Mo. Code Regs. Ann. tit. 8, § 50-5.020
1.09 Disabilities 1.25 2.50 PURPOSE: This rule sets forth procedures to 3.75 evaluate visual disability. 5.00 6.25 (1) Compensable disability for loss of vision should be based on that proportional part of 7.50 the compensation provided by law for loss of 8.75 use or loss of function of one (1) or of both 10.00 eyes which expresses the percentage loss of 11.25 visual efficiency of the individual. 12.50
13.75 means the best acuity obtainable at twenty 15.00 feet fourteen inches (20'14") without the use 16.25 of ophthalmic lenses, except that corrective 17.50 lenses shall be used for natural presbyopia 18.75 and other conditions clearly not the result of 20.00 injury. 21.25
22.50 degree or percentage of competence of the 23.75 eye to accomplish its physiologic function. 25.00
26.25 equivalent to the loss of use of one (1) eye. 27.50
28.75 20/200 (6/60 where the metric system is 30.00 used) or a reduction in visual efficiency to ten 31.25 percent (10%) or less constitutes industrial 32.50 blindness. 33.75
35.00 manent visual disability, the efficiency of the Compensation 8 CSR 50-5
Weeks coordinate function of both eyes should be determined on the basis of permanent partial 36.25 disability of the body as a whole. 37.50 38.75
40.00 each of which has an interdependent and 41.25 coordinate relation to full visual efficiency. 42.50 These coordinate factors are acuteness of 43.75 vision (central visual acuity), field of vision 45.00 and muscle function. Although these factors 46.25 do not possess an equal degree of impor- 47.50 tance, no act of vision is perfect without the 48.75 coordinate action of all. Other functions, 50.00 though secondary and dependent, are recog- 51.25 nized as important, such as, for instance, 52.50 depth perception, stereoscopic vision, fusion 53.75 sense, color perception, adaptation to light 55.00 and dark and accommodation. These sec- 56.25 ondary functions are inherently dependent on 57.50 the status of the three (3) primary coordinate 58.75 functions of vision and they also depend upon 60.00 the condition of the central nervous system.
(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 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.
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-
Snellen age of Notation Visual at 20 feet Snellen at Efficiency or 6 m 14 inches Retained
20/20 14/14 20/25 14/17.5 20/30 14/21 20/35 14/24.5 20/40 14/28 20/45 14/31.5 20/50 14/35 20/60 14/42 20/70 14/49 20/80 14/56 20/90 14/63 20/100 14/70 20/120 14/84 20/140 14/98 20/160 14/112 20/180 14/126 20/200 14/140
100.0 0.0 94.0 6.0 88.0 12.0 82.4 17.6 77.4 22.6 72.8 27.2 68.1 31.9 60.0 40.0 52.5 47.5 46.4 53.6 41.2 58.8 35.9 64.1 27.8 72.2 20.2 79.8 13.0 87.0 6.0 94.0 0.0 100.0
the use of
ophthalmic lenses shall be used in determining the degree of visual efficiency, except when natural presbyopia or other conditions clearly not the result of injury exist; then it is permissible to measure the visual acuity both for distance and near with correction. As an example, a high myopia with a vision without correction of 20/200 or less in each eye should be measured with the best corrective lenses, using the best vision of the uninjured eye as a standard. The practical difficulties of fitting, expense of and tolerance of wearing contact lenses are too great at the present time to favor the use of other than regular ophthalmic lenses to determine the best corrected vision. Having determined the best visual acuity for twenty feet fourteen inches (20'14"), the visual efficiency is ascertained by the weighted values assigned for central visual acuity at twenty feet (20') and central acuity at fourteen inches (14"). A one-fold value is given the distance vision and a twofold value is given for near vision. As an example: best visual acuity twenty feet (20'), 20/40; best visual acuity fourteen inches (14"), 14/35. Reference to Table No. 1 shows 20/40 equals 77.4 retained visual acuity and 14/35 equals 68.1 retained visual acuity. Thus the visual acuity efficiency for one eye would be ((77.4 × 1) plus (68.1 × 2)) divided by 3 equals .712 or 71.2% visual acuity efficiency (or a 28.8% loss).
(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.
which is the field of vision efficiency of the affected eye. (See Field of Vision Chart).
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%).
Loss in Muscle Function
1/20 2/20 3/20 4/20 5/20 6/20 7/20 8/20 9/20 10/20 11/20 12/20 13/20 14/20 15/20 16/20 17/20 18/20 19/20 20/20
MATT BLUNT
TABLE NO. 2
Loss Retained
= 5% = 10% = 15% = 20% = 25% = 30% = 35% = 40% = 45% = 50% = 55% = 60% = 65% = 70% = 75% = 80% = 85% = 90% = 95% = 100%
95% efficient of the two (2) eyes is determined by 90% using only the factors of central visual acuity 85% and the field of vision efficiency. The formu- 80% la for computing binocular visual efficiency 75% loss in weeks is as follows: To the loss of 70% visual efficiency of the poorer eye in weeks 65% (based on the percentage of value of one (1) 60% eye in weeks, one hundred and forty (140) 55% being the basis) add the loss of visual effi- 50% ciency of the second eye in weeks (based on 45% the percentage of the difference between the 40% value of one (1) eye in weeks and the value of 35% both eyes in weeks, that is, four hundred 30%
25% hundred sixty (260) weeks). For examples: 20% poorer eye (right eye), seventy-five percent 15% (75%) loss, 140 ×.75 = 105 weeks; second 10% eye (left eye), five percent (5%) loss, 260 5% ×.05 = 13 weeks; binocular visual efficien- 0% cy, loss one hundred eighteen (118) weeks. 8 CSR 50-5
(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.
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.
Ptosis Loss is visual efficiency Loss
Iridectomy With photo- 30% —Traumatic phobia or or surgical dazzling resulting AUTHORITY: section 287.650, RSMo 1986.*
sent the commutable value of compensation
Symble- Unilateral 10% for permanent partial disability and the death pharon (also *Bilateral See footnote benefit, excluding widows.
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).
| limited muscle | ||||
|---|---|---|---|---|
| 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 | commutable value of compensation for per- | |||
| DISTURBANCE OF COORDINATE | Lagophthalmus Unilateral | 10% | manent partial disability and the death bene- | |
| FACTORS | *Bilateral | See footnote | fit other than to widow only. Source for the | |
| larger part of the table is Workers’ | ||||
| (The percentages are for unilateral losses | Epiphora | Unilateral | 10% | Compensation Law by William R. Schneider, |
| unless otherwise noted) | *Bilateral | See footnote | who gave permission 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% | ||
|---|---|---|---|---|
| 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 | 19, 1958, effective June 30, 1958. Amended: |
| efficiency when it is known by the examining | modation | Filed Sept. 4, 1963, effective Sept. 15, 1963. | ||
| physician that there was present a pre-existing | ||||
| subnormal vision, compensable disability | Eye Brow | Unilateral | 10% | *Original authority: 287.650, RSMo 1939, amended |
| shall be based on the loss incurred as a result | (complete | *Bilateral | See footnote | 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% | 8 CSR 50-5.030 Present Worth Table |
| or no adequate and positive evidence of pre- | (complete | *Bilateral | See footnote | |
| existing subnormal vision, it shall be | loss of) | PURPOSE: The purpose of this rule is to pre- |
Weeks Present Worth Weeks
1 $ 00.9992 PRESENT WORTH TABLE Present Worth Weeks
8 $ 56.7283
1.9977 60 2.9955 1 3.9925 2 4.9887 3 5.9842 4 6.9789 5 7.9739 6 8.9661 7 9.9586 8 10.9503 9 11.9413 70 12.9316 1 13.9211 2 14.9098 3 15.8978 4 16.8851 5 17.8716 6 18.8574 7 19.8424 8 20.8267 9 21.8102 80 22.7930 1 23.7751 2 24.7564 3 25.7370 4 26.7168 5 27.6959 6 28.6743 7 29.6519 8 30.6288 9 31.6050 90 32.5804 1 33.5550 2 34.5200 3 35.5022 4 36.4747 5 37.4464 6 38.4174 7 39.3877 8 40.3572 9 41.3261 100 42.2942 1 43.2615 2 44.2281 3 45.1940 4 46.1592 5 47.1237 6 48.0874 7 49.0504 8 50.1027 9 50.9742 110 51.9350 1 52.8951 2 53.8545 3 54.8131 4 55.7711 5 8 CSR 50-5
Present Worth
6 $ 111.0284
57.6847 7 58.6405 8 59.5955 9 60.5499 120 61.5035 1 62.4563 2 63.4085 3 64.3599 4 65.3107 5 66.2607 6 67.2100 7 68.1585 8 69.1064 9 70.0536 130 71.0000 1 71.9457 2 72.8907 3 73.8350 4 74.7786 5 75.7215 6 76.6636 7 77.6051 8 78.5458 9 79.4858 140 80.4252 1 81.3638 2 82.3017 3 83.2389 4 84.1754 5 85.1112 6 86.0462 7 86.9806 8 87.9142 9 88.8471 150 89.7794 1 90.7109 2 91.6418 3 92.5719 4 93.5014 155 94.4301 6 95.3581 7 96.2855 8 97.2122 9 98.1381 160 99.0633 1 99.9879 2 100.9118 3 101.8349 4 102.7574 165 103.6792 6 104.6002 7 105.5206 8 106.4403 9 107.3593 170 108.2776 1 109.1952 2 110.1122 3 111.9439 112.8588 113.7729 114.6864 115.5992 116.5112 117.4226 118.3334 119.2434 120.1527 121.0614 121.9694 122.8766 123.7832 124.6892 125.5944 126.4989 127.4028 128.3060 129.2085 130.1103 131.0115 131.9119 132.8117 133.7108 134.6092 135.5070 136.4041 137.3005 138.1962 139.0913 139.9856 140.8794 141.7724 142.6648 143.5564 144.4474 145.3378 146.2274 147.1164 148.0048 148.8924 149.7794 150.6657 151.5514 152.4363 153.3207 154.2043 155.0873 155.9696 156.8512 157.7322 158.6126 159.4922 160.3712 161.2495 162.1272 Weeks Present Worth Weeks
4 $ 163.0042 PRESENT WORTH TABLE Present Worth Weeks
163.8806 3 164.7563 4 165.6313 235 166.5057 6 167.3794 7 168.2524 8 169.1248 9 169.9966 240 170.8676 1 171.7380 2 172.6078 3 173.4769 4 174.3454 245 175.2132 6 176.0803 7 176.9468 8 177.8126 9 178.6778 250 179.5424 1 180.4063 2 181.2695 3 182.1321 4 182.9940 255 183.8553 6 184.7159 7 185.5758 8 186.4352 9 187.2938 260 188.1519 1 189.0093 2 189.8660 3 190.7221 4 191.5775 265 192.4323 6 193.2865 7 194.1400 8 194.9929 9 195.8451 270 196.6967 1 197.5476 2 198.3980 3 199.2476 4 200.0966 275 200.9450 6 201.7928 7 202.6398 8 203.4863 9 204.3321 280 205.1773 1 206.0219 2 206.8658 3 207.7090 4 208.5517 285 209.3937 6 210.2351 7 211.0758 8 211.9159 9 Present Worth
$ 212.7554 290 $ 260.3771 213.5942 1 214.4324 2 215.2700 3 216.1069 4 216.9432 295 217.7789 6 218.6139 7 219.4484 8 220.2821 9 221.1158 300 221.9478 222.7797 2 223.6110 3 224.4417 4 225.2717 305 226.1011 6 226.9299 7 227.7580 8 228.5856 9 229.4125 310 230.2387 1 231.0644 2 231.8894 3 232.7139 4 233.5377 315 234.3608 6 235.1834 7 236.0053 8 236.8266 9 237.6473 320 238.4674 1 239.2868 2 240.1056 3 240.9238 4 241.7414 325 242.5584 6 243.3748 7 244.1905 8 245.0056 9 245.8202 330 246.6341 1 247.4474 2 248.2600 3 249.0721 4 249.8836 335 250.6944 6 251.5047 7 252.3143 8 253.1233 9 253.9317 340 254.7395 1 255.5467 2 256.3533 3 257.1593 4 257.9647 345 258.7694 6 259.5736 7 261.1801 261.9824 262.7841 263.5853 264.3858 265.1857 265.9850 266.7837 267.5818 268.3793 269.1762 269.9725 270.7682 271.5633 272.3578 273.1516 273.9449 274.7376 275.5297 276.3212 277.1121 277.9024 278.6921 279.4812 280.2698 281.0577 281.8450 282.6317 283.4179 284.2034 284.9884 285.7727 286.5565 287.3397 288.1223 288.9043 289.6857 290.4666 291.2468 292.0265 292.8055 293.5840 294.3619 295.1302 295.9160 296.6921 297.4677 298.2426 299.1070 299.7908 300.5641 301.3367 302.1088 302.8802 303.6511 304.4214 305.1912 Weeks Present Worth Weeks
8 $ 305.9603 PRESENT WORTH TABLE Present Worth Weeks
6 $ 349.5926
306.7289 7 307.4969 8 308.2643 9 309.0311 410 309.7974 1 310.5630 2 311.3281 3 312.0926 4 312.8566 415 313.6200 6 314.3827 7 315.1450 8 315.9066 316.6677 420 317.4282 1 318.1881 2 318.9474 3 319.7062 4 320.4644 425 321.2220 6 321.9791 7 322.7356 8 323.4915 9 324.2468 430 324.0016 1 325.7558 2 326.5094 3 327.2625 4 328.0150 435 328.7669 6 329.5183 7 330.2691 8 331.0194 9 331.7690 440 332.5181 1 333.2667 2 334.0147 3 334.7621 4 335.5089 445 336.2552 6 337.0010 7 337.7461 8 338.4907 9 339.2348 450 339.9782 1 340.7212 2 341.4635 3 342.2053 4 342.9466 455 343.6872 6 344.4274 7 345.1669 8 345.9059 9 346.6444 460 347.3823 1 348.1106 2 348.8564 3 8 CSR 50-5
Present Worth
4 $ 391.3571
350.3282 465 351.0633 6 351.7979 7 352.5319 8 353.2653 9 353.9982 470 354.7306 1 355.4624 2 356.1936 3 356.9243 4 357.6544 475 358.3840 6 359.1131 7 359.8416 8 360.5695 9 361.2969 480 362.0237 1 362.7500 2 363.4758 3 364.2010 4 364.9256 485 365.6497 6 366.3733 7 367.0963 8 367.8188 9 368.5407 490 369.2621 1 369.9829 2 370.7032 3 371.4230 4 372.1422 495 372.8608 6 373.5790 7 374.2966 8 375.0136 9 375.7301 500 376.4461 1 377.1615 2 377.8764 3 378.5907 4 379.3045 505 380.1078 6 380.7305 7 381.4427 8 382.1543 9 382.8654 510 383.5760 1 384.2860 2 384.9958 3 385.7045 4 386.4130 515 387.1209 6 387.8282 7 388.5351 8 389.2414 9 389.9472 520 390.6524 1 392.0613 392.7650 393.4681 394.1707 394.8727 395.5742 396.2752 396.9757 397.6757 398.3751 399.0740 399.7723 400.4702 401.1675 401.8642 402.5605 403.2562 403.9514 404.6461 405.3403 406.0339 406.7270 406.4196 408.1117 408.8032 409.4943 410.1848 410.8747 411.5642 412.2531 412.9416 413.6295 414.3169 415.0037 415.6901 416.3759 417.0612 417.7460 418.4303 419.1141 419.7973 420.4801 421.1623 421.8440 422.5252 423.2059 423.8860 424.5657 425.2448 425.9234 426.6016 427.2792 427.9562 428.6328 429.3089 429.9845 430.6606 Weeks Present Worth Weeks
2 $ 431.3351 PRESENT WORTH TABLE Present Worth Weeks
432.0091 1 432.6826 2 433.3556 3 434.0281 4 434.7001 585 435.3716 6 436.0426 7 436.7131 8 437.3831 9 438.0526 590 438.7216 1 439.3901 2 440.0581 3 440.7256 4 441.3926 595 442.0591 6 442.7251 7 443.3905 8 444.0554 9 444.7198 600 445.3837 1 446.0471 2 446.7100 3 447.3724 4 448.0343 605 448.6957 6 449.3566 7 450.0170 8 450.6769 9 451.3364 610 451.9954 1 452.6539 2 453.3119 3 453.9694 4 454.6264 615 455.2829 6 455.9389 7 456.5944 8 457.2494 9 457.9039 620 458.5579 1 459.2114 2 459.8644 3 460.5169 4 461.1689 625 461.8204 6 462.4715 7 463.1221 8 463.7722 9 464.4218 630 465.0709 1 465.7195 2 466.3676 3 467.0152 4 467.6623 635 468.3089 6 468.9551 7 Present Worth
$ 469.6008 8 $ 506.2285 470.2460 9 470.8907 640 471.5349 1 472.1786 2 472.8218 3 473.4646 4 474.1069 645 474.7487 6 475.3900 7 476.0308 8 476.6711 9 477.3110 650 477.9504 1 478.5893 2 479.2277 3 479.8656 4 480.5030 655 481.1400 6 481.7765 7 482.4125 8 483.0480 9 483.6830 660 484.3176 1 484.9517 2 485.5853 3 486.2184 4 487.8511 665 487.4833 6 488.1150 7 488.7462 8 489.3769 9 490.0072 670 490.6370 1 491.2663 2 491.8951 3 492.5235 4 493.1514 675 493.7788 6 494.4058 7 495.0323 8 495.6583 9 496.2838 680 496.9089 1 497.5335 2 498.1576 3 498.7813 4 499.4045 685 500.0272 6 500.6494 7 501.2712 8 501.8925 9 502.5133 690 503.1337 1 503.7536 2 504.3730 3 504.9920 505.6105 506.8461 507.4632 508.0798 508.6960 509.3117 509.9269 510.5417 511.1560 511.7699 512.3833 512.9962 513.6087 514.2207 514.8322 515.4433 516.0539 516.6641 517.2738 517.8830 518.4918 519.1001 519.7080 520.3154 520.9223 521.5288 522.1348 522.7404 523.3455 523.9502 524.5544 525.1581 525.7614 526.3642 526.9666 527.5685 528.1700 528.7710 529.3716 529.9717 530.5714 531.1706 531.7694 532.3677 532.9656 533.5630 534.1600 534.7565 535.3526 535.9482 536.5434 537.1381 537.7324 538.3262 538.9196 539.5125 AUTHORITY: section 287.650, RSMo 1986.* Original rule filed Dec. 23, 1953, effective 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.