Free Injury Description Table - Alabama


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Pages: 4
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State: Alabama
Category: Workers Compensation
Author: pcrb user
Word Count: 928 Words, 5,552 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://dir.alabama.gov/docs/forms/wcio_part_table.pdf

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Injury Description Table Part of Body Code I. Head Any Combination of Below Parts 10. Multiple Head Injury 11. Skull 12. Brain 13. Ear(s) IAIABC Subsequent Report of Injury (SROI) Codes 13A 13B 13C 14. Eye(s) IAIABC Subsequent Report of Injury (SROI) Codes 14A 14B 14C 15. Nose 16. Teeth 17. Mouth 18. Soft Tissue 19. Facial Bones II. Neck 20. Multiple Neck Injury 21. Vertebrae 22. Disc 23. Spinal Cord 24. Larynx 25. Soft Tissue 26. Trachea III. Upper Extremities 30. Multiple Upper Extremities Any Combination of Below Parts, Excluding Hands and Wrists Combined Any Combination of Below Parts Includes: Spinal Column Bone, "Cervical Segment" Includes: Spinal Column Cartilage, "Cervical Segment" Includes: Nerve Tissue, "Cervical Segment" Includes: Cartilage and Vocal Cords Other than Larynx or Trachea Includes: Jaw Includes: Lips, Tongue, Throat, Taste The loss of eye by enucleation (including disfigurement resulting there from) Total blindness of one eye Blindness in both eyes Includes: Nasal Passage, Sinus, Sense of Smell Total deafness of both ears Total deafness of one ear Where worker prior to injury has suffered a total loss of hearing in one ear, and as a result of the accident loses total hearing in remaining ear Includes: Optic Nerves, Vision, Eye Lids Includes: Hearing, Inside Eardrum Narrative Description

Code 31. Upper Arm 32. Elbow 33. Lower Arm 34. Wrist 35. Hand 36. Finger(s) IAIABC Subsequent Report of Injury (SROI) Codes 36A 36B 36C 36D 36E 36F 36G 36H 36I 36J 36K 36L 36M 36N 36O 36P 37. Thumb 37A 37B 37C 38. Shoulder(s) 39. Wrist (s) & Hand(s) IV. Trunk 40. Multiple Trunk 41. Upper Back Area

Narrative Description Humerus and Corresponding Muscles, Excluding Clavicle and Scapula Radial Head Fore Arm Radius, Ulna and Corresponding Muscles Carpals and Corresponding Muscles Metacarpals and Corresponding Muscles Excluding Wrist or Fingers Other than Thumb and Corresponding Muscles

The loss of an index finger and metacarpal bone there of The loss of an index finger at the proximal joint The loss of an index finger at the second joint The loss of an index finger at the distal joint The loss of a second finger and the metacarpal bone there of The loss of a middle finger at the proximal at the proximal joint The loss of a middle finger at the second joint The loss of a middle finger at the distal joint The loss of a third or ring finger and the metacarpal thereof The loss of a ring finger at the proximal joint The loss of a ring finger at the second joint The loss of a ring finger at the distal joint The loss of a little finger and the metacarpal bone thereof The loss of a little finger at the proximal joint The loss of a little finger at the second joint The loss of a little finger at the distal joint The loss of a thumb and metacarpal bone thereof The loss of a thumb at the proximal joint The loss of a thumb at the second or distal joint
Armpit, Rotator Cuff, Trapezius, Clavicle, Scapula

Any Combination of Below Parts (Thoracic Area) Upper Back Muscles, Excluding, Vertebrae, Disc, Spinal Cord

Code 42. Lower Back Area

Narrative Description (Lumbar Area and Lumbo Sacral) Lower Back Muscles, Excluding Sacrum, Coccyx, Pelvis, Vertebrae, Disc, Spinal Cord Spinal Column Cartilage Other than Cervical Segment Including Ribs, Sternum, Soft Tissue Final Nine Vertebrae-Fused Nerve Tissue Other than Cervical Segment Other than Heart and Lungs

43. Disc 44. Chest 45. Sacrum and Coccyx 46. Pelvis 47. Spinal Cord 48. Internal Organs 49. Heart 60. Lungs 61. Abdomen Including Groin 62. Buttocks 63. Lumbar & or Sacral Vertebrae (Vertebra NOC Trunk) V. Lower Extremities 50. Multiple Lower Extremities 51. Hip 52. Upper Leg 53. Knee 54. Lower Leg 55. Ankle 56. Foot 57. Toes IAIABC Subsequent Report of Injury (SROI) Codes 57A 57B 57C 57D 57E 57F 57G

Excluding Injury to Internal Organs Soft Tissue Bone Portion of the Spinal Column

Any Combination of Below Parts Femur and Corresponding Muscles Patella Tibia, Fibula and Corresponding Muscles Tarsals Metatarsals, Heel, Achilles Tendon and Corresponding Muscles Excluding Ankle or Toes

Little toe metatarsal bone Little toe at distal joint The loss of any other toe with the metatarsal bone thereof The loss of any other toe at the proximal joint Other toe at middle joint The loss of any other toe at the second or distal joint Other toe at distal joint

Code 58. Great Toe IAIABC Subsequent Report of Injury (SROI) Codes 58A 58B 58C VI. Multiple Body Parts 64. Artificial Appliance 65. Insufficient Info to Properly Identify Unclassified 66. No Physical Injury 90. Multiple Body Parts (Including Body Systems & Body Parts)

Narrative Description

The loss of a great toe with the metatarsal bone thereof The loss of a great toe at the proximal joint The loss of great toe at the second or distal joint

Braces, Etc. Insufficient Information to Identify Part Affected Mental Disorder Applies when More than One Major Body Part has been Affected, Such as an Arm and a Leg and Multiple Internal Organs Applies to the Functioning of an Entire Body System Has Been Affected Without Specific Injury to Any Other Part, as in the Case of Poisoning, Corrosive Action, Inflammation, Affecting Internal Organs, Damage to Nerve Centers, Etc. Does NOT Apply When the Systemic Damage Results from an External Injury Affecting an External Part Such as a Back Injury Which Includes Damage to the Nerves of the Spinal Cord. A code referencing the anatomic classification of the injury.

91. Body Systems and Multiple Body Systems

99. Whole Body