Division 1 - Chapter 4
Division 1
Assessment of the Degree of an Employee's Permanent Impairment Resulting from an Injury
Chapter 4 - Disfigurement and Skin Disorders
4.0 Introduction
In conducting an assessment, the assessor must have regard to the Principles of Assessment and the definitions contained in the Glossary.
Impairments assessed under Chapter 4 include those caused by secondary conditions accompanying an endocrine system condition. A WPI rating from a table in Chapter 3 - The Endocrine System should be combined with WPI ratings resulting from the secondary conditions assessed under Chapter 4.
Loss of one or both breasts in females should be assessed under both:
- Table 3.4: Gonads and Mammary Glands (Chapter 3 - The Endocrine System); and
- Table 4.3: Bodily Disfigurement;
and the resulting WPI ratings combined.
In cases where two or three of Tables 4.1, 4.2 and 4.3 apply, WPI ratings from each table can be combined using the Combined Values Chart (see Appendix 1).
WPI ratings awarded under Table 4.2 cannot be combined with WPI ratings arising under section 6.4 - Other Ocular Abnormalities, or section 6.5 - Other Conditions Causing Permanent Deformities Causing up to 10% Impairment of the Whole Person (Chapter 6 - The Visual System).
4.1 Skin Disorders
For the purposes of Table 4.1: Skin Disorders:
- ?intermittent treatment? means a course of treatment leading to a break, treatment alternately ceasing and beginning again;
- 'constant treatment' means treatment that continues on a regular basis without interruption;
- 'complex treatment' means treatment that requires regular and close supervision, usually by a dermatologist. Such supervision could involve regular blood tests and relevant regular physical examinations, such as blood pressure measurement. Complex treatments would be expected to have a potential for adverse side effects. Categories of drugs forming a part of, or the whole of, complex treatment would include high doses of systemic corticosteroids, or immunosuppressive medications such as azathioprine, methotrexate and cyclosporin. Phototherapy, photochemotherapy, or photophoresis, would also be considered a complex treatment.
Column 4 in Table 4.1 is referenced to Figure 4-A:Activities of Daily Living, immediately below the table.
Table 4.1: Skin Disorders
|
% WPI |
Signs and Symptoms |
Requirement for Treatment |
Column 4 Activities of Daily Living Affected |
|
0 |
Absent. |
None, intermittent. |
up to 2 |
|
5 |
Absent. |
Constant. |
up to 2 |
|
5 |
Intermittent. |
Intermittent or constant. |
up to 2 |
|
10 |
Present on a daily basis for periods aggregating 3 or more months per year, but less than 6 months per year. |
Intermittent or constant. |
1 to 3 |
|
15 |
Present on a daily basis for period aggregating 6 or more months per year, but less than 9 months per year. |
Intermittent or constant. |
1 to 3 |
|
20 |
Present on a daily basis for periods aggregating 9 months per year or more. |
Intermittent or constant. |
1 to 3 |
|
25 |
Present on a daily basis for periods aggregating 9 months per year or more. |
Constant. |
4 to 5 |
|
30 |
Present on a daily basis for period aggregating 9 months per year or more. |
Constant and complex. |
6 or more |
Figure 4-A: Activities of Daily Living - See Column 4 in Table 4.1
|
No. |
Activities |
Examples |
|
1 |
Self care, personal hygiene. |
Bathing, grooming, dressing, eating, eliminating. |
|
2 |
Communication. |
Hearing, speaking, reading, writing, using keyboard. |
|
3 |
Physical activity. |
Standing, sitting, reclining, walking, stooping, squatting, kneeling, reaching, bending, twisting, leaning, carrying, lifting, pulling, pushing, climbing, exercising. |
|
4 |
Sensory function. |
Tactile feeling. |
|
5 |
Hand functions. |
Grasping, holding, pinching, percussive movements, sensory discrimination. |
|
6 |
Travel. |
Driving or travelling as a passenger. |
|
7 |
Sexual function. |
Participating in desired sexual activity. |
|
8 |
Sleep. |
Having a restful sleep pattern. |
|
9 |
Social and recreational. |
Participating in individual or group activities, sports activities, hobbies. |
4.2 Facial Disfigurement
Table 4.2: Facial Disfigurement
|
% WPI |
Criteria |
|
0 |
No structural changes. Normal facial appearance. Hyperpigmentation, depigmentation, redness or telangiectasis occupying less than 10% of facial area (excluding actinic damage). Scarring that does not significantly alter the appearance of the face. |
|
5 |
Hyperpigmentation, depigmentation, redness or telangiectasis occupying 10% or more of the facial area (excluding actinic damage); or Scars and/or skin grafts occupying less than 5% of facial area that significantly alter the appearance of the face; or Depressed cheek, nasal or frontal bones. Total or partial loss of one pinna. |
|
10 |
Scars and/or skin grafts occupying 5-15% of facial area that significantly alter the appearance of the face; or Total or partial loss of both pinnas; or Loss of less than 50% of the nose. |
|
15 |
Scars and/or skin grafts occupying 15-25% of facial area that significantly alter the appearance of the face; or Loss of 50-75% of the nose. |
|
20
|
Scars and/or skin grafts occupying more than 25% of facial area that significantly alter the appearance of the face; or Loss of more than 75% of the nose. |
4.3 Bodily Disfigurement
Table 4.3: Bodily Disfigurement
|
% WPI |
Criteria |
|
0 |
Normal body appearance. Scars and/or skin grafts occupying less than 10% of body area. |
|
5 |
Scars and/or skin grafts occupying 11% to 20% of body surface. |
|
10 |
Scars and/or skin grafts occupying 21% to 40% of body area; or Tissue loss causing noticeable unilateral alteration of body line. |
|
15 |
Scars and/or skin grafts occupying 41% to 60% of body area. |
|
20 |
Scars and/or skin grafts occupying 61% to 80% of body area; or Tissue loss causing noticeable bilateral alteration of body line. |
|
25 |
Scars and/or skin grafts occupying more than 80% of body surface area. |
Acknowledgments | Introduction | Tables and Figures
| Principles of Assessment
Division 1 | 1 - The Cardiovascular System | 2 - The Respiratory System
3 - The Endocrine System | 4 - Disfigurement and Skin Disorders
5 - Psychiatric Conditions | 6 - The Visual System
7 - Ear, Nose and Throat Disorders | 8 - The Digestive System
9 - The Musculoskeletal System | 10 - The Urinary System
11 - The Reproductive System | 12 - The Neurological System
13 - The Haematopoietic System
Division 2 | Division 3 | Appendix