Opinion
Syllabus by the Court
1. Standards of review for workers compensation cases and for statutory interpretation are reviewed and restated.
2. Under the facts of this case, where the claimant suffered amputation of his little finger and a portion of the corresponding fifth metacarpal bone of his hand, and the impairment to his hand was opined to be from 19% to 41% loss of use, the award was properly based on the percentage of the loss of use of claimant's hand rather than on the loss of his entire hand.
Brad I. Pearson, of DeSimone Pearson, L.C., of Overland Park, argued the cause, and David J. DeSimone, of the same firm, was with him on the briefs for appellant.
Daniel L. Doyle, of Blackwell, Sanders, Matheny, Weary & Lombardi, L.L.P., of Overland Park, argued the cause, and Jeffrey S. Austin, of the same firm, was with him on the brief for appellee.
LARSON, J.:
This appeal raises the issue of the proper workers compensation award for Donald A. Landry. Landry sustained an injury while operating a printing press at work resulting in amputation of his fourth (little) finger and a portion of the fifth metacarpal (the bone extending from the fourth finger into the hand). The only issue in this appeal is the compensation award to be entered as it is undisputed that Landry's July 1995 injury arose from and in the course of his employment. The treating physician, Dr. John Moore, IV, testified that he removed "the portion that was already damaged and just enough of the metacarpal ... to give [Landry] a more smooth, normal-appearing hand." Dr. Moore opined Landry suffered a functional impairment of 19% of the upper left extremity at the wrist level.
Dr. Daniel D. Zimmerman testified that Landry's injury was a partial amputation of the hand which resulted in a 41% functional impairment to the left upper extremity at the hand level.
The administrative law judge (ALJ) treated the injury as the loss of a hand and awarded Landry compensation for a 150-week period.
The Workers Compensation Board (Board) determined Landry's injury amounted to the loss of use of a portion of the hand rather than loss of the entire hand. The Board utilized K.S.A. 44-510d(a)(23), which states the loss of a scheduled member is to be rated using the American Medical Association Guidelines for the Evaluation of Physical Impairment, and averaged the functional disability ratings of two doctors to award benefits for a 30% functional impairment.
The Court of Appeals, in an unpublished opinion filed March 26, 1999, 979 P.2d 1265, affirmed the Board. We granted Landry's petition for review. See Rule 8.03 (1999 Kan. Ct. R. Annot. 53).
Statutes and regulations
Mainly at issue in this case are certain provisions of K.S.A. 44-510d and K.A.R. 51-7-8, which relate to compensation for scheduled injuries.
K.S.A. 44-510d provides in relevant part:
"(a) ... If there is an award of permanent disability as a result of the injury there shall be a presumption that disability existed immediately after the injury and compensation is to be paid for not to exceed the number of weeks allowed in the following schedule:
.... (5) For the loss of a fourth finger, commonly called the little finger, 15 weeks. (6) Loss of the first phalange of the thumb or of any finger shall be considered to be equal to the loss of 1/2 of such thumb or finger, and the compensation shall be 1/2 of the amount specified above. The loss of the first phalange and any part of the second phalange of any finger, which includes the loss of any part of the bone of such second phalange, shall be considered to be equal to the loss of 2/3 of such finger and the compensation shall be 2/3 of the amount specified above. The loss of the first phalange and any part of the second phalange of a thumb which includes the loss of any part of the bone of such second phalange, shall be considered to be equal to the loss of the entire thumb. The loss of the first and second phalanges and any part of the third proximal phalange of any finger, shall be considered as the loss of the entire finger. Amputation through the joint shall be considered a loss to the next higher schedule. .... (11) For the loss of a hand, 150 weeks.
.... (18) Amputation or severance below the wrist shall be considered as the loss of a hand. Amputation at the wrist and below the elbow shall be considered as the loss of the forearm. Amputation at or above the elbow shall be considered loss of the arm....
.... (21)Permanent loss of the use of a finger, thumb, hand,shoulder, arm, forearm, ... shall be equivalent to theloss thereof. For the permanent partial loss of the useof a finger, thumb, hand, shoulder, arm, ...compensation shall be paid as provided for in K.S.A.44-510c and amendments thereto, per week during thatproportion of the number of weeks in the foregoingschedule provided for the loss of such finger, thumb,... which partial loss thereof bears to the total lossof a finger, thumb, ... but in no event shall thecompensation payable hereunder for such partial lossexceed the compensation payable under the schedule forthe total loss of such finger, thumb ... exclusive ofthe healing period.... Page 760 .... (23)Loss of a scheduled member shall be based uponpermanent impairment of function to the scheduledmember as determined using the third edition, revised,of the American Medical Association Guidelines for theEvaluation of Physical Impairment, if the impairment iscontained therein." K.A.R. 51-7-8 states in relevant part: "[b](3)If part of a finger, thumb or toe is amputated,compensation shall be calculated as follows:
.... "(4)If a scheduled member other than a part of a finger,thumb or toe is amputated, compensation shall becomputed by multiplying the number of weeks on theschedule by the worker's weekly temporary totalcompensation rate. The temporary total compensationpreviously paid shall be deducted from the totalamount allowed for the member. .... "[d](1)An injury involving the metacarpals shall beconsidered an injury to the hand..... "(2)If the injury results in loss of use of one or morefingers and also loss of use of the hand, thecompensation payable for the injury shall be on theschedule for the hand. Any percentage of permanentpartial loss of use of the hand shall be at leastsufficient to equal the compensation payable for theinjuries to the finger or fingers alone." ALJ'sdecision Inawarding Landry 150 weeks of compensation forpermanent partial impairment as if Landry's handhad been amputated at the wrist, the ALJ focused onthe sentence of K.S.A. 44-510d(a)(18) that states:"Amputation or severance below the wrist shallbe considered as the loss of a hand." TheALJ considered this result similar to the result inBergemann v. North Central Foundry, Inc., 215 Kan. 685, 686, 527 P.2d 1044 (1974), where theclaimant was awarded recovery for loss of a footbased on what the Bergemann opiniondescribed as a "partial amputation of his rightfoot." However, the ALJ in the present caseadmitted that the question of whether to award theclaimant compensation for "loss of" versus"loss of use of" the foot was not an issuein Bergemann. Board'sdecision TheBoard did not agree with the ALJ's decision andexplained its own decision in the following manner: "Amputationof the little finger and a substantial portion of themetacarpal entitles the claimant to disabilitybenefits at the level of the hand but does notentitle claimant to the 150 weeks of benefits givenfor amputation of the hand. "Thecentral issue in this case is whether the amputation,which included part of the fifth metacarpal as wellas the little finger, entitles the claimant to thefull 150 weeks allotted for loss of the hand or onlya portion of that 150 weeks. In support of hisargument for 150 weeks of benefits, claimant citesBergemann v. North Central Foundry, Inc., 215 Kan. 685, 527 P.2d 1044 (1974). In that case,claimant suffered a crush injury to this right footand underwent surgical procedures resulting inpartial amputation. The dispute in that caseconcerned the back complaints which appeared afterthe injury and hospitalization.... In discussing thefacts, the Court stated that claimant is entitled toa minimum award of 125 weeks for loss of the footplus the healing period. The entitlement to the 125weeks was not at issue. The statement that claimantwas entitled to 125 weeks was dicta. In addition, theopinion does not indicate where the amputationoccurred, only that it was partial. For these reasonsthe Board does not consider the Bergemanndecision to be binding precedent on the issue beforethe Board. "Permanentdisability benefits for injuries to the hand andfingers are governed by K.S.A. 44-510d. Subsection(a)(5) provides for 15 weeks of benefits for loss of the little finger. Subsection (a)(11)provides for 150 a hand.Page 761"Claimant argues for the full 150 weeks, inpart, on the basis of subsection (a)(18) of K.S.A.44-510d:
"Amputationor severance below the wrist shall be considered asthe loss of a hand. Amputation at the wrist andbelow the elbow shall be considered as the loss ofthe forearm.
"Claimant also points, in support of hisargument, to provisions of K.S.A. 44-510d(a)(6) whichstates:
"Amputationthrough the joint shall be considered a loss to thenext higher schedule. "Finally,claimant refers to provisions of K.A.R. 51-7-8.Subsection (b)(3) of that regulation provides amethod for computation of partial amputation of afinger or toe. Subsection (b)(4) then provides:
"TheAppeals Board concludes, however, that the languagein K.S.A. 44-510d(a)(18) assumes a severance belowthe wrist which crosses the entire width of thehand. The Appeals Board has construed the statutein this fashion principally for two reasons. First,an amputation such as that suffered by claimantleaves a substantial portion of the function or useof the hand available to the claimant. It is,therefore, logical to treat it differently from theloss of the entire hand. In addition, the statutegoverning benefits for scheduled injuries, K.S.A.44-510d, was amended in 1993. Subsection (a)(23)stated that loss of a scheduled member is to berated using the third edition, revised, of the'American Medical Association Guidelines forthe Evaluation of Physical Impairment.'
"Ifa scheduled member other than a part of afinger, thumb or toe is amputated, compensationshall be computed by multiplying the number ofweeks on the schedule by the worker'sweekly temporary total compensation rate.
"Figure3 on page 15 of those Guides specifies a percentagefor amputation at each of the various possiblelevels of the hand. Amputations which do not runacross the entire width of the hand are shown thereat less than 100 percent of the hand. Amputationthrough the metacarpophalangeal joint on the littlefinger is rated as 10 percent loss of the hand andno higher rating is shown for amputation of themetacarpal below that joint. The Appeals Boardconcludes that the legislature intended that anyamputation below the wrist, other than thespecifically accounted for finger amputations, betreated on the basis of rating to the hand. Thelegislature did not intend that any and all suchamputations be entitled to the full 150 weeksbenefits for loss of the entire hand." Courtof Appeals decision TheCourt of Appeals affirmed the Board'sinterpretation of the statutes and regulations inissue and held that Bergemann does notgovern this case. Afterciting authority establishing the necessity ofconstruing statutes to make them consistent,harmonious and sensible, the Court of Appealsconcluded the Board's decision was more wellreasoned and sensible in light of the Act'sprovisions and concluded: "K.A.R.51-7-8(d)(2) provides further support for theBoard's decision. It states: ' If theinjury results in loss of use of one or morefingers and also loss of use of the hand, thecompensation payable for the injury shall be on theschedule for the hand. Any percentage ofpermanent partial loss of use of the hand shall beat least sufficient to equal the compensationpayable for the injuries to the finger or fingersalone.' (Emphasis added.) This regulation doesnot contemplate a finding that the hand has beenamputated. "AlthoughK.S.A. 44-510d(a)(18) states: 'Amputation orseverance below the wrist shall be considered asthe loss of a hand,' the Board'sinterpretation that this means a severance whichcrosses the entire width of the hand is proper.Only claimant's fifth finger and a portion ofhis metacarpal were amputated. He maintains use ofmuch of his hand." Slip opinion at 9.Page 762 Standardsof review and statutory interpretation Our standard of review is statutorily defined bythe Act for Judicial Review and Civil Enforcementof Agency Actions, K.S.A. 77-601 et seq.See Nance v. Harvey County, 263 Kan. 542,550-51, 952 P.2d 411 (1997). Under K.S.A.77-621(c)(4), we may grant relief where the agencyhas erroneously interpreted or applied the law.Interpretation of statutory and regulatoryprovisions are questions of law over which we haveunlimited review. While we give deference to theBoard's interpretation of the law, if such isinterpreted or applied erroneously, we are to takecorrective action. Burton v. RockwellInternational, 266 Kan. 1, 5, 967 P.2d 290(1998). Becausethe primary issue in this appeal involves theinterpretation of statutes and regulations, we notethe applicable rules of statutory construction setforth in Todd v. Kelly, 251 Kan. 512, 516,837 P.2d 381 (1992):
"Section 3.1b of the [Guides] states:
"Amputation of all digits at themetacarpophalangeal joint level is consideredto be 100% impairment of the hand or 90%impairment of the upper extremity. (Emphasisadded.)
" 'In construing statutes, the legislativeintention is to be determined from a generalconsideration of the entire act. Effect must begiven, if possible, to the entire act and everypart thereof. To this end, it is the duty of thecourt, as far as practicable, to reconcile thedifferent provisions so as to make them consistent,harmonious, and sensible.' in re marriageof ross, 245 kan. 591, 594, 783 P.2d 331(1989). '[t]he court must give effect to thelegislature's intent even though words, phrasesor clauses at some place in the statute must beomitted or inserted.' Ross, 245 Kan.at 594, 783 P.2d 331.'Inorder to ascertain the legislative intent, courtsare not permitted to consider only a certainisolated part or parts of an act, but are requiredto consider and construe together all parts thereofin pari materia.' " Landry'scontentions Landryasserts that functional impairment ratings shouldnever be the criteria for compensation ofamputation injuries. He argues that amputations aretreated differently than other scheduled injuriesand that the legislature has created a sequentialframework in which amputation through eachsuccessive joint requires compensation at the nexthigher level on the schedule whether the loss orloss of use of the scheduled member be partial orof the entire member. Landrysays the Board and Court of Appeals' ruling isin direct conflict with the wording of K.A.R.51-7-8(b)(4), that states: "Ifa scheduled member other than a part of a finger,thumb or toe is amputated, compensation shall becomputed by multiplying the number of weeks on theschedule by the worker's weekly temporary totalcompensation rate."Using this statement, Landry argues that becausethis regulatory subsection refers to andspecifically excludes amputations of partof a finger, thumb, or toe, it means thatpartial amputations of all other scheduled members(like his hand) must be computed by applying thefull number of scheduled weeks. Thisargument illustrates the danger of reading onesentence in isolation from the other provisions ofa statute or regulation. The "other than apart of" language of K.A.R. 51-7-8(b)(4)appears to be necessary because the previoussubsection (b)(3) sets forth the method forcomputing compensation for amputation of "partof a finger, thumb or toe." The calculation ofbenefits for parts of fingers, thumbs, and toes in(b)(3) states compensation is calculated [268 Kan.366] by multiplying the percent of the loss asgoverned by K.S.A. 44-510d by the weeks on the fullschedule for that member. The calculation ofbenefits for parts of fingers, thumbs, and toes inK.S.A. 44-510d is different from most of the restof the schedule because it specifies thecompensation for such losses at different jointlevels for fingers, thumbs, and toes asfractions of the weeks allowed for loss ofa whole finger, thumb, or toe. The two separateregulatory subsections simply attempt to addressthis aspect of the schedule. They are notpersuasive authority for the result Landrychampions. Next,Landry argues that the Board's conclusion thatK.S.A. 44-510d(a)(18) assumes a severance throughthe entire width of the hand is contrary to thelast sentence ofPage 763K.S.A. 44-510d(a)(6), which states:"Amputation through the joint shall beconsidered a loss to the next higherschedule." Because his amputation extendedpast the knuckle joint of his little finger, Landrycontends (a)(6) means his partial amputation shouldbe considered as the entire loss of the member ofthe next higher schedule, in this case, as loss ofa hand. Thelanguage of the last sentence of (a)(6) that Landryrelies on is contained in a subsection that earliersets forth the method and fractional losses indetermining benefits allowed for amputationsoccurring at progressively higher points alongfingers and thumbs, culminating in recovery forloss of an entire finger. The sentence which Landryrelies on is not a separate subsection generallyapplicable to the whole schedule but must beconfined to the subsection in which it iscontained. Even if the sentence in K.S.A.44-510d(a)(6) relied upon by Landry were consideredmore generally applicable to all scheduled members,that does not necessarily resolve the issue ofwhether the legislature really intended anamputation that passes "through"one of the joints connecting the digits tothe hand to be considered the loss of theentire hand. The amputation toLandry's hand may have been an amputationbeyond one of the five joints connectingthe digits to the hand, but the other fourdigits and the four joints connecting those digitsto the hand are in tact--there was no amputation"through" those other four joints. Landryfurther notes that K.A.R. 51-7-8(d)(1) states:"An injury involving the metacarpals shall beconsidered an injury to the hand." He relieson this provision to support his argument thatbecause the metacarpals are bones of the hand, aninjury involving the metacarpals would beconsidered an injury to the hand. However, thiswording of the regulation does not resolve theissue of whether the legislature intended anamputation to one metacarpal or a portion thereofof a hand to be considered an amputation of thewhole hand for purposes of determining benefits. DespiteLandry's attempts to pick different sentencesout of the regulations or statute to support hisarguments, when they are read in their entirety,neither the statute nor the regulations provideprecise guidance to resolve the statutoryinterpretation question we face. Ashe did in the forums below, Landry relies onBergemann, 215 Kan. 685, 527 P.2d 1044,and also cites McKinney v. Rodney MillingCo., 177 Kan. 401, 279 P.2d 221 (1955), ascases where the court has previously approvedmaximum benefits for loss of a scheduled limb undercircumstances of partial amputation. We agree withthe way the Board distinguished Bergemann.It is factually different and does not aid inresolving the issues before the court. McKinney involved amputation of aclaimant's lower leg a few inches below theknee. 177 Kan. at 402, 279 P.2d 221. The claimantwas compensated under the schedule for loss of hislower leg, but the issues in the case were noticeand whether there should also be award fortemporary total and permanent partial generaldisability. McKinney provides no guidanceon the present issue. Respondentand insurance carrier's contentions Therespondent, Graphic Technology, Inc., and itsinsurance carrier, ITT Hartford Insurance, hereinreferred to as Employer, understandably rely on thelogic and wording of the decisions of the Board andCourt of Appeals. Employerfactually distinguishes Bergemann as hasbeen done by the Board and the Court of Appeals.Employer argues that K.S.A. 44-510d(18) must beread in its entirety as simply describing whichportion of the schedule to use ( e.g., thehand, the forearm, etc.) as the starting point in determining disability for anamputation injury, rather than as a definitivestatement that all amputations occurring below thewrist must be treated as loss of theentire hand. Employernext contends that Landry fails to show there is alegislative mandate to treat an amputation injurydifferently from a loss of use injury. Employernotes that if a body part is amputated, theemployee has obviously lost the use of it. Insupport ofPage 764this argument, Employer points to K.A.R.51-7-8(d)(1) and (2), which state: "(d)(1)An injury involving the metacarpals shall beconsidered an injury to the hand. An injuryinvolving the metatarsals shall be considered aninjury to the foot. "(2)If the injury results in loss of use of one or morefingers and also a loss of use of the hand, thecompensation payable for the injury shall be on theschedule for the hand. Any percentage of permanentpartial loss of use of the hand shall be at leastsufficient to equal the compensation payable forthe injuries to the finger to fingers alone."Employer relies on these provisions to argue thatthere is no difference between the amputation ofthe body part and the loss of the use of the bodypart. Here, Employer utilizes a portion of theregulation without consideration of the entireregulation or the statute upon which it issupposedly based. Accordingly, we find thisargument subject to the same criticism asLandry's arguments. Mosthelpful to our analysis in this case is theEmployer's reliance on Decicco v. JohnMorrell & Co., 152 Kan. 601, 106 P.2d 1053(1940), which involved an issue closely analogousto the issue we now face. Decicco suffered awork-related injury in which part of the tip of hisleft index finger was torn off, taking a portion ofthe bone and detaching the nail completely. Theamputation involved approximately 3/16" of thefirst phalange of his finger. He suffered no lossof use and some of the nail on the finger regrew.G.S.1935, 44-510(3)(c)(6) (Corrick)--thecounterpart to current K.S.A.44-510d(a)(6)--provided that "loss of thefirst phalange of the thumb or of any finger shallbe considered to be equal to the loss of one halfof such thumb or finger" and compensation paidaccordingly. The commissioner interpreted theprovision to mean that the loss of any part of thebone of the first phalange be regarded [268 Kan.369] as the loss of the whole phalange. However,the trial court held there must be a substantialloss of the first phalange for the injury to beconsidered loss of the whole phalange and thatDecicco's loss was not substantial. Theclaimant appealed and, in affirming the trialcourt's ruling, the Supreme Court stated: "Wecannot agree with the appellant'sinterpretation of the act. Under thatinterpretation the loss of the smallest possibleportion of the bone at the end of the finger, withno loss of the nail, with no permanent interferencewhatever with the use of the first phalange or ofthe finger, would be regarded as loss of the entirefirst phalange. Appellant contends that unless suchan interpretation is made there would be no basiswhatever, under the act, for compensation for suchan injury. Such a result does not follow. No matterhow minor the injury to the end of the finger, ifit in fact temporarily incapacitates the workman,he is entitled to compensation during the time oftemporary disability. Such compensation was in factagreed upon [in this case]. "Ifthe result of the injury had been a permanentpartial loss of use of the phalange, a basis forcompensation would be found in paragraph 3[ (c)](19), G.S.1935, 44-510 [the counterpart to thecurrent K.S.A. 44-510d(a)(21) providingcompensation for permanent partial and permanenttotal loss of use of scheduled members]. This wouldbe true no matter how small a portion had beenremoved from the tip of the finger, or indeed if noportion at all of the bone had been removed. Butappellant does not dispute the physician'sfinding of no functional loss; he does not contendthat he has suffered any permanent partial loss ofuse of the first phalange or of the finger or thatthe injury has resulted in any handicap in hiswork. Moreover, as suggested by appellee, letus suppose that at a later time appellant, who nowhas the full use of the injured phalange, hasanother accident and loses the entire phalange ofthe same finger, how then would compensation befixed? Could he fairly be told that although by thesecond accident he had lost a perfectly goodphalange he could not receive compensation becausehe had already been compensated for it? Or couldthe employer fairly be told that he would have topay compensation for a second complete loss of thesame phalange? There is nothing in the act toPage 765
indicate that the legislature intended either suchanswer."Itis urged by appellant that the rule laid down bythe district court that the loss must be 'asubstantial loss of such phalange' in order tobe 'a loss of the first phalange' withinthe meaning of the act is too indefinite forpractical administration. It may be unfortunatethat in many matters human wisdom and ingenuity areinsufficient for prescribing mathematical orscientific formulas instantly applicable towhatever situation may arise. But the instant casepresent nothing unusual in this regard, and we findno reason to set aside the rule or principleannounced by the district court.... Whether theremight be cases where the amputation of even lessthan one-half of the first phalange should beregarded as substantial loss of the phalange weneed not speculate. Certainly if loss of use [268Kan. 370] resulted, the injury would be so regardedunder the provisions of paragraph (3)[ (c) ](19),G.S.1935, 44-510. In any event, we think that thetrial court was clearly correct in holding that theloss shown in this case was not so substantial asto be regarded as loss of the entirephalange." (Emphasis added.) 152 Kan. at604-05, 106 P.2d 1053.Thus, the opinion suggested that although Deciccohad lost too little of the first phalange toreasonably compensate him based on a totalloss of the phalange, had he suffered somepermanent partial loss of use of thephalange, he could have recovered on that basis.Applying the principles and reasoning ofDecicco to the present case suggests thatwhere a claimant such as Landry does not lose asubstantial portion of his hand so thatcompensation based on total loss of the hand wouldbe unreasonable, he may still recover under theschedule based on the partial loss of use of thehand. Decicco supports the Board'sdecision in this case to treat Landry's injuryon the basis of partial loss of use to the hand. K.A.R.51-7-8(d)(5) takes a similar approach where anamputation is so slight that it does not even gothrough the bone of the finger. That provisionstates: "If the tip of a finger, thumb or toeis amputated, the amputation does not go throughthe bone and it is determined that a disabilityexists, the disability rating shall be based on acomputation of a partial loss of use of the entirefinger." Though K.A.R. 51-7-8(d)(5) isobviously not directly applicable to Landry'scase, it illustrates that, in some cases, it may bemore appropriate to treat compensation for anamputation as a case of partial loss of use to thelarger member. Employeralso makes some unique arguments based on twoearlier Kansas cases, Stefan v. ElevatorCo., 106 Kan. 369, 187 P. 861 (1920), andNeuhaus v. Hope Engineering Co., 132 Kan.72, 294 P. 655 (1931), but we do not find thesecases as helpful as Decicco in resolvingthe particular issue before us. Discussionand conclusion It is ourduty to consider the entire Act and not merelyisolated sentences thereof and to avoidinterpretations which would lead to absurd orunreasonable results. In construing statutes andregulations, we are faced with inescapable medicaltestimony that while Landry undeniably suffered the loss of and loss ofuse of his little finger and a portion of his fifthmetacarpal bone, he did not lose his entire hand.His impairment to his hand was opined to be from19% to 41%, which conversely would mean that heretained between 81% down to 59% use of his hand.To award compensation of 100% of loss of or loss ofuse of the hand under such a factual scenario wouldnot be a reasonable interpretation of theapplicable statutory provisions. Basedon our reasoning and comments described throughoutthis opinion, we agree with the Board and the Courtof Appeals' holding that K.S.A. 44-510d and,most specifically, (a)(18) do not require treatingLandry's injury as the loss of his entire handand that his award was properly based instead onthe percentage of the loss of use of his hand. Asa final note, we have considered Landry'scriticism of the Board's and Court ofAppeals' reliance on K.S.A. 44-510d(a)(23) tosupport their decisions. This provision referencingAmerican Medical Association Guidelines for theEvaluation of Physical ImpairmentPage 766(Guides) was added to K.S.A. 44-510d by certain1993 amendments, and a similar reference was alsoadded in 1993 to K.S.A. 44-510E(a), which formerlyonly required "competent medicalevidence" to establish functional impairmentin unscheduled cases. K.S.A.1992 Supp. 44-510e(a). Despite extensive research of the relevantlegislative history and a review of various othermaterials, including seminar discussions about thewholesale changes to the 1993 Act, we find no clearlegislative intent that allows us to make anydefinitive statement that enactment of44-510e(a)(23) was intended to govern the issue ofwhether to treat injuries like Landry's as"loss of use" versus "loss of"injuries. However, having determined on othergrounds that the award for Landry's injury wasproperly based on the partial loss of use of hishand, we also find that the physicians in this caseproperly used the Guides in rendering theiropinions as to the percentage of Landry's lossof use. TheCourt of Appeals and the Board are affirmed.