     D                                        
                                        HG.                                                                     
  Echocardiogram.....................   Poor ejection fraction 35%..   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     D                                        
                                        Hg.                                                                     
  Cardiac catheterization............   Poor ejection fraction 35%..   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 5 METS....   D                                        
  Isotope, e.g., thallium study......   Definite ischemia 5 METS....   D                                        
Cardiomyopathy:                                                                                                 
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 5 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 10 mm    D                                        
                                        Hg.                                                                     
  Cardiac catheterization............   Mitral regurgitation severe.   D                                        
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
  Stress test........................   Peak exercise 5 METS........   D                                        
Pericardial disease:                                                                                            
  Cardiac catheterization............   Poor ejection fraction 35%..   D                                        
  Echocardiogram.....................   Poor ejection fraction 35%..   D                                        
Ventricular ectopy:                                                                                             
  Medical record review..............   Documented life threatening    D                                        
                                        arrhythmia.                                                             
  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                                        
----------------------------------------------------------------------------------------------------------------


[[Page 7554]]


                                                 D. Respiratory                                                 
----------------------------------------------------------------------------------------------------------------
          Confirmatory test                    Minimum result                        Requirements               
----------------------------------------------------------------------------------------------------------------
                                                                                                                
---------------------------------------------BODY PART: RESPIRATORY---------------------------------------------
                                               CONFIRMATORY TESTS                                               
----------------------------------------------------------------------------------------------------------------
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%       Highly recommended.                      
                                        when stable.                                                            
  Spirometry.........................   FEV1 below 75% of predicted    Highly recommended.                      
                                        when stable.                                                            
Cor pulmonale:                                                                                                  
  Electrocardiogram..................   Definite right ventricular     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       Highly recommended.                      
                                        with chest tube drainage.                                               
Restrictive lung disease:                                                                                       
  Chest X-ray........................   Restrictive lung changes....   Recommended.                             
  DLCO...............................   Abnormal....................   Highly recommended.                      
  Chest CAT scan.....................   Restrictive lung changes....   Recommended.                             
  Spirometry.........................   FVC <75% predicted..........   Highly recommended.                      
Silicosis:                                                                                                      
  Medical record review..............   Occupational exposure for at   Highly recommended.                      
                                        least 1 year.                                                           
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                                              
----------------------------------------------------------------------------------------------------------------
Asthma:                                                                                                         
  Spirometry.........................   Repeated spirometry FEV1                                                
                                        <40% over a 12 month period.                                            
Bronchiectasis:                                                                                                 
  Resting ABG........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 exercise.                                                               
  Pulmonary exercise test............   Maximum VO2 <15 ml/kg.......   D                                        
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
Chronic bronchitis:                                                                                             
  Spirometry.........................   Repeated spirometry FEV1       D                                        
                                        <40% over a 12 month period.                                            
  Resting ABG........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 exercise.                                                               
  Pulmonary exercise test............   Maximum VO2 <15 ml/kg.......   D                                        
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
Chronic obstructive pulmonary disease                                                                           
 (COPD):                                                                                                        
  Resting ABG........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 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:                                                                                             
  Resting ABG........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
  DLCO...............................   <45% predicted..............   D                                        

[[Page 7555]]

                                                                                                                
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 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:                                                                                       
  DLCO...............................   <45% predicted..............   D                                        
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 exercise.                                                               
  Pulmonary exercise test............   Maximum VO2 <15 ml/kg.......   D                                        
  Spirometry.........................   FVC <50% predicted..........   D                                        
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
Silicosis:                                                                                                      
  Resting ABG........................   PCO2 arterial >50 mm Hg If     D                                        
                                        stable.                                                                 
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: RESPIRATORY                                             
                                                JOB TITLE: CARMAN                                               
----------------------------------------------------------------------------------------------------------------
Asthma:                                                                                                         
  Spirometry.........................   Repeated spirometry FEV1       D                                        
                                        <40% over a 12 month period.                                            
Bronchiectasis:                                                                                                 
  Resting ABG........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 exercise.                                                               
  Pulmonary exercise test............   Maximum VO2 <15 ml/kg.......   D                                        
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
Chronic bronchitis:                                                                                             
  Spirometry.........................   Repeated spirometry FEV1       D                                        
                                        <40% over a 12 month period.                                            
  Resting ABG........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 exercise.                                                               
  Pulmonary exercise test............   Maximum VO2 <15 ml/kg.......   D                                        
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
Chronic obstructive pulmonary disease                                                                           
 (COPD):                                                                                                        
  Resting ABG........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 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:                                                                                             
  Resting ABG........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
  DLCO...............................   <45% predicted..............   D                                        
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 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:                                                                                       
  DLCO...............................   <45% predicted..............   D                                        
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 exercise.                                                               
  Pulmonary exercise test............   Maximum VO2 <15 ml/kg.......   D                                        
  Spirometry.........................   FVC <50% predicted..........   D                                        
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
Silicosis:                                                                                                      
  Resting ABG........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: RESPIRATORY                                             
                                              JOB TITLE: SIGNALMAN                                              
----------------------------------------------------------------------------------------------------------------
Asthma:                                                                                                         
  Spirometry.........................   Repeated spirometry FEV1       D                                        
                                        <40% over a 12 month period.                                            
Bronchiectasis:                                                                                                 
  Resting ABG........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 exercise.                                                               
  Pulmonary exercise test............   Maximum VO2 <15 ml/kg.......   D                                        
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
Chronic bronchitis:                                                                                             
  Spirometry.........................  Repeated spirometry FEV1 <40%   D                                        
                                        over a 12 month period.                                                 

[[Page 7556]]

                                                                                                                
  Resting ABG........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 exercise.                                                               
  Pulmonary exercise test............   Maximum VO2 <15 ml/kg.......   D                                        
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
Chronic obstructive pulmonary disease                                                                           
 (COPD):                                                                                                        
  Resting ABG........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 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:                                                                                             
  Resting ABG........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 
  DLCO...............................   <45% predicted..............   D                                        
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 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:                                                                                       
  DLCO...............................   <45% predicted..............   D                                        
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 exercise.                                                               
  Pulmonary exercise test............   Maximum VO2 <15 ml/kg.......   D                                        
  Spirometry.........................   FVC <50% predicted..........   D                                        
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
Silicosis:                                                                                                      
  Resting AGB........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: RESPIRATORY                                             
                                               JOB TITLE: TRACKMAN                                              
----------------------------------------------------------------------------------------------------------------
Asthma:                                                                                                         
  Spirometry.........................   Repeated spirometry FEV1       D                                        
                                        <40% over a 12 month period.                                            
Bronchiectasis:                                                                                                 
  Resting ABG........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 
  Pulmonary exercise test or exercise   PO2 >5 torr at maximum         D                                        
   ABG.                                 exercise.                                                               
  Pulmonary exercise test............   Maximum VO2 <15 ml/kg.......   D                                        
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
Chronic bronchitis:                                                                                             
  Spirometry.........................   Repeated spirometry FEV1       D                                        
                                        <40% over a 12 month period.                                            
  Resting ABG........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 exercise.                                                               
  Pulmonary exercise test............   Maximum VO2 <15 ml/kg.......   D                                        
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
Chronic obstructive pulmonary disease                                                                           
 (COPD):                                                                                                        
  Resting ABG........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 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:                                                                                             
  Resting ABG........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
  DLCO...............................   <45% predicted..............   D                                        
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 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:                                                                                       
  DLCO...............................   <45% predicted..............   D                                        
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 exercise.                                                               
  Pulmonary exercise test............   Maximum VO2 <15 ml/kg.......   D                                        
  Spirometry.........................   FVC <50% predicted..........   D                                        
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
Silicosis:                                                                                                      
  Resting ABG........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 

[[Page 7557]]

                                                                                                                
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: RESPIRATORY                                             
                                              JOB TITLE: MACHINIST                                              
----------------------------------------------------------------------------------------------------------------
Asthma:                                                                                                         
  Spirometry.........................   Repeated spirometry FEV1       D                                        
                                        <40% over a 12 month period.                                            
Bronchiectasis:                                                                                                 
  Resting ABG........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 exercise.                                                               
  Pulmonary exercise test............   Maximum VO2 <15 ml/kg.......   D                                        
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
Chronic bronchitis:                                                                                             
  Spirometry.........................   Repeated spirometry FEV1       D                                        
                                        <40% over a 12 month period.                                            
  Resting AGB........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 exercise.                                                               
  Pulmonary exercise test............   Maximum VO2 <15 ml/kg.......   D                                        
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
Chronic obstructive pulmonary disease                                                                           
 (COPD):                                                                                                        
  Resting ABG........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 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:                                                                                             
  Resting ABG........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
  DLCO...............................   <45% predicted..............   D                                        
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 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:                                                                                       
  DLCO...............................   <45% predicted..............   D                                        
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 exercise.                                                               
  Pulmonary exercise test............   Maximum VO2 <15 ml/kg.......   D                                        
  Spirometry.........................   FVC <50% predicted..........   D                                        
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
Silicosis:                                                                                                      
  Resting ABG........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: RESPIRATORY                                             
                                             JOB TITLE: SHOP LABORER                                            
----------------------------------------------------------------------------------------------------------------
Asthma:                                                                                                         
  Spirometry.........................   Repeated spirometry FEV1       D                                        
                                        <40% over a 12 month period.                                            
Bronchiectasis:                                                                                                 
  Resting ABG........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 exercise.                                                               
  Pulmonary exercise test............   Maximum VO2 <15 ml/kg.......   D                                        
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
Chronic bronchitis:                                                                                             
  Spirometry.........................   Repeated spirometry FEV1       D                                        
                                        <40% over a 12 month period.                                            
  Resting ABG........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 exercise.                                                               
  Pulmonary exercise test............   Maximum VO2 <15 ml/kg.......   D                                        
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
Chronic obstructive pulmonary disease                                                                           
 (COPD):                                                                                                        
  Resting ABG........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 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:                                                                                             
  Resting ABG........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 

[[Page 7558]]

                                                                                                                
  DLCO...............................   <45% predicted..............   D                                        
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 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:                                                                                       
  DLCO...............................   <45% predicted..............   D                                        
  Pulmonary exercise test or exercise   PO2 drop >5 torr at maximum    D                                        
   ABG.                                 exercise.                                                               
  Pulmonary exercise test............   Maximum VO2 <15 ml/kg.......   D                                        
  Spirometry.........................   FVC <50% predicted..........   D                                        
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
Silicosis:                                                                                                      
  Resting ABG........................   PCO2 arterial >50 mm Hg if     D                                        
                                        stable.                                                                 
  Electrocardiogram..................   Definite positive right        D                                        
                                        ventricular hypertrophy.                                                
----------------------------------------------------------------------------------------------------------------


                                             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       Recommended.                             
                                        disc changes.                                                           
  Computerized tomography............   Significant degenerative       Recommended.                             
                                        disc changes.                                                           
  Magnetic resonance imaging.........   Significant degenerative       Recommended.                             
                                        disc changes.                                                           
  Myelogram..........................   Significant degenerative       Recommended.                             
                                        disc changes.                                                           
  Displacement of lumbar disc:.......                                                                           
  X-ray-lumbar sacral spine..........   Significant degenerative       Recommended.                             
                                        disc changes.                                                           
  Computerized tomography............   Significant degenerative       Recommended.                             
                                        disc changes.                                                           
  Magnetic resonance imaging.........   Significant degenerative       Recommended.                             
                                        disc changes.                                                           
  Myelogram..........................   Significant degenerative       Recommended.                             
                                        disc 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.....   ommended.                                
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.                                                           

[[Page 7559]]

                                                                                                                
  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 spine................   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               Recommended.                             
                                        degeneration.                                                           
  Magnetic resonance imaging.........   Significant disc               Recommended.                             
                                        degeneration.                                                           
  Computerized tomography............   Significant disc               Recommended.                             
                                        degeneration.                                                           
  Myelogram..........................   Significant disc               Recommended.                             
                                        degeneration.                                                           
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.                                                        
  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       Recommended.                             
                                        with 2 cm difference between                                            
                                        limbs.                                                                  
  Physical examination: straight leg    Positive straight leg raise.   Recommended.                             
   raise.                                                                                                       
  Sensory examination................   Loss of sensation in           Recommended.                             
                                        affected dermatomes.                                                    
  Medical history....................   History of radicular pain...   Highly recommended.                      
  Computerized tomography............   Evidence of neural             Recommended.                             
                                        compression.                                                            
Lumbar spinal stenosis:                                                                                         
  Computerized tomography............   Significant narrowing:         Recommended.                             
                                        spinal cord canal or                                                    
                                        intervertebral foramen.                                                 
  Magnetic resonance imaging.........   Significant narrowing:         Recommended.                             
                                        spinal cord canal or                                                    
                                        intervertebral foramen.                                                 
  Myelogram..........................   Significant narrowing:         Recommended.                             
                                        spinal 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            Recommended.                             
                                        infection.                                                              
  Magnetic resonance imaging.........   Evidence of chronic            Recommended.                             
                                        infection.                                                              
  Computerized tomography............   Evidence of chronic            Recommended.                             
                                        infection.                                                              
Osteoporosis:                                                                                                   
  Computerized tomography............   Significant bone density       Recommended.                             
                                        loss.                                                                   
  Dual photon absorptiometry.........   Significant bone density       Recommended.                             
                                        loss.                                                                   
  X-ray-lumbar sacral spine..........   Significant bone density       Recommended.                             
                                        loss.                                                                   
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       Recommended.                             
                                        with 2 cm difference between                                            
                                        limbs.                                                                  
  Physical examination: straight leg    Positive straight leg raise.   Recommended.                             
   raise.                                                                                                       
  Sensory examination................   Loss of sensation in           Recommended.                             
                                        affected 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.                             

[[Page 7560]]

                                                                                                                
  Nerve conduction velocity..........   Definite slowing............   Recommended.                             
  Physical examination -- atrophy....   Atrophy in affected limb       Recommended.                             
                                        with 2 cm difference between                                            
                                        limbs.                                                                  
  Physical examination: straight leg    Positive straight leg raise.   Recommended.                             
   raise.                                                                                                       
  Sensory examination................   Loss of sensation in           Recommended.                             
                                        affected 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       Recommended.                             
                                        with 2 cm difference between                                            
                                        limbs.                                                                  
  Physical examination: straight leg    Positive straight leg raise.   Recommended.                             
   raise.                                                                                                       
  Sensory examination................   Loss of sensation in           Recommended.                             
                                        affected dermatomes.                                                    
  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.                                                        
  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                 Recommended.                             
                                        interarticularis.                                                       
  Computerized tomography............   Defect -- pars                 Recommended.                             
                                        interarticularis.                                                       
  Magnetic resonance imaging.........   Defect -- pars                 Recommended.                             
                                        interarticularis.                                                       
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.                                                          
----------------------------------------------------------------------------------------------------------------


[[Page 7561]]


                                                                                                                
----------------------------------------------------------------------------------------------------------------
           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 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).....   Titer of rheumatoid factor..   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.                                                            
  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...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Chronic herniated disc:                                                                                         
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Cervical spondylolysis:                                                                                         
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Cervical intervertebral disc                                                                                    
 degeneration:                                                                                                  
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Fracture: posterior element with                                                                                
 spinal canal displacement:                                                                                     
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Post laminectomy syndrome:                                                                                      
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Cervical radiculopathy:                                                                                         
  Physical examination...............   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                                        

[[Page 7572]]

                                                                                                                
  Myelogram..........................   Significant spinal cord        D                                        
                                        pressure.                                                               
  Physical examination: rectal.......   Impairment of sphincter tone   D                                        
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
  Physical examination: lower limb...   Lower extremity weakness or    D                                        
                                        significant 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...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Chronic herniated disc:                                                                                         
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Cervical spondylolysis:                                                                                         
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Cervical intervertebral disc                                                                                    
 degeneration:                                                                                                  
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Fracture: posterior element with                                                                                
 spinal canal displacement:                                                                                     
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Post laminectomy syndrome:                                                                                      
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Cervical radiculopathy:                                                                                         
  Physical examination:..............   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...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
  Physical examination: lower limb...   Lower extremity weakness or    D                                        
                                        significant spasticity.                                                 
----------------------------------------------------------------------------------------------------------------
                                               BODY PART: CE SPINE                                              
                                             JOB TITLE: DISPATCHER                                              
----------------------------------------------------------------------------------------------------------------
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: 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...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Chronic herniated disc:                                                                                         
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Cervical spondylolysis:                                                                                         
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Cervical intervertebral disc                                                                                    
 degeneration:                                                                                                  
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Fracture: posterior element with                                                                                
 spinal canal displacement:                                                                                     
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Post laminectomy syndrome:                                                                                      
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Cervical radiculopathy:                                                                                         
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             

[[Page 7573]]

                                                                                                                
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...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
  Physical examination: lower limb...   Lower extremity weakness or    D                                        
                                        significant 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...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Chronic herniated disc:                                                                                         
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Cervical spondylolysis:                                                                                         
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Cervical intervertebral disc                                                                                    
 degeneration:                                                                                                  
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Fracture: posterior element with                                                                                
 spinal canal displacement:                                                                                     
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Post laminectomy syndrome:                                                                                      
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Cervical radiculopathy:                                                                                         
  Physical examination...............   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...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
  Physical examination: lower limb...   Lower extremity weakness or    D                                        
                                        significant spasticity.                                                 
----------------------------------------------------------------------------------------------------------------
                                               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...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Chronic herniated disc:                                                                                         
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Cervical spondyloysis:                                                                                          
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Cervical intervertebral disc                                                                                    
 degeneration:                                                                                                  
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Fracture: posterior element with                                                                                
 spinal canal displacement:                                                                                     
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Post laminectomy syndrome:                                                                                      
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Cervical radiculopathy:                                                                                         
  Physical examination...............   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                                        

[[Page 7574]]

                                                                                                                
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
  Physical examination: lower limb...   Lower extremity weakness or    D                                        
                                        significant 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...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Chronic herniated disc:                                                                                         
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Cervical spondylolysis:                                                                                         
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Cervical intervertebral disc                                                                                    
 degeneration:                                                                                                  
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Fracture: posterior element with                                                                                
 spinal canal displacement:                                                                                     
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Post laminectomy syndrome:                                                                                      
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Cervical radiculopathy:                                                                                         
  Physical examination...............   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...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
  Physical examination: lower limb...   Lower extremity weakness or    D                                        
                                        significant 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                                        
  Physical examination: rectal.......   Impairment of sphincter tone   D                                        
  Physical examination: lower limb...   Lower extremity weakness or    D                                        
                                        significant spasticity.                                                 
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Chronic herniated disc:                                                                                         
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Cervical spondylolysis:                                                                                         
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Cervical intervertebral disc                                                                                    
 degeneration:                                                                                                  
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Fracture: posterior element with                                                                                
 spinal canal displacement:                                                                                     
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Post laminectomy syndrome:                                                                                      
  Physical examination...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
Cervical radiculopathy:                                                                                         
  Physical examination...............   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...............   Multi-level neurologic         D                                        
                                        compromise.                                                             
  Physical examination: lower limb...   Lower extremity weakness or    D                                        
                                        significant spasticity.                                                 
----------------------------------------------------------------------------------------------------------------

[[Page 7575]]

                                                                                                                
                                               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 and Elbow                                             
----------------------------------------------------------------------------------------------------------------
          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.                             
Medical diagnosis leading to a                                                                                  
 permanent functional limitation of                                                                             
 the 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.                                                   
----------------------------------------------------------------------------------------------------------------


                                                                                                                
----------------------------------------------------------------------------------------------------------------
           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.                                                                                                      
----------------------------------------------------------------------------------------------------------------
                                          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.                                                                                                      

[[Page 7576]]

                                                                                                                
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                                        
   moiton.                                                                                                      
Permanent functional limitation,                                                                                
 elbow:                                                                                                         
  Physical examination...............   >40 degrees deviation.......   D                                        
  Physical examination -- range of      Flexion limit to 60 degrees.   D                                        
   motion.                                                                                                      
----------------------------------------------------------------------------------------------------------------
                                          BODY PART: 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.                                                                                                      
----------------------------------------------------------------------------------------------------------------
                                          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.                                                                                                      
----------------------------------------------------------------------------------------------------------------
                                          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.                                                                                                      
  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.                                                                                                      
----------------------------------------------------------------------------------------------------------------
                                          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                                        

[[Page 7577]]

                                                                                                                
  Physical examination -- range of      Flexion limit to 60 degrees.   D                                        
   motion.                                                                                                      
----------------------------------------------------------------------------------------------------------------
                                          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.                                                                                                      
----------------------------------------------------------------------------------------------------------------


                                                 H. Hand and Arm                                                
----------------------------------------------------------------------------------------------------------------
          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.                                                           
  Nerve conduction testing...........   Definite median nerve          Highly recommended.                      
                                        conduction slowing at wrist.                                            
  Electromyography...................   Denervation in severe 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..................   Titer of rheumatoid factor..   Recommended.                             
  Medical record review..............   History of objective           Highly recommended.                      
                                        findings 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.                                                 
  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                                              
----------------------------------------------------------------------------------------------------------------
Fracture, wrist:                                                                                                
  Physical examination -- range of      Extension -- limit to 30       D                                        
   motion.                              degrees.                                                                
  Physical examination -- range of      Flexion -- limit to 30         D                                        
   motion.                              degrees.                                                                
  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.                                                         

[[Page 7578]]

                                                                                                                
  Medical record review..............   Extensive medication use,      D                                        
                                        under treatment with                                                    
                                        rheumatologist.                                                         
Thumb: permanent functional                                                                                     
 limitation:                                                                                                    
  Adduction of thumb.................   Loss 4 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                                        
  Wrist: permanent functional                                                                                   
   limitation:.                                                                                                 
  Physical examination -- range of      Extension -- limit to 30       D                                        
   motion.                              degrees.                                                                
  Physical examination -- range of      Flexion -- limit to 30         D                                        
   motion.                              degrees.                                                                
  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          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                                        
  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                                        
Wrist: permanent functional                                                                                     
 limitation:                                                                                                    
  Physical examination -- range of      Extension -- limit to 30       D                                        
   motion.                              degrees.                                                                
  Physical examination -- range of      Flexion -- limit to 30         D                                        
   motion.                              degrees.                                                                
  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         D                                        
   motion.                              degrees.                                                                
  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                                        
  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                                        
Wrist: permanent functional                                                                                     
 limitation:                                                                                                    
  Physical examination -- range of      Extension -- limit to 30       D                                        
   motion.                              degrees.                                                                
  Physical examination -- range of      Flexion -- limit to 30         D                                        
   motion.                              degrees.                                                                
  Physical examination -- range of      Ankylosis: >20 degrees from    D                                        
   motion.                              neutral.                                                                
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: HAND AND ARM                                            
                                               JOB TITLE: CARMAN                                                
----------------------------------------------------------------------------------------------------------------
Fracture, wrist:                                                                                                
  Physical examination -- range of      Extension -- limit to 30       D                                        
   motion.                              degrees.                                                                
  Physical examination -- range of      Flexion -- limit to 30         D                                        
   motion.                              degrees.                                                                
  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.                                                         

[[Page 7579]]

                                                                                                                
  Medical record review..............   Extensive medication use,      D                                        
                                        under treatment with                                                    
                                        rheumatologist.                                                         
Thumb: permanent functional                                                                                     
 limitation:                                                                                                    
  Adduction of thumb:................   Loss 4 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                                        
Wrist: permanent functional                                                                                     
 limitation:                                                                                                    
  Physical examination -- range of      Extension -- limit to 30       D                                        
   motion.                              degrees.                                                                
  Physical examination -- range of      Flexion -- limit to 30         D                                        
   motion.                              degrees.                                                                
  Physical examination -- range of      Ankylosis: >20 degrees from    D                                        
   motion.                              neutral.                                                                
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: HAND AND ARM                                            
                                              JOB TITLE: SIGNALMAN                                              
----------------------------------------------------------------------------------------------------------------
Fracture, wrist:                                                                                                
  Physical examination -- range of      Extension -- limit to 30       D                                        
   motion.                              degrees.                                                                
  Physical examination -- range of      Flexion -- limit to 30         D                                        
   motion.                              degrees.                                                                
  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                                        
  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                                        
Wrist: permanent functional                                                                                     
 limitation:                                                                                                    
  Physical examination -- range of      Extension -- limit to 30       D                                        
   motion.                              degrees.                                                                
  Physical examination -- range of      Flexion -- limit to 30         D                                        
   motion.                              degrees.                                                                
  Physical examination -- range of      Ankylosis: >20 degrees from    D                                        
   motion.                              neutral.                                                                
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: HAND AND ARM                                            
                                               JOB TITLE: TRACKMAN                                              
----------------------------------------------------------------------------------------------------------------
Fracture, wrist:                                                                                                
  Physical examination -- range of      Extension -- limit to 30       D                                        
   motion.                              degrees.                                                                
  Physical examination -- range of      Flexion --limit to 30          D                                        
   motion.                              degrees.                                                                
  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                                        
  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                                        
Wrist: permanent functional                                                                                     
 limitation:                                                                                                    
  Physical examination -- range of      Extension -- -- limit to 30    D                                        
   motion.                              degrees.                                                                
  Physical examination -- range of      Flexion -- limit to 30         D                                        
   motion.                              degrees.                                                                
  Physical examination -- range of      Ankylosis: >20 degrees from    D                                        
   motion.                              neutral.                                                                
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: HAND AND ARM                                            
                                              JOB TITLE: MACHINIST                                              
----------------------------------------------------------------------------------------------------------------
Fracture, wrist:                                                                                                
  Physical examination -- range of      Extension -- limit to 30       D                                        
   motion.                              degrees.                                                                
  Physical examination -- range of      Flexion -- limit to 30         D                                        
   motion.                              degrees.                                                                
  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.                                                         

[[Page 7580]]

                                                                                                                
  Medical record review..............   Extensive medication use,      D                                        
                                        under treatment with                                                    
                                        rheumatologist.                                                         
Thumb: permanent functional                                                                                     
 limitation:                                                                                                    
  Adduction of thumb.................   Loss 4 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                                        
Wrist: permanent functional                                                                                     
 limitation:                                                                                                    
  Physical examination -- range of      Extension -- limit to 30       D                                        
   motion.                              degrees.                                                                
  Physical examination -- range of      Flexion -- limit to 30         D                                        
   motion.                              degrees.                                                                
  Physical examination -- range of      Ankylosis: >20 degrees from    D                                        
   motion.                              neutral.                                                                
----------------------------------------------------------------------------------------------------------------
                                             BODY PART: HAND AND ARM                                            
                                             JOB TITLE: SHOP LABORER                                            
----------------------------------------------------------------------------------------------------------------
Fracture, wrist:                                                                                                
  Physical examination -- range of      Extension -- limit to 30       D                                        
   motion.                              degrees.                                                                
  Physical examination -- range of      Flexion -- limit to 30         D                                        
   motion.                              degrees.                                                                
  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                                        
  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                                        
Wrist: permanent functional                                                                                     
 limitation:                                                                                                    
  Physical examination -- range of      Extension -- limit to 30       D                                        
   motion.                              degrees.                                                                
  Physical examination -- range of      Flexion -- limit to 30         D                                        
   motion.                              degrees.                                                                
  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         D                                        
   motion.                              degrees.                                                                
  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                                        
  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                                        
Wrist: permanent functional                                                                                     
 limitation:                                                                                                    
  Physical examination -- range of      Extension -- limit to 30       D                                        
   motion.                              degrees.                                                                
  Physical examination -- range of      Flexion -- limit to 30         D                                        
   motion.                              degrees.                                                                
  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         D                                        
   motion.                              degrees.                                                                
  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.                                                         

[[Page 7581]]

                                                                                                                
  Medical record review..............   Extensive medication use,      D                                        
                                        under treatment with                                                    
                                        rheumatologist.                                                         
Thumb: permanent functional                                                                                     
 limitation:                                                                                                    
  Adduction of thumb.................   Loss 4 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                                        
Wrist: permanent functional                                                                                     
 limitation:                                                                                                    
  Physical examination -- range of      Extension -- limit to 30       D                                        
   motion.                              degrees.                                                                
  Physical examination -- range of      Flexion -- limit to 30         D                                        
   motion.                              degrees.                                                                
  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.........................   Extreme 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            Recommended.                             
                                        infection.                                                              
  Computerized axial tomography......   Evidence of chronic            Recommended.                             
                                        infection.                                                              
Paget's disease:                                                                                                
  X-ray: hip.........................   Osteolytic or 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              D                                        
                                        destruction.                                                            
  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              D                                        
                                        destruction.                                                            
  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.                                                            
----------------------------------------------------------------------------------------------------------------

[[Page 7582]]

                                                                                                                
                                                 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.                                                            
  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              D                                        
                                        destruction.                                                            
  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              D                                        
                                        destruction.                                                            
  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              D                                        
                                        destruction.                                                            
  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 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 7583]]

                                                                                                                
  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              D                                        
                                        destruction.                                                            
  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              D                                        
                                        destruction.                                                            
  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: 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 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              D                                        
                                        destruction.                                                            
  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              D                                        
                                        destruction.                                                            
  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              D                                        
                                        destruction.                                                            
  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              D                                        
                                        destruction.                                                            
  Physical examination -- range of      30 degrees flexion             D                                        
   motion.                              contracture.                                                            

[[Page 7584]]

                                                                                                                
  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:                                                                                            
  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              D                                        
                                        destruction.                                                            
  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              D                                        
                                        destruction.                                                            
  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                                                
                                               CONFIRMATORY 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       Recommended.                             
                                        arthroscopy.                                                            
Intercondylar fracture:                                                                                         
  X-ray: knee........................   Evidence of fracture........   Highly Recommended.                      
Osteomyelitis: knee:                                                                                            
  Medical record review..............   Documented history of          Highly Recommended.                      
                                        osteomyelitis requiring                                                 
                                        treatment.                                                              
  X-ray: knee........................   Evidence of chronic            Recommended.                             
                                        infection.                                                              
  Computerized tomography............   Evidence of chronic            Recommended.                             
                                        infection.                                                              
  Magnetic resonance imaging.........   Evidence of chronic            Recommended.                             
                                        infection.                                                              
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.                      

[[Page 7585]]

                                                                                                                
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 patella..............   Highly Recommended.                      
Patellar -- subluxation -- recurrent:                                                                           
  Medical record review..............   History of recurrent           Highly Recommended.                      
                                        subluxation.                                                            
Supracondylar fracture:                                                                                         
  X-ray: knee........................   Evidence of fracture........   Recommended.                             
  Magnetic resonance imaging.........   Evidence of fracture........   Recommended.                             
  Computerized tomography............   Evidence of fracture........   Recommended.                             
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.                                                                
  Physical examination...............   Varus 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.                                                                
  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        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        D                                        
                                        degrees.                                                                
  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).                                                               

[[Page 7586]]

                                                                                                                
  Physical examination...............   Valgus deformity, 16 - 20      D                                        
                                        degrees.                                                                
  Physical examination...............   Varus deformity, 8 - 12        D                                        
                                        degrees.                                                                
  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: 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        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...............   Varus 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        D                                        
                                        degrees.                                                                
  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        D                                        
                                        degrees.                                                                
  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.                                                                

[[Page 7587]]

                                                                                                                
  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:                                                                                                 
  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        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...............   Varus 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        D                                        
                                        degrees.                                                                
  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        D                                        
                                        degrees.                                                                
  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.                                                                

[[Page 7588]]

                                                                                                                
  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...............   Varus 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.                                                                
  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        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        D                                        
                                        degrees.                                                                
  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        D                                        
                                        degrees.                                                                
  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.                                                                

[[Page 7589]]

                                                                                                                
  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        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 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        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        D                                        
                                        degrees.                                                                
  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        D                                        
                                        degrees.                                                                
  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).                                                               

[[Page 7590]]

                                                                                                                
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        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...............   Varus 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        D                                        
                                        degrees.                                                                
  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        D                                        
                                        degrees.                                                                
  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                                        
----------------------------------------------------------------------------------------------------------------

[[Page 7591]]

                                                                                                                
                                                 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        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...............   Varus 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        D                                        
                                        degrees.                                                                
  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        D                                        
                                        degrees.                                                                
  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                                        
----------------------------------------------------------------------------------------------------------------


[[Page 7592]]


                                                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..............   Documentation 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.                                                             
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       D                                        
   motion.                              more 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.                                                             
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          D                                        
                                        degrees (hindfoot).                                                     
Rheumatoid arthritis, foot:                                                                                     
  X-ray: foot........................   Significant degeneration....   D                                        
  Medical record review..............   Chronic flare-up with          D                                        
                                        treatment.                                                              
----------------------------------------------------------------------------------------------------------------

[[Page 7593]]

                                                                                                                
                                            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       D                                        
   motion.                              more 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.                                                             
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          D                                        
                                        degrees (hindfoot).                                                     
Rheumatoid arthritis, foot:                                                                                     
  X-ray: foot........................   Significant degeneration....   D                                        
  Medical record review..............   Chronic 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.                                                             
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          D                                        
                                        degrees (hindfoot).                                                     
Rheumatoid arthritis, foot:                                                                                     
  X-ray: foot........................   Significant degeneration....   D                                        
  Medical record review..............   Chronic 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.                                                        

[[Page 7594]]

                                                                                                                
  Physical examination -- range of      Ankylois in int or ext         D                                        
   motion.                              malrotation >15 degrees.                                                
  Physical examination -- range of      Ankylosis in varus 10 or       D                                        
   motion.                              more 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.                                                             
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          D                                        
                                        degrees (hindfoot).                                                     
Rheumatoid arthritis, foot:                                                                                     
  X-ray: foot........................   Significant degeneration....   D                                        
  Medical record review..............   Chronic 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:                                                                                               
  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       D                                        
   motion.                              more 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.                                                             
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          D                                        
                                        degrees (hindfoot).                                                     
Rheumatoid arthritis, foot:                                                                                     
  X-ray: foot........................   Significant degeneration....   D                                        
  Medical record review..............   Chronic flare-up with          D                                        
                                        treatment.                                                              
----------------------------------------------------------------------------------------------------------------

[[Page 7595]]

                                                                                                                
                                            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       D                                        
   motion.                              more 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.                                                             
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          D                                        
                                        degrees (hindfoot).                                                     
Rheumatoid arthritis, foot:                                                                                     
  X-ray: foot........................   Significant degeneration....   D                                        
  Medical record review..............   Chronic flare-up with          D                                        
                                        treatment.                                                              
----------------------------------------------------------------------------------------------------------------
                                            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       D                                        
   motion.                              more 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.                                                             
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                                        

[[Page 7596]]

                                                                                                                
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          D                                        
                                        degrees (hindfoot).                                                     
Rheumatoid arthritis, foot:                                                                                     
  X-ray: foot........................   Significant degeneration....   D                                        
  Medical record review..............   Chronic flare-up with          D                                        
                                        treatment.                                                              
----------------------------------------------------------------------------------------------------------------
                                            BODY PART: ANKLE AND FOOT                                           
                                             JOB TITLE: SHOP 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       D                                        
   motion.                              more 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.                                                             
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          D                                        
                                        degrees (hindfoot).                                                     
Rheumatoid arthritis, foot:                                                                                     
  X-ray: foot........................   Significant degeneration....   D                                        
  Medical record review..............   Chronic flare-up with          D                                        
                                        treatment.                                                              


[[Page 7597]]


----------------------------------------------------------------------------------------------------------------
           Disability test                      Test result                    Disability classification        
----------------------------------------------------------------------------------------------------------------
                                            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.                                                             
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          D                                        
                                        degrees (hindfoot).                                                     
Rheumatoid arthritis, foot:                                                                                     
  X-ray: foot........................   Significant degeneration....   D                                        
  Medical record review..............   Chronic flare-up with          D                                        
                                        treatment.                                                              
----------------------------------------------------------------------------------------------------------------

BILLING CODE 7905-01-P

[[Page 7598]]

Job Information Forms
[GRAPHIC] [TIFF OMITTED] TR13FE98.000


[[Page 7599]]

[GRAPHIC] [TIFF OMITTED] TR13FE98.001



[[Page 7600]]

[GRAPHIC] [TIFF OMITTED] TR13FE98.002



[[Page 7601]]

[GRAPHIC] [TIFF OMITTED] TR13FE98.003




[[Page 7602]]


    Dated: January 14, 1998.
Beatrice Ezerski,
Secretary to the Board.
[FR Doc. 98-2026 Filed 2-12-98; 8:45 am]
BILLING CODE 7905-01-C