Minnesota Rule 5223.0390
Minnesota lumbar spine PPD rating
Rule 5223.0390 rates permanent lumbar impairment under one category of subpart 2 (fractures), 3 (lumbar pain syndrome), or 4 (radicular syndromes), with once-only add-ons under items 4.D and 4.E and fusion add-ons under subpart 5 that attach only to a pain or radicular category.
Low-back ratings people actually search
A lumbar disc, fusion, or radiculopathy rating is a Rule 5223.0390 category, not a doctor's AMA Guides number. The families on this page pick one category each. Fusion has its own carve-out so you do not stack a fusion percent on top of a category the rule already treats as exclusive.
Wear from years of work with no single accident can still be a Minnesota injury. If that is the history, read the Gillette guide after you find the category that matches the records.
Rule text from the Minnesota Revisor of Statutes, retrieved 2026-08-02.
This is my working reading of Minnesota Rule chapter 5223. I keep checking it against the official rule text and published decisions. If a category, percent, or combination looks wrong, email hello@mncompbuddy.com and say what you found. A mismatch is a reason to look again, not a reason to treat this tool or a doctor rating as automatically correct.
How the rule decides
Each group below is a set of alternatives: the facts select at most one category from each group. Add-ons attach to their base category as the rule directs and are added, not statutorily combined.
Choose one: lumbar primary
Requires: Which lumbar spine category family fits the condition: fracture (subpart 2); and Type of vertebral fracture: compression fracture (item a); and Greatest loss of vertebral height, as a percent of 10 percent or less.
R. 5223.0390, subp. 2.A(1)
Requires: Which lumbar spine category family fits the condition: fracture (subpart 2); and Type of vertebral fracture: compression fracture (item a); and Greatest loss of vertebral height, as a percent above 10 percent; and Greatest loss of vertebral height, as a percent of 25 percent or less.
R. 5223.0390, subp. 2.A(2)
Requires: Which lumbar spine category family fits the condition: fracture (subpart 2); and Type of vertebral fracture: compression fracture (item a); and Greatest loss of vertebral height, as a percent above 25 percent; and Greatest loss of vertebral height, as a percent of 50 percent or less.
R. 5223.0390, subp. 2.A(3)
Requires: Which lumbar spine category family fits the condition: fracture (subpart 2); and Type of vertebral fracture: compression fracture (item a); and Greatest loss of vertebral height, as a percent above 50 percent.
R. 5223.0390, subp. 2.A(4)
Requires: Which lumbar spine category family fits the condition: fracture (subpart 2); and Type of vertebral fracture: posterior element fracture with dislocation (item b); and not: whether surgery was performed for the fracture; and Whether normal reduction was achieved.
R. 5223.0390, subp. 2.B(1)
Requires: Which lumbar spine category family fits the condition: fracture (subpart 2); and Type of vertebral fracture: posterior element fracture with dislocation (item b); and Whether surgery was performed for the fracture; and Whether normal reduction was achieved.
R. 5223.0390, subp. 2.B(2)
Requires: Which lumbar spine category family fits the condition: fracture (subpart 2); and Type of vertebral fracture: posterior element fracture with dislocation (item b); and not: whether surgery was performed for the fracture; and not: whether normal reduction was achieved.
R. 5223.0390, subp. 2.B(3)
Requires: Which lumbar spine category family fits the condition: fracture (subpart 2); and Type of vertebral fracture: posterior element fracture with dislocation (item b); and Whether surgery was performed for the fracture; and not: whether normal reduction was achieved.
R. 5223.0390, subp. 2.B(4)
Requires: Which lumbar spine category family fits the condition: fracture (subpart 2); and Type of vertebral fracture: other documented acute fracture (item c).
R. 5223.0390, subp. 2.C
Requires: Which lumbar spine category family fits the condition: lumbar spine pain syndrome (subpart 3); and not: persistent objective clinical findings in the lumbar spine (involuntary muscle tightness, or for radicular categories, objective radicular findings).
R. 5223.0390, subp. 3.A
Requires: Which lumbar spine category family fits the condition: lumbar spine pain syndrome (subpart 3); and Persistent objective clinical findings in the lumbar spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: no radiographic abnormality.
R. 5223.0390, subp. 3.B
Requires: Which lumbar spine category family fits the condition: lumbar spine pain syndrome (subpart 3); and Persistent objective clinical findings in the lumbar spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: radiographic abnormality not specifically addressed elsewhere (no nerve impingement); and Number of vertebral levels with the imaging abnormality is 1.
R. 5223.0390, subp. 3.C(1)
Requires: Which lumbar spine category family fits the condition: lumbar spine pain syndrome (subpart 3); and Persistent objective clinical findings in the lumbar spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: radiographic abnormality not specifically addressed elsewhere (no nerve impingement); and Number of vertebral levels with the imaging abnormality of 2 or more.
R. 5223.0390, subp. 3.C(2)
Requires: Which lumbar spine category family fits the condition: lumbar spine pain syndrome (subpart 3); and Persistent objective clinical findings in the lumbar spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: spondylolisthesis; and Spondylolisthesis grade (defined at 5223.0310, subparts 49 to 52) is 1.
R. 5223.0390, subp. 3.D(1)
Requires: Which lumbar spine category family fits the condition: lumbar spine pain syndrome (subpart 3); and Persistent objective clinical findings in the lumbar spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: spondylolisthesis; and Spondylolisthesis grade (defined at 5223.0310, subparts 49 to 52) is 2.
R. 5223.0390, subp. 3.D(2)
Requires: Which lumbar spine category family fits the condition: lumbar spine pain syndrome (subpart 3); and Persistent objective clinical findings in the lumbar spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: spondylolisthesis; and Spondylolisthesis grade (defined at 5223.0310, subparts 49 to 52): 3 or 4.
R. 5223.0390, subp. 3.D(3)
Requires: Which lumbar spine category family fits the condition: radicular syndrome (subpart 4); and not: persistent objective clinical findings in the lumbar spine (involuntary muscle tightness, or for radicular categories, objective radicular findings).
R. 5223.0390, subp. 4.A
Requires: Which lumbar spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the lumbar spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: no radiographic abnormality.
R. 5223.0390, subp. 4.B
Requires: Which lumbar spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the lumbar spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: radiographic abnormality not specifically addressed elsewhere (no nerve impingement); and Number of vertebral levels with the imaging abnormality is 1; and not: a surgery other than a fusion was performed as part of the treatment.
R. 5223.0390, subp. 4.C(1)
Requires: Which lumbar spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the lumbar spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: radiographic abnormality not specifically addressed elsewhere (no nerve impingement); and Number of vertebral levels with the imaging abnormality of 2 or more; and not: a surgery other than a fusion was performed as part of the treatment.
R. 5223.0390, subp. 4.C(2)
Requires: Which lumbar spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the lumbar spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: radiographic abnormality not specifically addressed elsewhere (no nerve impingement); and A surgery other than a fusion was performed as part of the treatment; and Number of levels operated on (non-fusion surgery) is 1.
R. 5223.0390, subp. 4.C(3)
Requires: Which lumbar spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the lumbar spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: radiographic abnormality not specifically addressed elsewhere (no nerve impingement); and A surgery other than a fusion was performed as part of the treatment; and Number of levels operated on (non-fusion surgery) of 2 or more.
R. 5223.0390, subp. 4.C(4)
Requires: Which lumbar spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the lumbar spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: disc bulge, protrusion, or herniation impinging a nerve root, correlated with the exam.
R. 5223.0390, subp. 4.D
Requires: Which lumbar spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the lumbar spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: spinal stenosis impinging a nerve root, correlated with the exam.
R. 5223.0390, subp. 4.E
Add-ons
Requires: Which lumbar spine category family fits the condition: fracture (subpart 2); and Type of vertebral fracture: compression fracture (item a) or posterior element fracture with dislocation (item b) or other documented acute fracture (item c); and Whether more than one vertebral level was fractured.
R. 5223.0390, subp. 2.D
Requires: Which lumbar spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the lumbar spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: disc bulge, protrusion, or herniation impinging a nerve root, correlated with the exam; and Chronic radicular pain or paresthesia persisting despite treatment.
R. 5223.0390, subp. 4.D(1)
Requires: Which lumbar spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the lumbar spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: disc bulge, protrusion, or herniation impinging a nerve root, correlated with the exam; and A surgery other than a fusion was performed as part of the treatment; and not: a fusion was performed as part or all of the surgical treatment.
R. 5223.0390, subp. 4.D(2)
Requires: Which lumbar spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the lumbar spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: disc bulge, protrusion, or herniation impinging a nerve root, correlated with the exam; and A surgery other than a fusion was performed as part of the treatment; and One or more additional surgeries, other than a fusion, after the first; and not: a fusion was performed as part or all of the surgical treatment.
R. 5223.0390, subp. 4.D(3)
Requires: Which lumbar spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the lumbar spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: disc bulge, protrusion, or herniation impinging a nerve root, correlated with the exam; and An additional concurrent lesion meeting the same criteria (contralateral side at the same level, or either side at another level).
R. 5223.0390, subp. 4.D(4)
Requires: Which lumbar spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the lumbar spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: spinal stenosis impinging a nerve root, correlated with the exam; and Chronic radicular pain or paresthesia persisting despite treatment.
R. 5223.0390, subp. 4.E(1)
Requires: Which lumbar spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the lumbar spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: spinal stenosis impinging a nerve root, correlated with the exam; and A surgery other than a fusion was performed as part of the treatment; and not: a fusion was performed as part or all of the surgical treatment.
R. 5223.0390, subp. 4.E(2)
Requires: Which lumbar spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the lumbar spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: spinal stenosis impinging a nerve root, correlated with the exam; and A surgery other than a fusion was performed as part of the treatment; and One or more additional surgeries, other than a fusion, after the first; and not: a fusion was performed as part or all of the surgical treatment.
R. 5223.0390, subp. 4.E(3)
Requires: Which lumbar spine category family fits the condition: radicular syndrome (subpart 4); and Persistent objective clinical findings in the lumbar spine (involuntary muscle tightness, or for radicular categories, objective radicular findings); and What imaging shows, at its most severe: spinal stenosis impinging a nerve root, correlated with the exam; and An additional concurrent lesion meeting the same criteria (contralateral side at the same level, or either side at another level).
R. 5223.0390, subp. 4.E(4)
Requires: Which lumbar spine category family fits the condition: lumbar spine pain syndrome (subpart 3) or radicular syndrome (subpart 4); and A fusion was performed as part or all of the surgical treatment; and Number of levels fused is 1.
R. 5223.0390, subp. 5.A
Requires: Which lumbar spine category family fits the condition: lumbar spine pain syndrome (subpart 3) or radicular syndrome (subpart 4); and A fusion was performed as part or all of the surgical treatment; and Number of levels fused of 2 or more.
R. 5223.0390, subp. 5.B
What the records must show
These are the facts the rule turns on. If one is unknown, the affected categories stay open questions with the document that would settle them; an unknown never counts as a no.
Proof: MRI report; CT scan report; x-ray report; myelogram report; clinic note documenting persistent findings; MMI report; IME report
Proof: MRI report; CT scan report; x-ray report; myelogram report
Proof: MRI report; CT scan report; x-ray report; myelogram report
Proof: operative report
Proof: MRI report; CT scan report; x-ray report; myelogram report; operative report
Proof: MRI report; CT scan report; x-ray report; myelogram report
Proof: clinic note documenting persistent findings; MMI report; IME report; EMG report
Proof: MRI report; CT scan report; x-ray report; myelogram report
Proof: MRI report; CT scan report; x-ray report; myelogram report
Proof: x-ray report; MRI report
Proof: operative report
Proof: operative report
Proof: operative report
Proof: clinic note documenting persistent findings; MMI report; IME report
Proof: MRI report; CT scan report; x-ray report; myelogram report
Proof: operative report
Proof: operative report
Worked examples with receipts
Each example runs through the same engine the calculator uses. The category total, the components, and the citations are computed, not typed in.
Correlated disc herniation with a three-level fusion (audit scenario S19)
whole-body total
Date of injury 2024-01-01
- Which lumbar spine category family fits the condition: radicular syndrome (subpart 4)
- Persistent objective clinical findings in the lumbar spine (involuntary muscle tightness, or for radicular categories, objective radicular findings): yes
- What imaging shows, at its most severe: disc bulge, protrusion, or herniation impinging a nerve root, correlated with the exam
- A fusion was performed as part or all of the surgical treatment: yes
- Number of levels fused: 3
- A surgery other than a fusion was performed as part of the treatment: no
- Chronic radicular pain or paresthesia persisting despite treatment: no
- An additional concurrent lesion meeting the same criteria (contralateral side at the same level, or either side at another level): no
- Lumbar Radicular Syndrome D: Disc Impingement + Objective Radicular Findings (Base): 19%
- Whole-body total: 19%
4.D base, chronic symptoms, two-level fusion (audit scenario S1)
whole-body total
Date of injury 2024-01-01
- Which lumbar spine category family fits the condition: radicular syndrome (subpart 4)
- Persistent objective clinical findings in the lumbar spine (involuntary muscle tightness, or for radicular categories, objective radicular findings): yes
- What imaging shows, at its most severe: disc bulge, protrusion, or herniation impinging a nerve root, correlated with the exam
- Chronic radicular pain or paresthesia persisting despite treatment: yes
- A fusion was performed as part or all of the surgical treatment: yes
- Number of levels fused: 2
- A surgery other than a fusion was performed as part of the treatment: no
- An additional concurrent lesion meeting the same criteria (contralateral side at the same level, or either side at another level): no
- Lumbar Radicular Syndrome D: Disc Impingement + Objective Radicular Findings (Base): 22%
- Whole-body total: 22%
Two-level compression fracture with 60 percent height loss (audit scenario S21)
whole-body total
Date of injury 2024-01-01
- Which lumbar spine category family fits the condition: fracture (subpart 2)
- Type of vertebral fracture: compression fracture (item a)
- Greatest loss of vertebral height, as a percent: 60
- Whether more than one vertebral level was fractured: yes
- Lumbar Compression Fracture: >50% Height Loss: 18%
- Whole-body total: 18%
Full 4.D ladder: base plus every subitem (audit scenario S4)
whole-body total
Date of injury 2024-01-01
- Which lumbar spine category family fits the condition: radicular syndrome (subpart 4)
- Persistent objective clinical findings in the lumbar spine (involuntary muscle tightness, or for radicular categories, objective radicular findings): yes
- What imaging shows, at its most severe: disc bulge, protrusion, or herniation impinging a nerve root, correlated with the exam
- Chronic radicular pain or paresthesia persisting despite treatment: yes
- A surgery other than a fusion was performed as part of the treatment: yes
- One or more additional surgeries, other than a fusion, after the first: yes
- An additional concurrent lesion meeting the same criteria (contralateral side at the same level, or either side at another level): yes
- A fusion was performed as part or all of the surgical treatment: no
- Lumbar Radicular Syndrome D: Disc Impingement + Objective Radicular Findings (Base): 25%
- Whole-body total: 25%
Full 4.E ladder: base plus every subitem (audit scenario S5)
whole-body total
Date of injury 2024-01-01
- Which lumbar spine category family fits the condition: radicular syndrome (subpart 4)
- Persistent objective clinical findings in the lumbar spine (involuntary muscle tightness, or for radicular categories, objective radicular findings): yes
- What imaging shows, at its most severe: spinal stenosis impinging a nerve root, correlated with the exam
- Chronic radicular pain or paresthesia persisting despite treatment: yes
- A surgery other than a fusion was performed as part of the treatment: yes
- One or more additional surgeries, other than a fusion, after the first: yes
- An additional concurrent lesion meeting the same criteria (contralateral side at the same level, or either side at another level): yes
- A fusion was performed as part or all of the surgical treatment: no
- Lumbar Radicular Syndrome E: Spinal Stenosis + Objective Radicular Findings (Base): 30%
- Whole-body total: 30%
Common questions
Can a lumbar fracture rating and a radicular rating be combined for one injury?
No. Subpart 1 allows the impairing condition from a single injury to be rated under only one category of subpart 2, 3, or 4. The category that most closely represents the condition applies.
Does a fusion add to a fracture rating?
No. Subpart 5 adds its percent to the otherwise appropriate category in subpart 3 or 4 only. A fracture rated under subpart 2 does not take a fusion add-on.
What if it is unknown whether surgery was performed?
The graph reports the affected categories as unresolved and names the missing fact and the documents that would settle it (an operative report). An unknown never silently counts as a no.
Interpretive notes
- Known simplification held over from the audited ppd-v2 model: the single fact medical.objectiveFindings stands in for both "persistent objective clinical findings confined to the region" (items B and C) and "objective radicular findings" (items D and E). Splitting these is an attorney-review decision; the graph flags it rather than changing audited rating behavior.
What to do next
Turn a category percent into dollars, combine multiple ratings, or see permanency inside a full settlement value.
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- PPD combination calculator
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