Manual Single National Disability Rating to Colombia - Decree 917 of 1999 (Part II of II) - Chapter XIII

MANUAL SINGLE NATIONAL DISABILITY
(PART II OF II)

CHAPTER XIII
13. SENSES: vision, hearing and balance, speech, smell, taste

13.1 VISUAL SYSTEM

Overview 13.1.1 For purposes of qualifying for the deficiency by alterations in the vision system should be taken into account the following criteria:

a) Assessment of visual acuity

b) Assessment of visual field, and

c) Assessment of ocular motility.

In cases of impaired visual acuity and / or visual field, should make the assessment of impairment after refractive correction of the defect presented by the individual. When changes are more than one of the above criteria should be combined deficiency values ​​assigned to each of them, for the overall deficit by altering the visual system.

13.1.2. Criteria for the assessment of impairment by changes in central visual acuity. Under the specialist system used for detecting disorders of visual acuity, using the English or the metric system, will use the following conversion table to convert decimal values ​​measures.

TABLE No.13.1 Table of equivalences for visual acuity measurements metric Measures Measures Measures English decimal 20/20 5 / 5 - 6 / 6 0.80

20/25 5/7.5 - 6/7.5 0.70

20/32 6/10 0.60

20/40 5/10 - 6/12 0.50

20/50 6/15 0.40

20/64 5/15 - 6/20 0.30

20/100 5/20 - 6/30 0.20

20/125 5/40 - 6/48 0.10

20/200 5/50 - 6/60 0.10

20/400 5/100 - 6/120 0.05

20/800 6/240 0.00

The following table shows the overall deficit as percentage of decrease in visual acuity.

TABLE No. 13.2 Deficiency Global changes in visual acuity

Visual acuity (Decimal) 0.8 0.7 0.6 0.5 0.4 0.3 0.2 0.1 0.05 0.0 (Ojo

Blind) Enucleation

0.8 0 2 3 4 5 6 8 9 11 12 15

0.7 2 3 4 5 6 8 10 11 13 15 20

0.6 3 4 5 6 8 10 12 14 15 17 25

0.5 4 5 6 8 10 12 15 16 18 20 27

0.4 5 6 8 10 12 15 18 20 23 25 33

0.3 6 8 10 12 15 18 20 23 25 30 35

0.2 8 10 12 15 18 20 23 27 30 33 37

0.1 9 11 14 16 20 23 27 30 33 35 40

0.05 11 13 15 18 23 25 30 33 35 38 45

0.0 (Eye Blind) 12 15 17 20 25 30 33 35 38 45 50

Enucleation 15 20 25 27 33 35 37 40 45 50 50

Explanation of Table 13.2:

a)    In case of loss or decrease in visual acuity of one eye, while the healthy one, the deficiency is determined by the percentage of visual acuity in the first horizontal line of the table.

b)    In cases of loss or bilateral decrease of visual acuity, impairment is determined at the intersection of the horizontal to the vertical column of the visions for the left and right eye.

c)    In case of a single eye, the deficiency will be determined at the intersection of the vertical levels of visual acuity in the first row of the table with the column horizontal blind eye.

d)    If there enucleation of an eye, the percentage of impairment shall be determined at the intersection of the vertical to the horizontal that says enucleation.

13.1.3. Criteria for evaluation of visual field alterations.

For the determination of visual field loss is required to have a study that includes central or peripheral visual field, which must be performed with best corrected visual acuity.

Extension Table No.13.3 minimum degree of each of the axes taken from the point of attachment.

Grade Area

Temporary 85

85 inferior temporal

Bottom 65

Inferior nasal 50

Nasal 60

Superior nasal 55

Top 45

55 superior temporal

Total 500

Inferior hemianopsia axes then undertake inferior, nasal and inferior temporal inferior, recording each kept freezing and the rest of axes its maximum value.

FIGURE 5: MAXIMUM EXTENT OF EACH OF THE LINES IN THE VISUAL FIELD

To calculate the overall deficit for visual field loss should be:

1. Calculate the magnitude of the field by the sum of the loss in degrees in each axis for each eye. Check the maximum normal values ​​in Table 13.3.
2. The magnitude of the field must be converted to the percentage of visual field loss of the eye, according to Table 13.4. If it comes to alterations in the central visual field, previously multiplied by two, taking into account that the maximum magnitude of the visual field is 270 °. In all cases, must obtain the percentage of visual field loss in both eyes.
3. To calculate the overall deficit for visual field loss, apply the following formula: "% Loss worse eye x 0.25 +% loss better eye x 0.75" That is, the major deficiency is multiplied by 0.25 and reduced by 0.75 and then added, resulting in impairment of the whole person impairment of bilateral visual field.

TABLE No.13.4 visual impairment visual field loss in one eye Grades Grades Grades

Conserv% Lost Lost Lost Conserv Conserv%%

0 500 0 170 330 17 340 160 34

10 490 1 180 320 18 350 150 35

20 480 2 190 310 19 360 140 36

30 470 3 200 300 20 370 130 37

40 460 4 210 290 21 380 120 38

50 450 5 220 280 22 390 110 39

60 440 6 230 270 23 400 100 40

70 430 7 240 260 24 410 90 41

80 420 8 250 250 25 420 80 42

90 410 9 260 240 26 430 70 43

100 400 10 270 230 27 440 60 44

110 390 11 280 220 28 450 50 45

120 380 12 290 210 29 460 40 46

130 370 13 300 200 30 470 30 47

140 360 14 310 190 31 480 20 48

150 350 15 320 180 32 490 10 49

160 340 16 330 170 33 500 0 50

Note: In cases which go unreported in the visual field grades lost but the percentage of visual field loss is equivalent to search for missing grades in Table 13.4, taking into account that 100% loss corresponds to 500 ° we lose. Example: We report a 60% loss of sight of his right eye and normal visual field for the left eye: Its equivalence according to Table 13.4 for the right eye is 300 ° lost his left eye and lost 0 °, therefore visual impairment of the right eye is then 30% and the left eye from 0% to find the overall deficit for bilateral visual field loss formula is applied, resulting in 22.5%.

13.1.4. Diplopia (oculomotor function disorders).

Table 13.5. Global deficiency diplopia.

Global Deficiency Criteria (%)

Diplopia in the highlands of sight. 4.0

Diplopia in the bottom of the field. 9.0

Diplopia on lateral gaze. 7.5

Diplopia in all gaze positions (not compensable and that force to occlude one eye). 11.5

13.1.5. Deficiencies of other unilateral eye injury.

Table 13.6 Global Deficiency unilateral ocular injures.

Criteria of the whole person impairment (%)

Total internal ophthalmoplegia, unilateral (accommodation) 11.5

Mydriasis and iris damage when they cause functional impairment, unilateral. 2.5

Ptosis or blepharospasm, unilateral pupil covered. 10.0

Eyelid deformities, unilateral. 5.0

Unilateral epiphora. 5.0

Unilateral lacrimal fistulas 5.0

5.0 bilateral glaucoma

These percentages of impairment, should be added in combination with other concepts found by other alterations, without exceeding the equivalent total eye loss.

EAR 13.2

13.2.1 General.

Within this system we consider the functions of hearing and balance. The hearing capacity of a person shall be evaluated according to language comprehension and speech discrimination hearing. For purposes of the classification of hearing loss is taken into account the frequencies 1000, 2000, 3000 and 4000 Hz must perform three audiometry using the same computer, using the techniques that ensure quality of output, such as idle listening of at least 12 hours, the examination during the first hours of the day, among others.

To determine the loss of working capacity of auditory origin, are required together: auditory evoked potentials, audiometry logo and bone conduction audiometry. The interpretation and overview of the results should be consistent. The bone conduction audiometry were taken as reference to describe this loss. If evoked potentials are reported as normal, although hearing tests are altered the overall deficit was taken as 0%.

13.2.2 Criteria for assessing the deficiency hearing impairment.

Audio evaluation metric must be performing the following calculations:

a) The calculation of the sum of decibel thresholds (SDU) for each ear.

b) The calculation of the binaural impairment.

c) The calculation of the overall deficit.

13.2.2.1. Calculating Decibel Sum Threshold (SDU) for each ear.

To make the calculation of the deficiency mono Follow these steps:

1. For purposes of the qualification will take into account the values ​​of 1000, 2000, 3000 and 4000 Hz for each of the three hearing tests for each ear.
2. To determine the average hearing thresholds of each of the above frequencies, align the thresholds found in the three hearing tests for each frequency and divided by three, finding the average. If the sum of the thresholds is less than 100 dB to 100 dB is approaching. When no hearing at a certain frequency, it is assigned a maximum value of 92 dB.
3. Then add these mean values ​​of the four frequencies for each ear. This represents the SDU of each ear.

13.2.2.2. Calculation of binaural impairment.

Once the SDU for both ears, calculate the binaural impairment as follows:

(% Better ear x 5) + (worst Ear x 1) x 0.5 =% binaural impairment. 6 Remember that the better ear is one whose SDU is about 100. Table 13.7 shows the binaural hearing impairment and include the two above calculations. With the result of binaural loss is estimated the overall deficit.

13.2.2.3 Calculation of the overall deficit.

After obtaining the binaural impairment, calculate the overall deficit as follows:

Overall deficit binaural impairment =% x 0.5

TABLE No. 13.7. Binaural Hearing Impairment

100 0.0 ear

105 0.2 1.0 worse

SDU 110 0.3 1.1 1.9

115 0.5 1.3 2.1 2.8

120 0.7 1.4 2.2 3.0 3.8 SDU better ear

125 0.8 1.6 2.4 3.2 3.9 4.7

130 1.0 1.7 2.5 3.3 4.1 4.9 5.7

135 1.1 1.9 2.7 3.5 4.2 5.0 5.8 6.6

140 1.3 2.1 2.8 3.6 4.4 5.2 6.0 6.7 7.5

145 1.4 2.2 3.0 3.8 4.6 5.3 6.1 6.9 7.7 8.5

150 1.6 2.4 3.2 3.9 4.7 5.5 6.3 7.1 7.8 8.6 9.4

155 1.7 2.5 3.3 4.1 4.9 5.7 6.4 7.2 8.0 8.8 9.6 10.3

160 1.9 2.7 3.5 4.2 5.0 5.8 6.6 7.4 8.2 8.9 9.7 10.5 11.3

165 2.1 2.8 3.6 4.4 5.2 6.0 6.7 7.5 8.3 9.1 9.9 10.7 11.4 12.2

170 2.2 3.0 3.8 4.6 5.3 6.1 6.9 7.7 8.5 9.2 10.0 10.8 11.6 12.4 13.2

175 2.4 3.2 3.9 4.7 5.5 6.3 7.1 7.8 8.6 9.4 10.2 11.0 11.7 12.5 13.3 14.1

180 2.5 3.3 4.1 4.9 5.7 6.4 7.2 8.0 8.8 9.6 10.3 11.1 11.9 12.7 13.5 14.2 15.0

185 2.7 3.5 4.2 5.0 5.8 6.6 7.4 8.2 8.9 9.7 10.5 11.3 12.1 12.8 13.6 14.4 15.2 16.0

190 2.8 3.6 4.4 5.2 6.0 6.7 7.5 8.3 9.1 9.9 10.7 11.4 12.2 13.0 13.8 14.6 15.3 16.1 16.9

195 3.0 3.8 4.6 5.3 6.1 6.9 7.7 8.5 9.2 10.0 10.8 11.6 12.4 13.2 13.9 14.7 15.5 16.3 17.1

200 3.2 3.9 4.7 5.5 6.3 7.1 7.8 8.6 9.4 10.2 11.0 11.7 12.5 13.3 14.1 14.9 15.7 16.4 17.2

205 3.3 4.1 4.9 5.7 6.4 7.2 8.0 8.8 9.6 10.3 11.1 11.9 12.7 13.5 14.2 15.0 15.8 16.6 17.4

210 3.5 4.2 5.0 5.8 6.6 7.4 8.2 8.9 9.7 10.5 11.3 12.1 12.8 13.6 14.4 15.2 16.0 16.7 17.5

215 3.6 4.4 5.2 6.0 6.7 7.5 8.3 9.1 9.9 10.7 11.4 12.2 13.0 13.8 14.6 15.3 16.1 16.9 17.7

220 3.8 4.6 5.3 6.1 6.9 7.7 8.5 9.2 10.0 10.8 11.6 12.4 13.2 13.9 14.7 15.5 16.3 17.1 17.8

225 3.9 4.7 5.5 6.3 7.1 7.8 8.6 9.4 10.2 11.0 11.7 12.5 13.3 14.1 14.9 15.7 16.4 17.2 18.0

230 4.1 4.9 5.7 6.4 7.2 8.0 8.8 9.6 10.3 11.1 11.9 12.7 13.5 14.2 15.0 15.8 16.6 17.4 18.2

235 4.2 5.0 5.8 6.6 7.4 8.2 8.9 9.7 10.5 11.3 12.1 12.8 13.6 14.4 15.2 16.0 16.7 17.5 18.3

240 4.4 5.2 6.0 6.7 7.5 8.3 9.1 9.9 10.7 11.4 12.2 13.0 13.8 14.6 15.3 16.1 16.9 17.7 18.5

245 4.6 5.3 6.1 6.9 7.7 8.5 9.2 10.0 10.8 11.6 12.4 13.2 13.9 14.7 15.5 16.3 17.1 17.8 18.6

250 4.7 5.5 6.3 7.1 7.8 8.6 9.4 10.2 11.0 11.7 12.5 13.3 14.1 14.9 15.7 16.4 17.2 18.0 18.8

255 4.9 5.7 6.4 7.2 8.0 8.8 9.6 10.3 11.1 11.9 12.7 13.5 14.2 15.0 15.8 16.6 17.4 18.2 18.9

260 5.0 5.8 6.6 7.4 8.2 8.9 9.7 10.5 11.3 12.1 12.8 13.6 14.4 15.2 16.0 16.7 17.5 18.3 19.1

265 5.2 6.0 6.7 7.5 8.3 9.1 9.9 10.7 11.4 12.2 13.0 13.8 14.6 15.3 16.1 16.9 17.7 18.5 19.2

270 5.3 6.1 6.9 7.7 8.5 9.2 10.0 10.8 11.6 12.4 13.2 13.9 14.7 15.5 16.3 17.1 17.8 18.6 19.4

275 5.5 6.3 7.1 7.8 8.6 9.4 10.2 11.0 11.7 12.5 13.3 14.1 14.9 15.7 16.4 17.2 18.0 18.8 19.6

280 5.7 6.4 7.2 8.0 8.8 9.6 10.3 11.1 11.9 12.7 13.5 14.2 15.0 15.8 16.6 17.4 18.2 18.9 19.7

285 5.8 6.6 7.4 8.2 8.9 9.7 10.5 11.3 12.1 12.8 13.6 14.4 15.2 16.0 16.7 17.5 18.3 19.1 19.9

290 6.0 6.7 7.5 8.3 9.1 9.9 10.7 11.4 12.2 13.0 13.8 14.6 15.3 16.1 16.9 17.7 18.5 19.2 20.0

295 6.1 6.9 7.7 8.5 9.2 10.0 10.8 11.6 12.4 13.2 13.9 14.7 15.5 16.3 17.1 17.8 18.6 19.4 20.2

300 6.3 7.1 7.8 8.6 9.4 10.2 11.0 11.7 12.5 13.3 14.1 14.9 15.7 16.4 17.2 18.0 18.8 19.6 20.3

305 6.4 7.2 8.0 8.8 9.6 10.3 11.1 11.9 12.7 13.5 14.2 15.0 15.8 16.6 17.4 18.2 18.9 19.7 20.5

310 6.6 7.4 8.2 8.9 9.7 10.5 11.3 12.1 12.8 13.6 14.4 15.2 16.0 16.7 17.5 18.3 19.1 19.9 20.7

315 6.7 7.5 8.3 9.1 9.9 10.7 11.4 12.2 13.0 13.8 14.6 15.3 16.1 16.9 17.7 18.5 19.2 20.0 20.8

320 6.9 7.7 8.5 9.2 10.0 10.8 11.6 12.4 13.2 13.9 14.7 15.5 16.3 17.1 17.8 18.6 19.4 20.2 21.0

325 7.1 7.8 8.6 9.4 10.2 11.0 11.7 12.5 13.3 14.1 14.9 15.7 16.4 17.2 18.0 18.8 19.6 20.3 21.1

330 7.2 8.0 8.8 9.6 10.3 11.1 11.9 12.7 13.5 14.2 15.0 15.8 16.6 17.4 18.2 18.9 19.7 20.5 21.3

335 7.4 8.2 8.9 9.7 10.5 11.3 12.1 12.8 13.6 14.4 15.2 16.0 16.7 17.5 18.3 19.1 19.9 20.7 21.4

340 7.5 8.3 9.1 9.9 10.7 11.4 12.2 13.0 13.8 14.6 15.3 16.1 16.9 17.7 18.5 19.2 20.0 20.8 21.6

345 7.7 8.5 9.2 10.0 10.8 11.6 12.4 13.2 13.9 14.7 15.5 16.3 17.1 17.8 18.6 19.4 20.2 21.0 21.7

350 7.8 8.6 9.4 10.2 11.0 11.7 12.5 13.3 14.1 14.9 15.7 16.4 17.2 18.0 18.8 19.6 20.3 21.1 21.9

355 8.0 8.8 9.6 10.3 11.1 11.9 12.7 13.5 14.2 15.0 15.8 16.6 17.4 18.2 18.9 19.7 20.5 21.3 22.1

360 8.2 8.9 9.7 10.5 11.3 12.1 12.8 13.6 14.4 15.2 16.0 16.7 17.5 18.3 19.1 19.9 20.7 21.4 22.2

365 8.3 9.1 9.9 10.7 11.4 12.2 13.0 13.8 14.6 15.3 16.1 16.9 17.7 18.5 19.2 20.0 20.8 21.6 22.4

368 8.4 9.2 10.0 10.7 11.5 12.3 13.1 13.9 14.7 15.4 16.2 17.0 17.8 18.6 19.3 20.1 20.9 21.7 22.5

100 105 110 115 120 125 130 135 140 145 150 155 160 165 170 175 180 185 190

TABLE No. 13.7. Binaural Hearing Impairment "Continuation"

190

195 17,8

200 18,0 18,8

205 18,2 18,9 19,7

210 18,3 19,1 19,9 20,7

215 18,5 19,2 20,0 20,8 21,6

220 18,6 19,4 20,2 21,0 21,7 22,5

225 18,8 19,6 20,3 21,1 21,9 22,7 23,5

230 18,9 19,7 20,5 21,3 22,1 22,8 23,6 24,4

235 19,1 19,9 20,7 21,4 22,2 23,0 23,8 24,6 25,3

240 19,2 20,0 20,8 21,6 22,4 23,2 23,9 24,7 25,5 26,3

245 19,4 20,2 21,0 21,7 22,5 23,3 24,1 24,9 25,7 26,4 27,2

250 19,6 20,3 21,1 21,9 22,7 23,5 24,2 25,0 25,8 26,6 27,4 28,2

255 19,7 20,5 21,3 22,1 22,8 23,6 24,4 25,2 26,0 26,7 27,5 28,3 29,1

260 19,9 20,7 21,4 22,2 23,0 23,8 24,6 25,3 26,1 26,9 27,7 28,5 29,2 30,0

265 20,0 20,8 21,6 22,4 23,2 23,9 24,7 25,5 26,3 27,1 27,8 28,6 29,4 30,2 31,0

270 20,2 21,0 21,7 22,5 23,3 24,1 24,9 25,7 26,4 27,2 28,0 28,8 29,6 30,3 31,1 31,9

275 20,3 21,1 21,9 22,7 23,5 24,2 25,0 25,8 26,6 27,4 28,2 28,9 29,7 30,5 31,3 32,1 32,8

280 20,5 21,3 22,1 22,8 23,6 24,4 25,2 26,0 26,7 27,5 28,3 29,1 29,9 30,7 31,4 32,2 33,0 33,8

285 20,7 21,4 22,2 23,0 23,8 24,6 25,3 26,1 26,9 27,7 28,5 29,2 30,0 30,8 31,6 32,4 33,2 33,9

290 20,8 21,6 22,4 23,2 23,9 24,7 25,5 26,3 27,1 27,8 28,6 29,4 30,2 31,0 31,7 32,5 33,3 34,1

295 21,0 21,7 22,5 23,3 24,1 24,9 25,7 26,4 27,2 28,0 28,8 29,6 30,3 31,1 31,9 32,7 33,5 34,2

300 21,1 21,9 22,7 23,5 24,2 25,0 25,8 26,6 27,4 28,2 28,9 29,7 30,5 31,3 32,1 32,8 33,6 34,4

305 21,3 22,1 22,8 23,6 24,4 25,2 26,0 26,7 27,5 28,3 29,1 29,9 30,7 31,4 32,2 33,0 33,8 34,6

310 21,4 22,2 23,0 23,8 24,6 25,3 26,1 26,9 27,7 28,5 29,2 30,0 30,8 31,6 32,4 33,2 33,9 34,7

315 21,6 22,4 23,2 23,9 24,7 25,5 26,3 27,1 27,8 28,6 29,4 30,2 31,0 31,7 32,5 33,3 34,1 34,9

320 21,7 22,5 23,3 24,1 24,9 25,7 26,4 27,2 28,0 28,8 29,6 30,3 31,1 31,9 32,7 33,5 34,2 35,0

325 21,9 22,7 23,5 24,2 25,0 25,8 26,6 27,4 28,2 28,9 29,7 30,5 31,3 32,1 32,8 33,6 34,4 35,2

330 22,1 22,8 23,6 24,4 25,2 26,0 26,7 27,5 28,3 29,1 29,9 30,7 31,4 32,2 33,0 33,8 34,6 35,3

335 22,2 23,0 23,8 24,6 25,3 26,1 26,9 27,7 28,5 29,2 30,0 30,8 31,6 32,4 33,2 33,9 34,7 35,5

340 22,4 23,2 23,9 24,7 25,5 26,3 27,1 27,8 28,6 29,4 30,2 31,0 31,7 32,5 33,3 34,1 34,9 35,7

345 22,5 23,3 24,1 24,9 25,7 26,4 27,2 28,0 28,8 29,6 30,3 31,1 31,9 32,7 33,5 34,2 35,0 35,8

350 22,7 23,5 24,2 25,0 25,8 26,6 27,4 28,2 28,9 29,7 30,5 31,3 32,1 32,8 33,6 34,4 35,2 36,0

355 22,8 23,6 24,4 25,2 26,0 26,7 27,5 28,3 29,1 29,9 30,7 31,4 32,2 33,0 33,8 34,6 35,3 36,1

360 23,0 23,8 24,6 25,3 26,1 26,9 27,7 28,5 29,2 30,0 30,8 31,6 32,4 33,2 33,9 34,7 35,5 36,3

365 23,2 23,9 24,7 25,5 26,3 27,1 27,8 28,6 29,4 30,2 31,0 31,7 32,5 33,3 34,1 34,9 35,7 36,4

368 23,2 24,0 24,8 25,6 26,4 27,2 27,9 28,7 29,5 30,3 31,1 31,8 32,6 33,4 34,2 35,0 35,7 36,5

195 200 205 210 215 220 225 230 235 240 245 250 255 260 265 270 275 280

TABLE No. 13.7. Binaural Hearing Impairment "Continuation"

280

285 34,7

290 34,9 35,7

295 35,0 35,8 36,6

300 35,2 36,0 36,7 37,5

305 35,3 36,1 36,9 37,7 38,5

310 35,5 36,3 37,1 37,8 38,6 39,4

315 35,7 36,4 37,2 38,0 38,8 39,6 40,3

320 35,8 36,6 37,4 38,2 38,9 39,7 40,5 41,3

325 36,0 36,7 37,5 38,3 39,1 39,9 40,7 41,4 42,2

330 36,1 36,9 37,7 38,5 39,2 40,0 40,8 41,6 42,4 43,2

335 36,3 37,1 37,8 38,6 39,4 40,2 41,0 41,7 42,5 43,3 44,1

340 36,4 37,2 38,0 38,8 39,6 40,3 41,1 41,9 42,7 43,5 44,2 45,0

345 36,6 37,4 38,2 38,9 39,7 40,5 41,3 42,1 42,8 43,6 44,4 45,2 46,0

350 36,7 37,5 38,3 39,1 39,9 40,7 41,4 42,2 43,0 43,8 44,6 45,3 46,1 46,9

355 36,9 37,7 38,5 39,2 40,0 40,8 41,6 42,4 43,2 43,9 44,7 45,5 46,3 47,1 47,8

360 37,1 37,8 38,6 39,4 40,2 41,0 41,7 42,5 43,3 44,1 44,9 45,7 46,4 47,2 48,0 48,8

365 37,2 38,0 38,8 39,6 40,3 41,1 41,9 42,7 43,5 44,2 45,0 45,8 46,6 47,4 48,2 48,9 49,7

368 37,3 38,1 38,9 39,7 40,4 41,2 42,0 42,8 43,6 44,3 45,1 45,9 46,7 47,5 48,2 49,0 49,8 50,0

285 290 295 300 305 310 315 320 325 330 335 340 345 350 355 360 365 368

13.2.2.4. Special Situations

a) In case of individuals who have a cochlear implant, audiometry should be performed with the implant operation.

b) A cosmetic defects that do not cause functional impairment are not given deficiency.

13.2.3 Criteria for assessment of deficiency and balance disorders.

The evaluation of the auditory system deficiency balance disorders are considered only the problems resulting from defects of the labyrinth, the vestibule and its ways. Not included in this chapter, the dizziness caused by central nervous system disorders, which are described in the chapter on the Central Nervous System.

13.2.3.1. Complete Loss of Vestibular Function

This loss may be unilateral or bilateral. When the loss is unilateral balance has not been permanently altered, so should not be granted a percentage of disability for this condition. When the loss is bilateral can expect some degree of compensation for the kinesthetic and visual mechanisms, so depending on the degree of this compensation the rate will be evaluated in Table 13.8.

13.2.3.2. Criteria for evaluating Global Gap Vestibular Vertigo

Class Description of criteria DeficiencyGlobal (%)

I "There are symptoms of peripheral vertigo," and can perform activities of daily living without any kind of help. 1.0

II "You have symptoms of peripheral vertigo," and can be carried out without assistance, activities of daily living, except those enclosing personal danger or others, like driving all types of vehicles, working at heights, working with management tools that is risky, and so on. 5.0

III "You have symptoms of peripheral vertigo," and can not perform activities of daily living without assistance, except personal care, housekeeping, travel in short distances down the street and go in a vehicle driven by other 15.0

IV "There are symptoms of peripheral vertigo," And, you can not perform activities of daily living, except to take care of itself. 25.0

V "There are symptoms of peripheral vertigo," You can not perform activities of daily living without help, except for personal care and must be homebound 35.0

13.3 SMELL AND TASTE

These rules give a single value of 3% of global impairment of the person when there is a complete loss of these senses.

SPOKEN 13.4

13.4.1 OverviewOrganic loss of speech.

Glossectomy, laryngectomy or cicatricial stenosis of the larynx result in a loss of voice production by its normal means. The evaluation of the organic waste includes language deficiency produce by any means, including rehabilitation phoniatric mechanical or electronic devices. If the condition is due to neurological damage it must be evaluated with the criteria of the chapter.

13.4.2 Evaluation of speech impairment.

TABLE No. 13.8 Global deficiency disorders in speech.

Class Description of criteria Global Deficit (%)

I · audibility. The patient can be heard as sufficient in most cases but sometimes have to make an effort and sometimes this will fail. · Intelligibility. The patient can articulate enough in most cases but sometimes have to repeat and sometimes unable to articulate certain sounds. · Functional efficiency. The patient can pronounce and articles in most cases with adequate speed and ease, but then hesitate or slow down. 2.0

II · audibility. The patient can be heard enough on many occasions, is understood in normal conditions but have difficulty in making himself understood in buses, trains, stations, restaurants etc. · Intelligibility. The patient can articulate enough on many occasions. Can understand anyone saying your name, address, etc. You can make many mistakes and sometimes have great difficulty in articulating the word. · Functional efficiency. El paciente puede pronunciar y articular en MUCHAS ocasiones con velocidad y facilidad adecuada, pero a veces da la impresión de encontrar dificultad y tiene interrupciones, dudas o lo hace despacio. 5.0

III · audibility. The patient can sometimes be heard talking closely with someone else, but have difficulty in noisy. Her voice is inaudible tired quickly and a few seconds. · Intelligibility. The patient can articulate in some cases, talking with family and friends. However, people can not find much difficulty trying to understand, often have to repeat the statement. · Functional efficiency. The patient can speak and articulate in some cases with adequate speed and ease, but at times can only sustain a continuous conversation for brief periods, giving the impression of rapid fatigue 10.0

IV · audibility. The patient can be heard only rarely, rarely hear him. Not listened on the phone, you can whisper but no voice. · Intelligibility. The patient can rarely be heard, it just may give some phonetic units can mumble some names not understand him. · Functional efficiency. The patient can speak and articulate appropriate speed on a few occasions, only short sentences and single words, but can not hold a conversation. She struggles to speak and does so very slowly. 15.0

V · audibility. Can not be heard at all. · Intelligibility. You can not utter a word. · Functional efficiency. He can not pronounce or articulate 20.0