SideDR DL I Upper Figure - PSI Services LLC 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your personal information in the designated fields, including Name, Age, Sex, and Occupation. Ensure accuracy as this data is crucial for evaluation.
3. Proceed to the Diagnosis section. Here, you will need to indicate any abnormal motion or sensory loss related to the upper extremity. Use the provided checkboxes for clarity.
4. In the Motion section, record specific measurements such as Flexion and Extension angles. Mark any ankylosis present and calculate impairment percentages based on your findings.
5. Continue through each section methodically, combining digit impairments and calculating total upper extremity impairment as instructed. Utilize tables referenced in the document for accurate conversions.
6. Finally, review all entries for completeness before saving or exporting your completed form.

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