[From functional assessment to estimating the reduction in earning capacity : A three-step guide to medicolegal assessment in orthopedics and trauma surgery within German statutory accident insurance].

backgroundThe December 2025 DGUV (Deutsche Gesetzliche Unfallversicherung) consensus paper provides reference values for selected musculoskeletal injury outcomes in pensions granted for an indefinite period. These values are comparators, not a formula. Each assessment must therefore identify the reference condition that most closely reflects the documented functional impairment.

objectiveTo provide a concise and accessible guide that leads less experienced or occasional medical experts from clarification of the mandate to a transparent estimate of the reduction in earning capacity (MdE). MATERIALS AND

methodsThe 2025 DGUV consensus paper was the starting point. Statutory provisions, case law, and supplementary medicolegal literature were reviewed narratively to structure the case-specific reference comparison into three steps. The reference values were adopted without modification. Three case examples illustrate their application.

resultsThe guide follows three steps: clarify the mandate, assessment date, and accepted consequences; describe the documented impairment and its impact on general work demands; and identify the closest reference condition. Six guiding questions make the comparison and estimate explicit.

conclusionThe approach supports clear and verifiable reasoning, especially for beginners, and may aid training and quality control. It does not replace individual expert judgement and has not yet been evaluated empirically.