How do you avoid pyramiding for multiple parts of the body?

• A. Use the MDT multiple disability table.
• B. Take the average of part ratings.
• C. Ignore interactions.
• D. Apply the highest single value.

Answer: (A)

When a person has impairments in more than one part of the body, you avoid pyramiding by using the Multiple Disability Table (MDT). Pyramiding happens when you simply add each impairment’s percentage, which can overstate the overall disability because disabilities often interact and don’t add up linearly. The MDT provides a standardized way to combine multiple impairment ratings into a single total that more accurately reflects the overall impact.

In practice, you rate each part according to its impairment, then apply the MDT to merge those ratings. You start with one impairment, use the table to combine it with the next, get a new total, and continue if there are additional impairments. The resulting total is typically less than the sum of the parts, capturing how different disabilities influence each other rather than just stacking percentages.

Other methods—averaging the ratings, taking the highest single value, or ignoring interactions—don’t account for how impairments interact and can misstate the overall disability. The MDT is the established approach to prevent that overstatement.