In the realm of Workers’ Compensation, determining a claimant’s SLU often requires precise assessment of their range of motion. One key element in this process is whether to use the contralateral, or opposite, limb as a baseline for comparison. This decision has significant implications, as outlined in Section 1.3 of the Workers’ Compensation Guidelines for Determining Impairment (2018 Guidelines). Below, we explore when the contralateral member is appropriate for comparison and situations where it may not be.
The Role of the Contralateral Member in SLU Assessment
The primary purpose of using the contralateral member is to establish a baseline for determining whether the injured member’s ROM deficits stem from the work-related injury rather than non-injury-related factors like degenerative changes or body habitus. The guidelines assume symmetry in physical and functional capabilities between the injured and contralateral limbs unless there is clear evidence of impairment in the contralateral member. Employer: Town of Hempstead (WCB# G231 8559, December 7, 2023).
This approach ensures that assessments are specific to the claimant’s unique physiological characteristics and not based on generalized normative values.
The Value of Contralateral Comparison
Using the contralateral member as a comparative baseline is essential in distinguishing impairments caused directly by the work-related injury from other non-work-related conditions. This approach enhances the accuracy and fairness of the SLU assessment, ensuring claimants receive appropriate compensation based on the true impact of their workplace injury.
By adhering to these guidelines and assessing the availability and suitability of the contralateral member, medical providers and legal professionals can uphold the integrity of the SLU determination process.
When to Use the Contralateral Member
It is presumed appropriate to use the contralateral member for comparison absent evidence of permanent physical or functional impairment to that member. Situations where the contralateral member can and should be used if the contralateral limb has not been subject to any prior trauma, surgery, or condition resulting in permanent impairment. See Employer: South Beach Psychiatric (WCB# G271 5210, January 24, 2023). In other words, a contralateral member cannot be used for comparison when there is credible evidence of a permanent physical or functional impairment due to a traumatic injury or condition unrelated to the work injury.
What If a Doctor Does Not Consider the Contralateral Member?
If a doctor fails to use the contralateral member when performing a permanency evaluation, it may be enough for the Board to find their report is insufficient to support their permanency opinion. For instance, in one case, Dr. Roberts admitted to neglecting to evaluate the claimant’s contralateral members, as required by the 2018 Workers’ Compensation Guidelines. This omission resulted in inadequate support for Dr. Roberts’ permanency findings, leaving insufficient evidence to grant SLU awards. Such a failure demonstrates the critical importance of adhering to the guidelines to ensure assessments are thorough, accurate, and aligned with best practices. See Employer: New York City Transit Authority (WCB# G176 0512; August 2, 2022).
The Burden of Proof
The burden rests on the claimant to prove that the contralateral member is unsuitable for comparison. This should include providing medical evidence of:
- The nature of any prior traumatic injury or surgical procedure; and
- Whether injury or surgery resulted in residual permanent deficits or impairments in ROM or function.
Absent such evidence, the contralateral limb is presumed symmetrical and appropriate for assessment.