Table 12.1 of the Approved Guide is in the following form:
The different cranial nerves are numbered I to XII. For a description of what they are, refer to a medical text or other reference source such as Chapter 2 of the American Medical Association Guides to the Assessment of Permanent Impairment.
Please note that assessments for sight, smell and taste can be made under other tables. They have been included here as well so that this table is complete. Do not make two separate assessments and combine them. Use one or the other. The other relevant tables are Table 6.1 “Visual System”, and Table 7.2 “Ear, Nose and Throat Disorders - Miscellaneous”.
|
% WPI |
UNILATERAL LOSS OR PARALYSIS |
CRITERIA BILATERAL LOSS OR PARALYSIS |
OTHER |
|
0 |
I |
I |
|
|
0 |
XII |
||
|
5 |
V (motor) |
VII (complete loss of taste) |
|
|
10 |
V (sensory) |
XII (swallowing impairment, with diet restricted to semi-solids) |
Swallowing impairment due to one or two combinations of IX, X and XI, and resulting in diet restricted to semi-solids |
|
15 |
VII |
||
|
20 |
Atypical facial neuralgia |
||
|
25 |
II OR |
||
|
25 |
III, IV, VI alone or in combination (diplopia corrected by covering one eye |
||
|
30 |
XII (swallowing impairment, with diet restricted to liquids) |
Swallowing impairment due to one or two combinations of IX, X and XI, and resulting in diet restricted to liquids |
|
|
35 |
V (sensory) |
||
|
45 |
V (motor) |
||
|
50 |
Intractable typical trigeminal neuralgia or tic douloureux |
||
|
60 |
XII (swallowing impairment, with diet by tube feeding or gastronomy |
Swallowing impairment due to one or two combinations of IX, X & XI, and resulting in diet by tube feeding or gastronomy |
|
|
85 |
II |