This activity has eight descriptors. The figure in brackets is the number of points awarded for each descriptor.
The handbook says that this activity is about "the function of the wrists and hands as a measure of the ability to grip and to perform fine manipulations."
The fourth descriptor about using a pen or pencil has attracted much comment. The handbook quotes the a Commissioner's decision to the effect that the test is whether or not the claimant is physically capable of writing and goes on to say that this has nothing to do with the claimant's level of literacy. Medical examiners are asked to note how quickly and reliably the claimant can write.
The handbook points out that "The use of a walking stick in the dominant hand should have no effect on manual dexterity if the upper limb function is normal" and that "tying a bow in laces requires two hands, one to stabilise the loop and the other to do the finer movements"
The following are listed as relevant activities of daily living-
Where manual dexterity is an issue medical examiners are encouraged to test grip and the ability to perform pincer movements and the opposition of the thumb. Doctors are also asked to specify whether the problem is unilateral or bilateral.
