Civil Liability Regulation 2014

1Short title

This regulation may be cited as the Civil Liability Regulation 2014.

2Commencement

This regulation commences on 1 July 2014.

3Definitions

Schedule 8 defines particular words used in this regulation.

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

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

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

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

6Prescribed amount of damages for loss of consortium or loss of servitium—Act, s 58(1)(b)

For an injury arising during a period stated in an item of the following table, the amount stated in the item is prescribed.

Item	Period (dates inclusive)	Amount
1	2 December 2002 to 30 June 2010	$30,000
2	1 July 2010 to 30 June 2011	$35,340
3	1 July 2011 to 30 June 2012	$36,400
4	1 July 2012 to 30 June 2013	$38,390
5	1 July 2013 to 30 June 2014	$40,460
6	1 July 2014 to 30 June 2015	$41,990
7	1 July 2015 to 30 June 2017	$43,020
8	1 July 2017 to 30 June 2018	$44,070
9	1 July 2018 to 30 June 2019	$45,430
10	1 July 2019 to 30 June 2020	$46,800
11	1 July 2020 to 30 June 2021	$47,850
12	1 July 2021 to 30 June 2022	$48,030
13	1 July 2022 and after	$49,700

s 6 sub 2015 SL No. 47 s 4

amd 2017 SL No. 110 s 4; 2018 SL No. 82 s 4; 2019 SL No. 113 s 4; 2020 SL No. 117 s 4; 2021 SL No. 52 s 4; 2022 SL No. 80 s 4

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

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

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

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

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

(5)Schedule 6 provides the PIRS that may be used with schedule 4.

(6)Schedule 5 provides—

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

(b)requirements with which a medical expert must comply in assessing a PIRS rating for a mental disorder of an injured person.

8General damages calculation provisions—Act, s 62(2), definition general damages calculation provisions

(1)For each period stated in a table in schedule 7, this section and that table are the general damages calculation provisions for the period.

(2)For an injury within the injury scale value stated in an item of a table, the general damages are the sum of—

(a)the base amount for the item (if any); and

(b)the variable amount for the item.

(3)In this section—

variable amount means the amount worked out in the way stated in the column of a table with the heading ‘variable amount’.

s 8 sub 2015 SL No. 47 s 5

9Prescribed amount of award for future loss—Act, s 64(2)

For an injury arising during a period stated in an item of the following table, the amount stated in the item is prescribed.

Item	Period (dates inclusive)	Amount
1	2 December 2002 to 30 June 2010	$100,000
2	1 July 2010 to 30 June 2011	$117,800
3	1 July 2011 to 30 June 2012	$121,350
4	1 July 2012 to 30 June 2013	$128,000
5	1 July 2013 to 30 June 2014	$134,910
6	1 July 2014 to 30 June 2015	$140,020
7	1 July 2015 to 30 June 2017	$143,450
8	1 July 2017 to 30 June 2018	$146,960
9	1 July 2018 to 30 June 2019	$151,490
10	1 July 2019 to 30 June 2020	$156,060
11	1 July 2020 to 30 June 2021	$159,560
12	1 July 2021 to 30 June 2022	$160,170
13	1 July 2022 and after	$165,730

s 9 sub 2015 SL No. 47 s 5

amd 2017 SL No. 110 s 5; 2018 SL No. 82 s 5; 2019 SL No. 113 s 5; 2020 SL No. 117 s 5; 2021 SL No. 52 s 5; 2022 SL No. 80 s 5

10Repeal

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

11Transitional provision

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

(2)In this section—

commencement means the commencement of this section.

repealed regulation means the Civil Liability Regulation 2003 as in force immediately before the commencement.

section 4

Australian Helicopters Pty Ltd ABN 50 011 075 460 when providing aeromedical, air rescue and other emergency helicopter services under an agreement with the State

Brisbane City Council

Capricorn Helicopter Rescue Service Limited ABN 35 071 728 295

CareFlight Medical Services Limited ABN 83 101 511 719

CareFlight (Qld) Limited ABN 45 010 316 462

Central Queensland Helicopter Rescue Service Ltd ABN 73 415 515 751

The department administering the Disaster Management Act 2003

A local government or joint local government under the Local Government Act 2009

North Queensland Helicopter Rescue Service ABN 81 268 344 031

Queensland Ambulance Service established under the Ambulance Service Act 1991

Queensland Fire and Emergency Service established under the Fire and Emergency Services Act 1990

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

Royal Flying Doctor Service Queensland Section ABN 80 009 663 478

Royal Life Saving Society Queensland Incorporated and affiliated bodies providing services at or near the following places—

(a)Bulcock Beach, Caloundra;

(b)Tallebudgera Creek, Gold Coast;

(c)public swimming pools

A rural fire brigade registered under the Fire and Emergency Services Act 1990

The State Emergency Service under the Fire and Emergency Services Act 1990

St John Ambulance Australia—Queensland

Sunshine Coast Helicopter Rescue Service Ltd ABN 34 010 104 560

Surf Life Saving Queensland ABN 27 360 485 381 and affiliated bodies

Volunteer Marine Rescue Association Queensland Inc. and affiliated bodies

section 5

Australian Helicopters Pty Ltd ABN 50 011 075 460 when providing aeromedical, air rescue and other emergency helicopter services under an agreement with the State

Brisbane City Council

Capricorn Helicopter Rescue Service Limited ABN 35 071 728 295

CareFlight Medical Services Limited ABN 83 101 511 719

CareFlight (Qld) Limited ABN 45 010 316 462

Central Queensland Helicopter Rescue Service Ltd ABN 73 415 515 751

The department administering the Disaster Management Act 2003

A local government or joint local government under the Local Government Act 2009

North Queensland Helicopter Rescue Service ABN 81 268 344 031

Queensland Ambulance Service established under the Ambulance Service Act 1991

Queensland Fire and Emergency Service established under the Fire and Emergency Services Act 1990

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

Royal Flying Doctor Service Queensland Section ABN 80 009 663 478

Royal Life Saving Society Queensland Incorporated and affiliated bodies providing services at or near the following places—

(a)Bulcock Beach, Caloundra;

(b)Tallebudgera Creek, Gold Coast;

(c)public swimming pools

A rural fire brigade registered under the Fire and Emergency Services Act 1990

The State Emergency Service under the Fire and Emergency Services Act 1990

St John Ambulance Australia—Queensland

Sunshine Coast Helicopter Rescue Service Ltd ABN 34 010 104 560

Surf Life Saving Queensland ABN 27 360 485 381 and affiliated bodies

Volunteer Marine Rescue Association Queensland Inc. and affiliated bodies

section 7(1)

1Objectives of sch 4

The objectives of schedule 4 include promoting—

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

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

Note—

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

2Injury mentioned in sch 4

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

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

3Multiple injuries

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

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

4Multiple injuries and maximum dominant ISV inadequate

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

(2)To reflect the level of impact, the court may make an assessment of the ISV for the multiple injuries that is higher than 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 scale running from 0 to 100.

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

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

(5)In this section—

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

5Adverse psychological reaction

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

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

6Mental 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 person is relevant under schedule 4.

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

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

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

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

7Aggravation of pre-existing condition

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

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

8Court 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 to assess 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 those provisions to the extent they are relevant in a particular case.

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

9Court may have regard to other matters

In assessing an ISV, a court may have regard to other matters to 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 person whether or not the injury happened

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

10Whole person impairment

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

11Medical report stating whole person impairment percentage

If a medical report states a whole person impairment percentage, 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 under AMA 5—

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

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

Notes—

1It 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.

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

12Greater weight to assessments based on AMA 5

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

(2)In assessing an ISV, a court must give greater weight to a medical assessment of a whole person impairment percentage based on the criteria for the assessment of whole person impairment provided under AMA 5 than to a medical assessment of a whole person impairment percentage not based on the criteria.

13Greater weight to assessments of PIRS rating

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

14ISV 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 running from 0 to 100.

section 7(1)

1Quadriplegia

		Examples of factors affecting ISV assessment	75 to 100
		•  presence and extent of pain
		•  extent of any residual movement
		•  degree of insight
		•  adverse psychological reaction
		•  level of function and pre-existing function
		•  degree of independence
		•  ability to participate in daily activities, including employment
		•  presence and extent of secondary medical complications
		Comment about appropriate level of ISV
		An ISV at or near the top of the range will be appropriate only if the injured person has assisted ventilation, full insight, extreme physical limitation and gross impairment of ability to communicate.

2Paraplegia

		Examples of factors affecting ISV assessment	60 to 80
		•  presence and extent of pain
		•  extent of any residual movement
		•  adverse psychological reaction
		•  level of function and pre-existing function
		•  degree of independence
		•  ability to participate in daily activities, including employment
		•  loss of reproductive or sexual function
		•  bowel or bladder incontinence
		•  presence and extent of secondary medical complications

3Hemiplegia or severe paralysis of more than 1 limb

		Comment for item 3
		Incomplete paralysis causing whole person impairment of less than 40% must be assessed under part 6 if it is the only injury or the dominant injury of multiple injuries.
		Examples of factors affecting ISV assessment for item 3
		The same examples apply as for item 2.
3.1		Complete or nearly complete paralysis	60 to 80
3.2		Other paralysis, causing whole person impairment of at least 40%	45 to 60

4Monoplegia

		Comment
		See items 5, 6 and 7 and part 6.

5Extreme brain injury

		Comment
		The injury will involve major trauma to the brain with severe permanent 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 the range will be appropriate only if the injured person needs full-time nursing care and has the following—
		•  substantial insight despite gross disturbance of brain function
		•  significant physical limitation and destruction of pre-existing lifestyle
		•  epileptic seizures
		•  double incontinence
		•  little or no language function
		•  little or no meaningful response to environment.
		•  An injured person with an injury for which an ISV at or near the top of the range is appropriate may have some ability to follow basic commands, recovery of eye opening, return of postural reflex movement and return to pre-existing sleep patterns.
		Examples of factors affecting ISV assessment for item 5.1
		•  degree of insight
		•  life expectancy
		•  extent of bodily impairment
5.2		Substantially reduced insight
		Comment for items 5.2.1 and 5.2.2
		•  The injured person will have major trauma to the brain with severe permanent impairment.
		•  The injured person’s insight of his or her condition may change.
		•  Insight may be impaired in the degree, or continuity of, appreciation of the injured person’s condition.
		Examples of factors affecting ISV assessment for items 5.2.1 and 5.2.2
		The same examples apply as for an item 5.1 injury, but reducing levels of insight progressively reduce the level of suffering and the appropriate level of ISV.
5.2.1		The injured person will have partial or complete insight (as evidenced by appropriate responses to physical or emotional stimuli) for not more than half of the person’s waking hours.	36 to 70
5.2.2		The injured person will have infrequent periods of partial insight and will show unreliable, rare or limited responses to physical or emotional stimuli.	16 to 35
5.3		Grossly reduced insight	10 to 15
		Comment for item 5.3
		The injured person will be in a persistent vegetative state and have little or no insight.
		Comment about appropriate level of ISV for item 5.3
		If some minor awareness of loss remains, an ISV at or near the top of the range may be appropriate.

6Serious brain injury

		Comment	56 to 70
		The injured person will be very seriously disabled.
		Example of the injury
		serious brain damage causing—
		(a)  physical impairment, for example, limb paralysis; or
		(b)  cognitive impairment with marked impairment of intellect and personality
		Examples of factors affecting ISV assessment
		•  degree of insight
		•  life expectancy
		•  extent of physical limitations
		•  extent of cognitive limitations
		•  extent of sensory limitation, for example, limitation of hearing or sense of taste or smell
		•  level of function and pre-existing function
		•  degree of independence
		•  ability to communicate
		•  behavioural or psychological changes
		•  epilepsy or a high risk of epilepsy
		•  presence of and extent of secondary medical complications
		Comment about appropriate level of ISV
		An ISV at or near the top of the range will be appropriate only if the injured person substantially depends on others and needs substantial professional and other care.

7Moderate brain injury

		Comment	21 to 55
		The injured person will be seriously disabled, but the degree of the injured person’s dependence on others, although still present, is lower than for an item 6 injury.
		Examples of factors affecting ISV assessment
		•  degree of insight
		•  life expectancy
		•  extent of physical limitations
		•  extent of cognitive limitations
		•  extent of sensory limitation, for example, limitation of hearing or sense of taste or smell
		•  level of function and pre-existing function
		•  degree of independence
		•  ability to communicate
		•  behavioural or psychological changes
		•  epilepsy or a high risk of epilepsy
		•  presence of, and extent of, secondary medical complications
		Comment about appropriate level of ISV
		•  An ISV of 21 to 25 will be appropriate if there is reduced concentration and memory, or reduced mood control, and either or both—
		•  reduced capacity for employment
		•  a noticeable interference with lifestyle and leisure.
		•  An ISV of 26 to 40 will be appropriate if there is an increased risk of epilepsy and either or both—
		•  a moderate cognitive impairment
		•  loss of, or greatly reduced capacity for, employment.
		•  An ISV of 41 to 55 will be appropriate if there is no capacity for employment, and 1 or more of the following—
		•  moderate to severe cognitive impairment
		•  marked personality change
		•  dramatic effect on speech, sight or other senses
		•  epilepsy or a high risk of epilepsy.

8Minor brain injury

		Comment	6 to 20
		The injured person will make a good recovery and be able to take part in normal social life and to return to work. There may be minor problems persisting that prevent a restoration of normal function.
		Examples of factors affecting ISV assessment
		•  severity of any physical injury causing the brain damage, having regard to—
		(a)  any medical assessment made immediately after the injury was caused, for example, CT or MRI scans, an ambulance officer’s assessment or hospital emergency unit assessment; and
		(b)  any post-traumatic amnesia
		•  extent of any ongoing, and possibly permanent, disability
		•  extent of any personality change
		•  depression
		•  degree of insight
		•  life expectancy
		•  extent of physical limitations
		•  extent of cognitive limitations
		•  extent of sensory limitation, for example, limitation of hearing or sense of taste or smell
		•  level of function and pre-existing function
		•  degree of independence
		•  ability to communicate
		•  behavioural or psychological changes
		•  epilepsy or a high risk of epilepsy
		•  presence of, and extent of, secondary medical complications
		Comment about appropriate level of ISV
		An ISV at or near the top of the range will be appropriate if the injured person has—
		(a)  an increased risk of epilepsy; and
		(b)  ongoing reduced concentration and memory, or reduced mood control, that does not significantly interfere with the person’s ability to take part in normal social life or return to work.

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

		Comment	0 to 5
		Brain damage, if any, is minimal.
		Examples of the injury
		•  uncomplicated skull fracture
		•  concussion with transitory loss of consciousness and no residual effects
		Examples of factors affecting ISV assessment
		•  severity of any physical injury causing brain damage
		•  length of time to recover from any symptoms
		•  extent of ongoing symptoms
		•  presence of, or absence of, headaches
		Comment about appropriate level of ISV
		•  An ISV at or near the bottom of the range will be appropriate for an injury from which the injured person fully recovers within a few weeks.
		•  An ISV at or near the top of the range will be appropriate if there is an uncomplicated skull fracture and there are associated concussive symptoms of dizziness, headache and memory loss persisting for less than 6 months.

		General comment for items 10 to 13
		This part includes references to ratings on the psychiatric impairment rating scale set out in schedule 6 (PIRS ratings). A PIRS rating is capable of being accepted by a court only if it is assessed by a medical expert as required under schedules 5 and 6 and provided to the court in a PIRS report.
		Examples of factors affecting ISV assessment for items 10 to 13
		•  PIRS rating
		•  degree of insight
		•  age and life expectancy
		•  pain and suffering
		•  loss of amenities of life
		•  likelihood difficulties would have emerged in any event
		•  if there is extreme psychological trauma, for example, intense helplessness or horror, the immediate adverse psychological reaction

10Extreme mental disorder

		Example of the injury	41 to 65
		a mental disorder with a PIRS rating between 31% and 100%
		Comment about appropriate level of ISV
		Despite a very high PIRS rating, an ISV at or near the bottom of the range may be appropriate if the injured person has reduced insight.

11Serious mental disorder

		Example of the injury	11 to 40
		a mental disorder with a PIRS rating between 11% and 30%

12Moderate mental disorder

		Comment	2 to 10
		There is generally only moderate impairment.
		Example of the injury
		a mental disorder with a PIRS rating between 4% and 10%

13Minor mental disorder

		Comment	0 to 1
		For many persons who have suffered the injury there will be little or no impact on their lives.
		Example of the injury
		a mental disorder with a PIRS rating between 0% and 3%

		Examples of factors affecting ISV assessment for items 14 to 22
		•  extent of skeletal or functional damage
		•  degree of cosmetic damage or disfigurement
		•  adverse psychological reaction
		•  availability of cosmetic repair

14Extreme facial injury

		Comment	26 to 45
		The injury will involve severe traumatic injury to the face requiring substantial reconstructive surgery.
		Examples of the injury
		•  a Le Fort I fracture or Le Fort II fracture if the degree of incapacity and disfigurement after reconstructive surgery will be very severe
		•  a Le Fort III fracture causing incapacity in daily activities
		Note— Le Fort I fracture, Le Fort II fracture and Le Fort III fracture are defined in schedule 8 (Dictionary).
		Additional example of factor affecting ISV assessment
		the extent of any neurological impairment or effect on the airway

15Serious facial injury

		Comment	14 to 25
		The injury will involve serious traumatic injury to the face requiring reconstructive surgery that is not substantial.
		Examples of the injury
		•  a Le Fort I fracture or Le Fort II fracture if the degree of incapacity and disfigurement after reconstructive surgery will not be very severe
		•  a Le Fort III fracture if no serious deformity will remain after reconstructive surgery
		•  a serious or multiple fracture of the nasal complex either or both—
		(a)  requiring more than 1 operation; and
		(b)  causing 1 or more of the following—
		•  permanent damage to the airway
		•  permanent damage to nerves or tear ducts
		•  facial deformity
		•  a serious cheekbone fracture that will require surgery and cause serious disfigurement and permanent effects despite reconstructive surgery, for example, hyperaesthesia or paraesthesia
		•  a very serious multiple jaw fracture that will—
		(a)  require prolonged treatment; and
		(b)  despite reconstructive surgery, cause permanent effects, for example, severe pain, restriction in eating, paraesthesia or a risk of arthritis in the joints
		•  a severed trunk of the facial nerve (7th cranial nerve), causing total paralysis of facial muscles on 1 side of the face
		Additional examples of factors affecting ISV assessment
		•  any neurological impairment or effect on the airway
		•  permanent cosmetic deformity
		Comment about appropriate level of ISV
		•  An ISV at or near the bottom of the range will be appropriate if the injury causes permanent cosmetic deformity, asymmetry of 1 side of the face and limited adverse psychological reaction.
		•  An ISV at or near the top of the range will be appropriate if the injury causes serious bilateral deformity and significant adverse psychological reaction.

16Moderate facial injury

		Examples of the injury	6 to 13
		•  a simple cheekbone fracture, requiring minor reconstructive surgery, from which the injured person will fully recover with little or no cosmetic damage
		•  a fracture of the jaw causing—
		(a)  permanent effects, for example, difficulty in opening the mouth or in eating; or
		(b)  hyperaesthesia or paraesthesia in the area of the fracture
		•  a displaced fracture of the nasal complex from which the injured person will almost fully recover after surgery
		•  severed branches of the facial nerve (7th cranial nerve) with paralysis of some of the facial muscles
		•  a severed sensory nerve of the face with minor permanent paraesthesia

17Minor facial injury

		Examples of the injury	0 to 5
		•  a simple cheekbone fracture, for which surgery is not required and from which the injured person will recover fully
		•  a simple jaw fracture, requiring immobilisation and from which the injured person will fully recover
		•  a stable fracture of the joint process of the jaw
		•  a displaced fracture of the nasal complex requiring only manipulation
		•  a simple undisplaced fracture of the nasal complex, from which the injured person will fully recover
		•  a severed sensory nerve of the face, with good repair causing minimal or no paraesthesia

18Injury to teeth or gums

		Comment
		There will generally have been a course of treatment as a result of the injury.
		Additional examples of factors affecting ISV assessment
		•  extent and degree of discomfort during treatment
		•  difficulty with eating
		Comment about appropriate level of ISV
		If protracted dentistry causes the injury, the ISV may be higher than the ISV for the same injury caused by something else.
18.1		Loss of or serious damage to more than 3 teeth, serious gum injury or serious gum infection	6 to 10
18.2		Loss of or serious damage to 2 or 3 teeth, moderate gum injury or moderate gum infection	3 to 5
18.3		Loss of or serious damage to 1 tooth, minor gum injury or minor gum infection	0 to 2

		General comment for items 19 to 22
		This division will usually apply to an injury involving skeletal damage only if the skeletal damage is minor.

19Extreme facial scarring

		Examples of the injury	21 to 45
		•  widespread area scarring, for example, over the side of the face or another whole area
		•  severe contour deformity
		•  significant deformity of the mouth or eyelids with muscle paralysis or tic
		Comment about appropriate level of ISV
		•  An ISV in the upper half of the range may be appropriate if the injured person is relatively young, the cosmetic damage is very disfiguring and the adverse psychological reaction is severe.
		•  An ISV at or near the top of the range will be appropriate if the injury is caused by burns that resulted in loss of the entire nose, eyelids or ears.

20Serious facial scarring

		Examples of the injury	11 to 20
		•  substantial disfigurement and significant adverse psychological reaction
		•  severe linear scarring
		•  discoloured hypertrophic (keloid) scarring
		•  atrophic scarring
		•  serious contour defects

21Moderate facial scarring

		Comment	6 to 10
		Any adverse psychological reaction is small, or having been considerable at the outset, has greatly diminished.
		Examples of the injury
		•  scarring, the worst effects of which will be reduced by plastic surgery that will leave minor cosmetic damage
		•  scars crossing lines of election with discoloured, indurated, hypertrophic or atrophic scarring, of moderate severity

22Minor facial scarring

		Examples of the injury	0 to 5
		•  a single scar able to be camouflaged
		•  more than 1 very small scar if the overall effect of the scars is to mar, but not to markedly affect, appearance and adverse psychological reaction is minor
		•  almost invisible linear scarring, in lines of election, with normal texture and elevation

		General comment for items 23 to 33
		Injuries mentioned in this part are commonly symptoms of brain or nervous system injury.

23Total sight and hearing impairment

		Comment	90 to 100
		The injury ranks with the most devastating injuries.
		Examples of factors affecting ISV assessment
		•  degree of insight
		•  age and life expectancy

24Total sight impairment

		Examples of factors affecting ISV assessment	50 to 80
		•  degree of insight
		•  age and life expectancy

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

		Comment about appropriate level of ISV	25 to 50
		An ISV at or near the top of the range will be appropriate if there is serious risk of further significant deterioration in the remaining eye.

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

		Examples of factors affecting ISV assessment	26 to 30
		•  the extent to which the injured person’s activities are adversely affected by the impairment or loss
		•  associated scarring or cosmetic damage
		Comment about appropriate level of ISV
		An ISV at or near the top of the range will be appropriate if there is a minor risk of sympathetic ophthalmia.

27Serious eye injury

		Examples of the injury	11 to 25
		•  a serious but incomplete loss of vision in 1 eye without significant risk of loss or reduction of vision in the other eye
		•  an injury causing double vision that is not minor and intermittent

28Moderate eye injury

		Example of the injury	6 to 10
		minor but permanent impairment of vision in one eye, including if there is double vision that is minor and intermittent

29Minor eye injury

		Examples of the injury	0 to 5
		a minor injury, for example, from being struck in the eye, exposed to smoke or other fumes or being splashed by liquids—
		(a)  causing initial pain and temporary interference with vision; and
		(b)  from which the injured person will fully recover within a relatively short time

		Comment for items 30 to 33
		The injuries commonly, but not always, involve hearing loss. If the injury is to a single ear, the binaural loss must be assessed.
		Examples of factors affecting ISV assessment for item 30 to 33 injuries
		•  whether the injury has an immediate effect, allowing the injured person no opportunity to adapt, or whether it occurred over a period of time, for example, from exposure to noise
		•  whether the injury was suffered at an early age so that it has affected or will affect speech
		•  whether the injury will affect balance
		•  the extent to which former activities will be affected
		•  presence of tinnitus

30Extreme ear injury

		Definition of injury	36 to 55
		The injury involves a binaural hearing loss of at least 80%.
		Additional examples of factors affecting ISV assessment
		•  associated problems, for example, severe tinnitus, moderate vertigo, a moderate vestibular disturbance or headaches
		•  availability of hearing aids or other devices that may reduce the hearing loss
		Comment about appropriate level of ISV
		An ISV at or near the top of the range will be appropriate if the injury happened at an early age so as to prevent or to seriously affect the development of normal speech.

31Serious ear injury

		Definition of injury	26 to 35
		The injury involves—
		(a)  a binaural hearing loss of at least 50% but less than 80%; or
		(b)  severe permanent vestibular disturbance.
		Comment about appropriate level of ISV
		An ISV in the lower half of the range will be appropriate if there is no speech impairment or tinnitus.
		An ISV in the upper half of the range will be appropriate if there is speech impairment and tinnitus.

32Moderate ear injury

		Definition of injury	11 to 25
		The injury involves—
		(a)  a binaural hearing loss of at least 20% but less than 50%; or
		(b)  significant permanent vestibular disturbance.
		Comment about appropriate level of ISV
		An ISV at or near the top of the range will be appropriate if there are problems associated with the injury, for example, severe tinnitus, moderate vertigo, a moderate vestibular disturbance or headaches.

33Minor ear injury

		Definition of injury
		The injury involves a binaural hearing loss of less than 20%.
		Comment
		•  This item covers the bulk of hearing impairment cases.
		•  The injury is not to be judged simply by the degree of hearing loss.
		•  There will often be a degree of tinnitus present.
		•  There may also be minor vertigo or a minor vestibular disturbance causing loss of balance.
		•  A vestibular disturbance may increase the level of ISV.
33.1		Moderate tinnitus or hearing loss, or both	6 to 10
33.2		Mild tinnitus with some hearing loss	4 to 5
33.3		Slight or occasional tinnitus with slight hearing loss or an occasional vestibular disturbance, or both	0 to 3

34Total loss of taste or smell, or both

		Comment about appropriate level of ISV	6 to 9
		•  An ISV at or near the bottom of the range will be appropriate if there will be a total loss of either taste or smell.
		•  An ISV at or near the top of the range will be appropriate if there will be a total loss of both taste and smell.

35Partial loss of smell or taste, or both

		Comment about appropriate level of ISV	0 to 5
		•  An ISV at or near the bottom of the range will be appropriate if there will be a partial loss of either taste or smell.
		•  An ISV at or near the top of the range will be appropriate if there will be a partial loss of both taste and smell.

		Example of factor affecting ISV assessment for items 36 to 39
		the level of any reduction in the capacity for employment and enjoyment of life

36Extreme chest injury

		Comment	46 to 65
		The injury will involve severe traumatic injury to the chest, or a large majority of the organs in the chest cavity, causing a high level of disability and ongoing medical problems.
		Comment about appropriate level of ISV
		An ISV at or near the top of the range will be appropriate if there will be total removal of 1 lung or serious heart damage, or both, with serious and prolonged pain and suffering and significant permanent scarring.

37Serious chest injury

		Comment	21 to 45
		The injury will involve serious traumatic injury to the chest or organs in the chest cavity, causing serious disability and ongoing medical problems.
		Examples of the injury
		•  a trauma to 1 or more of the following, causing permanent damage, physical disability and impairment of function—
		•  the chest
		•  the heart
		•  1 or both of the lungs
		•  the diaphragm
		•  an injury that causes the need for oxygen therapy for about 16 to 18 hours a day
		Example of factors affecting ISV assessment
		The need for a permanent tracheostomy
		Comment about appropriate level of ISV
		An ISV at or near the top of the range will be appropriate if, after recovery, there are both of the following—
		(a)  serious impairment to cardio-pulmonary function;
		(b)  whole person impairment for the injury of, or of nearly, 40%.

38Moderate chest injury

		Example of the injury	11 to 20
		the injury will involve serious traumatic injury to the chest or organs in the chest cavity, causing moderate disability and ongoing medical problems
		Examples of factors affecting ISV assessment
		•  duration and intensity of pain and suffering
		•  the degree of permanent impairment of lung or cardiac function, as evidenced by objective test results
		•  the need for a temporary tracheostomy for short-term airway management
		Comment about appropriate level of ISV
		•  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.

39Minor chest injury

		Examples of factors affecting ISV assessment for items 39.1 and 39.2
		•  complexity of any fractures
		•  extent of injury to underlying organs
		•  extent of any disability
		•  duration and intensity of pain and suffering
39.1		Complicated or significant fracture, 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 or sternum, or both, that may cause cardio-pulmonary contusion
		•  internal injuries that cause some tissue damage but no significant long-term effect on organ function
		Comment about appropriate level of ISV
		•  An ISV at or near the bottom of the range will be appropriate if there is a fractured sternum that substantially resolves, and there is some ongoing pain and activity restriction.
		•  An ISV at or near the top of the range will be appropriate if the injury causes significant persisting pain and significant activity restriction.
39.2		Soft tissue injury, minor fracture or minor internal organ injury	0 to 4
		Comment
		•  The injury will involve a soft tissue injury, minor fracture, or minor and non-permanent injury to internal organs.
		•  There may be persistent pain from the chest, for example, from the chest wall or sternocostal or costochondral joints.
		Examples of the injury
		•  a single penetrating wound, causing some tissue damage but no long-term effect on lung function
		•  an injury to the lungs caused by the inhalation of toxic fumes or smoke that will not permanently interfere with lung function
		•  a soft tissue injury to the chest wall, for example, a laceration or serious seatbelt bruising
		•  fractured ribs or a minor fracture of the sternum causing serious pain and disability for weeks, without internal organ damage or permanent disability
		Comment about appropriate level of ISV
		•  An ISV at or near the bottom of the range will be appropriate if there is a soft tissue injury from which the injured person will fully recover.
		•  An ISV at or near the top of the range will be appropriate if there is an injury causing a small pneumothorax that does not require intercostal catheter insertion, and from which the injured person will fully recover.

		General comment for items 40 to 43
		The level of an ISV for lung disease often reflects the fact that the disease is worsening and there is a risk of the development of secondary medical consequences.
		Examples of factors affecting ISV assessment for items 40 to 43
		•  a history of smoking tobacco will reduce the level of ISV
		•  adverse psychological reaction may increase the level of ISV

40Extreme lung injury

		Examples of the injury	46 to 65
		•  diagnosed lung cancer
		•  lung disease involving serious disability causing severe pain and dramatic impairment of function and quality of life
		•  a recurrent pulmonary embolism resulting in failure of the right side of the heart requiring a lung transplant, heart transplant or both
		Additional examples of factors affecting ISV assessment
		•  age
		•  likelihood of progressive worsening
		•  duration and intensity of pain and suffering

41Serious lung injury

41.1		Serious lung injury if progressive worsening of lung function	25 to 45
		Example of item 41.1
		lung disease, for example, emphysema, causing—
		•  significantly reduced and worsening lung function
		•  prolonged and frequent coughing
		•  disturbance of sleep
		•  restriction of physical activity, employment and enjoyment of life
		Additional examples of factors affecting ISV assessment for item 41.1
		•  the possibility of lung cancer developing may increase the level of ISV
		•  the need for continuous oxygen therapy
41.2		Serious lung injury if no progressive worsening of lung function	11 to 24
		Examples of item 41.2
		•  lung disease causing breathing difficulties, short of disabling breathlessness, requiring frequent use of an inhaler
		•  lung disease causing a significant effect on employment and social life, including inability to tolerate a smoky environment, with an uncertain prognosis
		•  a recurrent pulmonary embolism causing pulmonary hypertension and cor pulmonale

42Moderate lung injury

		Examples of the injury	6 to 10
		•  bronchitis that does not cause serious symptoms, with little or no serious or permanent effect on employment or social life
		•  a pulmonary embolism requiring anticoagulant therapy for at least 1 year or pulmonary endarterectomy

43Minor lung injury

		Examples of the injury	0 to 5
		•  lung disease causing slight breathlessness, with—
		(a)   no effect on employment; and
		(b)  the likelihood of substantial and permanent recovery within a few years after the injury is caused
		•  a pulmonary embolism requiring anticoagulant therapy for less than 1 year
		Comment about appropriate level of ISV
		An ISV at or near the bottom of the range will be appropriate if there is lung disease causing temporary aggravation of bronchitis, or other chest problems, that will resolve within a few months.

44Extreme asthma

		Comment	31 to 55
		The most serious cases may confine a person to the home and destroy capacity for employment.
		Example of the injury
		severe and permanent disabling asthma causing—
		•  prolonged and frequent coughing
		•  disturbance of sleep
		•  severe restriction of physical activity and enjoyment of life
		•  gross reduction of capacity for employment

45Severe asthma

		Example of the injury	11 to 30
		chronic asthma, with a poor prognosis, causing—
		•  breathing difficulties
		•  the need to frequently use an inhaler
		•  significantly reduced capacity for employment

46Moderate asthma

		Example of the injury	6 to 10
		asthma, with symptoms that include bronchitis and wheezing, affecting employment or social life

47Minor asthma

		Example of the injury	0 to 5
		asthma with minor symptoms that has no effect on employment or social life
		Comment about appropriate level of ISV
		An ISV at or near the bottom of the range will be appropriate if there is asthma treated by a general practitioner that will resolve within 1 year after the injury is caused.

		General comment for items 48 to 51
		•  This division applies to injuries caused by physical trauma rather than as a secondary result of a mental disorder.
		•  For a mental disorder that causes loss of reproductive system function, see part 2 (Mental disorders).
		•  Sterility is usually either—
		(a)  caused by surgery, chemicals or disease; or
		(b)  caused by a traumatic injury that is often aggravated by scarring.
		Examples of factors affecting ISV assessment for items 48 to 51
		•  adverse psychological reaction
		•  effect on social and domestic life

48Impotence and sterility

		Additional examples of factors affecting ISV assessment	5 to 37
		•  age
		•  whether the injured person has children
		•  whether the injured person intended to have children or more children
		Comment about appropriate level of ISV
		•  An ISV at or near the bottom of the range will be appropriate if the sterility has little impact.
		•  An ISV in the lower half of the range will be appropriate if an injured person with children may have intended to have more children and has uncomplicated sterility, without impotence or any aggravating features.
		•  An ISV in the upper half of the range will be appropriate if a young injured person without children has uncomplicated sterility, without impotence or any aggravating features.
		•  An ISV at or near the middle of the range will be appropriate if a middle-aged injured person with children has sterility and permanent impotence.
		•  An ISV at or near the top of the range will be appropriate if a young injured person has total impotence and loss of sexual function and sterility.

49Loss of part or all of penis

		Additional examples of factors affecting ISV assessment	5 to 25
		•  extent of the penis remaining
		•  availability of a prosthesis
		•  extent to which sexual activity will be possible

50Loss of both testicles

		Comment
		See item 48 because sterility results.
		Additional example of factor affecting ISV assessment
		level of any pain or residual scarring

51Loss of 1 testicle

		Additional example of factors affecting ISV assessment	2 to 10
		age, cosmetic damage or scarring
		Comment about appropriate level of ISV
		An ISV at or near the bottom of the range will be appropriate if the injury does not reduce reproductive capacity.

		General comment for items 52 to 54
		•  This division applies to injuries caused by physical trauma rather than as a secondary result of a mental disorder.
		•  For a mental disorder that causes loss of reproductive system function, see part 2 (Mental disorders).
		Examples of factors affecting ISV assessment for items 52 to 54
		•  extent of any physical trauma
		•  whether the injured person has children
		•  whether the injured person intended to have children or more children
		•  age
		•  scarring
		•  depression or adverse psychological reaction
		•  effect on social and domestic life

52Infertility

52.1		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 15
		Example of item 52.2
		infertility without any medical complication if the injured person has a child or children
		Comment about appropriate level of ISV for item 52.2
		An ISV at or near the top of the range will be appropriate if there is significant adverse psychological reaction.
52.3		Infertility causing minor effects	0 to 8
		Example of item 52.3
		infertility if—
		(a)  the injured person was unlikely to have had children, for example, because of age; and
		(b)  there is little or no adverse psychological reaction

53Any other injury to the female reproductive system

53.1		Post-menopausal hysterectomy	5 to 15
53.2		Female impotence	5 to 15
		Comment for item 53.2
		The injury may be correctable by surgery.
		Additional example of factors affecting ISV assessment for item 53.2
		the level of sexual function or the extent of any corrective surgery
53.3		An injury causing an inability to give birth by normal vaginal delivery, for example, because of pelvic ring disruption or deformity	4 to 15
		Comment for item 53.3
		The injury may be correctable by surgery.
53.4		Injury to female genitalia or reproductive organs, or both	3 to 25
		Comment about appropriate level of ISV for item 53.4
		•  An ISV at or near the bottom of the range will be appropriate if there is a laceration or tear with good repair.
		•  An ISV at or near the middle of the range will be appropriate if the injury causes development of a prolapse or fistula.
		•  An ISV at or near the top of the range will be appropriate if the injury causes the early onset of menopause or irregular hormonal activity.
53.5		Reduced fertility, caused by, for example, trauma to ovaries or fallopian tubes	3 to 8
		Comment about appropriate level of ISV for item 53.5
		An ISV in the lower half of the range will be appropriate if the injury is caused by a delay in diagnosis of an ectopic pregnancy.

54Failed sterilisation leading to unwanted pregnancy

54.1		If no child is born and there is no serious adverse psychological reaction	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 25
		Comment about appropriate level of ISV for item 54.2
		An ISV at or near the top of the range will be appropriate if there is a difficult pregnancy or birth, or both, followed by medical problems, for example, post-natal depression.

55Extreme injury to the digestive system caused by trauma

		Examples of the injury	19 to 40
		•  severe permanent damage to the digestive system, with ongoing debilitating pain and discomfort, diarrhoea, nausea and vomiting that—
		(a)  are not controllable by drugs; and
		(b)  cause weight loss of at least 20%
		Note— Digestive system is defined in schedule 8 (Dictionary).
		•  an injury to the throat requiring a permanent gastrostomy
		Comment about appropriate level of ISV
		•  An ISV at or near the bottom of the range will be appropriate if there is an injury to the throat requiring a temporary gastrostomy for more than 1 year and permanent dietary changes, for example, a requirement for a soft food diet.
		•  An ISV at or near the top of the range will be appropriate if there is an injury to the throat requiring a permanent gastrostomy, with significant ongoing symptoms.
		Examples of factors affecting ISV assessment
		•  the extent of any voice or speech impairment
		•  need for ongoing endoscopic procedures

56Serious injury to the digestive system caused by trauma

		Examples of the injury	11 to 18
		•  a serious injury causing long-term complications aggravated by physical strain
		•  an injury requiring a feeding tube for between 3 and 12 months
		Examples of factors affecting ISV assessment
		•  the extent of any ongoing voice or speech impairment
		•  whether a feeding tube was required, and if so, for how long it was required

57Moderate injury to the digestive system caused by trauma

		Examples of the injury	6 to 10
		•  a simple penetrating stab wound, causing some permanent tissue damage, but with no significant long-term effect on digestive function
		•  an injury requiring a feeding tube for less than 3 months
		Examples of factors affecting ISV assessment
		•  whether a feeding tube was required, and if so, for how long it was required
		•  whether dietary changes are required to reduce the risk of aspiration because of impaired swallowing

58Minor injury to the digestive system caused by trauma

		Examples of the injury	0 to 5
		•  a soft tissue injury to the abdomen wall, for example, a laceration or serious seatbelt bruising to the abdomen or flank, or both
		•  a minor injury to the throat or tongue causing temporary difficulties with swallowing or speech
		•  a laceration of the tongue requiring suturing

		General comment for items 59 to 62
		There is a marked difference between those comparatively rare cases having a long-term or even permanent effect on quality of life and cases in which the only ongoing symptom is an allergy, for example, to specific foods, that may cause short-term illness.

59Extreme injury to the digestive system not caused by trauma

		Example of the injury	13 to 35
		severe toxicosis—
		(a)  causing serious acute pain, vomiting, diarrhoea and fever, requiring hospitalisation for days or weeks; and
		(b)  also causing 1 or more of the following—
		•  ongoing incontinence
		•  haemorrhoids
		•  irritable bowel syndrome; and
		(c)  having a significant impact on the capacity for employment and enjoyment of life
		Comment about appropriate level of ISV
		An ISV in the lower half of the range will be appropriate if the injury causes a chronic infection, that requires prolonged hospitalisation, that will not resolve after antibiotic treatment for 1 year.

60Serious injury to the digestive system not caused by trauma

		Examples of the injury	6 to 12
		•  serious but short-term food poisoning causing diarrhoea and vomiting—
		(a)  diminishing over 2 to 4 weeks; and
		(b)  with some remaining discomfort and disturbance of bowel function and impact on sex life and enjoyment of food, over a few years
		•  constant abdominal pain, causing significant discomfort, for up to 18 months caused by a delay in diagnosis of an injury to the digestive system
		Comment about appropriate level of ISV
		•  An ISV at or near the top of the range will be appropriate if there is an adverse response to the administration of a drug that—
		(a)  requires admission to an intensive care unit; and
		(b)  does not cause any permanent impairment; and
		(c)  causes the need for ongoing drug therapy for life.
		•  An ISV in the upper half of the range will be appropriate if a chronic infection—
		(a)  requires prolonged hospitalisation and additional treatment; and
		(b)  will be resolved by antibiotic treatment within 1 year.
		•  An ISV at or near the bottom of the range will be appropriate if there is an adverse response to the administration of a drug that—
		(a)  requires admission to an intensive care unit; and
		(b)  does not cause any permanent impairment; and
		(c)  does not cause the need for ongoing drug therapy for life.

61Moderate injury to the digestive system not caused by trauma

		Examples of the injury	3 to 5
		•  food poisoning—
		(a)  causing significant discomfort, stomach cramps, change of bowel function and fatigue; and
		(b)  requiring hospitalisation for days; and
		(c)  with symptoms lasting a few weeks; and
		(d)  from which the injured person will fully recover within 1 or 2 years
		•  an infection that is resolved by antibiotic treatment, with or without additional treatment in hospital, within 3 months after the injury is caused
		•  an adverse response to the administration of a drug, causing any of the following continuing over a period of more than 7 days and requiring hospitalisation—
		(a)  vomiting;
		(b)  shortness of breath;
		(c)  hypertension;
		(d)  skin irritation

62Minor injury to the digestive system not caused by trauma

		Examples of the injury	0 to 2
		•  disabling pain, cramps and diarrhoea, ongoing for days or weeks
		•  a localised infection, requiring antibiotic treatment, that heals within 6 weeks after the start of treatment
		•  an adverse response to the administration of a drug, causing any of the following continuing over a period of not more than 7 days, and not requiring hospitalisation—
		(a)  vomiting;
		(b)  shortness of breath;
		(c)  hypertension;
		(d)  skin irritation
		•  intermittent abdominal pain for up to 6 months caused by a delay in diagnosis of an injury to the digestive system

		General comment for items 63 to 66
		An injury to a ureter or the ureters alone, without loss of, or serious damage to, a kidney will generally be assessed under item 65 or 66.
		Examples of factors affecting ISV assessment for items 63 to 66
		•  age
		•  risk of ongoing kidney or ureter problems, complications or symptoms
		•  need for future medical procedures

63Extreme 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 or intermittent dialysis	31 to 55
		Examples of factors affecting ISV assessment
		•  the effect of dialysis and loss of kidney function on activities of daily living
		•  the length of time for which dialysis was required or the frequency of intermittent dialysis
		•  ongoing requirement for medication, for example, to control blood pressure
		•  whether the injury caused the need for dietary changes, and if so, for how long
		Comment about appropriate level of ISV
		•  An ISV at or near the bottom of the range will be appropriate if dialysis was required for an initial 3-month period, with intermittent dialysis required after that.
		•  An ISV at or near the top of the range will be appropriate if the injury required dialysis for about 1 year and ongoing dietary changes and medication.

64Serious injury to kidneys or ureters

		Comment	19 to 30
		The injury may require temporary dialysis for less than 3 months.
		Example of the injury
		loss of 1 kidney if there is severe damage to, and a risk of loss of function of, the other kidney
		Comment about appropriate level of ISV
		The higher the risk of loss of function of the other kidney, the higher the ISV.

65Moderate injury to kidneys or ureters

		Examples of the injury	11 to 18
		•  loss of 1 kidney, with no damage to the other kidney
		•  an injury to a ureter or the ureters that requires surgery or placement of stents

66Minor injury to kidneys or ureters

		Example of the injury	0 to 10
		a laceration or contusion to 1 or both of the kidneys
		Comment about appropriate level of ISV
		•  An ISV at or near the bottom of the range will be appropriate if there is an injury to a kidney causing a contusion.
		•  An ISV at or near the top of the range will be appropriate if a partial removal of a kidney is required.

		Examples of factors affecting ISV assessment for items 67 to 70
		•  whether there are recurrent episodes of infection or obstruction
		•  whether there is a risk of developing biliary cirrhosis

67Extreme injury to liver, gall bladder or biliary tract

		Example of the injury	51 to 70
		loss, or injury causing effective loss, of liver function, requiring constant substitutional therapy
		Comment about appropriate level of ISV
		•  An ISV at or near the bottom of the range will be appropriate if there are recurrent episodes of liver failure that require hospital admission and medical management but do not require liver transplantation.
		•  An ISV at or near the top of the range will be appropriate if the injury requires liver transplantation.

68Serious injury to liver, gall bladder or biliary tract

		Example of the injury	36 to 50
		serious damage causing loss of over 30% of the tissue of the liver, but with some functional capacity of the liver remaining

69Moderate injury to liver, gall bladder or biliary tract

		Example of the injury	16 to 35
		a laceration or contusion to the liver, with a moderate effect on liver function
		Comment about appropriate level of ISV
		•  An ISV at or near the bottom of the range will be appropriate if the injury causes impaired liver function with symptoms of intermittent nausea and vomiting.
		•  An ISV at or near the bottom of the range will also be appropriate if there is a gall bladder injury with recurrent infection or symptomatic stone disease, the symptoms of which may include, for example, pain or jaundice.
		•  An ISV at or near the middle of the range will be appropriate if the injury involves removal of the gall bladder causing a bile duct injury.
		•  An ISV at or near the top of the range will be appropriate if—
		(a)  surgery is required to remove not more than 30% of the liver; or
		(b)  bile ducts require repair, for example, placement of stents.
		•  An ISV at or near the top of the range will also be appropriate if there is an injury to the gall bladder, that despite biliary surgery, causes ongoing symptoms, infection or the need for further endoscopic surgery.

70Minor injury to liver, gall bladder or biliary duct

		Comment	3 to 15
		An injury within this item should not require surgery to the liver.
		Example of the injury
		a laceration or contusion to the liver, with a minor effect on liver function
		Comment about appropriate level of ISV
		An ISV in the lower half of the range will be appropriate if there is an uncomplicated removal of the gall bladder with no ongoing symptoms.

		Examples 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 dietary changes are required to manage chronic pain or diarrhoea caused by the injury

71Extreme bowel injury

		Example of the injury	41 to 60
		an injury causing a total loss of natural bowel function and dependence on colostomy

72Serious bowel injury

		Example of the injury	19 to 40
		a serious abdominal injury causing either or both of the following—
		(a)  impairment of bowel function (which often requires permanent or long-term colostomy, leaving disfiguring scars);
		(b)  restrictions on employment and diet

73Moderate bowel injury

		Comment about appropriate level of ISV	7 to 18
		•  An ISV at or near the bottom of the range will be appropriate if—
		(a)  the injury requires an ileostomy or colostomy for less than 3 months; and
		(b)  bowel function returns to normal; and
		(c)  there are no ongoing symptoms.
		•  An ISV at or near the top of the range will be appropriate if—
		(a)  the injury requires temporary surgical diversion of the bowel, for example, an ileostomy or colostomy; and
		(b)  there is ongoing intermittent abnormal bowel function requiring medication.

74Minor bowel injury

		Example of the injury	3 to 6
		an injury causing tears to the bowel, with minimal ongoing bowel problems

		Examples of factors affecting ISV assessment for items 75 to 78
		•  age
		•  risk of ongoing bladder, prostate or urethra problems, complications or symptoms
		•  need for future surgery

75Extreme bladder, prostate or urethra injury

		Example of the injury	40 to 60
		an injury causing a complete loss of bladder function and control, with permanent dependence on urostomy

76Serious bladder, prostate or urethra injury

		Example of the injury	19 to 39
		an injury causing serious impairment of bladder control, with some incontinence
		Comment about appropriate level of ISV
		An ISV in the upper half of the range will be appropriate if there is serious ongoing pain.

77Moderate bladder, prostate or urethra injury

		Example of the injury	7 to 18
		an injury causing continued impairment of bladder control, with minimal incontinence and minimal pain
		Comment about appropriate level of ISV
		•  An ISV at or near the bottom of the range will be appropriate if there is a laceration of the urethra, that required surgical repair and caused intermittent infection or bladder dysfunction.
		•  An ISV at or near the top of the range will be appropriate if there is—
		(a)  increased urinary frequency of more than once every 2 hours throughout the day and more than 3 times at night that is unresponsive to treatment; or
		(b)  an ongoing requirement for minor surgery, for example, cystoscopy or urethral dilation.

78Minor bladder, prostate or urethra injury

		Example of the injury	3 to 6
		a bladder injury, from which the injured person will fully recover, with some relatively long-term interference with natural bladder function

79Injuries to the pancreas

		Comment about appropriate level of ISV	10 to 35
		•  An ISV at or near the bottom of the range will be appropriate if there is a contusion to the pancreas that heals.
		•  An ISV at or near the middle of the range will be appropriate if there are chronic symptoms, for example, pain or diarrhoea.
		•  An ISV at or near the top of the range will be appropriate if—
		(a)  there are chronic symptoms with significant weight loss of between 10% and 20% of body weight, and pancreatic enzyme replacement is required; or
		(b)  an injury to the pancreas causes diabetes.
		Examples of factors affecting ISV assessment
		•  the extent of any ongoing risk of internal infection and disorders, for example, diabetes
		•  the need for, and outcome of, further surgery, for example, surgery to manage pain caused by stone disease, infection or an expanding pseudocyst

80Loss of spleen (complicated)

		Example of the injury	8 to 20
		loss of spleen if there will be a risk, that is not minor, of ongoing internal infection and disorders caused by the loss
		Comment about appropriate level of ISV
		•  An ISV at or near the bottom of the range will be appropriate if the injury leads to a splenectomy, with intermittent symptoms of pain, nausea and vomiting that settle.
		•  An ISV at or near the middle of the range will be appropriate if—
		(a)  the injury leads to a splenectomy, with serious infection after the splenectomy; and
		(b)  the infection requires surgical or radiological intervention.
		•  An ISV at or near the top of the range will be appropriate if the injury leads to a splenectomy, with portal vein thrombosis after the splenectomy.

81Injury to the spleen or uncomplicated loss of spleen

		Example of the injury	0 to 7
		laceration or contusion to the spleen that—
		(a)  has been radiologically confirmed; and
		(b)  has no ongoing bleeding; and
		(c)  is managed conservatively; and
		(d)  resolves fully
		Comment about appropriate level of ISV
		An ISV at or near the top of the range will be appropriate if there has been removal of the spleen (splenectomy), with little or no risk of ongoing infections and disorders caused by the loss of the spleen.

82Severe hernia

		Example of the injury	11 to 20
		a hernia if after repair there is either or both—
		(a)  ongoing pain; or
		(b)  a restriction on physical activities, sport or employment

83Moderate hernia

		Example of the injury	6 to 10
		a hernia that after repair has some real risk of recurring in the short-term

84Minor hernia

		Example of the injury	0 to 5
		an uncomplicated inguinal hernia, whether or not repaired

		General comment for items 85 to 89
		•  This division does not apply to the following injuries (that are dealt with in items 1 to 3)—
		•  quadriplegia
		•  paraplegia
		•  hemiplegia or severe paralysis of more than 1 limb.
		•  Cervical spine injuries, other than those dealt with in items 1 to 3, range from cases of very severe disability to cases of a minor strain, with no time off work and symptoms only suffered for 2 or 3 weeks.
		•  Symptoms associated with nerve root compression or damage can not be taken into account in assessing an ISV under item 85, 86 or 87 unless objective signs are present of nerve root compression or damage, for example—
		•  CT or MRI scans or other radiological evidence
		•  muscle wasting
		•  clinical findings of deep tendon reflex loss, motor weakness and loss of sensation.

85Extreme cervical spine injury

		Comment	41 to 75
		•  These are extremely severe injuries that cause gross limitation of movement and serious interference with performance of daily activities.
		•  The injury will involve significant upper or lower extremity impairment and may require the use of an adaptive device or prosthesis.
		Examples of the injury
		•  a total neurological loss at a single level
		•  severe multilevel neurological dysfunction
		•  structural compromise of the spinal canal with extreme upper or lower extremity motor and sensory impairments
		•  fractures involving more than 50% compression of a vertebral body with neural compromise
		Comment about appropriate level of ISV
		•  An ISV at or near the bottom of the range will be appropriate if there is whole person impairment of about 29%.
		•  An ISV at or near the top of the range will be appropriate if there is a cervical spine injury causing monoplegia of the dominant upper limb and whole person impairment of at least 60%.

86Serious cervical spine injury

		Comment	16 to 40
		•  The injury will cause serious upper extremity impairment or serious permanent impairment of the cervical spine.
		•  The injury may involve—
		(a)  a change of motion segment integrity; or
		(b)  bilateral or multilevel nerve root compression or damage.
		Examples of the injury
		•  loss of motion in a motion segment because of a surgical or post-traumatic fusion
		•  a fracture involving more than 25% compression of 1 vertebral body
		•  an injury showing objective signs of nerve root damage after surgery
		Comment about appropriate level of ISV
		•  An ISV at or near the bottom of the range will be appropriate if—
		(a)  the injured person has had surgery and symptoms persist; or
		(b)  there is a fracture involving 25% compression of 1 vertebral body.
		•  An ISV in the middle of the range will be appropriate if there is a fracture involving about 50% compression of a vertebral body, with ongoing pain.
		•  An ISV at or near the top of the range will be appropriate if—
		(a)  the injured person has had a fusion of vertebral bodies that has failed, leaving objective signs of significant residual nerve root damage and ongoing pain, affecting 1 side of the body; and
		(b)  there is whole person impairment of about 28%.

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

		Comment about appropriate level of ISV	5 to 15
		•  An ISV at or near the top of the range will be appropriate if—
		(a)  there is a disc prolapse for which there is radiological evidence at an anatomically correct level; and
		(b)  there are symptoms of pain and 3 or more of the following objective signs that are anatomically localised to an appropriate spinal nerve root distribution—
		(i)  sensory loss;
		(ii)  loss of muscle strength;
		(iii)  loss of reflexes;
		(iv)  unilateral atrophy; and
		(c)  the impairment has not improved after non-operative treatment.
		•  An ISV of about 10 will be appropriate if there is a fracture of a vertebral body with up to 25% compression, and ongoing pain.
		•  An ISV at or near the bottom of the range will be appropriate for an uncomplicated fracture of a posterior element of 1 or more of the vertebral segments, for example, spinous or transverse processes, without neurological impairment.

88Moderate cervical spine injury—soft tissue injury

		Comment	5 to 10
		The injury will cause moderate permanent impairment, for which there is objective evidence, of the cervical spine.
		Comment about appropriate level of ISV
		An ISV of not more than 10 will be appropriate if there is whole person impairment of 8% caused by a soft tissue injury for which there is no radiological evidence.

89Minor cervical spine injury

		Comment	0 to 4
		•  Injuries within this item include a whiplash injury with no ongoing symptoms, other than symptoms that are merely a nuisance, remaining more than 18 months after the injury is caused.
		•  There will be no objective signs of neurological impairment.
		Example of the injury
		a soft tissue or whiplash injury if symptoms are minor and the injured person recovers, or is expected to recover, from the injury to a level where the injury is merely a nuisance within 18 months after the injury is caused
		Comment about appropriate level of ISV
		•  An ISV at or near the bottom of the range will be appropriate if the injury will resolve without any ongoing symptoms within months after the injury is caused.
		•  An ISV at or near the top of the range will be appropriate if the injury, despite improvement, causes headaches and some ongoing pain.

		General comment for items 90 to 94
		•  This division does not apply to the following injuries (that are dealt with in items 1 to 3)—
		•  quadriplegia
		•  paraplegia
		•  hemiplegia or severe paralysis of more than 1 limb.
		•  Thoracic or lumbar spine injuries, other than those dealt with in items 1 to 3, range from cases of very severe disability to cases of a minor strain, with no time off work and symptoms suffered only for 2 or 3 weeks.
		•  Symptoms associated with nerve root compression or damage can not be taken into account in assessing an ISV under item 90, 91 or 92 unless objective signs are present of nerve root compression or damage, for example—
		•  CT or MRI scans or other radiological evidence
		•  muscle wasting
		•  clinical findings of deep tendon reflex loss, motor weakness and loss of sensation.

90Extreme thoracic or lumbar spine injury

		Comment	36 to 60
		These are extremely severe injuries causing gross limitation of movement and serious interference with performance of daily activities. There may be some motor or sensory loss, and some impairment of bladder, ano-rectal or sexual function.
		Example of the injury
		a fracture involving compression of a thoracic or lumbar vertebral body of more than 50%, with neurological impairment
		Comment about appropriate level of ISV
		•  An ISV at or near the bottom of the range will be appropriate if there is whole person impairment for the injury of 25%.
		•  An ISV at or near the top of the range will be appropriate if there is whole person impairment for the injury of at least 45%.

91Serious thoracic or lumbar spine injury

		Comment	16 to 35
		•  The injury will cause serious permanent impairment in the thoracic or lumbar spine.
		•  The injury may involve—
		(a)  bilateral or multilevel nerve root damage; or
		(b)  a change in motion segment integrity, for example, because of surgery.
		Example of the injury
		a fracture involving at least 25% compression of 1 thoracic or lumbar vertebral body
		Comment about appropriate level of ISV
		•  An ISV at or near the bottom of the range will be appropriate if—
		(a)  the injured person has had surgery and symptoms persist; or
		(b)  there is a fracture involving 25% compression of 1 vertebral body.
		•  An ISV in the middle of the range will be appropriate if there is a fracture involving 50% compression of a vertebral body, with ongoing pain.
		•  An ISV at or near the top of the range will be appropriate if the injured person has had a fusion of vertebral bodies that has failed—
		(a)  leaving objective signs of significant residual nerve root damage and ongoing pain, affecting 1 side of the body; and
		(b)  causing whole person impairment of 24%.

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

		Comment about appropriate level of ISV	5 to 15
		•  An ISV at or near the top of the range will be appropriate if—
		(a)  there is a disc prolapse for which there is radiological evidence at an anatomically correct level; and
		(b)  there are symptoms of pain and 3 or more of the following objective signs, that are anatomically localised to an appropriate spinal nerve root distribution—
		(i)  sensory loss;
		(ii)  loss of muscle strength;
		(iii)  loss of reflexes;
		(iv)  unilateral atrophy; and
		(c)  the impairment has not improved after non-operative treatment.
		•  An ISV of about 10 will be appropriate if there is a fracture of a vertebral body with up to 25% compression, and ongoing pain.
		•  An ISV at or near the bottom of the range will be appropriate for an uncomplicated fracture of a posterior element of 1 or more of the vertebral segments, for example spinous or transverse processes, without neurological impairment.

93Moderate thoracic or lumbar spine injury—soft tissue injury

		Comment	5 to 10
		The injury will cause moderate permanent impairment, for which there is objective evidence, of the thoracic or lumbar spine.
		Comment about appropriate level of ISV
		An ISV of not more than 10 will be appropriate if there is whole person impairment of 8% caused by a soft tissue injury for which there is no radiological evidence.

94Minor thoracic or lumbar spine injury

		Example of the injury	0 to 4
		a soft tissue injury of the thoracic or lumbar spine with no—
		•  significant clinical findings
		•  fractures
		•  documented neurological impairment
		•  significant loss of motion segment integrity
		•  other objective signs of impairment relating to the injury
		Comment about appropriate level of ISV
		•  An ISV at or near the top of the range will be appropriate, whether or not the injured person continues to suffer some ongoing pain, if the injury will substantially reach maximum medical improvement, with only minor symptoms, within about 18 months after the injury is caused.
		•  An ISV at or near the bottom of the range will be appropriate if the injury will resolve without any ongoing symptoms within months after the injury is caused.