Mo. Code Regs. Ann. tit. 8, § 50-5.020
PURPOSE: This rule sets forth procedures to evaluate visual disability.
(1) Compensable disability for loss of vision should be based on that proportional part of the compensation provided by law for loss of use or loss of function of one (1) or of both eyes which expresses the percentage loss of visual efficiency of the individual.
means the best acuity obtainable at twenty feet fourteen inches (20'14") without the use of ophthalmic lenses, except that corrective lenses shall be used for natural presbyopia and other conditions clearly not the result of injury.
(3) In order to determine the various degrees of visual efficiency, a) normal or maximum, and b) minimum limits for each coordinate function must be established, that is, the one hundred percent (100%) point and the zero percent (0%) point.
(A) The maximum efficiency for each of these is established by existing and accepted standards.
recognize letters or characters with subtend an angle of five (5) minutes, each unit part of which subtends a one (1) minute angle, is accepted as standard. Therefore a 20/20 (6/6 metric) Snellen is employed as the maximum acuity of central vision or one hundred percent (100%) acuity.
area which extends from the point of fixation outward eighty-five degrees (85°), down and out eighty-five degrees (85°), down sixty-five INDUSTRIAL RELATIONS
degrees (65°), down and in fifty degrees (50°), inward sixty degrees (60°), in and up fifty-five degrees (55°), upward forty-five degrees (45°), and up and out fifty-five degrees (55°) is accepted as one hundred percent (100%) industrial visual field efficiency.
muscle function is present when binocular single vision is present in all parts of the field of binocular fixation or when there is no limitation of motion in either eye.
(B) The minimum limit or the zero percent (0%) of each of the coordinate functions of vision is established as that degree of deficiency which reduces vision to a state of uselessness.
experiment and authoritative opinion establish that a distance central visual acuity of 20/200 Snellen and a near central visual acuity of 14/140 is the accepted threshold of industrial blindness.
for this function is established as a concentric central contraction of the visual field to five degrees (5°). This degree of contraction of the visual field reduces the visual efficiency to zero (0).
for this function is established by the presence of diplopia in all parts of the motor field, the loss of binocular single vision or inability to rotate the eye to any point of fixation in the normal motor field. These conditions constitute zero visual efficiency.
TABLE NO. 1
Percentage Loss of Visual Efficiency
Corresponding to Snellen Notations for Distant
and for Near Vision for Measurable Range of Quantitative Visual Acuity Using 20/200 = 100% Loss
Percent- Percent- Snellen age of age of Notation Visual Visual at 20 feet Snellen at Efficiency Efficiency or 6 m 14 inches Retained Loss
20/20 14/14 100.0 0.0 20/25 14/17.5 94.0 6.0 20/30 14/21 88.0 12.0 20/35 14/24.5 82.4 17.6 20/40 14/28 77.4 22.6 20/45 14/31.5 72.8 27.2 20/50 14/35 68.1 31.9 20/60 14/42 60.0 40.0 20/70 14/49 52.5 47.5 20/80 14/56 46.4 53.6 20/90 14/63 41.2 58.8 20/100 14/70 35.9 64.1 20/120 14/84 27.8 72.2 20/140 14/98 20.2 79.8 20/160 14/112 13.0 87.0 20/180 14/126 6.0 94.0 20/200 14/140 0.0 100.0
(5) The extent of the field of vision shall be determined by the use of the usual perimetric test methods, a white target being employed which subtends a one degree (1°) angle under illumination of not less than seven (7) footcandles and the result plotted on an ordinary visual field chart as shown on Figure No. 1.
Example: The following represent the find-
ings in an abnormal field of vision in one (1) eye Upward 40 degrees Up and Out 40 degrees Outward 70 degrees Down and Out 60 degrees Down 50 degrees Down and In 50 degrees In 45 degrees Up and In 35 degrees TOTAL 390 5.00 78%
which is the field of vision efficiency of the affected eye. (See Field of Vision Chart). (6) Muscle function shall be measured in all parts of the motor field, recognized methods being used for testing. A maximum normal extraocular muscle function is present when there is absence of diplopia (double vision) in all parts of the field of binocular fixation. Where diplopia is present, it shall be plotted on the motor field chart. This chart is divided into twenty (20) rectangles twenty by twentyfive degrees (20° × 25°) in size, as shown in Figure No. 2.
Motor field chart at 40 inches is approximately 40 inches square, and the 20 rectangles measure 8 inches by 10 inches.
The partial loss of muscle function due to diplopia is that proportional area which shows diplopia, as indicated on the plotted chart, compared with the entire motor field area. It shall be measured without corrective lenses, red glass or prism. For example, to determine the motor field efficiency of the eyes, assume the motor field chart shows a diplopia in eight (8) out of twenty (20) rectangles of the entire field. By referring to the Motor Field Chart, Figure No. 2 and Table No. 2, it is found that a loss of 8/20 gives a forty percent (40%) motor field loss or an efficiency of sixty percent (60%).
TABLE NO. 2
Loss in Muscle Function
Loss Retained 1/20 = 5% 95% 2/20 = 10% 90% 3/20 = 15% 85% 4/20 = 20% 80% 5/20 = 25% 75% 6/20 = 30% 70% 7/20 = 35% 65% 8/20 = 40% 60% 9/20 = 45% 55% 10/20 = 50% 50% 11/20 = 55% 45% 12/20 = 60% 40% 13/20 = 65% 35% 14/20 = 70% 30% 15/20 = 75% 25% 16/20 = 80% 20% 17/20 = 85% 15% 18/20 = 90% 10% 19/20 = 95% 5% 20/20 = 100% 0%
second eye in weeks (based on the percentage of the difference between the value of one (1) eye in weeks and the value of both eyes in weeks, that is, four hundred (400) less one hundred forty (140) or two hundred sixty (260) weeks). For examples: poorer eye (right eye), seventy-five percent (75%) loss, 140 ×.75 = 105 weeks; second eye (left eye), five percent (5%) loss, 260 ×.05 = 13 weeks; binocular visual efficiency, loss one hundred eighteen (118) weeks.
(9) Certain types of ocular disturbance are not included in the foregoing computations and these may result in disabilities, the value of which cannot be accurately measured by any scientific method available. Among them are disturbance of accommodation, of color vision, of adaptation to light and dark, metamorphopsia, entropion, ectropion, lagophthalmos, epiphora and muscle disturbances not included under diplopia. For such disabilities, additional compensation shall be allowed, but in no case shall such additional compensation make the total for loss in industrial visual efficiency greater than that provided by law for the total loss of the sight of one (1) eye when only one (1) eye is involved and that for permanent partial disability of the body as a whole when both eyes are involved.
preferably not more than sixteen (16) months
assumed that the visual efficiency prior to any injury was one hundred percent (100%) or at least equal to the visual efficiency of the
Traumatic Cataract: When a traumatic cataract has been successfully treated by surgical or medical methods, the best visual acuity for that eye with ophthalmic lenses shall be measured. Fifty percent (50%) of this best visual acuity efficiency with an ophthalmic lens shall represent the central visual acuity efficiency of the eye for rating purposes.
Dislocation of Lens—Traumatic: Partial—Withhold rating for 12 months; then rate as visual loss plus 50% (not to exceed 100%). Total—The loss shall be 100% unless the lens has been successfully removed by surgery or has been absorbed. When the lens has been successfully removed by surgery or has been absorbed, the eye shall be rated as an eye where a traumatic cataract has been removed. See: “Traumatic Cataract” preceding.
Symble- Unilateral 10% pharon (also *Bilateral See footnote
brows, loss of eye lashes, symblepharon, ectropion, entripion, lagophthalmus or epiphora, the percentage of unilateral loss in the poorer eye shall be taken of 140 weeks and to that shall be added the percentage of unilateral loss in the better eye taken of 260 weeks. (See section (9) for computation of binocular visual efficiency).
sent the commutable value of compensation for permanent partial disability and the death
| limited muscle | benefit, excluding widows. | |||
|---|---|---|---|---|
| uninjured eye. | function) | |||
| This table gives the present value of one dol- | ||||
| TABLE NO. 3 | Ectropion | Unilateral | 10% | |
| lar ($1) per week with compound interest at | ||||
| TYPES OF OCULAR INJURY | or Entropion | *Bilateral | See footnote | |
| four percent (4%). It is used to compute the | ||||
| NOT INCLUDED IN THE | ||||
| DISTURBANCE OF COORDINATE | Lagophthalmus Unilateral | 10% | commutable value of compensation for per- | |
| FACTORS | *Bilateral | See footnote | manent partial disability and the death benefit | |
| other than to widow only. Source for the larg- | ||||
| (The percentages are for unilateral losses | Epiphora | Unilateral | 10% | er part of the table is Workers’ Compensation |
| unless otherwise noted) | *Bilateral | See footnote | Law by William R. Schneider, who gave per- | |
| mission for its use. | ||||
| Disability | Approximate Rating * In the event of bilateral disabilities due to | |||
| Not to Exceed paralysis of accommodation, loss of eye |
| Scotoma | If not cen- | 10% | AUTHORITY: section 287.650, RSMo 1986.* |
|---|---|---|---|
| shall intervene before the examination shall —Traumatic | trally located | ||
| Original rule filed Dec. 23, 1953, effective | |||
| be made on which final compensable disabil- | |||
| Jan. 3, 1954. Amended: Filed Nov. 1, 1956, | |||
| ity is to be computed. Paralysis | Unilateral | 20% | |
| effective Nov. 12, 1956. Amended: Filed June | |||
| (G) In cases of additional loss in visual of Accom- | *Bilateral | See footnote | |
| modation | 19, 1958, effective June 30, 1958. Amended: | ||
| efficiency when it is known by the examining | |||
| Filed Sept. 4, 1963, effective Sept. 15, 1963. | |||
| physician that there was present a pre-existing | |||
| subnormal vision, compensable disability Eye Brow | Unilateral | 10% | |
| (complete | *Bilateral | See footnote | *Original authority: 287.650, RSMo 1939, amended |
| shall be based on the loss incurred as a result | 1949, 1961, 1980, 1993, 1995, 1998. | ||
| of eye injury or occupational condition loss of) | |||
| specifically responsible for the additional | |||
| loss. In cases in which there exists no record Eye Lashes | Unilateral | 10% | |
| (complete | *Bilateral | See footnote | 8 CSR 50-5.030 Present Worth Table |
| or no adequate and positive evidence of pre- | |||
| loss of) | |||
| existing subnormal vision, it shall be | PURPOSE: The purpose of this rule is to pre- |
| (11) In each case of eye injury resulting in | ||||
|---|---|---|---|---|
| defect. Final examination on which compen- | any degree of permanent disability, the | |||
| sation is to be based shall not be made until | Ptosis | Loss is visual | employer and insurer shall file Form 9-A, | |
| at least three (3) months shall have elapsed | efficiency Loss | Physician’s Report on Eye Injuries, complet- | ||
| after all visible evidences of inflammation | ed in all the detail the form asks for, as | |||
| have disappeared, except in cases of distur- | Iridectomy | With photo- | 30% | promptly as possible. If the Form 9-A shows |
| bance of extrinsic ocular muscles, optic nerve | —Traumatic | phobia or | final estimation of the visual disabilities, it | |
| atrophy, sympathetic ophthalmia, traumatic | or surgical | dazzling | may be used as a basis for computing the | |
| cataract and paralysis of accommodation; in | resulting | |||
| compensation due the injured worker. | ||||
| such cases at least twelve (12) months and |
Weeks Present Worth Weeks
1 $ 00.9992 2 1.9977 3 2.9955 4 3.9925 5 4.9887 6 5.9842 7 6.9789 8 7.9739 9 8.9661 10 9.9586 1 10.9503 2 11.9413 3 12.9316 4 13.9211 5 14.9098 6 15.8978 7 16.8851 8 17.8716 9 18.8574 20 19.8424 1 20.8267 2 21.8102 3 22.7930 4 23.7751 5 24.7564 6 25.7370 7 26.7168 8 27.6959 9 28.6743 30 29.6519 1 30.6288 2 31.6050 3 32.5804 4 33.5550 5 34.5200 6 35.5022 7 36.4747 8 37.4464 9 38.4174 40 39.3877 1 40.3572 2 41.3261 3 42.2942 4 43.2615 5 44.2281 6 45.1940 7 46.1592 8 47.1237 9 48.0874 50 49.0504 1 50.1027 2 50.9742 3 51.9350 4 52.8951 5 53.8545 6 54.8131 7 55.7711 PRESENT WORTH TABLE Present Worth Weeks
8 $ 56.7283 9 57.6847 60 58.6405 1 59.5955 2 60.5499 3 61.5035 4 62.4563 5 63.4085 6 64.3599 7 65.3107 8 66.2607 9 67.2100 70 68.1585 1 69.1064 2 70.0536 3 71.0000 4 71.9457 5 72.8907 6 73.8350 7 74.7786 8 75.7215 9 76.6636 80 77.6051 1 78.5458 2 79.4858 3 80.4252 4 81.3638 5 82.3017 6 83.2389 7 84.1754 8 85.1112 9 86.0462 90 86.9806 1 87.9142 2 88.8471 3 89.7794 4 90.7109 5 91.6418 6 92.5719 7 93.5014 8 94.4301 9 95.3581 100 96.2855 1 97.2122 2 98.1381 3 99.0633 4 99.9879 5 100.9118 6 101.8349 7 102.7574 8 103.6792 9 104.6002 110 105.5206 1 106.4403 2 107.3593 3 108.2776 4 109.1952 5 110.1122 8 CSR 50-5
Present Worth
6 $ 111.0284 7 111.9439 8 112.8588 9 113.7729 120 114.6864 1 115.5992 2 116.5112 3 117.4226 4 118.3334 5 119.2434 6 120.1527 7 121.0614 8 121.9694 9 122.8766 130 123.7832 1 124.6892 2 125.5944 3 126.4989 4 127.4028 5 128.3060 6 129.2085 7 130.1103 8 131.0115 9 131.9119 140 132.8117 1 133.7108 2 134.6092 3 135.5070 4 136.4041 5 137.3005 6 138.1962 7 139.0913 8 139.9856 9 140.8794 150 141.7724 1 142.6648 2 143.5564 3 144.4474 4 145.3378 155 146.2274 6 147.1164 7 148.0048 8 148.8924 9 149.7794 160 150.6657 1 151.5514 2 152.4363 3 153.3207 4 154.2043 165 155.0873 6 155.9696 7 156.8512 8 157.7322 9 158.6126 170 159.4922 1 160.3712 2 161.2495 3 162.1272 INDUSTRIAL RELATIONS
Weeks Present Worth Weeks
4 $ 163.0042 175 163.8806 6 164.7563 7 165.6313 8 166.5057 9 167.3794 180 168.2524 1 169.1248 2 169.9966 3 170.8676 4 171.7380 185 172.6078 6 173.4769 7 174.3454 8 175.2132 9 176.0803 190 176.9468 1 177.8126 2 178.6778 3 179.5424 4 180.4063 195 181.2695 6 182.1321 7 182.9940 8 183.8553 9 184.7159 200 185.5758 1 186.4352 2 187.2938 3 188.1519 4 189.0093 205 189.8660 6 190.7221 7 191.5775 8 192.4323 9 193.2865 210 194.1400 1 194.9929 2 195.8451 3 196.6967 4 197.5476 215 198.3980 6 199.2476 7 200.0966 8 200.9450 9 201.7928 220 202.6398 1 203.4863 2 204.3321 3 205.1773 4 206.0219 225 206.8658 6 207.7090 7 208.5517 8 209.3937 9 210.2351 230 211.0758 1 211.9159 PRESENT WORTH TABLE Present Worth Weeks
2 $ 212.7554 3 213.5942 4 214.4324 235 215.2700 6 216.1069 7 216.9432 8 217.7789 9 218.6139 240 219.4484 1 220.2821 2 221.1158 3 221.9478 4 222.7797 245 223.6110 6 224.4417 7 225.2717 8 226.1011 9 226.9299 250 227.7580 1 228.5856 2 229.4125 3 230.2387 4 231.0644 255 231.8894 6 232.7139 7 233.5377 8 234.3608 9 235.1834 260 236.0053 1 236.8266 2 237.6473 3 238.4674 4 239.2868 265 240.1056 6 240.9238 7 241.7414 8 242.5584 9 243.3748 270 244.1905 1 245.0056 2 245.8202 3 246.6341 4 247.4474 275 248.2600 6 249.0721 7 249.8836 8 250.6944 9 251.5047 280 252.3143 1 253.1233 2 253.9317 3 254.7395 4 255.5467 285 256.3533 6 257.1593 7 257.9647 8 258.7694 9 259.5736 Present Worth
290 $ 260.3771 1 261.1801 2 261.9824 3 262.7841 4 263.5853 295 264.3858 6 265.1857 7 265.9850 8 266.7837 9 267.5818 300 268.3793 1 269.1762 2 269.9725 3 270.7682 4 271.5633 305 272.3578 6 273.1516 7 273.9449 8 274.7376 9 275.5297 310 276.3212 1 277.1121 2 277.9024 3 278.6921 4 279.4812 315 280.2698 6 281.0577 7 281.8450 8 282.6317 9 283.4179 320 284.2034 1 284.9884 2 285.7727 3 286.5565 4 287.3397 325 288.1223 6 288.9043 7 289.6857 8 290.4666 9 291.2468 330 292.0265 1 292.8055 2 293.5840 3 294.3619 4 295.1302 335 295.9160 6 296.6921 7 297.4677 8 298.2426 9 299.1070 340 299.7908 1 300.5641 2 301.3367 3 302.1088 4 302.8802 345 303.6511 6 304.4214 7 305.1912 Weeks Present Worth Weeks
8 $ 305.9603 9 306.7289 350 307.4969 1 308.2643 2 309.0311 3 309.7974 4 310.5630 355 311.3281 6 312.0926 7 312.8566 8 313.6200 9 314.3827 360 315.1450 1 315.9066 2 316.6677 3 317.4282 4 318.1881 365 318.9474 6 319.7062 7 320.4644 8 321.2220 9 321.9791 370 322.7356 1 323.4915 2 324.2468 3 324.0016 4 325.7558 375 326.5094 6 327.2625 7 328.0150 8 328.7669 9 329.5183 380 330.2691 1 331.0194 2 331.7690 3 332.5181 4 333.2667 385 334.0147 6 334.7621 7 335.5089 8 336.2552 9 337.0010 390 337.7461 1 338.4907 2 339.2348 3 339.9782 4 340.7212 395 341.4635 6 342.2053 7 342.9466 8 343.6872 9 344.4274 400 345.1669 1 345.9059 2 346.6444 3 347.3823 4 348.1106 405 348.8564 PRESENT WORTH TABLE Present Worth Weeks
6 $ 349.5926 7 350.3282 8 351.0633 9 351.7979 410 352.5319 1 353.2653 2 353.9982 3 354.7306 4 355.4624 415 356.1936 6 356.9243 7 357.6544 8 358.3840 9 359.1131 420 359.8416 1 360.5695 2 361.2969 3 362.0237 4 362.7500 425 363.4758 6 364.2010 7 364.9256 8 365.6497 9 366.3733 430 367.0963 1 367.8188 2 368.5407 3 369.2621 4 369.9829 435 370.7032 6 371.4230 7 372.1422 8 372.8608 9 373.5790 440 374.2966 1 375.0136 2 375.7301 3 376.4461 4 377.1615 445 377.8764 6 378.5907 7 379.3045 8 380.1078 9 380.7305 450 381.4427 1 382.1543 2 382.8654 3 383.5760 4 384.2860 455 384.9958 6 385.7045 7 386.4130 8 387.1209 9 387.8282 460 388.5351 1 389.2414 2 389.9472 3 390.6524 8 CSR 50-5
Present Worth
4 $ 391.3571 465 392.0613 6 392.7650 7 393.4681 8 394.1707 9 394.8727 470 395.5742 1 396.2752 2 396.9757 3 397.6757 4 398.3751 475 399.0740 6 399.7723 7 400.4702 8 401.1675 9 401.8642 480 402.5605 1 403.2562 2 403.9514 3 404.6461 4 405.3403 485 406.0339 6 406.7270 7 406.4196 8 408.1117 9 408.8032 490 409.4943 1 410.1848 2 410.8747 3 411.5642 4 412.2531 495 412.9416 6 413.6295 7 414.3169 8 415.0037 9 415.6901 500 416.3759 1 417.0612 2 417.7460 3 418.4303 4 419.1141 505 419.7973 6 420.4801 7 421.1623 8 421.8440 9 422.5252 510 423.2059 1 423.8860 2 424.5657 3 425.2448 4 425.9234 515 426.6016 6 427.2792 7 427.9562 8 428.6328 9 429.3089 520 429.9845 1 430.6606 INDUSTRIAL RELATIONS
Weeks Present Worth Weeks
2 $ 431.3351 3 432.0091 4 432.6826 525 433.3556 6 434.0281 7 434.7001 8 435.3716 9 436.0426 530 436.7131 1 437.3831 2 438.0526 3 438.7216 4 439.3901 535 440.0581 6 440.7256 7 441.3926 8 442.0591 9 442.7251 540 443.3905 1 444.0554 2 444.7198 3 445.3837 4 446.0471 545 446.7100 6 447.3724 7 448.0343 8 448.6957 9 449.3566 550 450.0170 1 450.6769 2 451.3364 3 451.9954 4 452.6539 555 453.3119 6 453.9694 7 454.6264 8 455.2829 9 455.9389 560 456.5944 1 457.2494 2 457.9039 3 458.5579 4 459.2114 565 459.8644 6 460.5169 7 461.1689 8 461.8204 9 462.4715 570 463.1221 1 463.7722 2 464.4218 3 465.0709 4 465.7195 575 466.3676 6 467.0152 7 467.6623 8 468.3089 9 468.9551 PRESENT WORTH TABLE Present Worth Weeks
580 $ 469.6008 1 470.2460 2 470.8907 3 471.5349 4 472.1786 585 472.8218 6 473.4646 7 474.1069 8 474.7487 9 475.3900 590 476.0308 1 476.6711 2 477.3110 3 477.9504 4 478.5893 595 479.2277 6 479.8656 7 480.5030 8 481.1400 9 481.7765 600 482.4125 1 483.0480 2 483.6830 3 484.3176 4 484.9517 605 485.5853 6 486.2184 7 487.8511 8 487.4833 9 488.1150 610 488.7462 1 489.3769 2 490.0072 3 490.6370 4 491.2663 615 491.8951 6 492.5235 7 493.1514 8 493.7788 9 494.4058 620 495.0323 1 495.6583 2 496.2838 3 496.9089 4 497.5335 625 498.1576 6 498.7813 7 499.4045 8 500.0272 9 500.6494 630 501.2712 1 501.8925 2 502.5133 3 503.1337 4 503.7536 635 504.3730 6 504.9920 7 505.6105 Present Worth
8 $ 506.2285 9 506.8461 640 507.4632 1 508.0798 2 508.6960 3 509.3117 4 509.9269 645 510.5417 6 511.1560 7 511.7699 8 512.3833 9 512.9962 650 513.6087 1 514.2207 2 514.8322 3 515.4433 4 516.0539 655 516.6641 6 517.2738 7 517.8830 8 518.4918 9 519.1001 660 519.7080 1 520.3154 2 520.9223 3 521.5288 4 522.1348 665 522.7404 6 523.3455 7 523.9502 8 524.5544 9 525.1581 670 525.7614 1 526.3642 2 526.9666 3 527.5685 4 528.1700 675 528.7710 6 529.3716 7 529.9717 8 530.5714 9 531.1706 680 531.7694 1 532.3677 2 532.9656 3 533.5630 4 534.1600 685 534.7565 6 535.3526 7 535.9482 8 536.5434 9 537.1381 690 537.7324 1 538.3262 2 538.9196 3 539.5125 AUTHORITY: section 287.650, RSMo 1986.* Department. It is used to compute death ben- Original rule filed Dec. 23, 1953, effective efits payable to widows only. Jan. 3, 1954. Amended: Filed May 1, 1973, effective May 12, 1973.
*Original authority: 287.650, RSMo 1939, amended 1949, 1961, 1980, 1993, 1995, 1998.