Minnesota Rule 5223.0470
Minnesota wrist and carpal tunnel PPD rating
Rule 5223.0470 rates the wrist under exclusive categories (painful organic syndrome including tendonitis and de Quervain syndrome, and the ulnar/radial/median entrapment ladders, where carpal tunnel syndrome persisting despite treatment with EMG confirmation pays three percent), combinable categories (the arthroplasty group from total wrist at 18 percent down to pisiform excision at 2, the carpal instability ladder at 4/7/11, the unratable fracture catch-all), and loss of measured motion under subpart 4. Distinct impairing conditions combine under 5223.0300, subpart 3, item E, and the whole part is capped at the amputation value for the arm at the wrist.
Carpal tunnel on this schedule
Carpal tunnel is the median-nerve entrapment ladder in Minnesota Rule 5223.0470. A resolved case, a persistent case without EMG confirmation, and a persistent case with EMG confirmation are different rungs. The schedule pays three percent when the syndrome persists despite treatment and EMG confirms the entrapment.
Guyon canal (ulnar) and radial sensory entrapment use the same three-rung pattern. Arthroplasty, carpal instability, and motion loss are separate categories and can combine when the rule says so.
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.
The percents on this page are the condition categories. This part also rates measured motion loss under subpart 4 (31 clauses). Those numbers live in the guided calculator. A total here is not the whole rating when the records also show lost motion.
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: wrist pain syndrome
Requires: Painful organic syndrome (as defined at 5223.0310, subp. 40), including tendonitis syndrome and de Quervain syndrome, substantiated by consistent, reproducible clinical findings, with persistent limitation of active motion; and not: passive range of motion of the wrist is limited.
R. 5223.0470, subp. 2.A
Choose one: wrist entrapment median
Requires: Median nerve entrapment at the wrist (carpal tunnel syndrome): resolved with treatment.
R. 5223.0470, subp. 2.B(1)
Requires: Median nerve entrapment at the wrist (carpal tunnel syndrome): pain and paresthesia persist or recur despite treatment, not substantiated by electrodiagnostic testing.
R. 5223.0470, subp. 2.B(2)
Requires: Median nerve entrapment at the wrist (carpal tunnel syndrome): pain and paresthesia persist despite treatment, substantiated by persistent findings on electrodiagnostic testing.
R. 5223.0470, subp. 2.B(3)
Choose one: wrist entrapment ulnar
Requires: Ulnar nerve entrapment at the wrist (Guyon canal syndrome): resolved with treatment.
R. 5223.0470, subp. 2.B(1)
Requires: Ulnar nerve entrapment at the wrist (Guyon canal syndrome): pain and paresthesia persist or recur despite treatment, not substantiated by electrodiagnostic testing.
R. 5223.0470, subp. 2.B(2)
Requires: Ulnar nerve entrapment at the wrist (Guyon canal syndrome): pain and paresthesia persist despite treatment, substantiated by persistent findings on electrodiagnostic testing.
R. 5223.0470, subp. 2.B(3)
Choose one: wrist entrapment radial
Requires: Radial (sensory) nerve entrapment at the wrist: resolved with treatment.
R. 5223.0470, subp. 2.B(1)
Requires: Radial (sensory) nerve entrapment at the wrist: pain and paresthesia persist or recur despite treatment, not substantiated by electrodiagnostic testing.
R. 5223.0470, subp. 2.B(2)
Requires: Radial (sensory) nerve entrapment at the wrist: pain and paresthesia persist despite treatment, substantiated by persistent findings on electrodiagnostic testing.
R. 5223.0470, subp. 2.B(3)
Choose one: wrist arthroplasty total
Requires: Total wrist arthroplasty performed.
R. 5223.0470, subp. 3.A(1)
Choose one: wrist arthroplasty ulnar head
Requires: Ulnar head arthroplasty (resection or implant of the distal ulna) performed.
R. 5223.0470, subp. 3.A(2)
Choose one: wrist arthroplasty carpal row
Requires: Proximal carpal row arthroplasty (proximal row carpectomy) performed.
R. 5223.0470, subp. 3.A(3)
Choose one: wrist arthroplasty single bone
Requires: Resection of a single carpal bone, other than the pisiform or the hook of the hamate.
R. 5223.0470, subp. 3.A(4)
Choose one: wrist arthroplasty pisiform hamate
Requires: Excision of the pisiform or the hook of the hamate.
R. 5223.0470, subp. 3.A(5)
Choose one: wrist carpal instability
Requires: Carpal instability (as defined at 5223.0310, subp. 12), by how it is confirmed: confirmed by clinical examination only.
R. 5223.0470, subp. 3.B(1)
Requires: Carpal instability (as defined at 5223.0310, subp. 12), by how it is confirmed: confirmed by both clinical examination and medical imaging study.
R. 5223.0470, subp. 3.B(2)
Requires: Carpal instability (as defined at 5223.0310, subp. 12), by how it is confirmed: confirmed by clinical examination and imaging which also demonstrates degenerative arthritis.
R. 5223.0470, subp. 3.B(3)
Choose one: wrist fracture other
Requires: Fracture or dislocation involving the radius, ulna, or a carpal bone not otherwise ratable under this part or 5223.0460.
R. 5223.0470, subp. 3.C
Choose one: wrist arthrodesis
Requires: Wrist arthrodesis (fusion) performed.
R. 5223.0470, subp. 1 (rated only under subp. 4)
Choose one: wrist unlisted motion loss
Requires: either A wrist condition no category of subparts 2 or 3 represents, rated only on measured loss of motion under subpart 4, or Painful organic syndrome (as defined at 5223.0310, subp. 40), including tendonitis syndrome and de Quervain syndrome, substantiated by consistent, reproducible clinical findings, with persistent limitation of active motion; and Passive range of motion of the wrist is limited.
R. 5223.0470, subp. 1 (rated only under subp. 4)
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: exam notes
Proof: exam notes with passive range of motion measurements
Proof: EMG/nerve conduction study; exam notes
Proof: EMG/nerve conduction study; exam notes
Proof: EMG/nerve conduction study; exam notes
Proof: operative report
Proof: operative report
Proof: operative report
Proof: operative report
Proof: operative report
Proof: exam notes; x-ray or MRI report
Proof: operative report
Proof: x-ray or CT report
Proof: diagnosis records; range of motion measurements
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. These receipts are category percents only. They do not include subpart 4 motion.
Carpal tunnel syndrome persisting despite treatment, substantiated by electrodiagnostic testing
category total
Date of injury 2024-01-01
- Median nerve entrapment at the wrist (carpal tunnel syndrome): pain and paresthesia persist despite treatment, substantiated by persistent findings on electrodiagnostic testing
- Carpal Tunnel Syndrome: Persistent: 3%
- Category total: 3%Does not include subpart 4 motion
Total wrist arthroplasty, category alone
category total
Date of injury 2024-01-01
- Total wrist arthroplasty performed: yes
- Wrist Arthroplasty (Total Wrist Replacement): 18%
- Category total: 18%Does not include subpart 4 motion
Carpal instability confirmed by exam and imaging with degenerative arthritis (a SLAC pattern)
category total
Date of injury 2024-01-01
- Carpal instability (as defined at 5223.0310, subp. 12), by how it is confirmed: confirmed by clinical examination and imaging which also demonstrates degenerative arthritis
- Carpal Instability: With Arthritis: 11%
- Category total: 11%Does not include subpart 4 motion
Proximal row carpectomy (9) combined with an ulnar head resection (5), distinct conditions per the master
category total
Date of injury 2024-01-01
- Proximal carpal row arthroplasty (proximal row carpectomy) performed: yes
- Ulnar head arthroplasty (resection or implant of the distal ulna) performed: yes
- Proximal Row Carpectomy: 9%
- Ulnar Head Arthroplasty: 5%
- Category total: 13.55%Does not include subpart 4 motion
Related rules
These cross-links come from the compiled graph. Read the official rule text for the full statutory language.
See also rule 5223.0460
Elbow and forearm permanency rule 5223.0460Subp. 3.C excludes fractures ratable under the elbow part (radius and ulna shaft fractures may rate there).
See also rule 5223.0400
Official text for 5223.0400Subp. 2.B(4): entrapment with objectively demonstrable motor loss rates under the upper-extremity motor nerve table of 5223.0400 (median and ulnar rows at the wrist).
See also rule 5223.0410
Official text for 5223.0410Subp. 2.B(4): entrapment with objectively demonstrable sensory loss rates under the upper-extremity sensory nerve table of 5223.0410.
See also rule 5223.0540
Official text for 5223.0540
Common questions
What does carpal tunnel syndrome rate?
On the subpart 2.B ladder: zero percent if resolved with treatment or unconfirmed by electrodiagnostic testing, three percent for pain and paresthesia persisting despite treatment with persistent EMG findings. Objectively demonstrable motor or sensory loss (thenar weakness, fixed sensory deficit) moves the rating to the nerve tables, 5223.0400 and 5223.0410, which pay more.
Does a successful carpal tunnel release mean zero percent?
If the symptoms resolved with treatment, yes: that is the express zero of subpart 2.B(1). If pain and paresthesia persist despite the release and EMG findings persist, the three percent category applies.
What does a wrist fusion rate?
Arthrodesis has no category percent. A fused wrist is rated on the ankylosis clauses of subpart 4, which pay by the position the joint is fixed in. A total wrist replacement rates 18 percent plus the measured motion loss.
How is carpal instability rated?
By how it is confirmed: four percent on clinical examination alone, seven percent when imaging confirms it, and eleven percent when imaging also demonstrates degenerative arthritis. It is one condition; the highest confirmed tier applies.
What does de Quervain syndrome rate?
De Quervain syndrome is expressly named in the painful organic syndrome category: zero percent when passive motion is full. If passive motion is limited, the condition rates on the measured motion under subpart 4 instead.
Interpretive notes
- Subpart 4 (loss of function) is delegated to the ROM module, including the flexion/extension and radial/ulnar deviation arcs.
- Unlike the shoulder and elbow, the master treats each subpart 3.A arthroplasty procedure as its own impairing condition, so a proximal row carpectomy and an ulnar head resection combine rather than excluding one another.
- The master dataset carries two endpoint records for the 3.C catch-all ('wrist-fracture-healed' and 'wrist-other-0', same cite, same zero); the graph binds one node for the clause.
What to do next
Turn a category percent into dollars, combine multiple ratings, or see permanency inside a full settlement value.
- Minnesota PPD calculator
Turn a rating percentage into dollars using the statutory tier for your date of injury.
- PPD combination calculator
Two or more ratings combine with a formula that yields less than the sum.
- Settlement exposure calculator
See permanency next to wage loss and medical when you weigh a settlement.
- All PPD rules by body part
Browse the other Minnesota Rule 5223 categories that may apply to your claim.
- Should I accept a workers comp settlement?
Permanency is one line in a settlement. Know what you are trading before you sign.
- Independent medical exams (IME)
Carpal tunnel and wrist ratings often turn on IME reports. Know what the exam can and cannot do.