civil liability regulation 2014 - legislation.qld.gov.au

Queensland

Civil Liability Regulation 2014

Subordinate Legislation 2014 No. 129

made under the

Civil Liability Act 2003

Contents

Page

1 Short title . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

2 Commencement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

3 Definitions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

4 Prescribed entities providing services to enhance public safety—Act, s 26(1)(a) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

5 Prescribed entities providing services to enhance public safety—Act, s 27(1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

6 Prescribed amount of damages for loss of consortium or loss of servitium—Act, s 58 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

7 Rules for assessing injury scale value—Act, s 61(1)(c)(i) . . . . . . 11

8 General damages calculation provisions—Act, s 62 . . . . . . . . . . 11

9 Prescribed amount of award for future loss—Act, s 64 . . . . . . . . 12

10 Repeal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

11 Transitional provision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Schedule 1 Prescribed entities providing services to enhance public safety—Act, section 26(1)(a) . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Schedule 2 Prescribed entities providing services to enhance public safety—Act, section 27(1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Schedule 3 Matters to which court may or must have regard in the application of schedule 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Part 1 Objectives of schedule 4 (Ranges of ISVs)

1 Objectives of sch 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Contents


Part 2 How to use schedule 4

Division 1 Injury

2 Injury mentioned in sch 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

3 Multiple injuries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

4 Multiple injuries and maximum dominant ISV inadequate . . . . . . 18

5 Adverse psychological reaction . . . . . . . . . . . . . . . . . . . . . . . . . . 19

6 Mental disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

7 Aggravation of pre-existing condition . . . . . . . . . . . . . . . . . . . . . . 19

Division 2 Other matters

8 Court must have regard to particular provisions of sch 4 . . . . . . . 20

9 Court may have regard to other matters. . . . . . . . . . . . . . . . . . . . 20

10 Whole person impairment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

11 Medical report stating whole person impairment percentage. . . . 21

12 Greater weight to assessments based on AMA 5 . . . . . . . . . . . . 21

13 Greater weight to assessments of PIRS rating. . . . . . . . . . . . . . . 22

14 ISV must be a whole number . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Schedule 4 Ranges of ISVs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

Part 1 Central nervous system and head injuries

1 Quadriplegia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

2 Paraplegia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

3 Hemiplegia or severe paralysis of more than 1 limb. . . . . . . . . . . 24

4 Monoplegia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

5 Extreme brain injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

6 Serious brain injury. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

7 Moderate brain injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

8 Minor brain injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31

9 Minor head injury, other than an injury mentioned in part 3 . . . . . 32

Part 2 Mental disorders

10 Extreme mental disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

11 Serious mental disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

12 Moderate mental disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

13 Minor mental disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

Part 3 Facial injuries

Division 1 Skeletal injuries of the facial area

14 Extreme facial injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

15 Serious facial injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

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16 Moderate facial injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

17 Minor facial injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

18 Injury to teeth or gums . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

Division 2 Scarring to the face

19 Extreme facial scarring. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41

20 Serious facial scarring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

21 Moderate facial scarring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

22 Minor facial scarring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43

Part 4 Injuries affecting the senses

Division 1 General comment

Division 2 Injuries affecting the eyes

23 Total sight and hearing impairment . . . . . . . . . . . . . . . . . . . . . . . 43

24 Total sight impairment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

25 Complete sight impairment in 1 eye with reduced vision in the other eye . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

26 Complete sight impairment in 1 eye or total loss of 1 eye . . . . . . 44

27 Serious eye injury. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

28 Moderate eye injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

29 Minor eye injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

Division 3 Injuries affecting the ears

30 Extreme ear injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

31 Serious ear injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

32 Moderate ear injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

33 Minor ear injury. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

Division 4 Impairment of taste or smell

34 Total loss of taste or smell, or both. . . . . . . . . . . . . . . . . . . . . . . . 49

35 Partial loss of smell or taste, or both . . . . . . . . . . . . . . . . . . . . . . 49

Part 5 Injuries to internal organs

Division 1 Chest injuries

36 Extreme chest injury. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

37 Serious chest injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

38 Moderate chest injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

39 Minor chest injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

Division 2 Lung injury other than asthma

40 Extreme lung injury. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

41 Serious lung injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

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42 Moderate lung injury. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

43 Minor lung injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

Division 3 Asthma

44 Extreme asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

45 Severe asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

46 Moderate asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

47 Minor asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

Division 4 Injuries to male reproductive system

48 Impotence and sterility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

49 Loss of part or all of penis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

50 Loss of both testicles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

51 Loss of 1 testicle. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

Division 5 Injuries to female reproductive system

52 Infertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

53 Any other injury to the female reproductive system . . . . . . . . . . . 64

54 Failed sterilisation leading to unwanted pregnancy . . . . . . . . . . . 65

Division 6 Injuries to digestive system

Subdivision 1 Injury caused by trauma

55 Extreme injury to the digestive system caused by trauma . . . . . . 66

56 Serious injury to the digestive system caused by trauma . . . . . . 67

57 Moderate injury to the digestive system caused by trauma . . . . . 68

58 Minor injury to the digestive system caused by trauma . . . . . . . . 68

Subdivision 2 Injury not caused by trauma

59 Extreme injury to the digestive system not caused by trauma . . . 69

60 Serious injury to the digestive system not caused by trauma . . . 70

61 Moderate injury to the digestive system not caused by trauma . . 72

62 Minor injury to the digestive system not caused by trauma . . . . . 73

Division 7 Kidney or ureter injuries

63 Extreme injury to kidneys or ureters. . . . . . . . . . . . . . . . . . . . . . . 74

64 Serious injury to kidneys or ureters . . . . . . . . . . . . . . . . . . . . . . . 75

65 Moderate injury to kidneys or ureters . . . . . . . . . . . . . . . . . . . . . . 75

66 Minor injury to kidneys or ureters . . . . . . . . . . . . . . . . . . . . . . . . . 76

Division 8 Liver, gall bladder or biliary tract injuries

67 Extreme injury to liver, gall bladder or biliary tract . . . . . . . . . . . . 77

68 Serious injury to liver, gall bladder or biliary tract . . . . . . . . . . . . . 77

69 Moderate injury to liver, gall bladder or biliary tract . . . . . . . . . . . 78

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70 Minor injury to liver, gall bladder or biliary duct . . . . . . . . . . . . . . 79

Division 9 Bowel injuries

71 Extreme bowel injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80

72 Serious bowel injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80

73 Moderate bowel injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80

74 Minor bowel injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81

Division 10 Bladder, prostate or urethra injuries

75 Extreme bladder, prostate or urethra injury . . . . . . . . . . . . . . . . . 81

76 Serious bladder, prostate or urethra injury . . . . . . . . . . . . . . . . . . 82

77 Moderate bladder, prostate or urethra injury . . . . . . . . . . . . . . . . 82

78 Minor bladder, prostate or urethra injury . . . . . . . . . . . . . . . . . . . 83

Division 11 Spleen and pancreas injuries

79 Injuries to the pancreas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83

80 Loss of spleen (complicated) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84

81 Injury to the spleen or uncomplicated loss of spleen . . . . . . . . . . 85

Division 12 Hernia injuries

82 Severe hernia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86

83 Moderate hernia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86

84 Minor hernia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86

Part 6 Orthopaedic injuries

Division 1 Cervical spine injuries

85 Extreme cervical spine injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87

86 Serious cervical spine injury. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88

87 Moderate cervical spine injury—fracture, disc prolapse or nerve root compression or damage . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90

88 Moderate cervical spine injury—soft tissue injury . . . . . . . . . . . . 91

89 Minor cervical spine injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92

Division 2 Thoracic spine or lumbar spine injuries

90 Extreme thoracic or lumbar spine injury . . . . . . . . . . . . . . . . . . . . 94

91 Serious thoracic or lumbar spine injury . . . . . . . . . . . . . . . . . . . . 95

92 Moderate thoracic or lumbar spine injury—fracture, disc prolapse or nerve root compression or damage. . . . . . . . . . . . . . 96

93 Moderate thoracic or lumbar spine injury—soft tissue injury . . . . 97

94 Minor thoracic or lumbar spine injury . . . . . . . . . . . . . . . . . . . . . . 98

Division 3 Shoulder injuries

95 Extreme shoulder injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99

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96 Serious shoulder injury. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100

97 Moderate shoulder injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101

98 Minor shoulder injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102

Division 4 Amputation of upper limbs

99 Loss of both upper limbs, or loss of 1 arm and extreme injury to the other arm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103

100 Loss of 1 upper limb . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104

Division 5 Elbow injuries

101 Extreme elbow injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106

102 Serious elbow injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106

103 Moderate elbow injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107

104 Minor elbow injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108

Division 6 Wrist injuries

105 Extreme wrist injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108

106 Serious wrist injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109

107 Moderate wrist injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110

108 Minor wrist injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110

Division 7 Hand injuries

109 Total or effective loss of both hands . . . . . . . . . . . . . . . . . . . . . . . 111

110 Serious injury to both hands. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112

111 Total or effective loss of 1 hand . . . . . . . . . . . . . . . . . . . . . . . . . . 112

112 Amputation of the thumb or part of the thumb . . . . . . . . . . . . . . . 113

113 Amputation of index, middle and ring fingers, or any 2 of them . . 114

114 Amputation of individual fingers . . . . . . . . . . . . . . . . . . . . . . . . . . 116

115 Amputation of thumb and all fingers. . . . . . . . . . . . . . . . . . . . . . . 117

116 Any other injury to 1 or more of the fingers or the thumb . . . . . . . 117

117 Extreme hand injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120

118 Serious hand injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121

119 Moderate hand injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122

120 Minor hand injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122

Division 8 Upper limb injuries, other than injuries mentioned in divisions 3 to 7

121 Extreme upper limb injury, other than an injury mentioned in divisions 3 to 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123

122 Serious upper limb injury, other than an injury mentioned in divisions 3 to 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124

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123 Moderate upper limb injury, other than an injury mentioned in divisions 3 to 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125

124 Minor upper limb injury, other than an injury mentioned in divisions 3 to 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126

Division 9 Pelvis or hip injuries

125 Extreme pelvis or hip injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127

126 Serious pelvis or hip injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128

127 Moderate pelvis or hip injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129

128 Minor pelvis or hip injury. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130

Division 10 Amputation of lower limbs

Subdivision 1 Amputation of both lower limbs

129 Loss of both lower limbs above or through the knee . . . . . . . . . . 131

130 Below the knee amputation of both lower limbs . . . . . . . . . . . . . . 131

Subdivision 2 Amputation of 1 lower limb

131 Above or through the knee amputation of 1 lower limb . . . . . . . . 132

132 Below the knee amputation of 1 lower limb . . . . . . . . . . . . . . . . . 132

Division 11 Lower limb injuries, other than injuries mentioned in division 9 or 10 or divisions 12 to 15

133 Extreme lower limb injury, other than an injury mentioned in division 9 or 10 or divisions 12 to 15 . . . . . . . . . . . . . . . . . . . . . . 133

134 Serious lower limb injury, other than an injury mentioned in division 9 or 10 or divisions 12 to 15 . . . . . . . . . . . . . . . . . . . . . . 134

135 Moderate lower limb injury, other than an injury mentioned in division 9 or 10 or divisions 12 to 15 . . . . . . . . . . . . . . . . . . . . . . 135

136 Minor lower limb injury, other than an injury mentioned in division 9 or 10 or divisions 12 to 15 . . . . . . . . . . . . . . . . . . . . . . 136

Division 12 Knee injuries

137 Extreme knee injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138

138 Serious knee injury. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138

139 Moderate knee injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139

140 Minor knee injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140

Division 13 Ankle injuries

141 Extreme ankle injury. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140

142 Serious ankle injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141

143 Moderate ankle injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142

144 Minor ankle injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142

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Division 14 Foot injuries

Subdivision 1 Amputations

145 Amputation of both feet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143

146 Amputation of 1 foot . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144

Subdivision 2 Other foot injuries

147 Extreme foot injury that is not an amputation . . . . . . . . . . . . . . . . 145

148 Serious foot injury. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145

149 Moderate foot injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146

150 Minor foot injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146

Division 15 Toe injuries

151 Extreme toe injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146

152 Serious toe injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148

153 Moderate toe injury. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148

154 Minor toe injury. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149

Division 16 Limb disorders

Part 7 Scarring to parts of the body other than the face

155 Scarring to a part of the body other than the face . . . . . . . . . . . . 152

Part 8 Burn injuries

Part 9 Injuries affecting hair

156 Extreme injury affecting head hair . . . . . . . . . . . . . . . . . . . . . . . . 155

157 Serious injury affecting head hair . . . . . . . . . . . . . . . . . . . . . . . . . 155

158 Moderate injury affecting head hair or loss of body hair. . . . . . . . 156

Part 10 Dermatitis

159 Extreme dermatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156

160 Serious dermatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156

161 Moderate dermatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157

162 Minor dermatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157

Schedule 5 Matters relevant to PIRS assessment by medical expert . . . 158

Part 1 Explanation of the PIRS

1 PIRS rates permanent impairment caused by mental disorder . . 158

2 Areas of functional impairment. . . . . . . . . . . . . . . . . . . . . . . . . . . 158

Part 2 Assessment of PIRS rating

3 Medical expert must comply with requirements . . . . . . . . . . . . . . 159

4 How to assess a PIRS rating . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159

5 Assessment if pre-existing mental disorder . . . . . . . . . . . . . . . . . 160

6 How to work out a median class score. . . . . . . . . . . . . . . . . . . . . 161

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Contents


7 Conversion table. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161

8 Example worksheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163

Part 3 Particular cases

9 Refusal of treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163

10 Cognitive impairment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164

11 Pre-existing mental disorder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164

Part 4 Report of PIRS rating

12 Court to be given PIRS report . . . . . . . . . . . . . . . . . . . . . . . . . . . 165

Schedule 6 Psychiatric impairment rating scale . . . . . . . . . . . . . . . . . . . . 167

Schedule 7 General damages calculation provisions . . . . . . . . . . . . . . . . 179

1 General damages calculation provisions—2 December 2002 to 30 June 2010 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179

2 General damages calculation provisions—1 July 2010 to 30 June 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180




6 General damages calculation provisions—1 July 2014 . . . . . . . . 187

Schedule 8 Dictionary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190

2014 SL No. 129

[s 1]


1 Short title

This regulation may be cited as the Civil Liability Regulation2014.

2 Commencement

This regulation commences on 1 July 2014.

3 Definitions

Schedule 8 defines particular words used in this regulation.

4 Prescribed entities providing services to enhance public safety—Act, s 26(1)(a)

For section 26(1)(a) of the Act, each entity mentioned inschedule 1 is prescribed.

5 Prescribed entities providing services to enhance public safety—Act, s 27(1)

For section 27(1) of the Act, each entity mentioned inschedule 2 is prescribed.

6 Prescribed amount of damages for loss of consortium or loss of servitium—Act, s 58

For the Act, section 58(1)(b), the amount prescribed is—

(a) for an injury arising on or after 2 December 2002 to andincluding 30 June 2010—$30000; or

(b) for an injury arising on or after 1 July 2010 to andincluding 30 June 2011—$35340; or

(c) for an injury arising on or after 1 July 2011 to andincluding 30 June 2012—$36400; or

(d) for an injury arising on or after 1 July 2012 to andincluding 30 June 2013—$38390; or

(e) for an injury arising on or after 1 July 2013 to andincluding 30 June 2014—$40460; or

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[s 7]


(f) for an injury arising on or after 1 July 2014—$41990.

7 Rules for assessing injury scale value—Act, s 61(1)(c)(i)

(1) This section and schedules 3 to 6 provide the rules underwhich a court must assess the injury scale value for an injury.

(2) Schedule 4 provides the ranges of injury scale values forparticular injuries that the court is to consider in assessing theinjury scale value for those injuries.

(3) In assessing an injury scale value for an injury not mentionedin schedule 4, a court may have regard to the rangesprescribed in schedule 4 for other injuries.

(4) Schedule 3 provides matters to which a court may or musthave regard in applying schedule 4.

(5) Schedule 6 provides the PIRS that may be used with schedule4.

(6) Schedule 5 provides—

(a) matters relevant to the application of schedule 6; and

(b) requirements with which a medical expert must complyin assessing a PIRS rating for a mental disorder of aninjured person.

8 General damages calculation provisions—Act, s 62

For section 62 of the Act, the provisions prescribed as thegeneral damages calculations provisions for an injury are—

(a) for an injury on or after 2 December 2002 to andincluding on 30 June 2010—schedule 7, section 1; or

(b) for an injury arising on or after 1 July 2010 to andincluding 30 June 2011—schedule 7, section 2; or

(c) for an injury arising on or after 1 July 2011 to andincluding 30 June 2012—schedule 7, section 3; or

(d) for an injury arising on or after 1 July 2012 to andincluding 30 June 2013—schedule 7, section 4; or

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[s 9]


(e) for an injury arising on or after 1 July 2013 to andincluding 30 June 2014—schedule 7, section 5; or

(f) for an injury arising on or after 1 July 2014—schedule7, section 6.

9 Prescribed amount of award for future loss—Act, s 64

For section 64 of the Act, the amount prescribed is—

(a) for an injury arising on or after 2 December 2002 to andincluding 30 June 2010—$100000; or

(b) for an injury arising on or after 1 July 2010 to andincluding 30 June 2011—$117800; or

(c) for an injury arising on or after 1 July 2011 to andincluding 30 June 2012—$121350; or

(d) for an injury arising on or after 1 July 2012 to andincluding 30 June 2013—$128000; or

(e) for an injury arising on or after 1 July 2013 to andincluding 30 June 2014—$134910; or

(f) for an injury arising on or after 1 July 2014—$140020.

10 Repeal

The Civil Liability Regulation 2003, SL No. 229 is repealed.

11 Transitional provision

(1) Subject to sections 6, 8 and 9, the repealed regulationcontinues, despite its repeal, to apply to injuries arising beforethe commencement.

(2) In this section—

commencement means the commencement of this section.

repealed regulation means the Civil Liability Regulation2003 as in force immediately before the commencement.

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Schedule 1


Schedule 1 Prescribed entities providing services to enhance public safety—Act, section 26(1)(a)

section 4

Australian Helicopters Pty Ltd ABN 50 011 075 460 whenproviding aeromedical, air rescue and other emergencyhelicopter services under an agreement with the State

Brisbane City Council

Capricorn Helicopter Rescue Service Limited ABN 35 071728 295

CareFlight Medical Services Limited ABN 83 101 511 719

CareFlight (Qld) Limited ABN 45 010 316 462

Central Queensland Helicopter Rescue Service Ltd ABN 73415 515 751

The department administering the Disaster Management Act2003

A local government or joint local government under the LocalGovernment Act 2009

North Queensland Helicopter Rescue Service ABN 81 268344 031

Queensland Ambulance Service established under theAmbulance Service Act 1991

Queensland Fire and Emergency Service established underthe Fire and Emergency Services Act 1990

The Queensland flotillas of The Australian Volunteer CoastGuard Association Inc. ABN 99 392 980 313

Royal Flying Doctor Service Queensland Section ABN 80009 663 478

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Schedule 1


Royal Life Saving Society Queensland Incorporated andaffiliated bodies providing services at or near the followingplaces—

(a) Bulcock Beach, Caloundra;

(b) Tallebudgera Creek, Gold Coast;

(c) public swimming pools

A rural fire brigade registered under the Fire and EmergencyServices Act 1990

The State Emergency Service under the Fire and EmergencyServices Act 1990

St John Ambulance Australia—Queensland

Sunshine Coast Helicopter Rescue Service Ltd ABN 34 010104 560

Surf Life Saving Queensland ABN 27 360 485 381 andaffiliated bodies

Volunteer Marine Rescue Association Queensland Inc. andaffiliated bodies

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Schedule 2


Schedule 2 Prescribed entities providing services to enhance public safety—Act, section 27(1)

section 5

Australian Helicopters Pty Ltd ABN 50 011 075 460 whenproviding aeromedical, air rescue and other emergencyhelicopter services under an agreement with the State

Brisbane City Council

Capricorn Helicopter Rescue Service Limited ABN 35 071728 295

CareFlight Medical Services Limited ABN 83 101 511 719

CareFlight (Qld) Limited ABN 45 010 316 462

Central Queensland Helicopter Rescue Service Ltd ABN 73415 515 751

The department administering the Disaster Management Act2003

A local government or joint local government under the LocalGovernment Act 2009

North Queensland Helicopter Rescue Service ABN 81 268344 031

Queensland Ambulance Service established under theAmbulance Service Act 1991

Queensland Fire and Emergency Service established underthe Fire and Emergency Services Act 1990

The Queensland flotillas of The Australian Volunteer CoastGuard Association Inc. ABN 99 392 980 313

Royal Flying Doctor Service Queensland Section ABN 80009 663 478

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Schedule 2


Royal Life Saving Society Queensland Incorporated andaffiliated bodies providing services at or near the followingplaces—

(a) Bulcock Beach, Caloundra;

(b) Tallebudgera Creek, Gold Coast;

(c) public swimming pools

A rural fire brigade registered under the Fire and EmergencyServices Act 1990

The State Emergency Service under the Fire and EmergencyServices Act 1990

St John Ambulance Australia—Queensland

Sunshine Coast Helicopter Rescue Service Ltd ABN 34 010104 560

Surf Life Saving Queensland ABN 27 360 485 381 andaffiliated bodies

Volunteer Marine Rescue Association Queensland Inc. andaffiliated bodies

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Schedule 3


Schedule 3 Matters to which court may or must have regard in the application of schedule 4

section 7(1)

Part 1 Objectives of schedule 4 (Ranges of ISVs)

1 Objectives of sch 4

The objectives of schedule 4 include promoting—

(a) consistency between assessments of general damagesawarded by courts for similar injuries; and

(b) similar assessments of general damages awarded bycourts for different types of injury that have a similarlevel of adverse impact on an injured person.

Note—

For the assessment of an ISV by a court if general damages are to beawarded, see section 61 of the Act.

Part 2 How to use schedule 4

Division 1 Injury

2 Injury mentioned in sch 4

(1) In assessing the ISV for an injury mentioned in the injurycolumn of schedule 4, a court must consider the range of ISVsstated in schedule 4 for the injury.

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(2) The range of ISVs for the injury reflects the level of adverseimpact of the injury on the injured person.

3 Multiple injuries

(1) Subject to section 4, in assessing the ISV for multiple injuries,a court must consider the range of ISVs for the dominantinjury of the multiple injuries.

(2) To reflect the level of adverse impact of multiple injuries onan injured person, the court may assess the ISV for themultiple injuries as being higher in the range of ISVs for thedominant injury of the multiple injuries than the ISV the courtwould assess for the dominant injury only.

4 Multiple injuries and maximum dominant ISV inadequate

(1) This section applies if a court considers the level of adverseimpact of multiple injuries on an injured person is so severethat the maximum dominant ISV is inadequate to reflect thelevel of impact.

(2) To reflect the level of impact, the court may make anassessment of the ISV for the multiple injuries that is higherthan the maximum dominant ISV.

(3) However, the ISV for the multiple injuries—

(a) must not be more than 100; and

Note—

Under section 61(1)(a) of the Act, an ISV is assessed on a scalerunning from 0 to 100.

(b) should rarely be more than 25% higher than themaximum dominant ISV.

(4) If the increase is more than 25% of the maximum dominantISV, the court must give detailed written reasons for theincrease.


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maximum dominant ISV, in relation to multiple injuries,means the maximum ISV in the range for the dominant injuryof the multiple injuries.

5 Adverse psychological reaction

(1) This section applies if a court is assessing an ISV where aninjured person has an adverse psychological reaction to aphysical injury.

(2) The court must treat the adverse psychological reactionmerely as a feature of the injury.

6 Mental disorder

(1) This section applies if—

(a) a court is assessing an ISV; and

(b) a PIRS rating for a mental disorder of an injured personis relevant under schedule 4.

(2) The PIRS rating for the mental disorder of the injured personis the PIRS rating accepted by the court.

(3) A PIRS rating is capable of being accepted by the court only ifit is—

(a) assessed by a medical expert as required underschedules 5 and 6; and

(b) provided to the court in a PIRS report as required underschedule 5, section 12.

7 Aggravation of pre-existing condition

(1) This section applies if an injured person has a pre-existingcondition that is aggravated by an injury for which a court isassessing an ISV.

(2) In considering the impact of the aggravation of thepre-existing condition, the court may have regard only to theextent to which the pre-existing condition has been madeworse by the injury.

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Schedule 3


Division 2 Other matters

8 Court must have regard to particular provisions of sch 4

(1) In addition to providing ranges of ISVs for particular injuries,schedule 4 sets out provisions relevant to using schedule 4 toassess an ISV for particular injuries.

Examples of relevant provisions—

• examples of the injury

• examples of factors affecting ISV assessment

• comments about appropriate level of ISV

(2) In assessing an ISV, a court must have regard to thoseprovisions to the extent they are relevant in a particular case.

(3) The fact that schedule 4 provides examples of factorsaffecting an ISV assessment is not intended to discourage acourt from having regard to other factors it considers arerelevant in a particular case.

9 Court may have regard to other matters

In assessing an ISV, a court may have regard to other mattersto the extent they are relevant in a particular case.

Examples of other matters—

• the injured person’s age, degree of insight, life expectancy, pain,suffering and loss of amenities of life

• the effects of a pre-existing condition of the injured person

• difficulties in life likely to have emerged for the injured personwhether or not the injury happened

• in assessing an ISV for multiple injuries, the range for, and otherprovisions of schedule 4 in relation to, an injury other than thedominant injury of the multiple injuries

10 Whole person impairment

The extent of whole person impairment is an importantconsideration, but not the only consideration affecting theassessment of an ISV.

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11 Medical report stating whole person impairment percentage

If a medical report states a whole person impairmentpercentage, it must state how the percentage is calculated,including—

(a) the clinical findings; and

(b) how the impairment is calculated; and

(c) if the percentage is based on criteria provided underAMA 5—

(i) the provisions of AMA 5 setting out the criteria;and

(ii) if a range of percentages is available under AMA 5for an injury of the type being assessed—thereason for assessing the injury at the selected pointin the range.

Notes—

1 It is not a function of a doctor to identify—

(a) the item in schedule 4 to which an injury belongs; or

(b) the appropriate ISV for an injury.

2 A medical report tendered in evidence in a proceeding for a claimfor personal injury damages must comply with the Uniform CivilProcedure Rules 1999, chapter 11, part 5.

12 Greater weight to assessments based on AMA 5

(1) This section does not apply to a medical assessment ofscarring or of a mental disorder.

(2) In assessing an ISV, a court must give greater weight to amedical assessment of a whole person impairment percentagebased on the criteria for the assessment of whole personimpairment provided under AMA 5 than to a medicalassessment of a whole person impairment percentage notbased on the criteria.

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13 Greater weight to assessments of PIRS rating

In assessing an ISV, a court must give greater weight to aPIRS report provided as required under schedule 5 than toanother medical assessment of the permanent impairmentcaused by a mental disorder.

14 ISV must be a whole number

An ISV assessed by a court must be a whole number.

Note—

Under section 61(1)(a) of the Act, an ISV is assessed on a scale runningfrom 0 to 100.

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Schedule 4


Schedule 4 Ranges of ISVs

section 7(1)

Item no.

Injury Other provisions Range of ISVs

Part 1 Central nervous system and head injuries

1 Quadriplegia 75 to 100Examples of factors affecting ISV assessment

• presence and extent of pain

• extent of any residualmovement

• degree of insight

• adverse psychological reaction

• level of function andpre-existing function

• degree of independence

• ability to participate in dailyactivities, includingemployment

• presence and extent ofsecondary medicalcomplications

Comment about appropriate level of ISV

An ISV at or near the top of therange will be appropriate only if theinjured person has assistedventilation, full insight, extremephysical limitation and grossimpairment of ability tocommunicate.

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2 Paraplegia 60 to 80Examples of factors affecting ISV assessment

• presence and extent of pain

• extent of any residualmovement




• ability to participate in dailyactivities, includingemployment

• loss of reproductive or sexualfunction

• bowel or bladder incontinence

• presence and extent ofsecondary medicalcomplications

3 Hemiplegia or severe paralysis of more than 1 limb

Comment for item 3

Incomplete paralysis causing wholeperson impairment of less than 40%must be assessed under part 6 if it isthe only injury or the dominantinjury of multiple injuries.Examples of factors affecting ISV assessment for item 3

The same examples apply as foritem 2.

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Schedule 4


3.1 Complete or nearly completeparalysis

60 to 80

3.2 Other paralysis, causing wholeperson impairment of at least 40%

45 to 60

4 Monoplegia

Comment

See items 5, 6 and 7 and part 6.

5 Extreme brain injury

Comment

The injury will involve majortrauma to the brain with severepermanent impairment.

5.1 Substantial insight remaining 71 to 100

Comment about appropriate level of ISV for item 5.1

• An ISV at or near the top of therange will be appropriate onlyif the injured person needsfull-time nursing care and hasthe following—

• substantial insight despitegross disturbance of brainfunction

• significant physicallimitation and destructionof pre-existing lifestyle

• epileptic seizures

• double incontinence

• little or no languagefunction

• little or no meaningfulresponse to environment.

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• An injured person with aninjury for which an ISV at ornear the top of the range isappropriate may have someability to follow basiccommands, recovery of eyeopening, return of posturalreflex movement and return topre-existing sleep patterns.

Examples of factors affecting ISV assessment for item 5.1


• life expectancy

• extent of bodily impairment

5.2 Substantially reduced insightComment for items 5.2.1 and 5.2.2

• The injured person will havemajor trauma to the brain withsevere permanent impairment.

• The injured person’s insight ofhis or her condition maychange.

• Insight may be impaired in thedegree, or continuity of,appreciation of the injuredperson’s condition.

Examples of factors affecting ISV assessment for items 5.2.1 and 5.2.2

The same examples apply as for anitem 5.1 injury, but reducing levelsof insight progressively reduce thelevel of suffering and theappropriate level of ISV.

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5.2.1 The injured person will havepartial or complete insight (asevidenced by appropriate responsesto physical or emotional stimuli)for not more than half of theperson’s waking hours.

36 to 70

5.2.2 The injured person will haveinfrequent periods of partialinsight and will show unreliable,rare or limited responses tophysical or emotional stimuli.

16 to 35

5.3 Grossly reduced insight 10 to 15Comment for item 5.3

The injured person will be in apersistent vegetative state and havelittle or no insight.Comment about appropriate level of ISV for item 5.3

If some minor awareness of lossremains, an ISV at or near the top ofthe range may be appropriate.

6 Serious brain injury

56 to 70

Comment

The injured person will be veryseriously disabled.Example of the injury

serious brain damage causing—

(a) physical impairment, forexample, limb paralysis; or

(b) cognitive impairment withmarked impairment of intellectand personality

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Schedule 4


Examples of factors affecting ISV assessment


• life expectancy

• extent of physical limitations

• extent of cognitive limitations

• extent of sensory limitation, forexample, limitation of hearingor sense of taste or smell



• ability to communicate

• behavioural or psychologicalchanges

• epilepsy or a high risk ofepilepsy

• presence of and extent ofsecondary medicalcomplications


An ISV at or near the top of therange will be appropriate only if theinjured person substantiallydepends on others and needssubstantial professional and othercare.

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Schedule 4


7 Moderate brain injury

21 to 55

Comment

The injured person will be seriouslydisabled, but the degree of theinjured person’s dependence onothers, although still present, islower than for an item 6 injury.Examples of factors affecting ISV assessment


• life expectancy



• extent of sensory limitation, forexample, limitation of hearingor sense of taste or smell






• presence of, and extent of,secondary medicalcomplications

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Schedule 4



• An ISV of 21 to 25 will beappropriate if there is reducedconcentration and memory, orreduced mood control, andeither or both—

• reduced capacity foremployment

• a noticeable interferencewith lifestyle and leisure.

• An ISV of 26 to 40 will beappropriate if there is anincreased risk of epilepsy andeither or both—

• a moderate cognitiveimpairment

• loss of, or greatly reducedcapacity for, employment.

• An ISV of 41 to 55 will beappropriate if there is nocapacity for employment, and 1or more of the following—

• moderate to severecognitive impairment

• marked personality change

• dramatic effect on speech,sight or other senses

• epilepsy or a high risk ofepilepsy.

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8 Minor brain injury

6 to 20

Comment

The injured person will make agood recovery and be able to takepart in normal social life and toreturn to work. There may be minorproblems persisting that prevent arestoration of normal function.Examples of factors affecting ISV assessment

• severity of any physical injurycausing the brain damage,having regard to—

(a) any medical assessmentmade immediately after theinjury was caused, forexample, CT or MRI scans,an ambulance officer’sassessment or hospitalemergency unitassessment; and

(b) any post-traumaticamnesia.

• extent of any ongoing, andpossibly permanent, disability

• extent of any personality change

• depression


• life expectancy



• extent of sensory limitation, forexample, limitation of hearing orsense of taste or smell

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Schedule 4







• presence of, and extent of,secondary medicalcomplications


An ISV at or near the top of therange will be appropriate if theinjured person has—

(a) an increased risk of epilepsy;and

(b) ongoing reduced concentrationand memory, or reduced moodcontrol, that does notsignificantly interfere with theperson’s ability to take part innormal social life or return towork.

9 Minor head injury, other than an injury mentioned in part 3

0 to 5

Comment

Brain damage, if any, is minimal.Examples of the injury

• uncomplicated skull fracture

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Schedule 4


• concussion with transitory lossof consciousness and noresidual effects


• severity of any physical injurycausing brain damage

• length of time to recover fromany symptoms

• extent of ongoing symptoms

• presence, or absence of,headaches


• An ISV at or near the bottom ofthe range will be appropriate foran injury from which theinjured person fully recoverswithin a few weeks.

• An ISV at or near the top of therange will be appropriate ifthere is an uncomplicated skullfracture and there are associatedconcussive symptoms ofdizziness, headache andmemory loss persisting for lessthan 6 months.

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Schedule 4


Part 2 Mental disordersGeneral comment for items 10 to 13

This part includes references toratings on the psychiatricimpairment rating scale set out inschedule 6 (PIRS ratings). A PIRSrating is capable of being acceptedby a court only if it is assessed by amedical expert as required underschedules 5 and 6 and provided tothe court in a PIRS report.Examples of factors affecting ISV assessment for items 10 to 13

• PIRS rating


• age and life expectancy

• pain and suffering

• loss of amenities of life

• likelihood difficulties wouldhave emerged in any event

• if there is extremepsychological trauma, forexample, intense helplessnessor horror, the immediateadverse psychological reaction

10 Extreme mental disorder

41 to 65

Example of the injury

a mental disorder with a PIRSrating between 31% and 100%

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Schedule 4



Despite a very high PIRS rating, anISV at or near the bottom of therange may be appropriate if theinjured person has reduced insight.

11 Serious mental disorder

11 to 40



12 Moderate mental disorder

2 to 10

Comment

There is generally only moderateimpairment.Example of the injury


13 Minor mental disorder

0 to 1

Comment

For many persons who havesuffered the injury there will belittle or no impact on their lives.Example of the injury


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Schedule 4


Part 3 Facial injuriesDivision 1 Skeletal injuries of the facial area

Examples of factors affecting ISV assessment for items 14 to 22

• extent of skeletal or functionaldamage

• degree of cosmetic damage ordisfigurement


• availability of cosmetic repair

14 Extreme facial injury

26 to 45

Comment

The injury will involve severetraumatic injury to the facerequiring substantial reconstructivesurgery.Examples of the injury

• a Le Fort I fracture or Le Fort IIfracture if the degree ofincapacity and disfigurementafter reconstructive surgery willbe very severe

• a Le Fort III fracture causingincapacity in daily activities

Note—Le Fort I fracture, Le Fort II fracture andLe Fort III fracture are defined in schedule8 (Dictionary).

Additional example of factor affecting ISV assessment

the extent of any neurologicalimpairment or effect on the airway

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Schedule 4


15 Serious facial injury

14 to 25

Comment

The injury will involve serioustraumatic injury to the facerequiring reconstructive surgery thatis not substantial.Examples of the injury

• a Le Fort I fracture or Le Fort IIfracture if the degree ofincapacity and disfigurementafter reconstructive surgery willnot be very severe

• a Le Fort III fracture if noserious deformity will remainafter reconstructive surgery

• a serious or multiple fracture ofthe nasal complex either orboth—

(a) requiring more than 1operation; and

(b) causing 1 or more of thefollowing—

• permanent damage tothe airway

• permanent damage tonerves or tear ducts

• facial deformity

• a serious cheekbone fracturethat will require surgery andcause serious disfigurement andpermanent effects despitereconstructive surgery, forexample, hyperaesthesia orparaesthesia

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Schedule 4


• a very serious multiple jawfracture that will—

(a) require prolongedtreatment; and

(b) despite reconstructivesurgery, cause permanenteffects, for example,severe pain, restriction ineating, paraesthesia or arisk of arthritis in the joints

• a severed trunk of the facialnerve (7th cranial nerve),causing total paralysis of facialmuscles on 1 side of the face

Additional examples of factors affecting ISV assessment

• any neurological impairment oreffect on the airway

• permanent cosmetic deformity


• An ISV at or near the bottom ofthe range will be appropriate ifthe injury causes permanentcosmetic deformity, asymmetryof 1 side of the face and limitedadverse psychological reaction.

• An ISV at or near the top of therange will be appropriate if theinjury causes serious bilateraldeformity and significantadverse psychological reaction.

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16 Moderate facial injury

6 to 13

Examples of the injury

• a simple cheekbone fracture,requiring minor reconstructivesurgery, from which the injuredperson will fully recover withlittle or no cosmetic damage

• a fracture of the jaw causing—

(a) permanent effects, forexample, difficulty inopening the mouth or ineating; or

(b) hyperaesthesia orparaesthesia in the area ofthe fracture

• a displaced fracture of the nasalcomplex from which the injuredperson will almost fully recoverafter surgery

• severed branches of the facialnerve (7th cranial nerve) withparalysis of some of the facialmuscles

• a severed sensory nerve of theface with minor permanentparaesthesia

17 Minor facial injury

0 to 5


• a simple cheekbone fracture, forwhich surgery is not requiredand from which the injuredperson will recover fully

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• a simple jaw fracture, requiringimmobilisation and from whichthe injured person will fullyrecover

• a stable fracture of the jointprocess of the jaw

• a displaced fracture of the nasalcomplex requiring onlymanipulation

• a simple undisplaced fracture ofthe nasal complex, from whichthe injured person will fullyrecover

• a severed sensory nerve of theface, with good repair causingminimal or no paraesthesia

18 Injury to teeth or gums

Comment

There will generally have been acourse of treatment as a result of theinjury.


• extent and degree of discomfortduring treatment

• difficulty with eatingComment about appropriate level of ISVIf protracted dentistry causes theinjury, the ISV may be higher thanthe ISV for the same injury causedby something else.

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18.1 Loss of or serious damage to morethan 3 teeth, serious gum injury orserious gum infection

6 to 10

18.2 Loss of or serious damage to 2 or3 teeth, moderate gum injury ormoderate gum infection

3 to 5

18.3 Loss of or serious damage to1 tooth, minor gum injury orminor gum infection

0 to 2

Division 2 Scarring to the faceGeneral comment for items 19 to 22

This division will usually apply toan injury involving skeletal damageonly if the skeletal damage is minor.

19 Extreme facial scarring

21 to 45


• widespread area scarring, forexample, over the side of theface or another whole area

• severe contour deformity

• significant deformity of themouth or eyelids with muscleparalysis or tic


• An ISV in the upper half of therange may be appropriate if theinjured person is relativelyyoung, the cosmetic damage isvery disfiguring and the adversepsychological reaction is severe.

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• An ISV at or near the top of therange will be appropriate if theinjury is caused by burns thatresulted in loss of the entirenose, eyelids or ears.

20 Serious facial scarring

11 to 20


• substantial disfigurement andsignificant adversepsychological reaction

• severe linear scarring

• discoloured hypertrophic(keloid) scarring

• atrophic scarring

• serious contour defects

21 Moderate facial scarring

6 to 10

Comment

Any adverse psychological reactionis small, or having beenconsiderable at the outset, hasgreatly diminished.Examples of the injury

• scarring, the worst effects ofwhich will be reduced by plasticsurgery that will leave minorcosmetic damage

• scars crossing lines of electionwith discoloured, indurated,hypertrophic or atrophicscarring, of moderate severity

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22 Minor facial scarring

0 to 5


• a single scar able to becamouflaged

• more than 1 very small scar ifthe overall effect of the scars isto mar, but not markedly toaffect, appearance and adversepsychological reaction is minor

• almost invisible linear scarring,in lines of election, with normaltexture and elevation

Part 4 Injuries affecting the sensesDivision 1 General comment

General comment for items 23 to 33

Injuries mentioned in this part arecommonly symptoms of brain ornervous system injury.

Division 2 Injuries affecting the eyes23 Total sight

and hearing impairment

90 to 100

Comment

The injury ranks with the mostdevastating injuries.Examples of factors affecting ISV assessment



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24 Total sight impairment

50 to 80




25 Complete sight impairment in 1 eye with reduced vision in the other eye

25 to 50


An ISV at or near the top of therange will be appropriate if there isserious risk of further significantdeterioration in the remaining eye.

26 Complete sight impairment in 1 eye or total loss of 1 eye

26 to 30


• the extent to which the injuredperson’s activities are adverselyaffected by the impairment orloss

• associated scarring or cosmeticdamage

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An ISV at or near the top of therange will be appropriate if there isa minor risk of sympatheticophthalmia.

27 Serious eye injury

11 to 25


• a serious but incomplete loss ofvision in 1 eye withoutsignificant risk of loss orreduction of vision in the othereye

• an injury causing double visionthat is not minor andintermittent

28 Moderate eye injury

6 to 10


minor but permanent impairment ofvision in one eye, including if thereis double vision that is minor andintermittent

29 Minor eye injury

0 to 5


• a minor injury, for example,from being struck in the eye,exposed to smoke or otherfumes or being splashed byliquids—

(a) causing initial pain andtemporary interferencewith vision; and

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(b) from which the injuredperson will fully recoverwithin a relatively shorttime

Division 3 Injuries affecting the earsComment for items 30 to 33

The injuries commonly, but notalways, involve hearing loss. If theinjury is to a single ear, the binauralloss must be assessed.Examples of factors affecting ISV assessment for item 30 to 33 injuries

• whether the injury has animmediate effect, allowing theinjured person no opportunity toadapt, or whether it occurredover a period of time, forexample, from exposure to noise

• whether the injury was sufferedat an early age so that it hasaffected or will affect speech

• whether the injury will affectbalance

• the extent to which formeractivities will be affected

• presence of tinnitus

30 Extreme ear injury

36 to 55

Definition of injury

The injury involves a binauralhearing loss of at least 80%.

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• associated problems, forexample, severe tinnitus,moderate vertigo, a moderatevestibular disturbance orheadaches

• availability of hearing aids orother devices that may reducethe hearing loss


An ISV at or near the top of therange will be appropriate if theinjury happened at an early age soas to prevent or to seriously affectthe development of normal speech.

31 Serious ear injury

26 to 35


The injury involves—

(a) a binaural hearing loss of atleast 50% but less than 80%; or

(b) severe permanent vestibulardisturbance.


An ISV in the lower half of therange will be appropriate if there isno speech impairment or tinnitus.

An ISV in the upper half of therange will be appropriate if there isspeech impairment and tinnitus.

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32 Moderate ear injury

11 to 25


The injury involves—

(a) a binaural hearing loss of atleast 20% but less than 50%; or

(b) significant permanentvestibular disturbance.


An ISV at or near the top of therange will be appropriate if there areproblems associated with the injury,for example, severe tinnitus,moderate vertigo, a moderatevestibular disturbance or headaches.

33 Minor ear injury


The injury involves a binauralhearing loss of less than 20%.Comment

• This item covers the bulk ofhearing impairment cases.

• The injury is not to be judgedsimply by the degree of hearingloss.

• There will often be a degree oftinnitus present.

• There may also be minor vertigoor a minor vestibulardisturbance causing loss ofbalance.

• A vestibular disturbance mayincrease the level of ISV.

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33.1 Moderate tinnitus or hearing loss,or both

6 to 10

33.2 Mild tinnitus with some hearingloss

4 to 5

33.3 Slight or occasional tinnitus withslight hearing loss or anoccasional vestibular disturbance,or both

0 to 3

Division 4 Impairment of taste or smell34 Total loss of

taste or smell, or both

6 to 9


• An ISV at or near the bottom ofthe range will be appropriate ifthere will be a total loss ofeither taste or smell.

• An ISV at or near the top of therange will be appropriate ifthere will be a total loss of bothtaste and smell.

35 Partial loss of smell or taste, or both

0 to 5


• An ISV at or near the bottom ofthe range will be appropriate ifthere will be a partial loss ofeither taste or smell.

• An ISV at or near the top of therange will be appropriate ifthere will be a partial loss ofboth taste and smell.

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Part 5 Injuries to internal organsDivision 1 Chest injuries

Example of factor affecting ISV assessment for items 36 to 39

the level of any reduction in thecapacity for employment andenjoyment of life

36 Extreme chest injury

46 to 65

Comment

The injury will involve severetraumatic injury to the chest, or alarge majority of the organs in thechest cavity, causing a high level ofdisability and ongoing medicalproblems.Comment about appropriate level of ISV

An ISV at or near the top of therange will be appropriate if therewill be total removal of 1 lung orserious heart damage, or both, withserious and prolonged pain andsuffering and significant permanentscarring.

37 Serious chest injury

21 to 45

Comment

The injury will involve serioustraumatic injury to the chest ororgans in the chest cavity, causingserious disability and ongoingmedical problems.

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• a trauma to 1 or more of thefollowing, causing permanentdamage, physical disability andimpairment of function—

• the chest

• the heart

• 1 or both of the lungs

• the diaphragm

• an injury that causes the needfor oxygen therapy for about 16to 18 hours a day

Example of factors affecting ISV assessment

The need for a permanenttracheostomyComment about appropriate level of ISV

An ISV at or near the top of therange will be appropriate if, afterrecovery, there are both of thefollowing—

(a) serious impairment tocardio-pulmonary function;

(b) whole person impairment forthe injury of, or of nearly,40%.

38 Moderate chest injury

11 to 20


the injury will involve serioustraumatic injury to the chest ororgans in the chest cavity, causingmoderate disability and ongoingmedical problems

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• duration and intensity of painand suffering

• the degree of permanentimpairment of lung or cardiacfunction, as evidenced byobjective test results

• the need for a temporarytracheostomy for short-termairway management


• An ISV at or near the bottom of the range will be appropriate if there will be the loss of a breast without significant adverse psychological reaction.

• An ISV in the lower half of the range will be appropriate if there was a pneumothorax, or haemothorax, requiring intercostal catheter insertion.

• An ISV at or near the top of the range will be appropriate if there are multiple rib fractures causing—

(a) a flail segment (flail chest) requiring mechanical ventilation in the acute stage; and

(b) moderate permanent impairment of cardio-pulmonary function.

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39 Minor chest injury

Examples of factors affecting ISV assessment for items 39.1 and 39.2

• complexity of any fractures

• extent of injury to underlyingorgans

• extent of any disability


39.1 Complicated or significantfracture, or internal organ injury,that substantially resolves

5 to 10

Comment

The injury will involve significant or complicated fractures, or internal injuries, that cause some tissue damage but no significant long-term effect on organ function.Examples of the injury

• multiple fractures of the ribs orsternum, or both, that may causecardio-pulmonary contusion

• internal injuries that cause sometissue damage but no significantlong-term effect on organfunction


• An ISV at or near the bottom ofthe range will be appropriate ifthere is a fractured sternum thatsubstantially resolves, and thereis some ongoing pain andactivity restriction.

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• An ISV at or near the top of therange will be appropriate if theinjury causes significantpersisting pain and significantactivity restriction.

39.2 Soft tissue injury, minor fractureor minor internal organ injury

0 to 4

Comment

• The injury will involve a softtissue injury, minor fracture, orminor and non-permanent injuryto internal organs.

• There may be persistent painfrom the chest, for example,from the chest wall orsternocostal or costochondraljoints.


• a single penetrating wound,causing some tissue damage butno long-term effect on lungfunction

• an injury to the lungs caused bythe inhalation of toxic fumes orsmoke that will not permanentlyinterfere with lung function

• a soft tissue injury to the chestwall, for example, a lacerationor serious seatbelt bruising

• fractured ribs or a minorfracture of the sternum causingserious pain and disability forweeks, without internal organdamage or permanent disability

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• An ISV at or near the bottom ofthe range will be appropriate ifthere is a soft tissue injury fromwhich the injured person willfully recover.

• An ISV at or near the top of therange will be appropriate ifthere is an injury causing asmall pneumothorax that doesnot require intercostal catheterinsertion, and from which theinjured person will fullyrecover.

Division 2 Lung injury other than asthmaGeneral comment for items 40 to 43

The level of an ISV for lung diseaseoften reflects the fact that thedisease is worsening and there is arisk of the development ofsecondary medical consequences.Examples of factors affecting ISV assessment for items 40 to 43

• a history of smoking tobaccowill reduce the level of ISV

• adverse psychological reactionmay increase the level of ISV

40 Extreme lung injury

46 to 65


• diagnosed lung cancer

• lung disease involving seriousdisability causing severe painand dramatic impairment offunction and quality of life

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• a recurrent pulmonaryembolism resulting in failure ofthe right side of the heartrequiring a lung transplant,heart transplant or both


• age

• likelihood of progressiveworsening


41 Serious lung injury

41.1 Serious lung injury if progressiveworsening of lung function

25 to 45

Example of item 41.1

lung disease, for example,emphysema, causing—

• significantly reduced andworsening lung function

• prolonged and frequentcoughing

• disturbance of sleep

• restriction of physical activity,employment and enjoyment oflife

Additional examples of factors affecting ISV assessment for item 41.1

• the possibility of lung cancerdeveloping may increase thelevel of ISV

• the need for continuous oxygentherapy

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41.2 Serious lung injury if noprogressive worsening of lungfunction

11 to 24

Examples of item 41.2

• lung disease causing breathingdifficulties, short of disablingbreathlessness, requiringfrequent use of an inhaler

• lung disease causing asignificant effect onemployment and social life,including inability to tolerate asmoky environment, with anuncertain prognosis

• a recurrent pulmonaryembolism causing pulmonaryhypertension and cor pulmonale

42 Moderate lung injury

6 to 10


• bronchitis that does not causeserious symptoms, with little orno serious or permanent effecton employment or social life

• a pulmonary embolismrequiring anticoagulant therapyfor at least 1 year or pulmonaryendarterectomy

43 Minor lung injury

0 to 5


• lung disease causing slightbreathlessness, with—

(a) no effect on employment;and

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(b) the likelihood ofsubstantial and permanentrecovery within a fewyears after the injury iscaused

• a pulmonary embolismrequiring anticoagulant therapyfor less than 1 year


An ISV at or near the bottom of therange will be appropriate if there islung disease causing temporaryaggravation of bronchitis, or otherchest problems, that will resolvewithin a few months.

Division 3 Asthma44 Extreme

asthma31 to 55

Comment

The most serious cases may confinea person to the home and destroycapacity for employment.Example of the injury

severe and permanent disablingasthma causing—

• prolonged and frequentcoughing

• disturbance of sleep

• severe restriction of physicalactivity and enjoyment of life

• gross reduction of capacity foremployment

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45 Severe asthma

11 to 30


chronic asthma, with a poorprognosis, causing—

• breathing difficulties

• the need to frequently use aninhaler

• significantly reduced capacityfor employment.

46 Moderate asthma

6 to 10


asthma, with symptoms that includebronchitis and wheezing, affectingemployment or social life

47 Minor asthma 0 to 5Example of the injury

asthma with minor symptoms thathas no effect on employment orsocial lifeComment about appropriate level of ISV

An ISV at or near the bottom of therange will be appropriate if there isasthma treated by a generalpractitioner that will resolve within1 year after the injury is caused.

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Division 4 Injuries to male reproductive systemGeneral comment for items 48 to 51

• This division applies to injuriescaused by physical traumarather than as a secondary resultof a mental disorder.

• For a mental disorder thatcauses loss of reproductivesystem function, see part 2(Mental disorders).

• Sterility is usually either—

(a) caused by surgery,chemicals or disease; or

(b) caused by a traumaticinjury that is oftenaggravated by scarring.



• effect on social and domesticlife

48 Impotence and sterility

5 to 37


• age

• whether the injured person haschildren

• whether the injured personintended to have children ormore children

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• An ISV at or near the bottomof the range will be appropriateif the sterility has little impact.

• An ISV in the lower half of therange will be appropriate if aninjured person with childrenmay have intended to havemore children and hasuncomplicated sterility,without impotence or anyaggravating features.

• An ISV in the upper half of therange will be appropriate if ayoung injured person withoutchildren has uncomplicatedsterility, without impotence orany aggravating features.

• An ISV at or near the middleof the range will be appropriateif a middle-aged injured personwith children has sterility andpermanent impotence.

• An ISV at or near the top ofthe range will be appropriate ifa young injured person hastotal impotence and loss ofsexual function and sterility.

49 Loss of part or all of penis

5 to 25


• extent of the penis remaining

• availability of a prosthesis

• extent to which sexual activitywill be possible

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50 Loss of both testicles

Comment

See item 48 because sterility results.Additional example of factor affecting ISV assessment

level of any pain or residualscarring

51 Loss of 1 testicle

2 to 10

Additional example of factors affecting ISV assessment

age, cosmetic damage or scarringComment about appropriate level of ISV

An ISV at or near the bottom of therange will be appropriate if theinjury does not reduce reproductivecapacity.

Division 5 Injuries to female reproductive systemGeneral comment for items 52 to 54

• This division applies to injuriescaused by physical traumarather than as a secondary resultof a mental disorder.

• For a mental disorder thatcauses loss of reproductivesystem function, see part 2(Mental disorders).


• extent of any physical trauma

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• whether the injured person haschildren

• whether the injured personintended to have children ormore children

• age

• scarring

• depression or adversepsychological reaction

• effect on social and domesticlife

52 Infertility52.1 Infertility causing severe effects 16 to 35

Example of item 52.1

infertility with severe depression,anxiety and pain

52.2 Infertility causing moderate effects 9 to 15Example of item 52.2

infertility without any medicalcomplication if the injured personhas a child or childrenComment about appropriate level of ISV for item 52.2

An ISV at or near the top of therange will be appropriate if there issignificant adverse psychologicalreaction.

52.3 Infertility causing minor effects 0 to 8Example of item 52.3

infertility if—

(a) the injured person was unlikelyto have had children, forexample, because of age; and

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(b) there is little or no adversepsychological reaction

53 Any other injury to the female reproductive system

53.1 Post-menopausal hysterectomy 5 to 15

53.2 Female impotence 5 to 15Comment for item 53.2

The injury may be correctable bysurgery.Additional example of factors affecting ISV assessment for item 53.2

the level of sexual function or theextent of any corrective surgery

53.3 An injury causing an inability togive birth by normal vaginaldelivery, for example, because ofpelvic ring disruption or deformity

4 to 15

Comment for item 53.3

The injury may be correctable bysurgery.

53.4 Injury to female genitalia orreproductive organs, or both

3 to 25


• An ISV at or near the bottom ofthe range will be appropriate ifthere is a laceration or tear withgood repair.

• An ISV at or near the middle ofthe range will be appropriate ifthe injury causes developmentof a prolapse or fistula.

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• An ISV at or near the top of therange will be appropriate if theinjury causes the early onset ofmenopause or irregularhormonal activity.

53.5 Reduced fertility, caused by, forexample, trauma to ovaries orfallopian tubes

3 to 8


An ISV in the lower half of therange will be appropriate if theinjury is caused by a delay indiagnosis of an ectopic pregnancy.

54 Failed sterilisation leading to unwanted pregnancy

54.1 If no child is born and there is noserious adverse psychologicalreaction

3 to 10

Comment for item 54.1

For a mental disorder, see part 2(Mental disorders).

54.2 If a child is born 15 to 25Comment about appropriate level of ISV for item 54.2

An ISV at or near the top of therange will be appropriate if there isa difficult pregnancy or birth, orboth, followed by medicalproblems, for example, post-nataldepression.

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Division 6 Injuries to digestive systemSubdivision 1 Injury caused by trauma55 Extreme

injury to the digestive system caused by trauma

19 to 40


severe permanent damage to thedigestive system, with ongoingdebilitating pain and discomfort,diarrhoea, nausea and vomitingthat—

(a) are not controllable by drugs;and

(b) cause weight loss of at least20%.

Note—

Digestive system is defined in schedule8 (Dictionary).

• an injury to the throat requiringa permanent gastrostomy


• An ISV at or near the bottom ofthe range will be appropriate ifthere is an injury to the throatrequiring a temporarygastrostomy for more than 1year and permanent dietarychanges, for example, arequirement for a soft food diet.

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• An ISV at or near the top of therange will be appropriate ifthere is an injury to the throatrequiring a permanentgastrostomy, with significantongoing symptoms.


• the extent of any voice orspeech impairment

• need for ongoing endoscopicprocedures

56 Serious injury to the digestive system caused by trauma

11 to 18


• a serious injury causinglong-term complicationsaggravated by physical strain

• an injury requiring a feedingtube for between 3 and 12months


• the extent of any ongoing voiceor speech impairment

• whether a feeding tube wasrequired, and if so, for how longit was required

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57 Moderate injury to the digestive system caused by trauma

6 to 10


• a simple penetrating stabwound, causing somepermanent tissue damage, butwith no significant long-termeffect on digestive function

• an injury requiring a feedingtube for less than 3 months


• whether a feeding tube wasrequired, and if so, for how longit was required

• whether dietary changes arerequired to reduce the risk ofaspiration because of impairedswallowing

58 Minor injury to the digestive system caused by trauma

0 to 5


• a soft tissue injury to theabdomen wall, for example, alaceration or serious seatbeltbruising to the abdomen orflank, or both

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• a minor injury to the throat ortongue causing temporarydifficulties with swallowing orspeech

• a laceration of the tonguerequiring suturing

Subdivision 2 Injury not caused by traumaGeneral comment for items 59 to 62

There is a marked differencebetween those comparatively rarecases having a long-term or evenpermanent effect on quality of lifeand cases in which the only ongoingsymptom is an allergy, for example,to specific foods, that may causeshort-term illness.

59 Extreme injury to the digestive system not caused by trauma

13 to 35


severe toxicosis—

(a) causing serious acute pain,vomiting, diarrhoea and fever,requiring hospitalisation fordays or weeks; and

(b) also causing 1 or more of thefollowing—

• ongoing incontinence

• haemorrhoids

• irritable bowel syndrome;and

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(c) having a significant impact onthe capacity for employmentand enjoyment of life


An ISV in the lower half of therange will be appropriate if theinjury causes a chronic infection,that requires prolongedhospitalisation, that will not resolveafter antibiotic treatment for 1 year.

60 Serious injury to the digestive system not caused by trauma

6 to 12


• serious but short-term foodpoisoning causing diarrhoea andvomiting—

(a) diminishing over 2 to 4weeks; and

(b) with some remainingdiscomfort and disturbanceof bowel function andimpact on sex life andenjoyment of food, over afew years

• constant abdominal pain,causing significant discomfort,for up to 18 months caused by adelay in diagnosis of an injuryto the digestive system

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• An ISV at or near the top of therange will be appropriate ifthere is an adverse response tothe administration of a drugthat—

(a) requires admission to anintensive care unit; and

(b) does not cause anypermanent impairment; and

(c) causes the need for ongoingdrug therapy for life.

• An ISV in the upper half of therange will be appropriate if achronic infection—

(a) requires prolongedhospitalisation andadditional treatment; and

(b) will be resolved byantibiotic treatment within1 year.

• An ISV at or near the bottom ofthe range will be appropriate ifthere is an adverse response tothe administration of a drugthat—

(a) requires admission to anintensive care unit; and

(b) does not cause anypermanent impairment; and

(c) does not cause the need forongoing drug therapy forlife.

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61 Moderate injury to the digestive system not caused by trauma

3 to 5


• food poisoning—

(a) causing significantdiscomfort, stomachcramps, change of bowelfunction and fatigue; and

(b) requiring hospitalisationfor days; and

(c) with symptoms lasting afew weeks; and

(d) from which the injuredperson will fully recoverwithin 1 or 2 years

• an infection that is resolved byantibiotic treatment, with orwithout additional treatment inhospital, within 3 months afterthe injury is caused

• an adverse response to theadministration of a drug,causing any of the followingcontinuing over a period ofmore than 7 days and requiringhospitalisation—

(a) vomiting;

(b) shortness of breath;

(c) hypertension;

(d) skin irritation

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62 Minor injury to the digestive system not caused by trauma

0 to 2


• disabling pain, cramps anddiarrhoea, ongoing for days orweeks

• a localised infection, requiringantibiotic treatment, that healswithin 6 weeks after the start oftreatment

• an adverse response to theadministration of a drug,causing any of the followingcontinuing over a period of notmore than 7 days, and notrequiring hospitalisation—

(a) vomiting;

(b) shortness of breath;

(c) hypertension;

(d) skin irritation

• intermittent abdominal pain forup to 6 months caused by adelay in diagnosis of an injuryto the digestive system

Division 7 Kidney or ureter injuriesGeneral comment for items 63 to 66

An injury to a ureter or the uretersalone, without loss of, or seriousdamage to, a kidney will generallybe assessed under item 65 or 66.

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• age

• risk of ongoing kidney or ureterproblems, complications orsymptoms

• need for future medicalprocedures

63 Extreme injury to kidneys or ureters

63.1 Loss of both kidneys causing loss of renal function and requiring permanent dialysis or transplant

56 to 75

63.2 Serious damage to both kidneys,requiring temporary orintermittent dialysis

31 to 55


• the effect of dialysis and loss ofkidney function on activities ofdaily living

• the length of time for whichdialysis was required or thefrequency of intermittentdialysis

• ongoing requirement formedication, for example, tocontrol blood pressure

• whether the injury caused theneed for dietary changes, and ifso, for how long

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• An ISV at or near the bottom ofthe range will be appropriate ifdialysis was required for aninitial 3 month period, withintermittent dialysis requiredafter that.

• An ISV at or near the top of therange will be appropriate if theinjury required dialysis forabout 1 year and ongoingdietary changes and medication.

64 Serious injury to kidneys or ureters

19 to 30

Comment

The injury may require temporarydialysis for less than 3 months.Example of the injury

loss of 1 kidney if there is severedamage to, and a risk of loss offunction of, the other kidneyComment about appropriate level of ISV

The higher the risk of loss offunction of the other kidney, thehigher the ISV.

65 Moderate injury to kidneys or ureters

11 to 18


• loss of 1 kidney, with nodamage to the other kidney

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• an injury to a ureter or theureters that requires surgery orplacement of stents

66 Minor injury to kidneys or ureters

0 to 10


a laceration or contusion to 1 orboth of the kidneysComment about appropriate level of ISV

• An ISV at or near the bottom ofthe range will be appropriate ifthere is an injury to a kidneycausing a contusion.

• An ISV at or near the top of therange will be appropriate if apartial removal of a kidney isrequired.

Division 8 Liver, gall bladder or biliary tract injuriesExamples of factors affecting ISV assessment for items 67 to 70

• whether there are recurrentepisodes of infection orobstruction

• whether there is a risk ofdeveloping biliary cirrhosis

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67 Extreme injury to liver, gall bladder or biliary tract

51 to 70


loss, or injury causing effective loss,of liver function, requiring constantsubstitutional therapyComment about appropriate level of ISV

• An ISV at or near the bottom ofthe range will be appropriate ifthere are recurrent episodes ofliver failure that require hospitaladmission and medicalmanagement but do not requireliver transplantation.

• An ISV at or near the top of therange will be appropriate if theinjury requires livertransplantation.

68 Serious injury to liver, gall bladder or biliary tract

36 to 50


serious damage causing loss of over30% of the tissue of the liver, butwith some functional capacity of theliver remaining

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69 Moderate injury to liver, gall bladder or biliary tract

16 to 35


a laceration or contusion to theliver, with a moderate effect on liverfunctionComment about appropriate level of ISV

• An ISV at or near the bottom ofthe range will be appropriate ifthe injury causes impaired liverfunction with symptoms ofintermittent nausea andvomiting.

• An ISV at or near the bottom ofthe range will also beappropriate if there is a gallbladder injury with recurrentinfection or symptomatic stonedisease, the symptoms of whichmay include, for example, painor jaundice.

• An ISV at or near the middle ofthe range will be appropriate ifthe injury involves removal ofthe gall bladder causing a bileduct injury.

• An ISV at or near the top of therange will be appropriate if—

(a) surgery is required toremove not more than 30%of the liver; or

(b) bile ducts require repair,for example, placement ofstents.

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• An ISV at or near the top of therange will also be appropriate ifthere is an injury to the gallbladder, that despite biliarysurgery, causes ongoingsymptoms, infection or the needfor further endoscopic surgery.

70 Minor injury to liver, gall bladder or biliary duct

3 to 15

Comment

An injury within this item shouldnot require surgery to the liver.Example of the injury

a laceration or contusion to theliver, with a minor effect on liverfunctionComment about appropriate level of ISV

An ISV in the lower half of therange will be appropriate if there isan uncomplicated removal of thegall bladder with no ongoingsymptoms.

Division 9 Bowel injuriesExamples of factors affecting ISV assessment for items 71 to 74

• age

• risk of ongoing bowel problems,complications or symptoms

• need for future surgery

• the degree to which dietarychanges are required to managechronic pain or diarrhoea causedby the injury

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71 Extreme bowel injury

41 to 60


an injury causing a total loss ofnatural bowel function anddependence on colostomy

72 Serious bowel injury

19 to 40


a serious abdominal injury causingeither or both of the following—

(a) impairment of bowel function(which often requirespermanent or long-termcolostomy, leaving disfiguringscars);

(b) restrictions on employmentand diet

73 Moderate bowel injury

7 to 18


• An ISV at or near the bottom ofthe range will be appropriateif—

(a) the injury requires anileostomy or colostomy forless than 3 months; and

(b) bowel function returns tonormal; and

(c) there are no ongoingsymptoms.


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(a) the injury requirestemporary surgicaldiversion of the bowel, forexample, an ileostomy orcolostomy; and

(b) there is ongoingintermittent abnormalbowel function requiringmedication.

74 Minor bowel injury

3 to 6


an injury causing tears to the bowel,with minimal ongoing bowelproblems

Division 10 Bladder, prostate or urethra injuriesExamples of factors affecting ISV assessment for items 75 to 78

• age

• risk of ongoing bladder, prostateor urethra problems,complications or symptoms

• need for future surgery

75 Extreme bladder, prostate or urethra injury

40 to 60


an injury causing a complete loss ofbladder function and control, withpermanent dependence on urostomy

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76 Serious bladder, prostate or urethra injury

19 to 39


an injury causing seriousimpairment of bladder control, withsome incontinenceComment about appropriate level of ISV

An ISV in the upper half of therange will be appropriate if there isserious ongoing pain.

77 Moderate bladder, prostate or urethra injury

7 to 18


an injury causing continuedimpairment of bladder control, withminimal incontinence and minimalpainComment about appropriate level of ISV

• An ISV at or near the bottom ofthe range will be appropriate ifthere is a laceration of theurethra, that required surgicalrepair and caused intermittentinfection or bladderdysfunction.

• An ISV at or near the top of therange will be appropriate ifthere is—

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(a) increased urinaryfrequency of more thanonce every 2 hoursthroughout the day andmore than 3 times at nightthat is unresponsive totreatment; or

(b) an ongoing requirementfor minor surgery, forexample, cystoscopy orurethral dilation.

78 Minor bladder, prostate or urethra injury

3 to 6


a bladder injury, from which theinjured person will fully recover,with some relatively long-terminterference with natural bladderfunction

Division 11 Spleen and pancreas injuries79 Injuries to the

pancreas10 to 35


• An ISV at or near the bottom ofthe range will be appropriate ifthere is a contusion to thepancreas that heals.

• An ISV at or near the middle ofthe range will be appropriate ifthere are chronic symptoms, forexample, pain or diarrhoea.


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(a) there are chronicsymptoms with significantweight loss of between10% and 20% of bodyweight, and pancreaticenzyme replacement isrequired; or

(b) an injury to the pancreascauses diabetes.


• the extent of any ongoing risk ofinternal infection and disorders,for example, diabetes

• the need for, and outcome of,further surgery, for example,surgery to manage pain causedby stone disease, infection or anexpanding pseudocyst

80 Loss of spleen (complicated)

8 to 20


loss of spleen if there will be a risk,that is not minor, of ongoinginternal infection and disorderscaused by the lossComment about appropriate level of ISV

• An ISV at or near the bottom ofthe range will be appropriate ifthe injury leads to asplenectomy, with intermittentsymptoms of pain, nausea andvomiting that settle.

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• An ISV at or near the middle ofthe range will be appropriateif—

(a) the injury leads to asplenectomy, with seriousinfection after thesplenectomy; and

(b) the infection requiressurgical or radiologicalintervention.

• An ISV at or near the top of therange will be appropriate if theinjury leads to a splenectomy,with portal vein thrombosisafter the splenectomy.

81 Injury to the spleen or uncomplicated loss of spleen

0 to 7


laceration or contusion to the spleenthat—

(a) has been radiologicallyconfirmed; and

(b) has no ongoing bleeding; and

(c) is managed conservatively; and

(d) resolves fullyComment about appropriate level of ISV

An ISV at or near the top of therange will be appropriate if therehas been removal of the spleen(splenectomy), with little or no riskof ongoing infections and disorderscaused by the loss of the spleen.

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Division 12 Hernia injuries82 Severe hernia 11 to 20


a hernia if after repair there is eitheror both—

(a) ongoing pain; or

(b) a restriction on physicalactivities, sport or employment

83 Moderate hernia

6 to 10


a hernia that after repair has somereal risk of recurring in theshort-term

84 Minor hernia 0 to 5Example of the injury

an uncomplicated inguinal hernia,whether or not repaired

Part 6 Orthopaedic injuriesDivision 1 Cervical spine injuries

General comment for items 85 to 89

• This division does not apply tothe following injuries (that aredealt with in items 1 to 3)—

• quadriplegia

• paraplegia

• hemiplegia or severeparalysis of more than 1limb.

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• Cervical spine injuries, otherthan those dealt with in items 1to 3, range from cases of verysevere disability to cases of aminor strain, with no time offwork and symptoms onlysuffered for 2 or 3 weeks.

• Symptoms associated withnerve root compression ordamage can not be taken intoaccount in assessing an ISVunder item 85, 86 or 87 unlessobjective signs are present ofnerve root compression ordamage, for example—

• CT or MRI scans or otherradiological evidence

• muscle wasting

• clinical findings of deeptendon reflex loss, motorweakness and loss ofsensation.

85 Extreme cervical spine injury

41 to 75

Comment

These are extremely severe injuriesthat cause gross limitation ofmovement and serious interferencewith performance of daily activities.

The injury will involve significantupper or lower extremityimpairment and may require the useof an adaptive device or prosthesis.Examples of the injury

• a total neurological loss at asingle level

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• severe multilevel neurologicaldysfunction

• structural compromise of thespinal canal with extreme upperor lower extremity motor andsensory impairments

• fractures involving more than50% compression of a vertebralbody with neural compromise


• An ISV at or near the bottom ofthe range will be appropriate ifthere is whole personimpairment of about 29%.

• An ISV at or near the top of therange will be appropriate ifthere is a cervical spine injurycausing monoplegia of thedominant upper limb and wholeperson impairment of at least60%.

86 Serious cervical spine injury

16 to 40

Comment

• The injury will cause seriousupper extremity impairment orserious permanent impairmentof the cervical spine.

• The injury may involve—

(a) a change of motionsegment integrity; or

(b) bilateral or multilevelnerve root compression ordamage.

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• loss of motion in a motionsegment because of a surgical orpost-traumatic fusion

• a fracture involving more than25% compression of 1 vertebralbody

• an injury showing objectivesigns of nerve root damage aftersurgery



(a) the injured person has hadsurgery and symptomspersist; or

(b) there is a fractureinvolving 25%compression of 1 vertebralbody.

• An ISV in the middle of therange will be appropriate ifthere is a fracture involvingabout 50% compression of avertebral body, with ongoingpain.


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(a) the injured person has hada fusion of vertebral bodiesthat has failed, leavingobjective signs ofsignificant residual nerveroot damage and ongoingpain, affecting 1 side of thebody; and

(b) there is whole personimpairment of about 28%.

87 Moderate cervical spine injury—fracture, disc prolapse or nerve root compression or damage

5 to 15


• An ISV at or near the top of therange will be appropriate if —

(a) there is a disc prolapse forwhich there is radiologicalevidence at ananatomically correct level;and

(b) there are symptoms of painand 3 or more of thefollowing objective signsthat are anatomicallylocalised to an appropriatespinal nerve rootdistribution—

(i) sensory loss;

(ii) loss of musclestrength;

(iii) loss of reflexes;

(iv) unilateral atrophy; and

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(c) the impairment has notimproved afternon-operative treatment.

• An ISV of about 10 will beappropriate if there is a fractureof a vertebral body with up to25% compression, and ongoingpain.

• An ISV at or near the bottom ofthe range will be appropriate foran uncomplicated fracture of aposterior element of 1 or moreof the vertebral segments, forexample, spinous or transverseprocesses, without neurologicalimpairment.

88 Moderate cervical spine injury—soft tissue injury

5 to 10

Comment

The injury will cause moderatepermanent impairment, for whichthere is objective evidence, of thecervical spine.Comment about appropriate level of ISV

An ISV of not more than 10 will beappropriate if there is whole personimpairment of 8% caused by a softtissue injury for which there is noradiological evidence.

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89 Minor cervical spine injury

0 to 4

Comment

• Injuries within this item includea whiplash injury with noongoing symptoms, other thansymptoms that are merely anuisance, remaining more than18 months after the injury iscaused.

• There will be no objective signsof neurological impairment.


a soft tissue or whiplash injury ifsymptoms are minor and the injuredperson recovers, or is expected torecover, from the injury to a levelwhere the injury is merely anuisance within 18 months after theinjury is causedComment about appropriate level of ISV

• An ISV at or near the bottom ofthe range will be appropriate ifthe injury will resolve withoutany ongoing symptoms withinmonths after the injury iscaused.

• An ISV at or near the top of therange will be appropriate if theinjury, despite improvement,causes headaches and someongoing pain.

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Division 2 Thoracic spine or lumbar spine injuriesGeneral comment for items 90 to 94

• This division does not apply tothe following injuries (that aredealt with in items 1 to 3)—

• quadriplegia

• paraplegia

• hemiplegia or severeparalysis of more than 1limb.

• Thoracic or lumbar spineinjuries, other than those dealtwith in items 1 to 3, range fromcases of very severe disability tocases of a minor strain, with notime off work and symptomssuffered only for 2 or 3 weeks.

• Symptoms associated withnerve root compression ordamage can not be taken intoaccount in assessing an ISVunder item 90, 91 or 92 unlessobjective signs are present ofnerve root compression ordamage, for example—

• CT or MRI scans or otherradiological evidence

• muscle wasting

• clinical findings of deeptendon reflex loss, motorweakness and loss ofsensation.

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90 Extreme thoracic or lumbar spine injury

36 to 60

Comment

These are extremely severe injuriescausing gross limitation ofmovement and serious interferencewith performance of daily activities.There may be some motor orsensory loss, and some impairmentof bladder, ano-rectal or sexualfunction.Example of the injury

a fracture involving compression ofa thoracic or lumbar vertebral bodyof more than 50%, withneurological impairmentComment about appropriate level of ISV

• An ISV at or near the bottom ofthe range will be appropriate ifthere is whole personimpairment for the injury of25%.

• An ISV at or near the top of therange will be appropriate ifthere is whole personimpairment for the injury of atleast 45%.

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91 Serious thoracic or lumbar spine injury

16 to 35

Comment

• The injury will cause seriouspermanent impairment in thethoracic or lumbar spine.

• The injury may involve—

(a) bilateral or multilevel nerveroot damage; or

(b) a change in motion segmentintegrity, for example,because of surgery.


a fracture involving at least 25%compression of 1 thoracic or lumbarvertebral bodyComment about appropriate level of ISV


(a) the injured person has hadsurgery and symptomspersist; or

(b) there is a fracture involving25% compression of 1vertebral body.

• An ISV in the middle of therange will be appropriate ifthere is a fracture involving 50%compression of a vertebral body,with ongoing pain.

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• An ISV at or near the top of therange will be appropriate if theinjured person has had a fusionof vertebral bodies that hasfailed—

(a) leaving objective signs ofsignificant residual nerveroot damage and ongoingpain, affecting 1 side of thebody; and

(b) causing whole personimpairment of 24%.

92 Moderate thoracic or lumbar spine injury—fracture, disc prolapse or nerve root compression or damage

5 to 15



(a) there is a disc prolapse forwhich there is radiologicalevidence at an anatomicallycorrect level; and

(b) there are symptoms of painand 3 or more of thefollowing objective signs,that are anatomicallylocalised to an appropriatespinal nerve rootdistribution—

(i) sensory loss;

(ii) loss of musclestrength;

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(iii) loss of reflexes;

(iv) unilateral atrophy; and

(c) the impairment has notimproved afternon-operative treatment.

• An ISV of about 10 will beappropriate if there is a fractureof a vertebral body with up to25% compression, and ongoingpain.

• An ISV at or near the bottom ofthe range will be appropriate foran uncomplicated fracture of aposterior element of 1 or moreof the vertebral segments, forexample spinous or transverseprocesses, without neurologicalimpairment.

93 Moderate thoracic or lumbar spine injury—soft tissue injury

5 to 10

Comment

The injury will cause moderatepermanent impairment, for whichthere is objective evidence, of thethoracic or lumbar spine.Comment about appropriate level of ISV

An ISV of not more than 10 will beappropriate if there is whole personimpairment of 8% caused by a softtissue injury for which there is noradiological evidence.

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94 Minor thoracic or lumbar spine injury

0 to 4


a soft tissue injury of the thoracic orlumbar spine with no—

• significant clinical findings

• fractures

• documented neurologicalimpairment

• significant loss of motionsegment integrity

• other objective signs ofimpairment relating to the injury


• An ISV at or near the top of therange will be appropriate,whether or not the injuredperson continues to suffer someongoing pain, if the injury willsubstantially reach maximummedical improvement, with onlyminor symptoms, within about18 months after the injury iscaused.

• An ISV at or near the bottom ofthe range will be appropriate ifthe injury will resolve withoutany ongoing symptoms withinmonths after the injury iscaused.

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Division 3 Shoulder injuriesGeneral comment for items 95 to 98

• Injuries under items 95 to 98include subluxations ordislocations of thesternoclavicular joint,acromioclavicular joint orglenohumeral joint.

• Soft tissue injuries may involvethe musculoligamentoussupporting structures of thejoints.

• Fractures may involve theclavicle, the scapula (shoulderblade) and the humerus.

Comment about appropriate level of ISV for items 95 to 98

An ISV at or near the top of therange will generally only beappropriate if the injury is to theshoulder of the dominant upperlimb.

95 Extreme shoulder injury

31 to 50

Comment

These are the most severe traumaticinjuries causing gross permanentimpairment.Examples of the injury

• a severe fracture or dislocation,with secondary medicalcomplications

• joint disruption with pooroutcome after surgery

• degloving

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• permanent nerve palsies Additional comment about appropriate level of ISV

An ISV at or near the top of therange will be appropriate if there iswhole person impairment of 45%and complete loss of all shoulderfunction of the dominant upperlimb.

96 Serious shoulder injury

16 to 30

Comment

The injury will involve serioustrauma to the shoulder causingserious permanent impairment.Examples of the injury

• a crush injury

• a serious fracture withsecondary arthritis

• nerve palsies from which theinjured person will partiallyrecover

• established non-union of aclavicular or scapular fracturedespite open reduction andinternal fixation (ORIF)

• established non-union of aclavicular or scapular fracture ifsurgery is not appropriate or notpossible, and there is significantfunctional impairment

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Additional comment about appropriate level of ISV

An ISV at or near the top of therange will be appropriate if there iswhole person impairment for theinjury of 25% and the injury is tothe dominant upper limb.

97 Moderate shoulder injury

6 to 15


• traumatic adhesive capsulitiswith discomfort, limitation ofmovement and symptomspersisting or expected to persistfor about 2 years

• permanent and significant softtissue disruption, for example,from tendon tears or ligamenttears

• a fracture, from which theinjured person has made areasonable recovery, requiringopen reduction and internalfixation

• nerve palsies from which theinjured person has made a goodrecovery

• painful persisting dislocation ofthe acromioclavicular joint

• an injury to the sternoclavicularjoint causing permanent, painfulinstability

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• An ISV at or near the bottom ofthe range will be appropriate ifthere is whole personimpairment for the injury of 6%.

• An ISV at or near the top of therange will be appropriate ifthere is whole personimpairment for the injury of12% and the injury is to thedominant upper limb.

98 Minor shoulder injury

0 to 5


• soft tissue injury withconsiderable pain from whichthe injured person makes analmost full recovery in less than18 months

• fracture from which the injuredperson has made anuncomplicated recovery

• strain injury of theacromioclavicular joint orsternoclavicular joint

Division 4 Amputation of upper limbsComment about appropriate level of ISV for items 99 to 100.3

An ISV at or near the top of therange will generally only beappropriate if the amputation is ofthe dominant upper limb.

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99 Loss of both upper limbs, or loss of 1 arm and extreme injury to the other arm

55 to 85

Comment

The effect of the injury is to reducethe injured person to a state ofconsiderable helplessness.Examples of factors affecting ISV assessment

• whether the amputations areabove or below the elbow (theloss of the elbow joint addsgreatly to the disability)

• the length of any stump suitablefor use with a prosthesis

• severity of any phantom painsAdditional comment about appropriate level of ISV

• An ISV of 70 to 85 will beappropriate if—

(a) both upper limbs areamputated at the shoulder;or

(b) 1 arm is amputated at theshoulder, and there is a lossof function in the otherarm, causing whole personimpairment of 60%.


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(a) both upper limbs areamputated through theelbow or above the elbowbut below the shoulder; or

(b) 1 arm is amputated throughthe elbow or above theelbow but below theshoulder, and there is a lossof function in the otherarm, causing whole personimpairment of 57%.


(a) both upper limbs areamputated below theelbow; or

(b) 1 arm is amputated belowthe elbow, and there is aloss of function in the otherarm, causing whole personimpairment of 54%.

100 Loss of 1 upper limb


• whether the amputation is aboveor below the elbow (the loss ofthe elbow joint adds greatly tothe disability)

• whether the amputation was ofthe dominant arm

• the length of any stump suitablefor use with a prosthesis

• severity of any phantom pains

• extent of any disability in theother arm

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100.1 An upper limb amputation at theshoulder

50 to 65

100.2 An upper limb amputation throughthe elbow or above the elbow butbelow the shoulder

40 to 65

Additional comment about appropriate level of ISV for item 100.2

• An ISV at or near the bottom ofthe range will generally beappropriate if there is anamputation through the elbow.

• An ISV at or near the top of therange will be appropriate ifthere is a short stump because ashort stump may createdifficulties in the use of aprosthesis.

100.3 An upper limb amputation belowthe elbow

35 to 60

Additional comment about appropriate level of ISV for item 100.3

An ISV at or near the top of therange will be appropriate if there isan amputation through the forearmwith residual severe pain in thestump and phantom pains.

Division 5 Elbow injuriesComment about appropriate level of ISV for items 101 to 104

An ISV at or near the top of therange will generally only beappropriate if the injury is to theelbow of the dominant upper limb.

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101 Extreme elbow injury

26 to 50

Comment

The injury will involve anextremely severe elbow injury,falling short of amputation, leavinglittle effective use of the elbowjoint.Examples of the injury

• whole person impairment forthe injury of between 24% and42%

• a complex elbow fracture, ordislocation, with secondarycomplications

• joint disruption, with pooroutcome after surgery

• degloving

• permanent nerve palsies

• an injury causing severelimitation of elbow movementwith the joint constrained in anon-functional position

102 Serious elbow injury

13 to 25

Comment

The injury will involve significantdisability and require major surgery.Examples of the injury

• a serious fracture withsecondary arthritis

• a crush injury

• nerve palsies from which theinjured person will partiallyrecover

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• permanent, poor restriction ofrange of motion with the elbowconstrained in a satisfactoryfunctional position


An ISV at or near the top of therange will be appropriate if there iswhole person impairment for theinjury of 23% and the injury is tothe elbow of the dominant upperlimb.

103 Moderate elbow injury

6 to 12

Comment

The injury will cause moderatelong-term disability but does notrequire protracted surgery.Examples of the injury

• soft tissue disruption, forexample, a ligament or tendontear

• a fracture, from which theinjured person has made areasonable recovery, requiringopen reduction and internalfixation

• nerve palsies from which theinjured person has made a goodrecovery



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• An ISV at or near the top of therange will be appropriate ifthere is a moderately severeinjury to the elbow of thedominant upper limb—

(a) requiring prolonged treatment; and

(b) causing whole person impairment of 10%.

104 Minor elbow injury

0 to 5

Comment

The injury will cause no permanentdamage and no permanentimpairment of function.Examples of the injury

• a fracture with anuncomplicated recovery

• a soft tissue injury with pain,minor tennis elbow syndrome orlacerations

Division 6 Wrist injuriesComment about appropriate level of ISV for items 105 to 108

An ISV at or near the top of therange will generally only beappropriate if the injury is to thewrist of the dominant upper limb.

105 Extreme wrist injury

25 to 40

Comment

The injury will involve severefractures, or a dislocation, causing ahigh level of permanentimpairment.

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• a severe fracture or dislocationwith secondary jointcomplications

• joint disruption with pooroutcome after surgery

• degloving

• permanent nerve palsiesAdditional comment about appropriate level of ISV

An ISV at or near the top of therange will be appropriate if there iswhole person impairment for theinjury of 36% and the injury is tothe wrist of the dominant upperlimb.

106 Serious wrist injury

16 to 24


• an injury causing significantpermanent loss of wristfunction, for example, severeproblems with gripping orpushing objects, but with someuseful movement remaining

• non-union of a carpal fracture

• severe carpal instabilityAdditional comment about appropriate level of ISV

An ISV at or near the top of therange will be appropriate if there iswhole person impairment for theinjury of 20% and the injury is tothe wrist of the dominant upperlimb.

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107 Moderate wrist injury

6 to 15


• a wrist injury that is not seriousand causes some permanentdisability, for example, somepersisting pain and stiffness

• persisting radio-ulnar instability

• recurrent tendon subluxation orentrapment



• An ISV at or near the top of therange will be appropriate ifthere is whole personimpairment for the injury of12%.

108 Minor wrist injury

0 to 5


• a fracture from which theinjured person almost fullyrecovers

• a soft tissue injury, for example,severe bruising

• continued pain following carpaltunnel release

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Division 7 Hand injuriesGeneral comment for items 109 to 120

Hands are cosmetically andfunctionally the most important partof the upper limbs.Comment about appropriate level of ISV for items 109 to 120

• The appropriate ISV for loss ofa hand is only a little less thanthe appropriate ISV for the lossof the relevant arm.

• An ISV at or near the top of therange will generally beappropriate if the injury is to thedominant hand.

109 Total or effective loss of both hands

51 to 75


a serious injury causing extensivedamage to both hands making themlittle more than uselessExamples of factors affecting ISV assessment

• the level of residual capacity leftin either hand

• severity of any phantom pains ifthere has been an amputation oramputations

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• An ISV at or near the bottom ofthe range will be appropriate ifboth hands remain attached tothe forearms and are of somecosmetic importance.

• An ISV at or near the top of therange will be appropriate if bothhands are amputated through thewrist.

110 Serious injury to both hands

40 to 50

Comment

The injury will involve significantloss of function in both hands, forexample, loss of 50% or more of theuse of each hand.

111 Total or effective loss of 1 hand

35 to 60


• a crushed hand that has beensurgically amputated

• traumatic amputation of allfingers and most of the palm

Example of factor affecting ISV assessment

severity of any phantom pain ifthere has been an amputation

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• An ISV at or near the bottom ofthe range will be appropriate ifthere has been an amputation ofthe fingers at themetacarpophalangeal joints, butthe thumb remains, and there iswhole person impairment forthe injury of 32%.


(a) there has been amputationof the dominant hand at thewrist; and

(b) there is residual severepain in the stump andongoing complications, forexample, chronic regionalpain syndrome or neuromaformation.

112 Amputation of the thumb or part of the thumb

15 to 28


• the level of amputation, forexample, at carpo metacarpal(CMC) joint, through the distalthird of the thumb metacarpal,at the metacarpophalangeal(MCP) joint or thumbinterphalangeal (IP) joint

• whether the injury is to thedominant hand

• the extent of any damage to thefingers

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(a) there has been anamputation through theinterphalangeal joint of thethumb; and

(b) there is whole personimpairment for the injuryof 11%.

• An ISV at or near the middle ofthe range will be appropriate ifthere has been an amputationthrough the proximal phalanx.


(a) there has been anamputation at the base ofthe thumb at thecarpometacarpal (CMC)joint level of the dominanthand; and

(b) there are ongoingdebilitating complications.

113 Amputation of index, middle and ring fingers, or any 2 of them

15 to 30

Comment

The amputation will cause completeloss or nearly complete loss of 2 orall of the following fingers of thehand—

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• index finger

• middle finger

• ring finger.Example of factor affecting ISV assessment

the level of the amputation, forexample, whether the hand has beenmade to be of very little use and anyremaining grip is very weakAdditional comment about appropriate level of ISV

• An ISV at or near the bottom ofthe range will be appropriate if2 fingers, whether index, middleor ring fingers, are amputated atthe level of the proximalinterphalangeal joints.

• An ISV at or near the middle ofthe range will be appropriate ifthere is whole personimpairment for the injury of19%.


(a) the index, middle and ringfingers are amputated atthe level of themetacarpophalangeal joint(MCP joint) or there iswhole person impairmentfor the injury of at least27%; and

(b) the injury is to thedominant hand.

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114 Amputation of individual fingers

5 to 20


• whether the amputation was ofthe index or middle finger

• the level of the amputation

• any damage to other fingersshort of amputation



(a) there has been anamputation at the level ofthe distal interphalangealjoint of the little or ringfinger; or


• An ISV of not more than 11 willbe appropriate if—

(a) there has been anamputation of the index ormiddle finger at theproximal interphalangealjoint (PIP joint); or


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• An ISV at or near the top of therange will be appropriate ifthere is complete loss of theindex or middle finger of thedominant hand, and seriousimpairment of the remainingfingers causing whole personimpairment of at least 15%.

115 Amputation of thumb and all fingers

Comment

As the injury will cause effectiveloss of the hand, see item 111.

116 Any other injury to 1 or more of the fingers or the thumb

Comment about appropriate level of ISV for items 116.1 to 116.4

An ISV of not more than 5 will beappropriate if substantial functionof the hand remains.Examples of factors affecting ISV

• whether the injury is to thethumb, or index or middle finger

• any damage to other fingers

• whether the injury is to thedominant hand

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116.1 Extreme injury to 1 or more of the fingers or the thumb

16 to 25


total loss of function of 1 or more ofthe fingers, with the jointsankylosed in non-functionalpositionsAdditional comment about appropriate level of ISV


• An ISV at or near the top of therange will be appropriate ifthere is an injury to the thumbof the dominant hand causingtotal loss of function of thethumb.

116.2 Serious injury to 1 or more of thefingers or the thumb

11 to 15


• a severe crush injury causingankylosis of the fingers

• a bursting wound, or an injurycausing severe finger damage,causing residual scarring anddysfunction

• an injury leaving a digit thatinterferes with the remainingfunction of the hand

• division of 1 or more of the longflexor tendons of the finger,with unsuccessful repair

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116.3 Moderate injury to 1 or more of thefingers or the thumb

6 to 10

Comment

There will be permanentdiscomfort, pain or sensitivescarringExamples of the injury

• moderate injury to the thumb orindex finger causing loss ofmovement or dexterity

• a crush injury causing multiplefractures of 2 or more fingers

• division of 1 or more of the longflexor tendons of the finger,with moderately successfulrepair


An ISV at or near the top of therange will be appropriate if there iswhole person impairment for theinjury of 8% and the injury is to thedominant hand.

116.4 Minor injury to 1 or more of thefingers or the thumb

0 to 5


an uncomplicated fracture or softtissue injury that has healed withminimal residual symptoms

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• An ISV at or near the bottom ofthe range will be appropriate ifthere is a straightforwardfracture of 1 or more of thefingers, with completeresolution within a short time.

• An ISV at or near the top of therange will be appropriate ifthere has been—

(a) a fracture causing minorangular or rotationalmalunion of the thumb, orindex or middle finger, ofthe dominant hand; or

(b) some adherence of atendon following surgicalrepair, limiting fullfunction of the digit.

117 Extreme hand injury

31 to 45

Comment

• The injury will involve a severetraumatic injury to the hand,which may include amputationof part of the hand, causinggross impairment of the hand.

• A hand injury causing wholeperson impairment for the injuryof 35% will generally fall withinthis item.


• an injury reducing a hand’scapacity to 50% or less

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• an injury involving theamputation of several fingersthat are rejoined to the handleaving it clawed, clumsy andunsightly

• an amputation of some fingersand part of the palm causinggrossly reduced grip anddexterity and grossdisfigurement


• An ISV at or near the bottom ofthe range will be appropriate ifthe injured hand has someresidual usefulness forperforming activities of dailyliving.

• An ISV at or near the top of therange will be appropriate if theinjured hand—(a) has little or no residual

usefulness for performingactivities of daily living;and

(b) is the dominant hand.

118 Serious hand injury

16 to 30


• a severe crush injury causingsignificantly impaired functiondespite surgery

• serious permanent tendondamage

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An ISV at or near the top of therange will be appropriate if there iswhole person impairment for theinjury of 20%.

119 Moderate hand injury

6 to 15


• a crush injury, penetratingwound or deep laceration,requiring surgery

• moderately serious tendondamage

• a hand injury causing wholeperson impairment for the injuryof between 5% and 12%

120 Minor hand injury

0 to 5


a soft tissue injury, or an injury thatdoes not require surgery, withnearly full recovery of handfunction

Division 8 Upper limb injuries, other than injuries mentioned in divisions 3 to 7Comment about appropriate level of ISV for items 121 to 124

An ISV at or near the top of therange will generally only beappropriate if the injury is to thedominant upper limb.

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121 Extreme upper limb injury, other than an injury mentioned in divisions 3 to 7

36 to 65

Comment

The injury will involve anextremely serious upper limb injury,falling short of amputation, leavingthe injured person little better offthan if the whole arm had been lost.Examples of the injury

• a serious brachial plexus injuryaffecting peripheral nervefunction

• a non-union of a fracture, withperipheral nerve damage to theextent that an arm is nearlyuseless




(a) there is a completebrachial plexus lesionshown by a flail arm andparalysis of all muscles ofthe hand; and

(b) the injury is to thedominant limb.

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• An ISV at or near the top of therange will also be appropriate ifthere is a serious crush injurythat causes whole personimpairment for the injury of55%.

122 Serious upper limb injury, other than an injury mentioned in divisions 3 to 7

21 to 35


• a serious fracture of thehumerus, radius or ulna, or anycombination of the humerus,radius and ulna, if there issignificant permanent residualimpairment of function

• a brachial plexus injuryrequiring nerve grafts withpartial recovery of shoulder andelbow function and normal handfunction



• An ISV at or near the top of therange will be appropriate ifthere is an injury to thedominant limb causing wholeperson impairment of 30%.

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123 Moderate upper limb injury, other than an injury mentioned in divisions 3 to 7

6 to 20


• a fracture that causesimpairment of associated softtissues, including nerves andblood vessels

• a fracture with delayed union orinfection

• multiple fractures of thehumerus, radius or ulna, ormultiple fractures of anycombination of the humerus,radius and ulna


• An ISV at or near the bottom ofthe range will be appropriate ifthere is whole personimpairment for the injury of 6%

• An ISV in the lower half of therange will be appropriate ifthere is a complicated fractureof the humerus, radius or ulna,or any combination of thehumerus, radius and ulna—

(a) requiring open reductionand internal fixation; and

(b) from which the injuredperson has recovered or isexpected to recover.

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• An ISV at or near the top of therange will be appropriate ifthere is a crush injury causingsignificant skin or muscle losswith permanent residualimpairment.

• An ISV at or near the top of therange will also be appropriate ifthere is whole personimpairment for the injury of15%.

124 Minor upper limb injury, other than an injury mentioned in divisions 3 to7

0 to 5


an uncomplicated fracture of thehumerus, radius or ulna, or anycombination of the humerus, radiusand ulna, from which the injuredperson has fully recovered within ashort timeAdditional comment about appropriate level of ISV

• An ISV at or near the bottom ofthe range will be appropriate ifthere are soft tissue injuries,lacerations, abrasions andcontusions, from which theinjured person will fully oralmost fully recover.

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• An ISV at or near the top of therange will be appropriate ifthere is a brachial plexus injuryfrom which the injured personhas substantially recoveredwithin a few weeks, leavingsome minor functionalimpairment.

Division 9 Pelvis or hip injuriesGeneral comment for items 125 to 128

• The most serious injuries to thepelvis or hips can be asdevastating as a leg amputationand will have similar ISVs.

• However, the appropriate ISVfor other injuries to the pelvis orhips will generally be no higherthan about 20.


• exceptionally severe specificsequelae will increase the levelof ISV

• the availability of remedies, forexample, a total hip replacementis an important factor inassessing an ISV

• age

125 Extreme pelvis or hip injury

46 to 65


• an extensive pelvis fracture

• degloving

• permanent nerve palsies

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• An ISV at or near the top of therange will be appropriate if theinjured person is not able tomobilise without a wheelchairand is relatively young.

126 Serious pelvis or hip injury

26 to 45

Comment

There will be substantial residualdisability, for example, severe lackof bladder and bowel control, sexualdysfunction, or deformity makingthe use of 2 canes or crutchesroutine.Examples of the injury

• a fracture dislocation of thepelvis involving both ischial andpubic rami

• traumatic myositis ossificanswith formation of ectopic bonearound the hip

• a fracture of the acetabulumleading to degenerative changesand leg instability requiring anosteotomy, with the likelihoodof future hip replacementsurgery

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An ISV at or near the bottom of therange will be appropriate for aninjury causing whole personimpairment for the injury of 20%.

127 Moderate pelvis or hip injury

11 to 25


• a significant pelvis or hip injury,with no major permanentdisability

• a hip fracture requiring a hipreplacement

• a fracture of the sacrumextending into the sacro-iliacjoint causing ongoingsignificant symptoms and wholeperson impairment of at least10%



• An ISV at or near the top of therange will be appropriate ifthere is a fracture requiring a hipreplacement that is onlypartially successful, so thatthere is a clear risk of the needfor revision surgery.

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128 Minor pelvis or hip injury

0 to 10


• an uncomplicated fracture of 1or more of the bones of thepelvis or hip that does notrequire surgery or causepermanent impairment

• undisplaced coccygeal fractures

• undisplaced or healed pubicrami fractures

• an injury to the coccyx,requiring surgery that issuccessful


• An ISV at or near the bottom ofthe range will be appropriate ifthere is a soft tissue injury fromwhich the injured person fullyrecovers.

• An ISV at or near the middle ofthe range will be appropriate ifthere is whole personimpairment for the injury of 5%.

• An ISV at or near the top of therange will be appropriate if theperson has ongoing coccydyniaand difficulties with sitting.

Division 10 Amputation of lower limbsSubdivision 1 Amputation of both lower limbs

Examples of factors affecting ISVassessment for items 129 and 130

• the level of each amputation

• severity of any phantom pain

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• pain in the stumps

• extent of any ongoingsymptoms

129 Loss of both lower limbs above or through the knee

55 to 70


An ISV at or near the top of therange will be appropriate if eachamputation is near the hips soneither stump can be used with aprosthesis.

130 Below the knee amputation of both lower limbs

50 to 65




(a) both legs are amputatedjust below the kneesleaving little or no stumpsfor use with prostheses;and

(b) there is poor quality skincover; and

(c) there is a chronic regionalpain syndrome.

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Subdivision 2 Amputation of 1 lower limbExamples of factors affecting ISV assessment for items 131 and 132

• the level of the amputation


• whether there have beenproblems with a prosthesis, forexample, pain and furtherdamage to the stump

131 Above or through the knee amputation of 1 lower limb

35 to 50


• An ISV at or near the bottom ofthe range will be appropriate ifthe amputation is through or justabove the knee.

• An ISV at or near the top of therange will be appropriate if theamputation is near the hip and aprosthesis can not be used.

132 Below the knee amputation of 1 lower limb

31 to 45


• An ISV at or near the bottom ofthe range will be appropriate ina straightforward case of abelow-knee amputation with nocomplications.

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• An ISV at or near the top of therange will be appropriate ifthere is an amputation close tothe knee joint, leaving little orno stump for use with aprosthesis.

Division 11 Lower limb injuries, other than injuries mentioned in division 9 or 10 or divisions 12 to 15

133 Extreme lower limb injury, other than an injury mentioned in division 9 or 10 or divisions 12 to 15

31 to 55

Comment

These are the most severe injuriesshort of amputation, leaving theinjured person little better off than ifthe whole leg had been lost.Examples of the injury

• extensive degloving of the lowerlimb

• an injury causing grossshortening of the lower limb

• a fracture that has not uniteddespite extensive bone grafting

• serious neurovascular injury

• a lower limb injury causingwhole person impairment of40%

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134 Serious lower limb injury, other than an injury mentioned in division 9 or 10 or divisions 12 to 15

21 to 30

Comment

• Removal of extensive muscletissue and extensive scarringmay have a significant enoughimpact to fall within this item.

• An injury to multiple joints orligaments causing instability,prolonged treatment and a longperiod of non-weight-bearingmay have a significant enoughimpact to fall within this item,but generally only if thoseresults are combined.


multiple complex fractures of thelower limb that are expected to takeyears to heal and cause seriousdeformity and serious limitation ofmobilityComment about appropriate level of ISV


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135 Moderate lower limb injury, other than an injury mentioned in division 9 or 10 or divisions 12 to 15

11 to 20


• a fracture causing impairment ofassociated soft tissues,including nerves and bloodvessels

• a fracture with delayed union orinfection

• multiple fractures of the femur,tibia or fibula, or multiplefractures of any combination ofthe femur, tibia and fibula


• period of non-weight-bearing

• presence or risk of degenerativechange

• imperfect union of a fracture

• muscle wasting

• limited joint movement

• unsightly scarring

• permanently increasedvulnerability to future damage

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• An ISV at or near the middle ofthe range will be appropriate ifthere is a deep vein thrombosisrequiring treatment for life.


136 Minor lower limb injury, other than an injury mentioned in division 9 or 10 or divisions 12 to 15

0 to 10


an uncomplicated fracture of thefemur, tibia or fibula, from whichthe injured person has fullyrecoveredComment about appropriate level of ISV

• An ISV at or near the bottom ofthe range will be appropriate ifthere is a deep vein thrombosisrequiring treatment for less than6 months, from which theinjured person will fullyrecover.

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• An ISV at or near the bottom ofthe range will also beappropriate if—

(a) there are soft tissueinjuries, lacerations, cuts,bruising or contusions,from which the injuredperson will fully or almostfully recover; and

(b) any residual disability willbe minor.

• An ISV at or near the top of therange will be appropriate ifthere is a deep vein thrombosisrequiring treatment for at least 1year.

• An ISV at or near the top of therange will also be appropriate ifthe injured person is left withimpaired mobility or a defectivegait.

• An ISV at or near the top of therange will also be appropriate ifthere is whole personimpairment for the injury of 9%.

Division 12 Knee injuriesGeneral comment for items 137 to 140

The availability of remedies, forexample, a total knee replacement,is an important factor in assessingan ISV under this division.

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137 Extreme knee injury

25 to 40


a severe knee injury if there is adisruption of the joint, grossligamentous damage, loss offunction after unsuccessful surgery,lengthy treatment and considerablepainComment about appropriate level of ISV


• An ISV at or near the top of therange will be appropriate if atotal knee replacement wasneeded and—

(a) it is very likely that theknee replacement willneed to be repeated; or

(b) there are ongoing severesymptoms, poor functionand whole personimpairment for the injuryof more than 30%.

138 Serious knee injury

11 to 24

Comment

The injury may involve—

(a) ongoing pain, discomfort,limitation of movement,instability or deformity; and

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(b) a risk, in the long-term, ofdegenerative changes causedby damage to the jointsurfaces, muscular wasting orligamentous or meniscalinjury.


a leg fracture extending into theknee joint, causing pain that isconstant, permanent and limitsmovement or impairs agilityComment about appropriate level of ISV

An ISV at or near the middle of therange will be appropriate if there isa ligamentous injury, whichrequired surgery and prolongedrehabilitation, causing whole personimpairment of 15% and functionallimitation.

139 Moderate knee injury

6 to 10


a dislocation or torn cartilage ormeniscus causing ongoing minorinstability, wasting and weaknessComment about appropriate level of ISV

An ISV at or near the top of therange will be appropriate if there iswhole person impairment for theinjury of 8%.

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140 Minor knee injury

0 to 5


• a partial cartilage, meniscal orligamentous tear

• a laceration

• a twisting or bruising injury

Division 13 Ankle injuriesComment about appropriate level of ISV for items 141 to 144

The appropriate ISV for the vastmajority of ankle injuries is 1 or 2.

141 Extreme ankle injury

21 to 35


• a transmalleolar fracture of theankle with extensive soft tissuedamage causing 1 or more ofthe following—

(a) severe deformity withvarus or valgusmalalignment;

(b) a risk that any future injuryto the relevant leg may leadto a below-kneeamputation of the leg;

(c) marked reduction inwalking ability withconstant dependence onwalking aids;

(d) inability to place therelevant foot for evenload-bearing distribution.

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• an ankylosed ankle in a severelymisaligned position with severeongoing pain and otherdebilitating complications

• whole person impairment forthe injury of more than 20%


• a failed arthrodesis

• regular disturbance of sleep

• need for an orthosis for loadbearing and walking

142 Serious ankle injury

11 to 20


an injury requiring a long period oftreatment, a long time in plaster orinsertion of pins and plates, if—

(a) there is permanent significantankle instability; or

(b) the ability to walk is severelylimited on a permanent basis


• unsightly scarring

• the significance of anymalunion

• a requirement for modifiedfootwear

• whether, and to what degree,there is swelling followingactivity

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• An ISV at or near the top of therange will be appropriate if amajor tendon controlling foot orankle movement is severed.

143 Moderate ankle injury

6 to 10


a fracture, ligamentous tear orsimilar injury causing moderatedisability, for example—

• difficulty in walking on unevenground

• awkwardness on stairs

• irritation from metal plates

• residual scarringAdditional comment about appropriate level of ISV

An ISV at or near the bottom of therange will be appropriate if there iswhole person impairment for theinjury of 6%.

144 Minor ankle injury

0 to 5


a sprain, ligamentous or soft tissueinjury or minor or undisplacedfracture

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• whether the injured person hasfully recovered from the injury,and if not, whether there is anytendency for the ankle to giveway

• whether there is scarring, achingor discomfort

Division 14 Foot injuriesSubdivision 1 Amputations145 Amputation

of both feet32 to 65



• pain in the stumps



• An ISV at or near the bottom ofthe range will be appropriate ifthere are amputations of bothfeet at the forefoot(transmetatarsal levelamputations).

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• An ISV of about 40 will beappropriate if there areamputations of both feet at themid foot (tarsometatarsal levelor Lisfranc amputations).

• An ISV at or near the top of therange will be appropriate if eachamputation is at the level of theankle (Syme’s amputation) andthe stumps can not be used withprostheses.

146 Amputation of 1 foot

20 to 35



• pain in the stump



• An ISV at or near the bottom ofthe range will be appropriate ifthe amputation is at the forefoot(transmetatarsal levelamputation).

• An ISV of about 26 will beappropriate if the amputation isat the mid foot (tarsometatarsallevel or Lisfranc amputation).

• An ISV at or near the top of therange will be appropriate if theamputation is at the level of theankle (Syme’s amputation) andthe stump can not be used with aprosthesis.

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Subdivision 2 Other foot injuries147 Extreme foot

injury that is not an amputation

13 to 25

Comment

There will be permanent and severepain or very serious permanentdisability.Example of the injury

an unusually severe foot injurycausing whole person impairmentof 15% or more, for example, a heelfusion or loss of the tibia-calcaneumangleComment about appropriate level of ISV

An ISV at or near the top of therange will be appropriate if there issubtalar fibrous ankylosis in aseverely malaligned position,ongoing pain and whole personimpairment for the injury of 24%.

148 Serious foot injury

9 to 12


• a severe midfoot deformitycausing whole personimpairment of 8%

• a lower level loss of thetibia-calcaneum angle

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149 Moderate foot injury

4 to 8


a displaced metatarsal fracturecausing permanent deformity, withongoing symptoms of minorseverity, for example, a limp thatdoes not prevent the injured personengaging in most daily activities

150 Minor foot injury

0 to 3


a simple metatarsal fracture,ruptured ligament, puncture woundor similar injuryComment about appropriate level of ISV

An ISV of 2 or less will beappropriate if there is astraightforward foot injury, forexample, a fracture, laceration orcontusions, from which the injuredperson will fully recover.

Division 15 Toe injuries151 Extreme toe

injuryExamples of factors affecting ISV assessment for items 151.1 to 151.3

• whether the amputation wastraumatic or surgical

• extent of the loss of the forefoot

• residual effects on mobility

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151.1 Amputation of all toes 8 to 20Comment about appropriate level of ISV

• An ISV at or near the middle ofthe range will be appropriate ifthe amputation is through themetatarsophalangeal joints(MTP joints) of all toes.

• An ISV at or near the top of therange will be appropriate ifthere is complete amputation ofall toes and amputation of asubstantial part of the forefoot.

151.2 Amputation of the great toe 6 to 12Example of factor affecting ISV assessment for item 151.2

the level at which the amputationhappens or any ongoing symptomsComment about appropriate level of ISV

An ISV at or near the top of therange will be appropriate if there iscomplete loss of the great toe andball of the foot caused by anamputation through the firstmetatarsal bone.

151.3 Amputation of individual lessertoes

3 to 5

Example of factor affecting ISV assessment for item 151.3

the level at which the amputationhappens or any ongoing symptoms

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• An ISV at or near the bottom ofthe range will be appropriate ifthere is an amputation of 1lesser toe and—

(a) there is no ongoing pain;and

(b) there is little or no loss offunction of the foot; and

(c) the cosmetic effect of theamputation is minor.

• An ISV at or near the top of therange will be appropriate ifthere is complete amputation ofall lesser toes and part of theforefoot.

152 Serious toe injury

8 to 12

Comment

The injury will cause serious and permanent disability.Examples of the injury

• a severe crush injury causingankylosis of the toes

• a bursting wound, or an injurycausing severe toe damage, withsignificant symptoms

153 Moderate toe injury

4 to 7

Comment

There will be permanentdiscomfort, pain or sensitivescarring.

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• a moderate injury to the greattoe

• a crush injury causing multiplefractures of 2 or more toes


An ISV at or near the top of therange will be appropriate if therehas been more than 1 unsuccessfuloperation, or there are persistingstabbing pains, impaired gait orsimilar effects.

154 Minor toe injury

0 to 3


a relatively straightforward fractureor soft tissue injuryComment about appropriate level of ISV

An ISV of 1 will be appropriate ifthere is a straightforward fracture of1 or more toes with completeresolution within a short time.

Division 16 Limb disordersGeneral comment

The ISV for a limb disorder must beassessed having regard to the itemof this schedule that—

(a) relates to the part of the bodyaffected by the disorder; and

(b) is for an injury that has asimilar level of adverse impactto the disorder.

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Examples of a limb disorder

• tenosynovitis (inflammation ofsynovial sheaths of tendonsusually resolving with rest overa short period and sometimesleading to ongoing symptoms ofloss of grip and dexterity)

• peripheral nerve injury (theconstriction of the motor orsensory nerves or thickening ofsurrounding tissue, for example,carpal tunnel syndrome orsciatica)

• epicondylitis (inflammationaround the elbow joint, forexample, medially (golfer’selbow) or laterally (tenniselbow))

• vascular disorders, for example,deep vein thrombosis


• whether the disorder is bilateralor one sided

• the level of pain, swelling,tenderness or crepitus or othersymptoms

• the capacity to avoid arecurrence of symptoms

• the ability to engage in dailyactivities

• the availability and likelybenefit of surgery

• whether the disorder is to adominant or non-dominant limb

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Part 7 Scarring to parts of the body other than the faceGeneral comment

• This part applies to externalappearance and physicalcondition of the skin only, andincludes scarring to the scalp,trunk and limbs.

• Facial scarring must be assessedunder part 3, division 2.

• This part does not apply toadhesions, or scarring, ofinternal organs.

• This part will usually apply toan injury involving skeletaldamage only if the skeletaldamage is minor.

• Many of the physical injuriesmentioned in this scheduleinvolve some scarring from theinitial injury and subsequentsurgery, including skin grafting,to repair the injury and this hasbeen taken into account infixing the range of ISVs for theinjuries.Example—

The ISV range for an injury causinga closed fracture of a limb takes intoaccount the potential need for openreduction and internal fixation ofthe fracture and the resultingsurgical wound and scar.

Examples of factors affecting ISV assessment for items 155.1 to 155.4

• location of a scar

• age

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• likelihood of a scar fading orbecoming less noticeable overtime

155 Scarring to a part of the body other than the face

155.1 Extreme scarring to a part of thebody other than the face

14 to 25


• An ISV at or near the bottom ofthe range will be appropriate ifthere is—

(a) extensive scarring to 1 ormore of the limbs andsignificant cosmeticdisfigurement; and

(b) either—

(i) the need to keep thelimb or limbs coveredor wear specialclothing; or

(ii) ongoing limitation inthe ability toparticipate in activitiesbecause of cosmeticdisfigurement orfunctional impairment.

• An ISV at or near the top of therange will be appropriate ifthere is gross permanentscarring over an extensive areaor areas of the body, withongoing pain and othersymptoms.

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155.2 Serious scarring to a part of thebody other than the face

9 to 13

Comment

There is serious scarring—

(a) requiring extensive medicaltreatment or surgery; and

(b) causing significant ongoinglimitation in the ability toparticipate in activities becauseof cosmetic disfigurement orfunctional impairment.


• significant scarring over theupper and lower arm requiringskin grafting if—

(a) there are post-operativecomplications requiringadditional medicaltreatment for up to 18months; and

(b) there is maximum medicalimprovement within 2years after the scarring iscaused.

• hypertrophic (keloid) scarringcaused by a burn to the front ofthe neck, with an intermittentsensation of burning, itching orirritation.

155.3 Moderate scarring to a part of thebody other than the face

4 to 8


• several noticeable scars that arehypertrophic (keloid)

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• a significant linear scar in anarea of cosmetic importance, forexample, the front of the neck

155.4 Minor scarring to a part of thebody other than the face

0 to 3


• scarring caused by a superficialburn that heals within a fewweeks and causes some minorchange of pigmentation in anoticeable area.

• a single noticeable scar, orseveral superficial scars, to 1 orboth of the legs, arms or hands,with some minor cosmeticdamage.

Part 8 Burn injuriesGeneral comment

• The ISV for a burn injury mustbe assessed having regard to theitem of this schedule that—

(a) relates to the part of thebody affected by the burninjury; and

(b) is for an injury that has asimilar level of adverseimpact to the burn injury.

• Burns to the face must beassessed under part 3, division2.

• In burns cases, the ISV for aninjury to a part of the bodycausing functional impairmentwill generally be at or near thetop of the range for an injury tothat part of the body.

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• In serious burns cases, theeffects of scarring are morecomprehensive and less able tobe remedied than the effects ofscarring from other causes.

Part 9 Injuries affecting hair156 Extreme

injury affecting head hair

11 to 15


total permanent loss of head hair

157 Serious injury affecting head hair

4 to 10


damage to head hair, caused by, forexample, defective waving ortinting, if—

(a) the physical effect of thedamage is—

(i) dermatitis; or

(ii) tingling or burning of thescalp, causing dry, brittlehair that breaks off or fallsout, or both; and

(b) the physical effect leads todepression, loss of confidenceand inhibited social life


An ISV in the upper half of therange will be appropriate if—

(a) thinning continues andprospects of regrowth are poor;or

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(b) there is a partial loss of areasof hair and regrowth is slow.

158 Moderate injury affecting head hair or loss of body hair

0 to 3


• hair that has been pulled outleaving bald patches

• the same example applies as foritem 157 but with fewer or onlymoderate symptoms

Example of factor affecting ISV assessment

length of time before regrowth

Part 10 Dermatitis159 Extreme

dermatitis11 to 20


permanent dermatitis having asevere effect on employment anddomestic capability, with somemental disorder

160 Serious dermatitis

8 to 10


dermatitis that—

(a) lasts for years or indefinitely;and

(b) involves cracking andsoreness; and

(c) affects employment anddomestic capability; and

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(d) causes marked adversepsychological reaction

161 Moderate dermatitis

3 to 7


dermatitis lasting for a significantperiod, but settling with treatmentor a change of personal conduct, orboth

162 Minor dermatitis

0 to 2


itching, skin irritation or a rash,alone or in combination, thatresolves with treatment within a fewmonths of the start of treatment

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Schedule 5 Matters relevant to PIRS assessment by medical expert

section 7(1)

Part 1 Explanation of the PIRS

1 PIRS rates permanent impairment caused by mental disorder

The PIRS set out in schedule 6 rates permanent impairmentcaused by a mental disorder.

Note—

PIRS ratings are referred to in schedule 4, part 2. A PIRS rating iscapable of being accepted by a court under schedule 3, section 6 only ifit is—

(a) assessed by a medical expert as required under this schedule andschedule 6; and

(b) provided to the court in a PIRS report as required under section 12.

2 Areas of functional impairment

(1) The PIRS consists of 6 scales, each of which rates permanentimpairment in an area of function.

(2) Each scale has 5 classes of impairment, ranging from little orno impairment to total impairment.

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Part 2 Assessment of PIRS rating

3 Medical expert must comply with requirements

(1) A medical expert must comply with this schedule andschedule 6 in assessing a PIRS rating for a mental disorder ofan injured person.

(2) The medical expert may give an assessment only if themedical expert has examined the injured person.

4 How to assess a PIRS rating

(1) To assess a PIRS rating for a mental disorder of an injuredperson, a medical expert must follow the steps set out in thissection.

Note—

Section 8 provides an example completed worksheet that could be usedto assess a PIRS rating.

(2) Step 1—for each area of functional impairment set out in thePIRS, the medical expert must—

(a) decide which level of impairment set out in the PIRSdescribes the level of impairment caused by the mentaldisorder of the injured person; and

(b) read off from the PIRS the class (for example, class 1)that corresponds to the level that has been decided.

(3) In deciding which level to choose for an area of functionalimpairment, the medical expert—

(a) must have regard to—

(i) the examples of indicators of the level ofimpairment set out in the PIRS for the area to theextent they are relevant in a particular case; and

(ii) all factors the medical expert considers relevant tothe injured person’s level of impairment, including,for example, the injured person’s age andpre-existing functional capacity for the area; and

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(b) may have regard to the range of percentages ofimpairment set out in the PIRS for the area as a guide tothe level of impairment.

Note—

The examples of impairment set out in the PIRS assume a fullpre-existing functional capacity for the area which may not beappropriate in a particular case.

(4) Step 2—the medical expert must list the class number of the 6classes read off under step 1 in ascending order.

(5) Step 3—the medical expert must work out the median of theclass numbers (the median class score) under section 6.

(6) Step 4—the medical expert must work out the total of theclass numbers (the total class score) by adding together all ofthe class numbers.

(7) Step 5—from the conversion table in section 7, the medicalexpert must read off the percentage impairment thatcorresponds to the particular median class score when foundin conjunction with the particular total class score.

(8) Subject to section 5, the percentage impairment is the PIRSrating assessed by the medical expert for the mental disorderof the injured person.

5 Assessment if pre-existing mental disorder

(1) If an injured person has a pre-existing mental disorder, amedical expert must—

(a) work out a percentage impairment for the pre-existingmental disorder at the time immediately before theinjury using the steps set out in section 4 (the pre-injuryrating); and

(b) work out a percentage impairment for the current mentaldisorder using the steps set out in section 4 (thepost-injury rating); and

(c) subtract the pre-injury rating from the post-injury rating.

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(2) The remaining percentage impairment is the PIRS ratingassessed by the medical expert for the mental disorder of theinjured person.

Editor’s note—

See also section 11 (Pre-existing mental disorder).

6 How to work out a median class score

(1) A median class score is the number that would fall at themiddle point between the third class number and the fourthclass number if all the class numbers are listed in ascendingorder.

(2) If the median class score under subsection (1) is not a wholenumber, the median class score must be rounded up to thenearest whole number.

7 Conversion table

This section sets out the conversion table for use under section4.

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Conversion table for percentage impairment

Median class score

1 2 3 4 5

Tota

l cla

ss s

core

6 0%

7 0%

8 1%

9 1% 4%

10 2% 5%

11 2% 5%

12 2% 6%

13 3% 7% 11%

14 3% 7% 13%

15 8% 15%

16 9% 17%

17 9% 19% 31%

18 10% 22% 34%

19 24% 37%

20 26% 41%

21 28% 44% 61%

22 30% 47% 65%

23 50% 70%

24 54% 74%

25 57% 78%

26 60% 83%

27 87%

28 91%

29 96%

30 100%

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8 Example worksheet

This section sets out an example of a completed worksheetthat could be used to assess a PIRS rating for a mentaldisorder.

Part 3 Particular cases

9 Refusal of treatment

(1) This section applies if an injured person refuses treatment thatcould lead to a significant improvement in the level ofpermanent impairment caused by a mental disorder of theinjured person.

(2) Despite the injured person’s refusal of treatment, a medicalexpert may assess a PIRS rating for the mental disorder of theinjured person.

Area of functional impairment Class

1 Self-care and personalhygiene

1

2 Social and recreationalactivities

2

3 Travel 34 Social functioning 55 Concentration, persistence

and pace5

6 Adaptation 5

List of class numbers inascending order: 1 2 3 5 5 5

Median class score (using section 6): 4

Total class score: 21

Percentage impairment (using conversion table in section 7): 44%

PIRS rating (if no pre-existing mental disorder): 44%

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(3) The refusal of treatment must not affect the medical expert’sassessment of the PIRS rating.

(4) The medical expert must note the refusal of treatment in thePIRS report and state in the report the likely effect oftreatment and any reasons known to the medical expert for therefusal of treatment.

(5) Subsection (6) applies if a PIRS report given to a court statesthat the injured person refuses treatment that could lead to asignificant improvement in the level of permanent impairmentcaused by the mental disorder of the injured person.

(6) The court may, in assessing the ISV for an injury or multipleinjuries of the injured person, take into account the refusal oftreatment and the matters stated in the PIRS report undersubsection (4).


PIRS report means a report under section 12.

10 Cognitive impairment

If a medical expert assessing a PIRS rating for a mentaldisorder of an injured person suspects the injured person has acognitive impairment, the medical expert must take intoaccount the following factors—

(a) the relevant medical history of the injured person;

(b) any medical treatment, and progress towardsrehabilitation, for the cognitive impairment;

(c) any results of radiological scans, including CT and MRIscans, electroencephalograms and psychometric testsmade available to the medical expert.

11 Pre-existing mental disorder

If a medical expert assessing a PIRS rating for a mentaldisorder of an injured person considers the injured person hada pre-existing mental disorder, the medical expert must—

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(a) make appropriate enquiry into the pre-existing mentaldisorder; and

(b) consider any psychiatric or psychological reports madeavailable to the medical expert.

Part 4 Report of PIRS rating

12 Court to be given PIRS report

(1) This section applies if a party to a proceeding wants a court toaccept a PIRS rating assessed by a medical expert for a mentaldisorder of an injured person.

(2) The party must give the court a written report from themedical expert stating the following matters—

(a) the mental disorder diagnosed by the medical expert;

(b) the PIRS rating assessed by the medical expert for themental disorder of the injured person;

(c) how the PIRS rating is assessed, including—

(i) for each area of functional impairment set out inthe PIRS—

(A) the relevant clinical findings; and

(B) the level of impairment set out in the PIRSthat the medical expert decided described thelevel of impairment caused by the mentaldisorder of the injured person; and

(C) the class set out in the PIRS that correspondsto the level that was decided; and

(ii) the median class score and total class score workedout under section 4; and

(iii) if the injured person had a pre-existing mentaldisorder, the information mentioned insubparagraphs (i) and (ii) in relation to the

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pre-injury rating and the post-injury rating asdefined under section 5;

(d) details of any cognitive impairment of the injuredperson.

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Schedule 6 Psychiatric impairment rating scale

section 7(1)

Area of functional impairment: self-care and personal hygiene

Class Level of impairment

Examples of indicators of level of impairment

Note—These examples must be had regard to under schedule 5, section 4(3)(a)(i).

Percentage impairment ranges

Note—

These ranges may be had regard to under schedule 5, section 4(3)(b).

Class 1 Little or noimpairment

0 to 3%

Class 2 Mildimpairment

4 to 10%

• can live independently

• looks after himself or herself adequately, although may look unkempt occasionally

• sometimes misses a meal orrelies on takeaway food

Class 3 Moderateimpairment

11 to 30%

• can not live independently without regular support

• needs prompting to shower daily and wear clean clothes

• does not prepare own meals

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• frequently misses meals

• if living independently, a family member or community nurse visits, or needs to visit, 2 to 3 times a week to ensure a minimum level of hygiene and nutrition

Class 4 Severeimpairment

31 to 60%

• needs supervised residential care

• if unsupervised, may accidentally or deliberately hurt himself or herself

Class 5 Totallyimpaired

more than 60%

• needs assistance with basic functions, for example, feeding or toileting

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Area of functional impairment: social and recreational activities


Examples of indicators of level ofimpairment

Note—These examples must be hadregard to under schedule 5, section4(3)(a)(i).


Note—These ranges may be had regard to under schedule 5, section 4(3)(b).


0 to 3%

• regularly goes to cinemas, restaurants or other recreational venues

• belongs to clubs or associations and is actively involved in them


4 to 10%

• occasionally goes to social events without needing a support person, but does not become actively involved, for example, by dancing or cheering a team


11 to 30%

• rarely goes to social events, and usually only when prompted by family or a friend

• does not become involved in social events

• will not go out without a support person

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Area of functional impairment: travel

• remains quiet and withdrawn


31 to 60%

• never leaves own residence

• tolerates the company of a family member or close friend

• will go to a different room or garden when a person, other than a family member or close friend, comes to visit someone at own residence


more than60%

• can not tolerate living with anybody

• extremely uncomfortable when visited by a close family member


Examples of indicators of level ofimpairment

Note—These examples must be hadregard to under schedule 5, section4(3)(a)(i).




0 to 3%

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• can travel to new environments without supervision


4 to 10%

• can travel without a support person, but only in a familiar area, for example, to go to the local shops or visit a neighbour


11 to 30%

• can not travel away from own residence without a support person

• there may be problems resulting from excessive anxiety or cognitive impairment


31 to 60%

• finds it extremely uncomfortable to leave own residence even with a trusted person


more than60%

• can not be left unsupervised, even at own residence

• may require 2 or more persons to supervise him or her when travelling

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Area of functional impairment: social functioning






Class 1 Little or no impairment

0 to 3%

• has no difficulty in forming and sustaining relationships, for example, with a spouse or close friend lasting years

Class 2 Mild impairment

4 to 10%

• existing relationships are strained

• tension and arguments between the injured person and a spouse or close family member

• some friendships are lost

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Class 3 Moderate impairment

11 to 30%

• established relationships are severely strained, as is shown by periods of separation or domestic violence

• if the injured person has children, then a spouse, family members or community services are providing most of the care for the children

Class 4 Severe impairment

31 to 60%

• can not form or sustain long-term relationships

• pre-existing relationships, for example, with a spouse or close friend, have ended

• can not care for dependents, for example, child dependents (if any) or an elderly parent

Class 5 Totally impaired

more than60%

• can not function within society

• lives away from populated areas

• actively avoids social contact

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Area of functional impairment: concentration, persistence and pace







0 to 3%

• can complete vocational education and training or a university course within a normal time frame


4 to 10%

• can undertake a basic or standard retraining course at a slower pace

• can focus on intellectually demanding tasks for up to 30 minutes, then may feel fatigued or develop headaches

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11 to 30%

• can not read more than newspaper articles

• finds it difficult to follow complex instructions, for example, operating manuals or building plans

• can not make significant repairs to motor vehicle or type long documents

• can not follow a pattern for making clothes or tapestry or knitting


31 to 60%

• able only to read a few lines before losing concentration

• has difficulty in following simple instructions

• impaired concentration is obvious even during brief conversation

• can not live alone or needs regular assistance from family members or community services


more than60%

• needs constant supervision and assistance within an institutional environment

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Area of functional impairment: adaptationNote—

This area of functional impairment deals with employability.







0 to 3%

• can work full-time in the position in which the injured person worked immediately before the injury (the pre-injury position)

• the injured person’s duties at work and performance of the duties are consistent with the person’s education and training

• can cope with the normal demands of the job

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4 to 10%

• can work in the pre-injury position, but for no more than 20 hours a week, for example, because the injured person is no longer happy to work with particular persons

• can work full-time in a different position where performance of the relevant duties requires the use of comparable skill and intellect to that required to perform the duties of the pre-injury position


11 to 30%

• can not work at all in the pre-injury position

• only able to work less than 20 hours a week in a different position where performance of the relevant duties requires less skill or is otherwise less demanding, for example, less stressful


31 to 60%

• can not work more than 1 or 2 days at a time

• works less than 20 hours a fortnight

• the pace at which work is done is reduced

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• attendance at work is erratic


more than60%

• needs constant supervision and assistance within an institutional environment

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Schedule 7 General damages calculation provisions

section 8

1 General damages calculation provisions—2 December 2002 to 30 June 2010

The general damages must be calculated for an injury arisingon or after 2 December 2002 to and including 30 June 2010 asfollows—

(a) if the injury scale value of the injury is assessed as 5 orless—by multiplying the injury scale value by $1000;

(b) if the injury scale value of the injury is assessed as 10 orless but more than 5—by adding to $5000 an amountcalculated by multiplying the number by which theinjury scale value exceeds 5 by $1200;

(c) if the injury scale value of the injury is assessed as 15 orless but more than 10—by adding to $11000 an amountcalculated by multiplying the number by which theinjury scale value exceeds 10 by $1400;

(d) if the injury scale value of the injury is assessed as 20 orless but more than 15—by adding to $18000 an amountcalculated by multiplying the number by which theinjury scale value exceeds 15 by $1600;

(e) if the injury scale value of the injury is assessed as 25 orless but more than 20—by adding to $26000 an amountcalculated by multiplying the number by which theinjury scale value exceeds 20 by $1800;

(f) if the injury scale value of the injury is assessed as 30 orless but more than 25—by adding to $35000 an amountcalculated by multiplying the number by which theinjury scale value exceeds 25 by $2000;

(g) if the injury scale value of the injury is assessed as 35 orless but more than 30—by adding to $45000 an amount

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calculated by multiplying the number by which theinjury scale value exceeds 30 by $2200;

(h) if the injury scale value of the injury is assessed as 40 orless but more than 35—by adding to $56000 an amountcalculated by multiplying the number by which theinjury scale value exceeds 35 by $2400;

(i) if the injury scale value of the injury is assessed as 50 orless but more than 40—by adding to $68000 an amountcalculated by multiplying the number by which theinjury scale value exceeds 40 by $2580;

(j) if the injury scale value of the injury is assessed as 60 orless but more than 50—by adding to $93800 an amountcalculated by multiplying the number by which theinjury scale value exceeds 50 by $2760;

(k) if the injury scale value of the injury is assessed as 70 orless but more than 60—by adding to $121400 an amountcalculated by multiplying the number by which theinjury scale value exceeds 60 by $2940;

(l) if the injury scale value of the injury is assessed as 80 orless but more than 70—by adding to $150800 an amountcalculated by multiplying the number by which theinjury scale value exceeds 70 by $3120;

(m) if the injury scale value of the injury is assessed as 90 orless but more than 80—by adding to $182000 an amountcalculated by multiplying the number by which theinjury scale value exceeds 80 by $3300;

(n) if the injury scale value of the injury is assessed as 100or less but more than 90—by adding to $215000 anamount calculated by multiplying the number by whichthe injury scale value exceeds 90 by $3500.

2 General damages calculation provisions—1 July 2010 to 30 June 2011

The general damages must be calculated for an injury arisingon or after 1 July 2010 to and including 30 June 2011 asfollows—

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(g) if the injury scale value of the injury is assessed as 35 orless but more than 30—by adding to $53000 an amountcalculated by multiplying the number by which theinjury scale value exceeds 30 by $2590;



(j) if the injury scale value of the injury is assessed as 60 orless but more than 50—by adding to $110500 an amount

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(d) if the injury scale value of the injury is assessed as 20 orless but more than 15—by adding to $21850 an amount

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(m) if the injury scale value of the injury is assessed as 90 orless but more than 80—by adding to $220850 an amount

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(g) if the injury scale value of the injury is assessed as 35 orless but more than 30—by adding to $57600 an amount

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(j) if the injury scale value of the injury is assessed as 60 orless but more than 50—by adding to $126600 an amount

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6 General damages calculation provisions—1 July 2014

The general damages must be calculated for an injury arisingon or after 1 July 2014 as follows—





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Schedule 8 Dictionary

section 3

adverse psychological reaction does not include a mentaldisorder.

AMA 5 means the 5th edition of the Guides to the Evaluationof Permanent Impairment published by the American MedicalAssociation.

ankylosis means fixation of a joint in a specific position.

digestive system—

(a) means the organs and other parts of the body formingthe alimentary tract, and includes the tongue, throat andabdominal wall; but

(b) does not include an organ or other part of the bodymentioned in the injury column of schedule 4.

dominant injury, of multiple injuries, means—

(a) if the highest range for 2 or more of the injuries of themultiple injuries is the same—the injury of thoseinjuries selected as the dominant injury by a courtassessing an ISV; or

(b) otherwise—the injury of the multiple injuries having thehighest range.

Note—

The selection of a particular injury as a dominant injury from 2 or moreinjuries having the same highest range will not affect the outcome of thecourt’s assessment of an ISV for the multiple injuries.

DSM 4 means the 4th edition of the Diagnostic and StatisticalManual of Mental Disorders, Text Revision (DSM-IV-TR)published by the American Psychiatric Association in 2000.

highest range means the range of ISVs having the highestmaximum ISV.

ISV means injury scale value.

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Le Fort I fracture means a horizontal segmented fracture ofthe alveolar process of the maxilla.

Le Fort II fracture means a unilateral or bilateral fracture ofthe maxilla—

(a) in which the body of the maxilla is separated from thefacial skeleton and pyramidal in shape; and

(b) that may extend through the body of the maxilla downthe midline of the hard palate, through the floor of theorbit and into the nasal cavity.

Le Fort III fracture means a fracture in which the entiremaxilla and 1 or more facial bones are completely separatedfrom the brain case.

medical expert, for an assessment of a PIRS rating, means aperson who—

(a) is appropriately qualified to perform the assessment,including a psychologist, neuropsychologist orpsychiatrist; and

(b) has had appropriate training in the use of the PIRS.

mental disorder means a mental disorder recognised underDSM 4.

permanent impairment, in relation to an injury, means theimpairment an injured person has, or is likely to have, evenafter maximum medical improvement.

PIRS means the psychiatric impairment rating scale set out inschedule 6.

PIRS rating, for a mental disorder, means a rating on thePIRS for the permanent impairment caused by the mentaldisorder.

pre-existing, in relation to an injury, means existing at thetime immediately before the injury.

range, in relation to an ISV for an injury, means the range ofISVs for the injury set out in schedule 4.

whole person impairment, in relation to an injury, means anestimate, expressed as a percentage, of the impact of a

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permanent impairment caused by the injury on the injuredperson’s overall ability to perform activities of daily livingother than employment.

ENDNOTES1 Made by the Governor in Council on 26 June 2014.2 Notified on the Queensland legislation website on 27 June 2014.3 The administering agency is the Department of Justice and

Attorney-General.

© State of Queensland 2014

Authorised by the Parliamentary Counsel

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civil liability regulation 2014 - legislation.qld.gov.au

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