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Complete this worksheet following the step-by-step procedure below. Keep a copy in the employee's personnel folder for future reference.
Step 1: Locate Upper ArmPosition
+1 -15o to 15o +2 -15o +2 +15o to 45o +45o to 90o
A. Arm & Wrist Analysis
+3 90o+ +4
Upper Upper Arm Arm 1
SCORES
Table ATable A
Lower Lower Arm Arm 1 2 1
Wrist Twist 1 2 1
B.Neck, Trunk & Leg Analysis
0 to 10o +1
o
10o to 20o +2
20o+
Step 9: Locate Neck Position
in extension +3 +4
Wrist 2
Wrist Twist 2 1
3
2 1
4
Wrist Twist 2
Wrist Twist
1 22 2 2 2 2 2 2 3 3 3 5 5 6 7 7 9
2 2 3 2 2 3 3 3 3 4 4 4 5 6 6 7 8 9
2 2 2 2 2 3 3 3 3 4 4 4 5 6 6 7 8 9
2 2 3 3 3 3 3 3 4 4 4 5 5 6 7 7 8 9
2 3 3 3 3 3 4 4 4 4 4 5 5 6 7 7 8 9
3 3 3 3 34 4 4 4 4 4 5 6 7 7 8 9 9
3 3 4 4 4 4 5 5 5 5 5 6 6 7 7 8 9 9
3 3 4 4 4 5 5 5 5 5 5 6
Step 1a: Adjust…
If shoulder is raised: +1; If upper arm is abducted: +1; If arm is supported or personis leaning: -1 Final Upper Arm Score =
2
Step 9a: Adjust…
=Final Neck Score 1 also if trunk is well supported while seated; 2 if not 0o to 10o 0o to 20o If neck is twisted: +1; If neck isside-bending: +1
3 1 2
Step 10: Locate Trunk Position
20o to 60o +2 +3 60o+ +4
Step 2: Locate LowerArm Position
+1 +1 -0
o
+1
3
3 1 2 3
+1 standing erect seated - 20o
+2 to 90
o90 +
o
+1
+1
Step 10a: Adjust…
= Final Trunk Score If trunk is twisted: +1; If trunk is side-bending: +1
Step 2a: Adjust…
If arm is working across midline of the body: +1; If arm outto side of body: +1 Final Lower Arm Score =
4
1 2 3
Step 11: Legs
= Final LegScore If legs & feet supported and balanced: +1; If not: +2
Trunk Posture Score
Step 3: Locate Wrist Position+1 15o+ +3 +2 0o to 15o +1 0o to 15o +2 +3 15o+
6
+1
5
1 2 3 1 2 3
7 7 8 9 9 9
1 Legs Neck 1 1
1 2 3 5 7 8
2 Legs 1
2 2 3 5 7 8
3 Legs 1
3 4 4 6 7 8
4 Legs 1
5 5 5 7 8...
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