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HYPOGLYCEMIA
Class 1. Impairmentof the Whole Person, 0% A patient has Class i impairment when surgical removal of an islet-cell adenoma results in complete remission of the symptoms and signs of hypoglycemia, and there are no postoperative sequelae.
Class 2. Impairment of the Whole Person, 1—50% A patient with symptoms and signs of hypoglycemia has Class 2 impairment of the whole person ranging from 1% to 50%, depending on the degree of control obtained with diet and medications and on how the condition affects activities of daily living.
GONADS A patient with anatomic loss or alteration of the gonads that results in an absence or abnormally high level of gonadal hormones would have 0% to 5% impairment of the whole person. Impairment due to inability to reproduce and other impairments associated with gonadal dysfunction should be evaluated in accordance with the criteria set forth in the genitourinary section.
MAMMARY GLANDS The mammary glands make, store, and deliver milk. Absence of the mam mary glands does not cause impairment of the whole person in males, but in females it will prevent nursing. Absence of mammary gland function in females due to an endocrine disorder can be rated 0—20% of the whole person. Cosmetic deformities should be rated under the section covering skin. In some endocrine disOrders there may be galactorrhea in the female and gynecomastia in the male. Gynecomastia in the male may be accompanied by galactorrhea.A female patient in the childbearing age with absence of the breasts, a patient with galactorrhea sufficient to require the use of absorbent pads, and a male patient with painful gynecomastia that interferes in the performance of daily activities would each have 0% to 5% impairment of the whole person.
METABOLIC BONE DISEASE Metabolic bone disease such as osteoporosis, vitamin D-resistant osteomalacia, and Paget’s disease, may require continuous therapy. These conditions; unless accompanied by pain, skeletal deformity, or peripheral nerve involvement, should be rated at 0% impairment of the whole person. When continuous hormones and mineral therapy give complete relief of symptoms, impairment of the whole person may be considered to be 3%. When continuous therapy is required to relieve pain, and the activities of daily living are restricted because of pain, the rating should be 5% to15% impairment of the whole person. Any associated loss of motion should be evaluated in accordance with the criteria set forth in the section on the extremities and spine, and the section on the nervous system.
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