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B.C. Reg. 61/2021
O.C. 113/2021
Deposited March 5, 2021
effective May 1, 2021
This consolidation is current to September 20, 2022.
Link to consolidated regulation (PDF)
Link to Point in Time

Insurance (Vehicle) Act

Permanent Impairment Regulation

[Last amended May 1, 2021 by B.C. Reg. 117/2021]

Contents
1Definitions for Act and regulation
2Meaning of "catastrophic injury"
3Compensation for permanent impairment
4Calculation of permanent impairment rating
5Calculation of permanent impairment component
6Enhancement component for symmetrical body parts
7Exceptions to section 6
8Permanent impairment compensation calculation — catastrophic injury
9Permanent impairment compensation calculation — non-catastrophic injury
10Compensation determined at time of accident
Schedule

Definitions for Act and regulation

1   (1) For the purposes of section 113 of the Act and in this regulation, "catastrophic injury" means a catastrophic injury within the meaning of section 2 of this regulation.

(2) In this regulation:

"Act" means the Insurance (Vehicle) Act;

"enhancement component" means the component of a permanent impairment rating that is

(a) calculated and determined in accordance with section 6 [enhancement component for symmetrical body parts], and

(b) expressed as a percentage;

"permanent impairment component" means the component of a permanent impairment rating that is

(a) calculated and determined in accordance with section 5 [calculation of permanent impairment component], and

(b) expressed as a percentage;

"permanent impairment rating" means the sum of the enhancement component and the permanent impairment component that is

(a) calculated and determined in accordance with section 4 [calculation of permanent impairment rating], and

(b) expressed as a percentage.

Meaning of "catastrophic injury"

2   (1) In this section, if a provision refers to an injury resulting in a percentage, the percentage is calculated and determined

(a) by applying section 4 [calculation of permanent impairment rating] as if the percentage to be calculated and determined were the permanent impairment rating,

(b) excluding all injuries resulting from the accident except those injuries listed in the applicable provision of this section, and

(c) as if the injury listed in this section was a permanent impairment within the meaning of this regulation.

(2) For the purposes of section 1 (1), an insured sustains a catastrophic injury if the insured sustains any of the following:

(a) quadriplegia or paraplegia that meets the criteria for classification as Grade A or B on the ASIA impairment scale and is determined to result in a percentage, using the method described in subsection (1), of 65% or more;

(b) two or more of the following amputations:

(i) forequarter amputation of a shoulder and arm;

(ii) shoulder disarticulation;

(iii) above-elbow amputation of an arm, involving the proximal third of the humerus;

(iv) above-elbow amputation of an arm, involving the middle or distal third of the humerus;

(v) hemipelvectomy;

(vi) hip disarticulation, involving the proximal 1/3 of the femur;

(vii) proximal, mid-thigh or distal above-knee amputation of a leg;

(c) loss of vision that is determined to result in a percentage, using the method described in subsection (1), of 80% or more;

(d) a functional alteration of the brain of any of the following types or any combination of them that is determined to result in a percentage, using the method described in subsection (1), of 50% or more:

(i) a communication disorder that

(A) results in the insured's complete inability to understand and use language,

(B) does not affect the insured's ability to understand linguistic symbols, but severely impairs the insured's ability to use sufficient or appropriate language,

(C) does not affect the insured's ability to understand linguistic symbols, but moderately impairs the insured's ability to use sufficient or appropriate language, or

(D) results in minor communication difficulties;

(ii) an alteration of consciousness, including stupor, coma or another disorder or disturbance, and including adverse effects from medication, that prevents the person from performing the activities of daily living to such an extent that the insured requires continuous supervision in an institutional or controlled setting;

(iii) an alteration of consciousness, including stupor, coma or another disorder or disturbance, and including adverse effects of medication, that

(A) impairs the insured's ability to perform the activities of daily living to the extent that the insured requires periodic supervision in an institutional or controlled setting for 50% or more of the time,

(B) impairs the insured's ability to perform the activities of daily living to the extent that the insured requires periodic supervision in an institutional or controlled setting for less than 50% of the time,

(C) impairs the insured's ability to perform the activities of daily living to the extent that the insured requires supervision but not in an institutional or controlled setting, or

(D) impairs the insured's ability to perform the activities of daily living but not to the extent that the insured requires supervision;

(iv) an alteration of the higher cognitive or integrative mental functions, including adverse effects of medication, that

(A) prevents the insured from performing the activities of daily living to the extent that the insured requires continuous supervision in an institutional or controlled setting,

(B) impairs the insured's ability to perform the activities of daily living to the extent that the insured requires periodic supervision in an institutional or controlled setting for 50% or more of the time,

(C) impairs the insured's ability to perform the activities of daily living to the extent that the insured requires periodic supervision in an institutional or controlled setting for less than 50% of the time,

(D) impairs the insured's ability to perform the activities of daily living to the extent that the insured requires supervision but not in an institutional or controlled setting, or

(E) impairs the insured's ability to perform the activities of daily living but not to the extent that the insured requires supervision;

(e) a psychiatric condition, syndrome or phenomenon, including adverse effects of medication, that

(i) impairs the insured's ability to perform the activities of daily living, ability to function socially or sense of well-being, to the extent that the insured requires continuous supervision in an institutional or controlled setting, or periodic supervision in such a setting for 50% or more of the time, and

(ii) is determined to result in a percentage, using the method described in subsection (1), of 70% or more;

(f) full-thickness burns resulting in consequential impairments, excluding scarring or disfigurement to all surface areas of the body other than the face, that are determined to result in a percentage, using the method described in subsection (1), of 75% or more;

(g) a combination of any of the following injuries that is determined to result in a percentage, using the method described in subsection (1), of 80% or more:

(i) an amputation referred to in paragraph (b) of this subsection;

(ii) one or more of the following amputations:

(A) elbow disarticulation, including amputation of the proximal third of the forearm;

(B) below-elbow amputation, involving the middle third of the forearm;

(C) wrist disarticulation, involving the distal third of the forearm;

(D) knee disarticulation, including proximal below-knee amputation, not suitable for a patellar tendon bearing prosthesis;

(E) below-knee amputation suitable for a patellar tendon bearing prosthesis;

(iii) quadriplegia or paraplegia that meets the criteria for classification as Grade C or D on the ASIA impairment scale with partial preservation of motor power, whether or not there is sensory preservation and whether the percentage under this subparagraph is the result of one or more permanent impairments;

(iv) loss of vision that is determined to result in a percentage, using the method described in subsection (1), of 50% or more but less than 80%;

(v) one or more of the following types of functional alteration of the brain that are determined to result in a percentage, using the method described in subsection (1), of 30% or more:

(A) inability to use both upper limbs for personal hygiene and self-care with evidence of both proximal and distal upper limb neurological dysfunction;

(B) inability to use one upper limb for personal hygiene and self-care with evidence of both proximal and distal upper limb neurological dysfunction;

(C) difficulty in using both upper limbs for personal hygiene and self-care with evidence of either proximal or distal upper limb neurological dysfunction bilaterally;

(D) difficulty in using one upper limb for personal hygiene and self-care with evidence of either proximal or distal upper limb neurological dysfunction;

(E) difficulty manipulating objects with impaired prehension confined to only one of the upper limbs, while still allowing independence in personal hygiene and self-care;

(F) difficulty manipulating objects with no impairment in prehension in either upper limb, while still allowing independence in personal hygiene and self-care;

(G) upper limb clumsiness, including tremor, dysmetria or dysdiadochokinesis, with impaired prehension confined to only one of the upper limbs, while still allowing independence in personal hygiene and self-care;

(H) upper limb clumsiness, including tremor, dysmetria or dysdiadochokinesis, with no impairment in prehension in either upper limb, while still allowing independence in personal hygiene and self-care;

(I) inability to stand or walk;

(J) ability to stand, but great difficulty or inability to walk;

(K) moderate difficulty in walking on irregular surfaces, stairways or uneven terrain;

(L) slight difficulty in walking;

(M) incontinence or urinary retention with complete loss of sphincter control;

(N) incontinence or urinary retention with partial loss of sphincter control;

(O) incontinence or urinary retention with dysfunction in the form of frequency or hesitancy;

(P) alteration of the bladder with or without enterocystoplasty;

(Q) a Class 1, 2 or 3 renal functional impairment;

(R) anorectal function with complete loss of control;

(S) anorectal function with limited control;

(T) a Class 1, 2 or 3 sexual dysfunction;

(U) one or more of the types of functional alteration of the brain referred to in paragraph (d) (i) (C) or (D), (d) (iii) (B) to (D) or (d) (iv) (C) to (E);

(vi) a peripheral nervous system injury involving all 3 trunks of the brachial plexus, with complete motor and sensory impairment, or a peripheral nervous system injury of one or more of the following types involving the brachial plexus:

(A) upper trunk, also known as Erb-Duchenne syndrome, with complete motor and sensory impairment;

(B) middle trunk, with complete motor and sensory impairment;

(C) lower trunk, also known as Klumpke-Déjerine syndrome, with complete motor and sensory impairment;

(vii) a psychiatric condition, syndrome or phenomenon, including adverse effects of medication, that

(A) impairs the insured's ability to perform the activities of daily living, ability to function socially or sense of well-being to the extent that the insured requires periodic supervision in an institutional or controlled setting for less than 50% of the time, and

(B) is determined to result in a percentage, using the method described in subsection (1), of 35% or more,

(viii) full-thickness burns resulting in consequential impairments, excluding scarring or disfigurement to all surface areas of the body other than the face, that are determined to result in a percentage, using the method described in subsection (1), of 40% or more.

Compensation for permanent impairment

3   The corporation must calculate and determine the permanent impairment compensation to which an insured is entitled under section 129 [permanent impairment compensation] of the Act by

(a) determining if the insured has sustained a catastrophic injury in accordance with section 2,

(b) determining the insured's permanent impairment rating in accordance with section 4, and

(c) determining the compensation that corresponds to, as applicable,

(i) the catastrophic injury in accordance with section 8 [permanent impairment compensation calculation — catastrophic injury], or

(ii) the permanent impairment rating in accordance with section 9 [permanent impairment compensation calculation — non-catastrophic injury].

Calculation of permanent impairment rating

4   The permanent impairment rating is the sum of

(a) the permanent impairment component calculated and determined in accordance with section 5, and

(b) one of the following:

(i) the enhancement component calculated and determined in accordance with section 6 [enhancement component for symmetrical body parts];

(ii) if no enhancement component is applicable, 0.

Calculation of permanent impairment component

5   (1) To determine an insured's permanent impairment component, the corporation must take the following steps in the following order:

(a) if the insured sustains a permanent impairment described in any of the following provisions, the corporation must calculate and determine the percentage that corresponds to the permanent impairment sustained by the insured in accordance with the Schedule:

(i) a percentage in relation to section 13 [wrist and hand — amputation] of the Schedule must be calculated and determined in accordance with that section;

(ii) a percentage in relation to Division 3 of Part 3 [throat and related structures] of the Schedule must be calculated and determined in accordance with section 100 [multiple impairments in Division added and multiplied by 0.7] of the Schedule;

(iii) a percentage in relation to item 7 of section 106 [other impairments to vision] of the Schedule must be calculated and determined in accordance with section 107 of the Schedule;

(iv) a percentage in relation to sections 149 to 152 [vestibulocochlear apparatus] of the Schedule must be calculated and determined in accordance with section 148 [formula to determine percentage for sections 149 to 152] of the Schedule;

(b) if the insured sustains a permanent impairment not calculated and determined in accordance with paragraph (a), the corporation must calculate and determine the percentage that corresponds to the permanent impairment sustained by the insured in accordance with the Schedule;

(c) if the insured sustains a permanent impairment that is not described in the Schedule, the corporation must calculate and determine a percentage for the permanent impairment using one or more permanent impairments described in the Schedule as a guide to establish a percentage for the permanent impairment not described in the Schedule.

(2) If, under subsection (1), the corporation calculates and determines only one percentage in the Schedule is applicable to a permanent impairment sustained by the insured, the percentage corresponding to the permanent impairment is the permanent impairment component.

(3) If an insured's permanent impairment component is determined by reference to more than one permanent impairment, the permanent impairment component must be determined using the following formula:

C = A + (B(1 − A))
where
A = (a) for the first application of the formula, subject to subsection (4), the highest percentage corresponding to the permanent impairments sustained by the insured;
  (b) for any subsequent application of the formula, the value solved for as C in the previous calculation;
B = (a) for the first application of the formula, subject to subsection (4), the second highest percentage corresponding to the permanent impairments sustained by the insured;
  (b) for any subsequent application of the formula, subject to subsection (4), the next highest percentage corresponding to the permanent impairments sustained by the insured;
C = (a) subject to subsection (4), the value to be used as A in each subsequent application of the formula;
  (b) if the B variable is the lowest percentage corresponding to the permanent impairments sustained by the insured when applying the formula, the permanent impairment component.

(4) If any of the following result in a fraction of a percentage, the fraction must be rounded to the nearest whole percentage and if a percentage ends in .5 it must be rounded up to the nearest whole percentage:

(a) the percentage corresponding to a permanent impairment sustained by the insured;

(b) the percentage determined in accordance with subsection (3) as the C variable in each subsequent application of the formula;

(c) the permanent impairment component calculated and determined in accordance with paragraph (b) of variable C.

Enhancement component for symmetrical body parts

6   (1) Subject to section 7, the enhancement component set out in subsection (2) is added to the permanent impairment component to determine the permanent impairment rating if an anatomicophysiological deficit resulting from the accident

(a) impairs symmetrical body parts, or

(b) impairs a body part that is symmetrical to a body part that was permanently impaired before the accident.

(2) For the purposes of subsection (1), the enhancement component must be calculated using the following formula:

EC = A × 0.25
where
EC = the enhancement component;
A = subject to subsection (3), the percentage calculated and determined
  (a) by applying section 5 as if the percentage to be calculated and determined were the permanent impairment component, and
  (b) excluding all permanent impairments resulting from the accident except those permanent impairments that correspond to the most severely impaired symmetrical part of the insured's body.

(3) For the purposes of variable A in subsection (2), the percentage of an anatomicophysiological deficit that existed before an accident must be calculated and determined in accordance with section 5 as if the deficit resulted from the accident.

Exceptions to section 6

7   The enhancement component determined in accordance with section 6 does not apply to any of the following anatomicophysiological deficits:

(a) a deficit that affects an internal organ;

(b) a deficit that affects an organ controlling vision, balance or hearing;

(c) a deficit that results from an injury to the central nervous system;

(d) a deficit that affects the teeth.

Permanent impairment compensation calculation — catastrophic injury

8   If the insured sustains a catastrophic injury, the permanent impairment compensation is $264 430.

Permanent impairment compensation calculation — non-catastrophic injury

9   (1) Subject to subsection (2), the compensation for an insured's permanent impairment that is not a catastrophic injury must be calculated and determined using the following formula:

P = PIR × $167 465
where
P = permanent impairment compensation in dollars;
PIR = the insured's permanent impairment rating.

(2) Despite subsection (1), if the permanent impairment compensation determined in accordance with subsection (1) is more than $0, the minimum compensation in relation to a permanent impairment is $836.

Compensation determined at time of accident

10   (1) For the purposes of this section, "permanent" in relation to an impairment, means

(a) following a period of time sufficient for optimal tissue repair, the impairment

(i) has become static, or

(ii) has stabilized, and

(b) the impairment is unlikely to change significantly with further therapy.

(2) The corporation must not pay the compensation under section 8 or 9 until the impairment is permanent.

(3) The corporation must calculate and determine the compensation under section 8 or 9 as of the date of the accident.

Schedule

Contents
1 Definition for Schedule
Part 1 — Musculoskeletal System
2 Application regarding amputation
  Division 1 — Upper Limb
3 Shoulder and arm — amputation
4 Shoulder, sternum, clavicle, rib and arm fracture and rib removal
5 Shoulder and arm — non-bony disruption
6 Shoulder and arm — ligamentous and other soft tissue disruption
7 Shoulder and arm — range of motion loss of shoulder joint complex
8 Elbow and forearm — amputation
9 Elbow and forearm — fracture
10 Elbow and forearm — non-bony disruption
11 Elbow and forearm — ligamentous and other soft tissue disruption
12 Elbow and forearm — range of motion loss
13 Wrist and hand — amputation
14 Wrist and hand — fracture
15 Wrist and hand — non-bony disruption
16 Wrist and hand — ligamentous and other soft tissue disruption
17 Wrist — range of motion loss
18 Hand — range of motion loss
  Division 2 — Lower Limb
19 Pelvis — amputation
20 Pelvis — fracture and loss of motion
21 Hip and thigh — amputation
22 Hip and thigh — fracture
23 Hip and thigh — non-bony disruption
24 Hip — range of motion loss
25 Thigh — muscular atrophy
26 Knee and leg — amputation
27 Knee and leg — fracture and fracture complication
28 Knee and leg — non-bony disruption
29 Knee and leg — ligamentous and other soft tissue disruption
30 Knee — range of motion loss
31 Lower leg — muscular atrophy
32 Ankle and foot — amputation
33 Ankle and foot — fracture and fracture complication
34 Ankle and foot — non-bony disruption
35 Ankle and foot — ligamentous disruption
36 Ankle and foot — range of motion loss
  Division 3 — Spine
37 Interpretation for Division
38 Cervical spine
39 Thoracic spine
40 Lumbar spine
41 Other spinal impairment
Part 2 — Central and Peripheral Nervous System
42 Definitions for Part
  Division 1 — Skull, Brain and Carotid Vessels
43 Alteration of brain tissue — cerebral concussion and contusion
44 Alteration of brain tissue — post-traumatic alteration of tissue
45 Alteration of skull — post-traumatic bony alteration
46 Alteration of skull — bony deformity following depressed fracture of calvarium
47 Alteration of cerebrovascular supply
48 Functional alteration of brain — upper limb function
49 Functional alteration of brain — effect on station and gait
50 Functional alteration of brain — effect on bladder function
51 Functional alteration of brain — effect on anorectal function
52 Functional alteration of brain — sexual dysfunction
53 Functional alteration of brain — communication disorder
54 Functional alteration of brain — alteration of consciousness
55 Functional alteration of brain — alteration of higher cognitive and integrative mental functions
  Division 2 — Spinal Cord
56 Interpretation for Division
57 Quadriplegia or paraplegia — ASIA Grades A and B
58 Quadriplegia or paraplegia — ASIA Grades C and D — upper limb function
59 Quadriplegia or paraplegia — ASIA Grades C and D — effect on station and gait
60 Quadriplegia or paraplegia — ASIA Grades C and D — effect on bladder function
61 Quadriplegia or paraplegia — ASIA Grades C and D — effect on anorectal function
62 Quadriplegia or paraplegia — ASIA Grades C and D — sexual dysfunction
63 Quadriplegia or paraplegia — ASIA Grades C and D — autonomic dysreflexia
  Division 3 — Cranial Nerves
64 Olfactory nerves — loss and distortion of smell
65 Oculomotor nerve and eye parasympathetic input
66 Trigeminal nerves
67 Facial nerve
68 Auditory nerve tinnitus
69 Glossopharyngeal, vagal and hypoglossal impairment
70 Spinal accessory impairment
  Division 4 — Peripheral Nervous System
71 Classification of motor impairment
72 Motor impairment — nerve roots
73 Motor impairment — peripheral roots — head and neck
74 Motor impairment — peripheral roots — upper limb
75 Motor impairment — peripheral roots — lower limb — thigh, leg and foot
76 Classification of sensory impairment
77 Sensory impairment — nerve roots
78 Sensory impairment — peripheral roots — head and neck
79 Sensory impairment — peripheral roots — upper limb
80 Sensory impairment — peripheral roots — lower limb — inguinal region
81 Sensory impairment — peripheral roots — lower limb — thigh, leg and foot
82 Sensory loss
83 Brachial plexus impairment
84 Lumbosacral plexus impairment
Part 3 — Maxillofacial System
  Division 1 — Temporomandibular Joint (TMJ), Maxilla, Mandible and Teeth
85 Temporomandibular joint (TMJ) — range of motion loss
86 Temporomandibular joint (TMJ) — other dysfunction
87 Maxilla
88 Mandible
89 Teeth — alteration and loss
  Division 2 — Fronto-Orbito-Nasal Area
90 Orbit — impairment of orbital wall causing displacement of eye
91 Orbit — disruption of medial and lateral canthus
92 Orbit — disruption of lacrimal apparatus
93 Orbit — malar bone and zygoma
94 Nasal — airflow obstruction
95 Nasal — mucosal dysfunction
96 Nasal — septal perforation
97 Nasal — paranasal sinus
98 Salivary gland
99 Tongue — anatomic loss and alteration
  Division 3 — Throat and Related Structures
100 Calculation and determination of multiple impairments in Division
101 Air passage deficits — upper airway
102 Mastication and deglutition
103 Loss of taste
104 Speech impairment
Part 4 — Vision
105 Definitions for Part
106 Vision loss
107 Calculation and determination of percentage for other impairments to vision
108 Central visual acuity — testing methods
109 Central visual acuity — percentage for variable D
110 Visual field — testing methods
111 Vision meridians
112 Deficit in visual field — percentage for variable E
113 Ocular motility — testing
114 Ocular motility — percentage for variable F
Part 5 — Urogenital System and Related
115 Kidney impairment
116 Ureteric impairment
117 Bladder impairment
118 Urethral impairment
119 Tissue alteration — posterolumbar and laparotomy
120 Renal function impairment
121 Reproductive system — organ tissue disruption
122 Sexual dysfunction
Part 6 — Respiratory System
123 Respiratory system tissue disruption
124 Respiratory functional impairment
Part 7 — Digestive Tract
125 Application regarding tissue disruption and functional loss
126 Upper gastrointestinal tract disorder
127 Lower gastrointestinal tract disorder — colon and rectum
128 Lower gastrointestinal tract — anal impairment
129 Liver and biliary tract — liver tissue disruption
130 Liver and biliary tract — residual hepatic functional impairment
131 Liver and biliary tract — biliary tract dysfunction
132 Hernia-related impairment
133 Post-operative abdominal wall-related impairment
Part 8 — Cardiovascular System
134 Thoracic arterial lesion
135 Functional limitation — cardiovascular lesion
136 Peripheral arterial lesion
137 Functional limitation — peripheral arterial lesion following lower limb vascular lesion
138 Functional limitation — peripheral arterial lesion following upper limb vascular lesion
139 Venous and lymphatic lesion
Part 9 — Endocrine System
140 Hypothalamus, pituitary, thyroid and parathyroid gland dysfunction
141 Diabetes mellitus
142 Adrenal gland
Part 10 — Hematopoietic System
143 Tissue disruption — spleen
144 Tissue disruption — thymus
145 Functional impairment — red blood cells
146 Functional impairment — white blood cells
Part 11 — Psychiatric Condition, Syndrome and Phenomenon
147 Psychiatric condition, syndrome and phenomenon
Part 12 — Vestibulocochlear Apparatus
148 Formula to determine percentages for sections 149 to 152
149 Hearing loss — percentage for variable H
150 Vestibular functional impairment — percentage for variable V
151 Vestibular functional impairment — loss of labyrinth — percentage for variable V
152 Tinnitus — percentage for variable T
153 External ear canal impairment
Part 13 — Skin
154 Interpretation for Part
  Division 1 — Facial Disfigurement
155 Facial disfigurement
  Division 2 — Disfigurement of Skin Overlaying Rest of Body
156 Disfigurement of skin, other than facial disfigurement
157 Facial or other body region disfigurement due to discolouration
  Division 3 — Disfigurement from Partial or Total Amputation
158 Application for Division
159 Disfigurement from amputation — eye
160 Disfigurement from amputation — upper limb
161 Disfigurement from amputation — lower limb

Definition for Schedule

1   In this Schedule, "non-specified abnormal healing" means an anatomic abnormality at the end of the expected healing process that is not described elsewhere in the Schedule and includes the following:

(a) a change in angulation of the fracture fragment;

(b) rotational abnormalities;

(c) shortening.

Part 1 — Musculoskeletal System

Application regarding amputation

2   In the case of an amputation described in this Part, any other permanent impairment described in this Part to the amputated body part is not included in the calculation of the permanent impairment component.

Division 1 — Upper Limb

Shoulder and arm — amputation

3   If the insured sustains a shoulder or arm amputation, the percentage in column 2 corresponds to the insured's amputation described opposite in column 1.

ItemColumn 1
Shoulder or arm amputation
Column 2
Percentage
1Forequarter amputation60%
2Shoulder disarticulation56%
3Above-elbow amputationproximal third of the humerus54%
(a) middle third of the humerus
(b) distal third of the humerus, or
(c) both the middle third and distal third of the humerus
52%

Shoulder, sternum, clavicle, rib and arm fracture and rib removal

4   (1) If the insured sustains a sternum, clavicle, scapula, arm or rib fracture or rib removal, the percentage in column 2 corresponds to the insured's fracture or removal described opposite in column 1.

(2) In respect of item 2, a rib fracture must be documented by an imaging study.

Item Column 1
Shoulder, rib or arm fracture or rib removal
Column 2
Percentage
1Fracture of sternum, clavicle, scapula or humerus with non-specified abnormal healing1%
2Subject to subsection (2), fracture of a rib 0.5% per rib to a maximum of 2%
3Removal of a rib2% per rib
4Humeral fracturewith angulation of more than 15° 5%
with angulation of 5° to 15° 2.5%
with shortening of more than 4 cm5%
with shortening of more than 2 cm to 4 cm3%
with shortening of 1 cm to 2 cm1.5%
5Chronic osteomyelitis of any upper limb bone with active drainage3%

Shoulder and arm — non-bony disruption

5   (1) If the insured sustains a permanent shoulder or arm non-bony disruption, the percentage in column 2 corresponds to the insured's disruption described opposite in column 1.

(2) If the insured sustains a disruption described in item 2, no percentage may be added that corresponds to disruption described in item 1.

Item Column 1
Shoulder or arm non-bony disruption
Column 2
Percentage
1Non-bony disruptionsubject to subsection (2), complete non-bony disruption or avulsion fracture affecting an upper limb 2%
subject to subsection (2), partial non-bony disruption or avulsion fracture affecting an upper limb1%
2Non-bony disruptionrotator cuff tear, imaging positive, full thickness, with no known prior rotator cuff pathology5%
rotator cuff tear, imaging positive, full thickness, with known prior rotator cuff pathology2%
rotator cuff tear, partial thickness2%
distal or proximal biceps tendon rupture, with no strength deficit in supination or elbow flexion1%
distal or proximal biceps tendon rupture, with strength deficit in supination or elbow flexion2%

Shoulder and arm — ligamentous and other soft tissue disruption

6   (1) If the insured sustains a permanent shoulder or arm ligamentous or other soft tissue disruption, the percentage in column 2 corresponds to the insured's ligamentous or other soft tissue disruption described opposite in column 1.

(2) In respect of items 2 and 3, confirmation must be provided by plane radiography.

(3) If a disruption described in item 3 includes a Bankart lesion, Hill-Sachs deformity or labral tear, 1% is added to the percentage in column 2.

ItemColumn 1
Ligamentous or soft tissue disruption
Column 2
Percentage
1Acromioclavicular or sternoclavicular joint injurygrade 1 separation0%
grade 2 separation1%
grade 3 separation2%
2Subject to subsection (2), glenohumeral instability including traumatic glenohumeral dislocationno recurrence of dislocation within one year of the accident, without prior instability 3%
no recurrence of dislocation within one year of the accident, with prior instability2%
3Subject to subsection (2), glenohumeral instability including traumatic glenohumeral dislocationrecurrence of dislocation within one year of the accident, without prior instabilitysubject to subsection (3), 5%
recurrence of dislocation within one year of the accident, with prior instabilitysubject to subsection (3), 2%

Shoulder and arm — range of motion loss of shoulder joint complex

7   If the insured sustains a permanent range of motion loss of the shoulder joint complex, the percentage in column 2 corresponds to the insured's range of motion loss described opposite in column 1.

ItemColumn 1
Range of motion loss of shoulder joint complex
Column 2
Percentage
1Flexion-extension, which is described as motion in the scapular planecombined range of motion of less than 61° 9%
combined range of motion of 61° to 120° 5%
combined range of motion of 121° to 180° 2%
combined range of motion of more than 180° 0%
2Abduction-adduction, which is described as motion in the coronal planecombined range of motion of less than 61° 6%
combined range of motion of 61° to 120° 3%
combined range of motion of 121° to 180° 1%
combined range of motion of more than 180° 0%
3Internal rotation — external rotationcombined glenohumeral range of motion of less than 46° 6%
combined glenohumeral range of motion of 46° to 90° 3%
combined glenohumeral range of motion of 91° to 135° 1%
combined glenohumeral range of motion of more than 135° 0%

Elbow and forearm — amputation

8   If the insured sustains an elbow or forearm amputation, the percentage in column 2 corresponds to the insured's amputation described opposite in column 1.

Item Column 1
Elbow or forearm amputation
Column 2
Percentage
1Elbow disarticulation, including amputation of the proximal 1/3 of the forearm50%
2Below-elbow amputation, involving the middle 1/3 of the forearm47%

Elbow and forearm — fracture

9   If the insured sustains an elbow or forearm fracture, the percentage in column 2 corresponds to the insured's fracture described opposite in column 1.

ItemColumn 1
Elbow or forearm fracture
Column 2
Percentage
1Fractures of the radius, ulna or humerus, with non-specified abnormal healing1%
2Fracture of the radiuswith angulation of more than 15° 5%
with angulation of 5° to 15° 2.5%
with shortening of more than 4 cm5%
with shortening of more than 2 cm to 4 cm3%
with shortening of 1 cm to 2 cm1.5%
3Fracture of the ulnawith angulation of more than 15° 5%
with angulation of 5° to 15° 2.5%
with shortening of more than 4 cm5%
with shortening of more than 2 cm to 4 cm3%
with shortening of 1 cm to 2 cm1.5%

Elbow and forearm — non-bony disruption

10   If the insured sustains a permanent elbow or forearm non-bony disruption, the percentage in column 2 corresponds to the insured's non-bony disruption described opposite in column 1.

ItemColumn 1
Non-bony disruption
Column 2
Percentage
1Complete non-bony disruption or avulsion fracture, affecting the elbow or forearm2%
2Partial non-bony disruption or avulsion fracture, affecting the elbow or forearm1%

Elbow and forearm — ligamentous and other soft tissue disruption

11   If the insured sustains a permanent elbow or forearm ligamentous or other soft tissue disruption, the percentage in column 2 corresponds to the insured's ligamentous or other soft tissue disruption described opposite in column 1.

ItemColumn 1
Ligamentous or other soft tissue disruption
Column 2
Percentage
1Ulnar and radial collateral injuriesgrade 1 sprain0%
grade 2 sprain1%
grade 3 sprain2%

Elbow and forearm — range of motion loss

12   If the insured sustains a permanent range of motion loss of an elbow, the percentage in column 2 corresponds to the insured's range of motion loss described opposite in column 1.

ItemColumn 1
Range of motion loss of elbow
Column 2
Percentage
1Flexion-extensionno movement14%
combined range of motion of 1° to 40° 12%
combined range of motion of 41° to 80° 7%
combined range of motion of 81° to 120° 4%
combined range of motion of 121° to 135° 1%
combined range of motion of more than 135° 0%
2Pronation-supinationno movement9%
combined range of motion of 1° to 50° 4%
combined range of motion of 51° to 100° 3%
combined range of motion of 101° to 140° 2%
combined range of motion of 141° to 150° 1%
combined range of motion of more than 150° 0%

Wrist and hand — amputation

13   (1) If the insured sustains one amputation in relation to a wrist or hand, the percentage in column 2 corresponds to the insured's amputation described opposite in column 1.

(2) If the insured sustains more than one amputation in relation to a wrist or hand, the percentage in respect of this section must be determined using the following formula:

C = A + (B(1 − A))
where
A = (a) for the first application of the formula, the highest percentage of the percentages in column 2 that corresponds to the description of the insured's amputations;
  (b) for any subsequent application of the formula, the value solved for as C in the previous calculation;
B = (a) for the first application of the formula, the second highest percentage of the percentages in column 2 that corresponds to the description of the insured's amputations;
  (b) for any subsequent application of the formula, the next highest percentage of the percentages in column 2 that corresponds to the description of the insured's amputations;
C = (a) the value to be used as A in each subsequent application of the formula;
  (b) if the B variable is the lowest percentage of the percentages in column 2 that corresponds to the description of the insured's amputations, the total percentage for this section.

(4) If any of the following result in a fraction of a percentage, the fraction must be rounded to the nearest whole percentage and if a percentage ends in .5 it must be rounded up to the nearest whole percentage:

(a) the percentage corresponding to an amputation sustained by the insured;

(b) the percentage determined in accordance with subsection (3) as the C variable in each subsequent application of the formula;

(c) the total percentage for this section calculated and determined in accordance with paragraph (b) of variable C.

ItemColumn 1
Wrist or hand amputation
Column 2
Percentage
1Wrist disarticulation, including the distal third of the forearm45%
2Transmetacarpal or metacarpophalangeal disarticulationfirst metacarpal22%
second or third metacarpal 11% per metacarpal
fourth or fifth metacarpal 5.5% per metacarpal
3Trans-digital (proximal phalanx) or proximal interphalangeal disarticulation thumb11%
index or middle fingers 8% per finger
ring or small fingers 4% per finger
4Trans-digital (middle or distal phalanx) or distal interphalangeal disarticulation thumb11%
index or middle fingers 5% per finger
ring or small fingers 3% per finger

Wrist and hand — fracture

14   If the insured sustains a wrist or hand fracture, the percentage in column 2 corresponds to the insured's fracture described opposite in column 1.

ItemColumn 1
Wrist or hand fracture
Column 2
Percentage
1Scaphoid fracture0%
2Scaphoid fracture with avascular necrosis2%
3Scaphoid fracture with non-union or pseudarthrosis2%
4Colles fracture with anatomic reduction0%
5Colles fracture with more than 15° of angulation of radius2%
6Avascular necrosis of lunate2%
7Fracture of a carpal, metacarpal or phalanx with abnormal healing1%

Wrist and hand — non-bony disruption

15   If the insured sustains a permanent wrist or hand non-bony disruption, the percentage in column 2 corresponds to the insured's non-bony disruption described opposite in column 1.

ItemColumn 1
Wrist or hand non-bony disruption
Column 2
Percentage
1Complete non-bony disruption or avulsion fracture, affecting the wrist or hand2%
2Partial non-bony disruption or avulsion fracture, affecting the wrist or hand1%

Wrist and hand — ligamentous and other soft tissue disruption

16   (1) If the insured sustains a permanent wrist or hand ligamentous or other soft tissue disruption, the percentage in column 2 corresponds to the insured's ligamentous or other soft tissue disruption described opposite in column 1.

(2) For the purposes of item 1, the carpal instability must be determined by radiological appearance, including carpal height, carpal translation and degree of joint arthrosis.

ItemColumn 1
Ligamentous or other soft tissue disruption
Column 2
Percentage
1Subject to subsection (2), carpal instabilitymild5%
moderate10%
severe14%
2Triangular fibrocartilage complex tears2%

Wrist — range of motion loss

17   If the insured sustains permanent range of motion loss of a wrist, the percentage in column 2 corresponds to the insured's range of motion loss described in column 1.

ItemColumn 1
Range of motion loss of wrist
Column 2
Percentage
1Flexion-extensionno movement8%
combined range of motion of 1° to 30° 4%
combined range of motion of 31° to 60° 3%
combined range of motion of 61° to 90° 2%
combined range of motion of 91° to 100° 1%
combined range of motion of more than 100° 0%
2Radial deviation or ulnar deviationno movement6%
combined range of motion of 1° to 25° 2%
combined range of motion of 26° to 40° 1%
combined range of motion of more than 40° 0%

Hand — range of motion loss

18   If the insured sustains permanent range of motion loss of a hand, the percentage in column 2 corresponds to the insured's range of motion loss described opposite in column 1.

ItemColumn 1
Range of motion loss of hand
Column 2
Percentage
1Thumb interphalangeal flexion-extensionankylosis in faulty position4%
ankylosis in functional position2%
combined total range of motion of 1° to 40° 1%
combined total range of motion of 41° to 70° 0.5%
combined total range of motion of more than 70° 0%
2Thumb metacarpophalangeal flexion-extensionno movement2%
combined total range of motion of 1° to 30° 1%
combined total range of motion of 31° to 50° 0.5%
combined total range of motion of more than 50° 0%
3Thumb adduction8 cm distance from flexor crease of the interphalangeal joint of the thumb to distal palmar crease overlying the metacarpophalangeal joint of the small finger4%
6 cm distance from flexor crease of the interphalangeal joint of the thumb to distal palmar crease overlying the metacarpophalangeal joint of the small finger2%
4 cm distance from flexor crease of the interphalangeal joint of the thumb to distal palmar crease overlying the metacarpophalangeal joint of the small finger1%
2 cm distance from flexor crease of the interphalangeal joint of the thumb to distal palmar crease overlying the metacarpophalangeal joint of the small finger0.5%
less than 2 cm distance from flexor crease of the interphalangeal joint of the thumb to distal palmar crease overlying the metacarpophalangeal joint of the small finger0%
4Thumb radial abductionno movement2%
combined total range of motion of 1° to 25° 1%
combined total range of motion of 26° to 40° 0.5%
combined total range of motion of more than 40° 0%
5Thumb opposition8 cm distance from flexor crease of the interphalangeal joint of the thumb to the distal palmar crease overlying the metacarpophalangeal joint of the middle finger 0%
6 cm distance from flexor crease of the interphalangeal joint of the thumb to the distal palmar crease overlying the metacarpophalangeal joint of the middle finger0.5%
4 cm distance from flexor crease of the interphalangeal joint of the thumb to the distal palmar crease overlying the metacarpophalangeal joint of the middle finger1%
2 cm distance from flexor crease of the interphalangeal joint of the thumb to the distal palmar crease overlying the metacarpophalangeal joint of the middle finger2%
less than 2 cm distance from flexor crease of the interphalangeal joint of the thumb to the distal palmar crease overlying the metacarpophalangeal joint of the middle finger4%
6Finger distal interphalangeal flexion-extensionno movement1%
combined range of motion of 1° to 35° 0.5%
combined range of motion of 36° to 70° 0%
7Finger proximal interphalangeal flexion-extensionno movement1%
combined range of motion of 1° to 65° 0.5%
combined range of motion of 66° to 130° 0%
8Finger metacarpophalangeal flexion-extensionno movement1%
combined range of motion of 1° to 55° 0.5%
combined range of motion of 56° to 110° 0%

Division 2 — Lower Limb

Pelvis — amputation

19   If the insured sustains a pelvic amputation, the percentage in column 2 corresponds to the insured's amputation described opposite in column 1.

ItemColumn 1
Pelvic amputation
Column 2
Percentage
1Hemipelvectomy50%

Pelvis — fracture and loss of motion

20   If the insured sustains pelvic fracture or permanent loss of motion, the percentage in column 2 corresponds to the insured's fracture or loss of motion described opposite in column 1.

ItemColumn 1
Pelvic fracture
Column 2
Percentage
1Undisplaced, non-articular, healed fracture with no other complications0%
2Range of motion loss of the sacroiliac joint0%
3Fracture involving the sacroiliac joint2%
4Pelvic fracture with non-specified abnormal healing1%

Hip and thigh — amputation

21   If the insured sustains a hip or thigh amputation, the percentage in column 2 corresponds to the insured's amputation described opposite in column 1.

ItemColumn 1
Hip or thigh amputation
Column 2
Percentage
1Hip disarticulation, including proximal 1/3 of the femur45%
2Above-knee amputationproximal45%
mid-thigh40%
distal35%

Hip and thigh — fracture

22   If the insured sustains a hip or thigh fracture, the percentage in column 2 corresponds to the insured's fracture described opposite in column 1.

Item Column 1
Hip or thigh fracture
Column 2
Percentage
1Injuries to the acetabulum or the head of the femur requiring a prosthetic joint replacement, including any shortening of the lower limb15%
2Intra-articular fracture of the femur2%
3Fracture complication with femoral shaft fractures with angulationmore than 20° 4%
10° to 20° 2%
4Fracture complication with femoral shaft fractures and malrotationmore than 20° 4%
10° to 20° 2%
5Femoral fractures with non-specified abnormal healing1%

Hip and thigh — non-bony disruption

23   If the insured sustains a permanent hip or thigh non-bony disruption, the percentage in column 2 corresponds to the insured's non-bony disruption described opposite in column 1.

ItemColumn 1
Hip or thigh non-bony disruption
Column 2
Percentage
1Complete non-bony disruption or avulsion fracture, affecting the hip or thigh2%
2Partial non-bony disruption or avulsion fracture, affecting the hip or thigh1%

Hip — range of motion loss

24   If the insured sustains permanent range of motion loss of a hip, the percentage in column 2 corresponds to the insured's range of motion loss described opposite in column 1.

ItemColumn 1
Range of motion loss of hip
Column 2
Percentage
1Hip joint ankylosisin a position prohibiting gait25%
in a position allowing gait20%
2Range of motion restriction in respect of flexion-extension combined range of motion of 0° to 30° 10%
combined range of motion of 31° to 60° 7%
combined range of motion of 61° to 90° 3%
combined range of motion of 91° to 120° 1%
combined range of motion of more than 120° 0%
3Range of motion restriction in respect of internal-external rotation combined range of motion of 0° to 30° 5%
combined range of motion of 31° to 60° 3%
combined range of motion of more than 60° 0%
4Range of motion restriction in respect of abduction-adduction combined range of motion of 0° to 15° 5%
combined range of motion of 16° to 45° 3%
combined range of motion of more than 45° 0%

Thigh — muscular atrophy

25   If the insured sustains permanent thigh muscular atrophy, the percentage in column 2 corresponds to the insured's muscular atrophy described opposite in column 1.

ItemColumn 1
Thigh muscular atrophy
Column 2
Percentage
1Thigh muscular atrophy of 2 cm or more, circumference as measured 15 cm above the superior pole of the patella, including any resulting weakness, resulting from non-bony disruption, underlying fracture or objective knee condition2%

Knee and leg — amputation

26   If the insured sustains a knee or leg amputation, the percentage in column 2 corresponds to the insured's amputation described opposite in column 1.

ItemColumn 1
Knee or leg amputation
Column 2
Percentage
1Knee disarticulation, including proximal below-knee amputationnot suitable for a patellar tendon bearing prosthesis32%
suitable for a patellar tendon bearing prosthesis28%

Knee and leg — fracture and fracture complication

27   (1) If the insured sustains a knee or leg fracture or fracture complication, the percentage in column 2 corresponds to the insured's fracture or fracture complication described opposite in column 1.

(2) For certainty,

(a) the impairment described in item 1 includes any weakness, and

(b) the impairment described in item 2 includes any limb shortening or weakness.

Item Column 1
Knee or leg fracture or fracture complication
Column 2
Percentage
1Tibial, fibular or patellar fractures with non-specified abnormal healing1%
2Fracture complication in relation to knee or leg fracturepatellar fractures resulting in its surgical removal 5%
fracture or dislocation of the patella resulting in quadriceps atrophy2%
tibial or fibular fractures resulting in single or multi-planar angulation of more than 15° 5%
tibial or fibular fractures resulting in single or multi-planar angulation of 10° to 15° 2.5%
tibial or fibular fractures resulting in malrotation of more than 20° 3%
tibial or fibular fractures resulting in malrotation of 10° to 20° 2%
knee, thigh or leg injuries requiring a knee arthroplasty8%
intra-articular fracture of the knee2%

Knee and leg — non-bony disruption

28   If the insured sustains a permanent knee or leg non-bony disruption, the percentage in column 2 corresponds to the insured's disruption described opposite in column 1.

ItemColumn 1
Knee or leg non-bony disruption
Column 2
Percentage
1Complete non-bony disruption or avulsion fracture, affecting the knee or leg2%
2Partial non-bony disruption or avulsion fracture, affecting the knee or leg1%

Knee and leg — ligamentous and other soft tissue disruption

29   (1) If the insured sustains a permanent knee or leg ligamentous or other soft tissue disruption, the percentage in column 2 corresponds to the insured's ligamentous or other soft tissue disruption described opposite in column 1.

(2) In respect of item 5, a chondral injury must be confirmed by magnetic resonance imaging or arthroscopy.

ItemColumn 1
Knee or leg ligamentous or other soft tissue disruption
Column 2
Percentage
1Cruciate or collateral ligament injuries associated withoccasional instability not interfering with occupational or recreational function2%
regular episodes of instability that interferes with occupational or recreational function7%
frequent episodes of instability that limits most occupational and recreational function10%
frequent episodes of instability that prohibit all occupational and recreational function15%
2Medial or lateral meniscal sprain or stretch with no tears0%
3Medial or lateral meniscal tears 2%
4Post-traumatic patellofemoral pain syndrome with objective signs1%
5Subject to subsection (2), chondral injury 2%

Knee — range of motion loss

30   (1) In this section, "neutral position" means a knee straight position.

(2) If the insured sustains permanent range of motion loss of a knee, the percentage in column 2 corresponds to the insured's range of motion loss described opposite in column 1.

Item Column 1
Range of motion loss of knee
Column 2
Percentage
1Knee ankylosis (a) in a faulty position, including recurvatum, varus, valgus and malrotation, and
(b) with or without any of the following:

(i) damage to the patella;
(ii) shortening of the lower limb;
(iii) muscular atrophy or weakness

20%
in a functional position, with or without any of the following:
(a) damage to the patella;
(b) shortening by 3 cm or less;
(c) altered alignment, including recurvatum, varus, valgus and rotation;
(d) muscular atrophy or weakness
15%
2Range of motion restriction in respect of flexion 5° to 60° of active range of motion14%
61° to 80° of active range of motion8%
81° to 110° of active range of motion2%
more than 110° of active range of motion0%
3Flexion contracture less than 5° away from neutral position0%
5° to 9° away from neutral position4%
10° to 20° away from neutral position8%
more than 20° away from neutral position14%

Lower leg — muscular atrophy

31   If the insured sustains permanent lower leg muscular atrophy, the percentage in column 2 corresponds to the insured's atrophy described opposite in column 1.

Item Column 1
Lower leg muscular atrophy
Column 2
Percentage
1Leg muscular atrophy of 1.5 cm or more, circumference as measured 15 cm below the inferior pole of the patella, including any weakness, resulting from non-bony disruption, underlying fracture or objective knee or ankle condition, not including ankylosis2%

Ankle and foot — amputation

32   If the insured sustains an ankle or foot amputation, the percentage in column 2 corresponds to the insured's amputation described opposite in column 1.

Item Column 1
Ankle or foot amputation
Column 2
Percentage
1Amputation at the ankle, also known as a Symes amputation25%
2Midtarsal amputation, also known as a Chopart amputation18%
3Tarsometatarsal amputation, also known as a Lisfranc amputation18%
4Transmetatarsal amputation16%
5Amputation of all 5 toes at the metatarsophalangeal joint 9%
6Amputation with loss of the distal end of the first metatarsal5%
7Bone amputation of the big toe at the metatarsophalangeal joint3%
8Amputation of the distal end of the fifth metatarsal2%
9Amputation of the big toe at the interphalangeal joint 2%
10Total or partial amputation of the second, third, fourth and fifth toes1% per toe

Ankle and foot — fracture and fracture complication

33   If the insured sustains an ankle or toe fracture or fracture complication, the percentage in column 2 corresponds to the insured's fracture or fracture complication described opposite in column 1.

ItemColumn 1
Ankle or foot fracture or fracture complication
Column 2
Percentage
1Fracture complication in relation to fracture of the tibia or fibulawith angulation of more than 15° 5%
with angulation of 5° to 15° 2.5%
with shortening of more than 4 cm5%
with shortening of more than 2 cm to 4 cm3%
with shortening of 1 cm to 2 cm1.5%
2Avascular necrosis of the talus5%
3Avascular necrosis of the navicular3%
4Chronic osteomyelitis of any lower limb bone with active drainage3%
5Post-traumatic tarsal or metatarsal deformity necessitating the use of a custom-fitted shoe or orthosis to accommodate for the condition0.5%
6Fractures of the tibia, fibula, tarsal or metatarsal bones with non-specified abnormal healing1%

Ankle and foot — non-bony disruption

34   If the insured sustains a permanent ankle or foot non-bony disruption, the percentage in column 2 corresponds to the insured's non-bony disruption described opposite in column 1.

Item Column 1
Ankle or foot non-bony disruption
Column 2
Percentage
1Complete non-bony disruption or avulsion fracture, affecting the foot or ankle2%
2Partial non-bony disruption or avulsion fracture, affecting the foot or ankle1%
3Achilles tendon rupture3%

Ankle and foot — ligamentous disruption

35   If the insured sustains permanent ankle or foot ligamentous disruption, the percentage in column 2 corresponds to the insured's ligamentous disruption described opposite in column 1.

Item Column 1
Ankle or foot ligamentous disruption
Column 2
Percentage
1Ligament injury resulting in chronic ankle instability1.5%

Ankle and foot — range of motion loss

36   If the insured sustains permanent range of motion loss of an ankle or foot, the percentage in column 2 corresponds to the insured's range of motion loss described opposite in column 1.

Item Column 1
Range of motion loss of ankle or foot
Column 2
Percentage
1Ankylosis of the ankle or footsubtalar, midtarsal, tibiotalar, also known as a pan-arthrodesis procedure12%
tibiotalar up to 10° of plantar flexion, with loss of inversion and eversion8%
subtalar and midtarsal, also known as a triple arthrodesis procedure4%
subtalar3%
tarsal-metatarsal2.5%
metatarsophalangeal of the big toe 1.5%
metatarsophalangeal of any toe other than the big toe0.5% per toe
interphalangeal of the big toe1%
interphalangeal of any other toe other than the big toe0.5% per toe
2Range of motion restriction in relation to tibiotalar plantar flexion1° to 10° 6%
11° to 20° 3%
more than 20° 0%
3Range of motion restriction in relation to tibiotalar dorsiflexion0 to 10° 3%
more than 10° 0%
4Range of motion restriction in relation to subtalar2%
5Range of motion restriction in relation to midtarsal1%
6Range of motion restriction in relation to toebig toe0%
any other toe0%

Division 3 — Spine

Interpretation for Division

37   (1) In this Division, "bony fusion" includes using an internal fixation device or bone graft material.

(2) For the purposes of items 3, 8 to 10 and 12 in section 38, items 1, 2, 4 and 5 of section 39 [thoracic spine], items 1, 2, 4 and 5 of section 40 [lumbar spine] and items 2 and 4 of section 41 [other spinal impairment], the following is the minimum slippage:

(a) in relation to the cervical vertebrae C3 to C7, 3.5 mm;

(b) in relation to the thoracic vertebra T1 to the lumbar vertebra L4, 5 mm;

(c) in relation to the lumbar vertebra L5 to the sacral vertebra S1, 5 mm.

Cervical spine

38   (1) If the insured sustains a permanent cervical spine impairment, the percentage in column 2 corresponds to the insured's cervical spine impairment described opposite in column 1.

(2) For the purpose of item 5, impairment of the active range of motion of the atlanto-axial joint must be documented by the inclinometer method.

(3) For the purpose of item 6, instability must be documented by evidence of excessive motion on flexion-extension views.

(4) For the purpose of item 8, instability must be documented by radiographic instability on flexion-extension views.

Item Column 1
Cervical spine impairment
Column 2
Percentage
1Fusion or bony fusion of the atlanto-occipital joint, also known as C0 and C1, including post-traumatic bony alterations 6%
2Fusion or bony fusion of the atlanto-axial joint, also known as C1 and C2, including post-traumatic bony alterations12%
3Non-union of the odontoid process following a fracture(a) with evidence of radiographic instability, and
(b) with minimum slippage in accordance with section 37 (2)
6%
(a) without evidence of radiographic instability, and
(b) with minimum slippage in accordance with section 37 (2)
3%
4Uncomplicated odontoid fracture without instability0.5%
5Subject to subsection (2), impaired active range of motion of the atlanto-axial joint, also known as C1 and C2, following a fracture or ligamentous injury2.5%
6Subject to subsection (3), instability of the atlanto-axial joint, also known as C1 and C2, following a fracture or ligamentous injuryforward slippage of less than 5mm 2.5%
forward slippage of 5mm or more5%
7Fusion or bony fusion of any of C3 to C7 vertebrae including, if applicable, any post-traumatic bony alterations as a result of a laminectomy, vertebrectomy or discectomy4% per inter-space
8Subject to subsection (4), excessive active range of motion of C3 to C7 following a ligamentous injury with a minimum measurement in accordance with section 37 (2)2% per inter-space
9Vertebral body non-compression fracture with a minimum measurement in accordance with section 37 (2)with radiographic instability6%
without radiographic instability3%
10Vertebral body compression fracture with radiographic instability on flexion-extension views with a minimum measurement in accordance with section 37 (2)loss of vertebral height, more than 50%6%
loss of vertebral height, from 25% to 50%4%
loss of vertebral height, less than 25% 2%
11Bone alteration following a compartmented fracture of a vertebral body0.5%
12Vertebral body compression fracture without radiographic instability on flexion-extension views, including any range of motion restriction and with a minimum measurement in accordance with section 37 (2)loss of vertebral height, more than 50%3%
loss of vertebral height, from 25% to 50%2%
loss of vertebral height, less than 25%1%

Thoracic spine

39   If the insured sustains a permanent thoracic spine impairment, the percentage in column 2 corresponds to the insured's thoracic spine impairment described opposite in column 1.

ItemColumn 1
Thoracic spine impairment
Column 2
Percentage
1Vertebral body compression fracture with radiographic instability on flexion-extension views with a minimum measurement in accordance with section 37 (2)loss of vertebral height, more than 50%6%
loss of vertebral height, from 25% to 50%4%
loss of vertebral height, less than 25%2%
2Vertebral body compression fracture without radiographic instability on flexion-extension views with a minimum measurement in accordance with section 37 (2), including any range of motion restrictionloss of vertebral height, more than 50%4%
loss of vertebral height, from 25% to 50%2%
loss of vertebral height, less than 25%1%
3Fusion or bony fusion of 2 or more adjacent thoracic vertebrae including any post-traumatic bony alterations, if applicable, as a result of a laminectomy, vertebrectomy or discectomy4% per inter-space
4Vertebral body non-compression fracture with a minimum measurement in accordance with section 37 (2)with radiographic instability6%
without radiographic instability3%
5Excessive active range of motion following a ligamentous injury as documented by radiographic instability on flexion-extension views and with a minimum measurement in accordance with section 37 (2)2%
6Excessive active range of motion following a costovertebral fracture or dislocation, including any range of motion restriction or radiographic instability0.5% per spinal segment

Lumbar spine

40   If the insured sustains a permanent lumbar spine impairment, the percentage in column 2 corresponds to the insured's lumbar spine impairment described opposite in column 1.

ItemColumn 1
Lumbar spine impairment
Column 2
Percentage
1Vertebral body compression fracture with radiographic instability with a minimum measurement in accordance with section 37 (2)loss of vertebral height, more than 50%6%
loss of vertebral height, from 25% to 50%4%
loss of vertebral height, less than 25%2%
2Vertebral body compression fracture without radiographic instability on flexion-extension views with a minimum measurement in accordance with section 37 (2), including any range of motion restrictionloss of vertebral height, more than 50%3%
loss of vertebral height, from 25% to 50%2%
loss of vertebral height, less than 25%1%
3Fusion or bony fusion of 2 or more adjacent lumbar vertebrae including, if applicable, any post-traumatic bony alterations as a result of a laminectomy, vertebrectomy or discectomy4% per inter-space
4Vertebral body non-compression fracture with a minimum measurement in accordance with section 37 (2)with radiographic instability6%
without radiographic instability3%
5Excessive active range of motion following a ligamentous injury, as documented by radiographic instability on flexion-extension views with a minimum measurement in accordance with section 37 (2)2%

Other spinal impairment

41   If the insured sustains a permanent spinal impairment, the percentage in column 2 corresponds to the insured's impairment described opposite in column 1.

Item Column 1
Spinal impairment
Column 2
Percentage
1(a) Post-traumatic alteration of an intervertebral disc, including

(i) disc herniation,
(ii) internal disc disruption,
(iii) disc space infection, or
(iv) discectomy, and


(b) including any range of motion restriction or radiographic instability without associated myelopathy or radiculopathy
3% per spinal segment
2Complete laminectomy including removal of both laminae and spinous processes with a minimum measurement in accordance with section 37 (2), including any radiographic evidence of range of motion restriction or instability 2% per spinal segment
3Partial laminectomy, laminotomy or foraminotomy, with preservation of one lamina1% per spinal segment
4Post-traumatic alteration of a spinous process, transverse process, lamina or zygapophyseal joint following a fracture, spondylolysis or pseudarthrosis with a minimum measurement in accordance with section 37 (2), including any radiographically documented range of motion restriction or instability0.5% per spinal segment
5Post-traumatic alteration of the coccyx with or without coccygectomy0.5%

Part 2 — Central and Peripheral Nervous System

Definitions for Part

42   In this Part:

"authorized health care provider" means authorized health care provider as defined in section 1 (1) of the Enhanced Accident Benefits Regulation;

"autonomic dysreflexia" means an alteration of autonomic reflexes associated with quadriplegia or paraplegia above the T6 level that can result in sudden and sustained elevation of blood pressure;

"paraplegia" means a neurological injury that

(a) affects the trunk and lower limbs, but does not affect the upper limbs and head, and

(b) manifests with alterations in motor power and control and sensory loss below the level of injury;

"quadriplegia" means a neurological injury that

(a) affects upper and lower limbs, and

(b) manifests with alterations in motor power and control and sensory loss below the level of injury.

Division 1 — Skull, Brain and Carotid Vessels

Alteration of brain tissue — cerebral concussion and contusion

43   (1) If the insured sustains a cerebral concussion or contusion, the percentage in column 2 corresponds to the insured's cerebral concussion or contusion described opposite in column 1.

(2) The signs and symptoms of a cerebral concussion or contusion described in column 1 must be

(a) observed at the time of the accident or immediately following the accident, and

(b) documented by an authorized health care provider within 48 hours of the accident, unless the insured has a reasonable excuse not to obtain medical attention within 48 hours of the accident.

(3) A cerebral concussion or contusion must be diagnosed by an authorized health care provider.

ItemColumn 1
Cerebral concussion or contusion
Column 2
Percentage
1Subject to subsections (2) and (3), a minor cerebral concussion or contusion, with
(a) post-traumatic amnesia of less than 30 minutes, or
(b) a loss of consciousness of less than 5 minutes
0.5%
2Subject to subsections (2) and (3), a moderate cerebral concussion or contusion, with
(a) post-traumatic amnesia of 30 minutes or more but less than 24 hours, or
(b) a loss of consciousness of 5 minutes or more but less than 1 hour
2%
3Subject to subsections (2) and (3), a severe cerebral concussion or contusion, with
(a) post-traumatic amnesia of 24 hours or more, or
(b) a loss of consciousness of 1 hour or more
5%

Alteration of brain tissue — post-traumatic alteration of tissue

44   If the insured sustains a permanent post-traumatic alteration of brain tissue, the percentage in column 2 corresponds to the insured's alteration described opposite in column 1.

ItemColumn 1
Post-traumatic alteration of brain tissue
Column 2
Percentage
1Post-traumatic alteration of brain tissue with laceration or intracerebral hematoma2%
with epidural hematoma2%
with subdural hematoma2%
with subarachnoid hemorrhage5%
with leakage of cerebrospinal fluid via one of the paranasal sinuses or via the external auditory meatus, including any elevation, craniotomy, craniectomy and plasty5%
2Encephalomalacia or axonal injury, including shear5%

Alteration of skull — post-traumatic bony alteration

45   If the insured sustains a permanent post-traumatic bony alteration of the skull, the percentage in column 2 corresponds to the insured's alteration described opposite in column 1.

ItemColumn 1
Post-traumatic bony alteration
Column 2
Percentage
1Following a linear skull fracture of the base2%
2Following a linear skull fracture of the calvarium1%
3Following a craniotomy or a craniectomy2%
4Following trephination0.5% per incision

Alteration of skull — bony deformity following depressed fracture of calvarium

46   If the insured sustains a permanent bony deformity of the skull following a depressed fracture of the calvarium, the percentage in column 2 corresponds to the insured's deformity described opposite in column 1.

ItemColumn 1
Bony deformity impairment following a depressed fracture of the calvarium
Column 2
Percentage
1Without dural lacerationrequiring a craniectomy and cranioplasty, including elevation4%
requiring elevation2%
not requiring elevation1%

Alteration of cerebrovascular supply

47   If the insured sustains a permanent alteration of cerebrovascular supply, the percentage in column 2 corresponds to the insured's alteration described opposite in column 1.

ItemColumn 1
Alteration of cerebrovascular supply
Column 2
Percentage
1Internal carotid artery occlusion10%
2Internal carotid artery stenosismore than 70%8%
50% to 70%5%
less than 50%2%
3Hydrocephalusnot requiring a cerebrospinal fluid shunt5%
requiring a cerebrospinal fluid shunt15%

Functional alteration of brain — upper limb function

48   If the insured sustains a permanent functional alteration of the brain that affects upper limb function, the percentage in column 2 corresponds to the insured's alteration described opposite in column 1.

ItemColumn 1
Upper limb function alteration
Column 2
Percentage
1Inability to use both upper limbs for personal hygiene and self-care with evidence of both proximal and distal upper limb neurological dysfunction80%
2Inability to use one upper limb for personal hygiene and self-care with evidence of both proximal and distal upper limb neurological dysfunction60%
3Difficulty in using both upper limbs for personal hygiene and self-care with evidence of either proximal or distal upper limb neurological dysfunction bilaterally50%
4Difficulty in using one upper limb for personal hygiene and self-care with evidence of either proximal or distal upper limb neurological dysfunction40%
5Difficulty manipulating objects with impaired prehension confined to only one of the upper limbs, while still allowing independence in personal hygiene and self-care30%
6Difficulty manipulating objects with no impairment in prehension in either upper limb, while still allowing independence in personal hygiene and self-care20%
7Upper limb clumsiness, including tremor, dysmetria or dysdiadochokinesis, with impaired prehension confined to only one of the upper limbs, while still allowing independence in personal hygiene and self-care15%
8Upper limb clumsiness, including tremor, dysmetria or dysdiadochokinesis, with no impairment in prehension in either upper limb, while still allowing independence in personal hygiene and self-care10%

Functional alteration of brain — effect on station and gait

49   If the insured sustains a permanent functional alteration of the brain that affects station and gait, the percentage in column 2 corresponds to the effect on the insured's station or gait described opposite in column 1.

ItemColumn 1
Effect on station or gait
Column 2
Percentage
1Inability to stand or walk50%
2Ability to stand, but great difficulty walking or inability to walk40%
3Moderate difficulty walking on
(a) irregular surfaces,
(b) stairways, or
(c) uneven terrain
15%
4Slight difficulty walking5%

Functional alteration of brain — effect on bladder function

50   If the insured sustains a permanent functional alteration of the brain that affects bladder function, the percentage in column 2 corresponds to the effect on the insured's bladder function described opposite in column 1.

ItemColumn 1
Effect on bladder function
Column 2
Percentage
1Incontinence or urinary retentionwith complete loss of sphincter control20%
with partial loss of sphincter control10%
with dysfunction in the form of frequency or hesitancy3%
2Alteration of the bladder with enterocystoplasty10%
3Alteration of the bladder without enterocystoplasty3%

Functional alteration of brain — effect on anorectal function

51   If the insured sustains a permanent functional alteration of the brain that affects anorectal function, the percentage in column 2 corresponds to the effect on the insured's anorectal function described opposite in column 1.

ItemColumn 1
Effect on anorectal function
Column 2
Percentage
1Complete loss of control10%
2Limited control5%

Functional alteration of brain — sexual dysfunction

52   If the insured sustains a permanent functional alteration of the brain that results in sexual dysfunction, the percentage in column 2 corresponds to the insured's sexual dysfunction described opposite in column 1.

ItemColumn 1
Sexual dysfunction
Column 2
Percentage
1Class 1, means sexual functioning is possible with lack of awareness, excitement or lubrication or difficulty of erection or ejaculation5%
2Class 2, means reflex sexual functioning is possible but there is no awareness10%
3Class 3, means
(a) infertility,
(b) total absence of sexual functioning, or
(c) both infertility and a total absence of sexual functioning
15%

Functional alteration of brain — communication disorder

53   If the insured sustains a permanent functional alteration of the brain that results in a communication disorder, the percentage in column 2 corresponds to the insured's communication disorder described opposite in column 1.

ItemColumn 1
Communication disorder
Column 2
Percentage
1Communication disorder that results in the insured's complete inability to understand and use language95%
2Communication disorder that does not affect the insured's ability to understand linguistic symbols, but severely impairs the insured's ability to use sufficient or appropriate language70%
3Communication disorder that does not affect the insured's ability to understand linguistic symbols, but moderately impairs the insured's ability to use sufficient or appropriate language40%
4Communication disorder that results in minor communication difficulties10%

Functional alteration of brain — alteration of consciousness

54   (1) In this section "alteration of consciousness" includes adverse effects from medication.

(2) If the insured sustains a permanent functional alteration of the brain that relates to an alteration of consciousness, the percentage in column 2 corresponds to the insured's alteration of consciousness described opposite in column 1.

ItemColumn 1
Alteration of consciousness
Column 2
Percentage
1Alteration of consciousness, including stupor, coma or another disorder or disturbance that prevents the insured from performing the activities of daily living to the extent that the insured requires continuous supervision in an institutional or controlled setting100%
2Alteration of consciousness that impairs the insured's ability to perform the activities of daily living to the extent that the insured requires periodic supervision in an institutional or controlled setting for 50% or more of the time70%
3Alteration of consciousness that impairs the insured's ability to perform the activities of daily living to the extent that the insured requires periodic supervision in an institutional or controlled setting for less than 50% of the time40%
4Alteration of consciousness that impairs the insured's ability to perform the activities of daily living to the extent that the insured requires supervision but not in an institutional or controlled setting15%
5Alteration of consciousness that impairs the insured's ability to perform the activities of daily living but not to the extent that the insured requires supervision 10%

Functional alteration of brain — alteration of higher cognitive and integrative mental functions

55   (1) In this section, "higher cognitive or integrative mental functions" includes organic cerebral syndrome, dementia and neurologic deficiencies and adverse effects of medication.

(2) If the insured sustains a permanent functional alteration of the brain that results in an alteration of higher cognitive or integrative mental functions, the percentage in column 2 corresponds to the insured's alteration of higher cognitive or integrative mental functions described opposite in column 1.

ItemColumn 1
Higher cognitive or integrative mental function alteration
Column 2
Percentage
1Alteration of the higher cognitive or integrative mental functions that prevents the insured from performing the activities of daily living to the extent that the insured requires continuous supervision in an institutional or controlled setting100%
2Alteration of the higher cognitive or integrative mental functions that impairs the insured's ability to perform the activities of daily living to the extent that the insured requires periodic supervision in an institutional or controlled setting for 50% or more of the time80%
3Alteration of the higher cognitive or integrative mental functions that impairs the insured's ability to perform the activities of daily living to the extent that the insured requires periodic supervision in an institutional or controlled setting for less than 50% of the time45%
4Alteration of the higher cognitive or integrative mental functions that impairs the insured's ability to perform the activities of daily living to the extent that the insured requires supervision but not in an institutional or controlled setting15%
5Alteration of the higher cognitive or integrative mental functions that impairs the insured's ability to perform the activities of daily living but not to the extent that the insured requires supervision5%

Division 2 — Spinal Cord

Interpretation for Division

56   In this Division, "ASIA impairment scale" means the International Standards for Neurological Classification of Spinal Cord Injury, as amended from time to time, of the American Spinal Injury Association.

Quadriplegia or paraplegia — ASIA Grades A and B

57   (1) If the insured sustains quadriplegia or paraplegia that meets the criteria for classification as Grade A on the ASIA impairment scale, the percentage in column 2 corresponds to the insured's quadriplegia or paraplegia described opposite in column 1.

(2) If the insured sustains quadriplegia or paraplegia that meets the criteria for classification as Grade B on the ASIA impairment scale, the percentage in column 3 corresponds to the insured's quadriplegia or paraplegia described opposite in column 1.

ItemColumn 1
Quadriplegia or paraplegia
Column 2
Percentage ASIA
impairment scale
Grade A
Column 3
Percentage ASIA
impairment scale
Grade B
1Quadriplegia, including
(a) all anatomical and physiological deficits inherent in quadriplegia, and
(b) any vertebrospinal impairments and grafting, if applicable
C5 level or higher100%95%
C6 level95%90%
C7 level90%85%
C8 or T1 level85%80%
2Paraplegia, including
(a) all anatomical and physiological deficits inherent in paraplegia, and
(b) any vertebrospinal impairments and grafting, if applicable
T2 to T7 level80%75%
below T775%70%
conus and cauda equina lesions70%65%

Quadriplegia or paraplegia — ASIA Grades C and D — upper limb function

58   If the insured sustains quadriplegia or paraplegia that

(a) relates to upper limb function, and

(b) meets the criteria for classification as Grade C or D on the ASIA impairment scale,

the percentage in column 2 corresponds to the insured's upper limb function described opposite in column 1.

ItemColumn 1
Upper limb function, ASIA impairment scale Grade C or D
Column 2
Percentage
1Inability to use both upper limbs for personal hygiene and self-care with evidence of both proximal and distal upper limb neurological dysfunction80%
2Inability to use one upper limb for personal hygiene and self-care with evidence of both proximal and distal upper limb neurological dysfunction60%
3Difficulty in using both upper limbs for personal hygiene and self-care with evidence of either proximal or distal upper limb neurological dysfunction bilaterally50%
4Difficulty in using one upper limb for personal hygiene and self-care with evidence of either proximal or distal upper limb neurological dysfunction40%
5Difficulty manipulating objects with impaired prehension confined to only one of the upper limbs, while still allowing independence in personal hygiene and self-care30%
6Difficulty manipulating objects with no impairment in prehension in either upper limb, while still allowing independence in personal hygiene and self-care20%
7Upper limb clumsiness, including tremor, dysmetria or dysdiadochokinesis, with impaired prehension confined to only one of the upper limbs, while still allowing independence in personal hygiene and self-care15%
8Upper limb clumsiness, including tremor, dysmetria or dysdiadochokinesis, with no impairment in prehension in either upper limb, while still allowing independence in personal hygiene and self-care10%

Quadriplegia or paraplegia — ASIA Grades C and D — effect on station and gait

59   If the insured sustains quadriplegia or paraplegia that

(a) affects the insured's station or gait, and

(b) meets the criteria for classification as Grade C or D on the ASIA impairment scale,

the percentage in column 2 corresponds to the insured's station or gait described opposite in column 1.

ItemColumn 1
Effect on station or gait, ASIA impairment scale Grade C or D
Column 2
Percentage
1Inability to stand or walk50%
2Ability to stand, but great difficulty walking or inability to walk40%
3Moderate difficulty walking on
(a) irregular surfaces,
(b) stairways, or
(c) uneven terrain
15%
4Slight difficulty walking5%

Quadriplegia or paraplegia — ASIA Grades C and D — effect on bladder function

60   If the insured sustains quadriplegia or paraplegia that

(a) affects the insured's bladder function, and

(b) meets the criteria for classification as Grade C or D on the ASIA impairment scale,

the percentage in column 2 corresponds to the insured's bladder function described opposite in column 1.

ItemColumn 1
Effect on bladder function, ASIA impairment scale Grade C or D
Column 2
Percentage
1Incontinence or urinary retentioncomplete loss of sphincter control20%
partial loss of sphincter control10%
dysfunction in the form of frequency or hesitancy3%
2Alteration of the bladder with enterocystoplasty10%
3Alteration of the bladder without enterocystoplasty3%

Quadriplegia or paraplegia — ASIA Grades C and D — effect on anorectal function

61   If the insured sustains quadriplegia or paraplegia that

(a) affects the insured's anorectal function, and

(b) meets the criteria for classification as Grade C or D on the ASIA impairment scale,

the percentage in column 2 corresponds to the insured's anorectal function described opposite in column 1.

ItemColumn 1
Effect on anorectal function, ASIA impairment scale Grade C or D
Column 2
Percentage
1Complete loss of control10%
2Limited control5%

Quadriplegia or paraplegia — ASIA Grades C and D — sexual dysfunction

62   If the insured sustains quadriplegia or paraplegia that

(a) results in sexual dysfunction, and

(b) meets the criteria for classification as Grade C or D on the ASIA impairment scale,

the percentage in column 2 corresponds to the insured's sexual dysfunction described opposite in column 1.

ItemColumn 1
Sexual dysfunction, ASIA impairment scale Grade C or D
Column 2
Percentage
1Class 1, means sexual functioning is possible with lack of awareness, excitement or lubrication or difficulty of erection or ejaculation5%
2Class 2, means reflex sexual functioning is possible but there is no awareness10%
3Class 3, means
(a) infertility,
(b) total absence of sexual functioning, or
(c) both infertility and a total absence of sexual functioning
15%

Quadriplegia or paraplegia — ASIA Grades C and D — autonomic dysreflexia

63   If the insured sustains quadriplegia or paraplegia that

(a) results in autonomic dysreflexia, and

(b) meets the criteria for classification as Grade C or D on the ASIA impairment scale,

the percentage in column 2 corresponds to the insured's autonomic dysreflexia described opposite in column 1.

ItemColumn 1
Autonomic dysreflexia
Column 2
Percentage
1Controlled by medication5%
2Frequent occurrences with medication15%

Division 3 — Cranial Nerves

Olfactory nerves — loss and distortion of smell

64   If the insured sustains a permanent loss or distortion of smell, the percentage in column 2 corresponds to the insured's loss or distortion of smell described opposite in column 1.

ItemColumn 1
Loss or distortion of smell
Column 2
Percentage
1Total loss4%
2Distortion of smellunpleasant smell, no interference with the activities of daily living0%
unpleasant smell, occasional interference with the activities of daily living2%
unpleasant smell, consistent interference with the activities of daily living4%
3Reduced smell or partial loss of smell0%

Oculomotor nerve and eye parasympathetic input

65   If the insured sustains permanent impairment in relation to the oculomotor nerve or the eye parasympathetic input, the percentage in column 2 corresponds to the insured's oculomotor nerve or eye parasympathetic input impairment described opposite in column 1.

ItemColumn 1
Oculomotor nerves or eye parasympathetic input impairment
Column 2
Percentage
1Ptosisdroop but pupil not covered0.5% per eye
lid partially covers pupil, interfering with vision2% per eye
complete ptosis4% per eye
complete and bilateral25%
2Pupil dilation, if symptomatic1% per eye
3Diplopiain gaze off midline that is correctable with prisms2%
in gaze off midline that is not correctable with prisms6%
in primary gaze that is correctable with prisms4%
in primary gaze that is not correctable with prisms8%

Trigeminal nerves

66   If the insured sustains a permanent trigeminal nerve impairment, the percentage in column 2 corresponds to the insured's trigeminal nerve impairment described opposite in column 1.

ItemColumn 1
Trigeminal nerve impairment
Column 2
Percentage
1Motor impairmentdetectable weakness but no functional impairment1% per side
weakness with resulting difficulty chewing2% per side
weakness with resulting difficulty swallowing5% per side
weakness with resulting difficulty speaking5% per side
weakness with malalignment resulting in pain5% per side
dystonic or other involuntary movement of jaw that is mild or does not need treatment2% per side
dystonic or other involuntary movement of jaw that is moderate but controllable with treatment5% per side
dystonic or other involuntary movement of jaw that is severe and uncontrollable and includes pain10% per side
2Sensory impairment in relation to the ophthalmic nerveclass 1, as evidenced by no impairment0% per side
class 2, as evidenced by hypoesthesia2% per side
class 3, as evidenced by complete loss5% per side
3Sensory impairment in relation to the maxillary nerveclass 1, as evidenced by no impairment0% per side
class 2, as evidenced by hypoesthesia1% per side
class 3, as evidenced by complete loss3% per side
4Sensory impairment in relation to the mandibular nerveclass 1, as evidenced by no impairment0% per side
class 2, as evidenced by hypoesthesia1% per side
class 3, as evidenced by complete loss3% per side
5Nerve impairment with associated paincontrolled by medication2% per side
partially controlled by medication, or not functionally limiting3% per side
uncontrolled by medication and functionally limiting10% per side

Facial nerve

67   (1) If the insured sustains a permanent facial nerve impairment, the percentage in column 2 corresponds to the insured's facial nerve impairment described opposite in column 1.

(2) In the case of facial weakness under item 2,

(a) if the facial weakness results in difficulty eating, 2% is added to the percentage in column 2, and

(b) if the facial weakness results in difficulty speaking, 2% is added to the percentage in column 2.

(3) In the case of loss of taste under item 8,

(a) if the loss of taste includes a distortion of taste that is unpleasant but not distracting, 1% is added to the percentage in the corresponding column 2,

(b) if the loss of taste includes a distortion of taste that is unpleasant and occasionally interferes with the activities of daily living, 2% is added to the percentage in the corresponding column 2, and

(c) if the loss of taste includes a distortion of taste that is unpleasant and constantly interferes with the activities of daily living, 4% is added to the percentage in the corresponding column 2.

Item Column 1
Facial nerve impairment
Column 2
Percentage
1Stapedius weaknessstapedius reflex lost with sonophobia or hyperacusis2%
2Facial weaknessclass 1, as evidenced by no weakness0%
class 2, as evidenced by weakness but full eye closuresubject to subsection (2), 2%
class 3, as evidenced by weakness with incomplete eye closuresubject to subsection (2), 4%
class 4, as evidenced by near complete paralysissubject to subsection (2), 6%
class 5, as evidenced by complete paralysissubject to subsection (2), 8%
3Facial synkinesia1%
4Hemifacial spasms3%
5Loss of sensation in ear canal0%
6Lacrimationdry eyes, no drops needed for
(a) one eye, or
(b) both eyes
0.5%
dry eyes, needing drops for
(a) one eye, or
(b) both eyes
2%
excessive tearing in
(a) one eye, or
(b) both eyes
1%
7Salivation dysfunction leading to dry mouth2%
8Tasteincomplete losssubject to subsection (3), 0.5%
total loss meaning a bilateral lesionsubject to subsection (3), 2%

Auditory nerve tinnitus

68   (1) If the insured sustains a permanent auditory nerve impairment resulting in tinnitus, the percentage in column 2 corresponds to the insured's tinnitus described opposite in column 1.

(2) For certainty, the percentage in column 2 applies if the tinnitus is unilateral or bilateral.

ItemColumn 1
Tinnitus
Column 2
Percentage
1Class 1, means tinnitus that
(a) is intermittent and noticeable only in a quiet environment, and
(b) does not disturb sleep
0.5%
2Class 2, means tinnitus that
(a) is constantly present and bothersome in a quiet environment,
(b) disturbs concentration, and
(c) disturbs sleep
2%
3Class 3, means tinnitus that
(a) is constantly present and bothersome in most environments,
(b) disturbs concentration,
(c) disturbs sleep, and
(d) disturbs one or more of the other activities of daily living
5%

[am. B.C. Reg. 117/2021, App. 7, s. 1.]

Glossopharyngeal, vagal and hypoglossal impairment

69   If the insured sustains a permanent glossopharyngeal, vagal or hypoglossal impairment, the percentage in column 2 corresponds to the insured's impairment described opposite in column 1.

ItemColumn 1
Glossopharyngeal, vagal or hypoglossal impairment
Column 2
Percentage
1Neuralgiacontrolled by medication2%
partially controlled by medication or not functionally limiting3%
uncontrolled by medication and functionally limiting10%
2Spasmodic dysphoniacontrolled by medication2%
partially controlled by medication or not functionally limiting3%
uncontrolled by medication and functionally limiting10%

Spinal accessory impairment

70   If the insured sustains a permanent spinal accessory impairment, the percentage in column 2 corresponds to the insured's impairment described opposite in column 1.

ItemColumn 1
Spinal accessory impairment
Column 2
Percentage
1Partial wasted muscles with weakness2%
2Complete weakness4%
3Cervical dystonia, with neck and head deviationminimal, not functionally limiting, but socially embarrassing5%
moderate, such that the insured is unable to perform certain tasks10%
severe, such that it interferes with the activities of daily living15%

Division 4 — Peripheral Nervous System

Classification of motor impairment

71   The classification of a motor impairment in sections 72, 73 [motor impairment — peripheral roots — head and neck] and 74 [motor impairment — peripheral roots — upper limb] must be determined in accordance with the following grades:

(a) grade 5 impairment as evidenced by no loss of motor function and the absence of weakness;

(b) grade 4 impairment as evidenced by weakness against strong resistance, including any muscle atrophy;

(c) grade 3 impairment as evidenced by weakness against minor resistance, with full range of motion against gravity, including any muscular atrophy;

(d) grade 2 impairment as evidenced by weakness with full range of motion with gravity eliminated, including any muscular atrophy;

(e) grade 1 impairment as evidenced by weakness with less than full range of motion, even with gravity eliminated, including muscular atrophy;

(f) grade 0 as evidenced by complete paralysis, including muscular atrophy.

Motor impairment — nerve roots

72   If the insured sustains a permanent nerve root impairment, the percentage in column 2, 3, 4, 5, 6 or 7, determined in accordance with section 71, corresponds to the insured's impaired structure described opposite in column 1.

ItemColumn 1
Impaired structure
Column 2
Grade 5 — percentage
Column 3
Grade 4 — percentage
Column 4
Grade 3 — percentage
Column 5
Grade 2 — percentage
Column 6
Grade 1 — percentage
Column 7
Grade 0 — percentage
1Upper limb, C50%4.5%9%13.5%18%18%
2Upper limb, C60%5%10.5%16%21%21%
3Upper limb, C70%6%11.5%17%23%23%
4Upper limb, C80%7%14.5%22%29%29%
5Upper limb, T10%3.5%7%10.5%14%14%
6Lower limb, L20%2%4%6%8%8%
7Lower limb, L30%2%4%6%8%8%
8Lower limb, L40%3.5%7%10.5%14%14%
9Lower limb, L50%4%7.5%11%15%15%
10Lower limb, S10%2%4%6%8%8%

Motor impairment — peripheral roots — head and neck

73   If the insured sustains a permanent peripheral root motor impairment in relation to the head or neck, the percentage in column 2, 3, 4, 5, 6 or 7, determined in accordance with section 71 [classification of motor impairment], corresponds to the insured's impaired structure described opposite in column 1.

ItemColumn 1
Impaired structure
Column 2
Grade 5 — percentage
Column 3
Grade 4 — percentage
Column 4
Grade 3 — percentage
Column 5
Grade 2 — percentage
Column 6
Grade 1 — percentage
Column 7
Grade 0 — percentage
1Greater occipital0%0%0%0%0%0%
2Lesser occipital 0%0%0%0%0%0%
3Auricular branch of C2 and C30%0%0%0%0%0%

Motor impairment — peripheral roots — upper limb

74   If the insured sustains a peripheral root motor impairment in relation to an upper limb, the percentage in column 2, 3, 4, 5, 6 or 7, determined in accordance with section 71 [classification of motor impairment], corresponds to the insured's impaired structure described opposite in column 1.

Item Column 1
Impaired structure
Column 2
Grade 5 — percentage
Column 3
Grade 4 — percentage
Column 4
Grade 3 — percentage
Column 5
Grade 2 — percentage
Column 6
Grade 1 — percentage
Column 7
Grade 0 — percentage
1Axillary0%5%10.5%16%21%21%
2Dorsal scapular0%1%1.5%2%3%3%
3Long thoracic 0%2%4.5%7%9%9%
4Medial antebrachial cutaneous0%0%0%0%0%0%
5Medial brachial cutaneous0%0%0%0%0%0%
6Median nerve, above mid-forearm0%6.5%13%19.5%26%26%
7Median nerve, anterior interosseous0%2%4.5%7%9%9%
8Median nerve, below mid-forearm0%2%3%4.5%6%6%
9Musculocutaneous0%4%7.5%11%15%15%
10Lateral pectoral 0%1%2%3%4%4%
11Medial pectoral 0%1%2%3%4%4%
12Radial with triceps lost0%6%12.5%19%25%25%
13Radial with triceps spared0%5%10.5%15%21%21%
14Lower subscapular 0%1%1.5%2%3%3%
15Upper subscapular 0%1%1.5%2%3%3%
16Suprascapular0%2.5%5%7.5%10%10%
17Thoracodorsal 0%1.5%3%4.5%6%6%
18Ulnar above mid-forearm0%7%14%21%28%28%
19Ulnar below mid-forearm0%5%10.5%16%21%21%

Motor impairment — peripheral roots — lower limb — thigh, leg and foot

75   If the insured sustains a permanent peripheral root motor impairment in relation to a thigh, leg or foot, the percentage in column 2, 3, 4, 5, 6 or 7, determined in accordance with section 71 [classification of motor impairment], corresponds to the insured's impaired structure described opposite in column 1.

ItemColumn 1
Impaired structure
Column 2
Grade 5 — percentage
Column 3
Grade 4 — percentage
Column 4
Grade 3 — percentage
Column 5
Grade 2 — percentage
Column 6
Grade 1 — percentage
Column 7
Grade 0 — percentage
1Femoral0%3.5%7%10.5%14%14%
2Inferior gluteal 0%2.5%5%7.5%10%10%
3Superior gluteal 0%2%4%6%8%8%
4Obturator0%1%2%3%4%4%
5Sciatic0%7.5%15%22.5%30%30%
6Peroneal, common0%3.5%7%10.5%14%14%
7Peroneal, deep, above mid-leg0%4%5%7.5%10%10%
8Peroneal, deep, below mid-leg0%0.5%1%1.5%2%2%
9Peroneal, superficial0%1%2%3%4%4%
10Tibial above-knee0%3.5%7%10.5%14%14%
11Tibial posterior, above mid-calf0%2.5%5%7.5%10%10%
12Tibial posterior, below mid-calf0%1.5%3%4.5%6%6%
13Tibial medial plantar0%0.5%1%1.5%2%2%
14Tibial lateral plantar0%0.5%1%1.5%2%2%

Classification of sensory impairment

76   The classification of permanent sensory impairment in sections 77 to 81 [sensory impairment — nerve roots and peripheral roots] must be determined in accordance with the following grades:

(a) grade 1 as evidenced by no sensory impairment;

(b) grade 2 as evidenced by hypesthesia, including dysesthesia, paresthesia and hyperesthesia;

(c) grade 3 as evidenced by anesthesia including pain.

Sensory impairment — nerve roots

77   If the insured sustains a permanent sensory impairment in relation to the nerve roots, the percentage in column 2, 3 or 4, determined in accordance with section 76, corresponds to the insured's impaired structure described opposite in column 1.

ItemColumn 1
Impaired structure
Column 2
Grade 1 — percentage
Column 3
Grade 2 — percentage
Column 4
Grade 3 — percentage
1Upper limb, C50%2%3%
2Upper limb, C60%3%5%
3Upper limb, C70%2%3%
4Upper limb, C80%2%3%
5Upper limb, T10%2%3%
6Lower limb, L20%1%2%
7Lower limb, L30%1%2%
8Lower limb, L40%1%2%
9Lower limb, L50%1%2%
10Lower limb, S10%1%2%

Sensory impairment — peripheral roots — head and neck

78   If the insured sustains a permanent peripheral root sensory impairment in relation to the head or neck, the percentage in column 2, 3 or 4, determined in accordance with section 76 [classification of sensory impairment], corresponds to the insured's impaired structure described opposite in column 1.

ItemColumn 1
Impaired structure
Column 2
Grade 1 — percentage
Column 3
Grade 2 — percentage
Column 4
Grade 3 — percentage
1Greater occipital0%0.5%1%
2Lesser occipital0%0.5%1%
3Auricula branch of C2 and C30%0.5%2%

Sensory impairment — peripheral roots — upper limb

79   If the insured sustains a permanent peripheral root sensory impairment in relation to an upper limb, the percentage in column 2, 3 or 4, determined in accordance with section 76 [classification of sensory impairment], corresponds to the insured's impaired structure described opposite in column 1.

ItemColumn 1
Impaired structure
Column 2
Grade 1 — percentage
Column 3
Grade 2 — percentage
Column 4
Grade 3 — percentage
1Axillary0%1.5%3%
2Dorsal scapular0%0%0%
3Long thoracic 0%0%0%
4Medial antebrachial cutaneous0%1.5%3%
5Medial brachial cutaneous0%1.5%3%
6Median nerve, above mid-forearm0%11.5%23%
7Median nerve, anterior interosseous0%0%0%
8Median nerve, below mid-forearm0%11.5%23%
9Median nerve, digital sensory branch, radial side of thumb 0%2%4%
10Median nerve, digital sensory branch, ulnar side of thumb0%3.5%7%
11Median nerve, digital sensory branch, radial side of index finger0%1.5%3%
12Median nerve, digital sensory branch, ulnar side of index finger0%1%2%
13Median nerve, digital sensory branch, radial side of middle finger0%1.5%3%
14Median nerve, digital sensory branch, ulnar side of middle finger0%1%2%
15Median nerve, digital sensory branch, radial side of ring finger0%0.5%1%
16Musculocutaneous0%1.5%3%
17Lateral pectoral 0%0%0%
18Medial pectoral 0%0%0%
19Radial with triceps lost0%1.5%3%
20Radial with triceps spared0%1.5%3%
21Lower subscapular 0%0%0%
22Upper subscapular0%0%0%
23Suprascapular0%1.5%3%
24Thoracodorsal0%0%0%
25Ulnar above mid-forearm0%2%4%
26Ulnar below mid-forearm0%2%4%
27Ulnar digital branch, ulnar side of ring finger0%0.5%1%
28Ulnar digital branch, radial side of small finger0%0.5%1%
29Ulnar digital branch, ulnar side of small finger0%0.5%1%

Sensory impairment — peripheral roots — lower limb — inguinal region

80   If the insured sustains a permanent peripheral root sensory impairment in relation to the lower limb inguinal region, the percentage in column 2, 3 or 4, determined in accordance with section 76 [classification of sensory impairment], corresponds to the insured's impaired structure described opposite in column 1.

ItemColumn 1
Impaired structure
Column 2
Grade 1 — percentage
Column 3
Grade 2 — percentage
Column 4
Grade 3 — percentage
1Iliohypogastric nerve 0%2%4%
2Ilioinguinal nerve 0%2%4%

Sensory impairment — peripheral roots — lower limb — thigh, leg and foot

81   If the insured sustains a permanent peripheral root sensory impairment in relation to a thigh, leg or foot, the percentage in column 2, 3 or 4, determined in accordance with section 76 [classification of sensory impairment], corresponds to the insured's impaired structure described opposite in column 1.

ItemColumn 1
Impaired structure
Column 2
Grade 1 — percentage
Column 3
Grade 2 — percentage
Column 4
Grade 3 — percentage
1Femoral0%1%2%
2Inferior gluteal0%0%0%
3Superior gluteal 0%0%0%
4Genitofemoral nerve0%1%2%
5Lateral femoral cutaneous0%2%4%
6Obturator0%0%0%
7Posterior thigh cutaneous0%1%2%
8Sciatic0%5%10%
9Peroneal, common0%1%2%
10Peroneal, deep, above mid-leg0%1%2%
11Peroneal, deep, below mid-leg0%0.5%1%
12Peroneal, superficial0%1%2%
13Tibial above knee0%2%6%
14Tibial posterior, above mid-calf0%2%6%
15Tibial posterior, below mid-calf0%1%6%
16Tibial medial plantar0%1%2%
17Tibial lateral plantar0%1%2%
18Tibial sural0%1%2%

Sensory loss

82   If the insured sustains permanent sensory loss in relation to a sensory impairment described in sections 77 to 80 [sensory impairment — nerve root and peripheral root sensory loss], the percentage in column 2 corresponds to the insured's class of sensory loss described opposite in column 1.

ItemColumn 1
Class of sensory loss
Column 2
Percentage
1Class 1 as evidenced by permanent, post-traumatic alteration of the skin sensation in the region of post-traumatic skin impairment, including a scar or abrasion, that is an altered cutaneous sensation surrounding all or a portion of the residual scar 0%
2Class 2 as evidenced by permanent, post-traumatic alteration of the skin sensation in the region of post-traumatic skin impairment, including a scar or abrasion, that is a region of skin alteration that does not conform to the territory of a peripheral nerve0%
3Class 3 as evidenced by permanent, post-traumatic alteration of the skin sensation in the region of post-traumatic skin impairment, including a scar or abrasion, that is a region of skin alteration that conforms to a portion of the territory of an anatomically defined peripheral nerve50% of the percentage attributed to the insured in accordance with sections 77 to 80
4Class 4 as evidenced by permanent, post-traumatic alteration of the skin sensation in the region of post-traumatic skin impairment, including a scar or abrasion, that is a region of skin alteration that conforms to the typical territory of an anatomically defined peripheral nerve100% of the percentage attributed to the insured in accordance with sections 77 to 80

Brachial plexus impairment

83   If the insured sustains a permanent brachial plexus impairment, the percentage in column 2 corresponds to the insured's impairment described opposite in column 1.

ItemColumn 1
Brachial plexus impairment
Column 2
Percentage
1Upper trunk, also known as Erb-Duchenne syndrome, with complete motor and sensory impairment49%
2Middle trunk with complete motor and sensory impairment 23%
3Lower trunk, also known as Klumpke-Déjerine syndrome, with complete motor and sensory impairment46%
4Any combination of 2 trunks described in items 1 to 3, with complete motor and sensory impairment60%
5All 3 trunks described in items 1 to 3, with complete motor and sensory impairment 60%

Lumbosacral plexus impairment

84   If the insured sustains a permanent lumbosacral plexus impairment, the percentage in column 2 corresponds to the insured's impairment described opposite in column 1.

ItemColumn 1
Lumbosacral plexus impairment
Column 2
Percentage
1Complete motor and sensory impairment35%

Part 3 — Maxillofacial System

Division 1 — Temporomandibular Joint (TMJ), Maxilla, Mandible and Teeth

Temporomandibular joint (TMJ) — range of motion loss

85   If the insured sustains a permanent temporomandibular joint range of motion loss, the percentage in column 2 corresponds to the insured's range of motion loss described opposite in column 1.

Item Column 1
Temporomandibular joint range of motion loss
Column 2
Percentage
1Bilateral temporomandibular joint ankylosisprior to growth plate fusion40%
after growth plate fusion30%
2Jaw excursion opening less than 6 mm as measured between the free edge of the upper and lower incisors25%
opening of 6 mm to 10 mm as measured between the free edge of the upper and lower incisors17%
opening of more than 10 mm to 20 mm as measured between the free edge of the upper and lower incisors10%
opening of more than 20 mm to 30 mm as measured between the free edge of the upper and lower incisors3%
opening more than 30 mm as measured between the free edge of the upper and lower incisors0%
3Reduction of laterotrusionlaterotrusion less than 5 mm4%
laterotrusion of 5 mm to 8 mm2%
laterotrusion more than 8 mm0%
4Reduction of protrusionprotrusion of less than 4 mm3%
protrusion of 4 mm to 7 mm1%
protrusion more than 7 mm0%

Temporomandibular joint (TMJ) — other dysfunction

86   If the insured sustains a permanent other dysfunction in relation to the temporomandibular joint, the percentage in column 2 corresponds to the insured's dysfunction described opposite in column 1.

ItemColumn 1
Temporomandibular joint other dysfunction
Column 2
Percentage
1Deviation in form1%
2Disc displacement with reduction1%
3Disc displacement without reduction2%
4Post-traumatic degenerative change2%
5Craniofacial muscle disorder characterized by chronic protective muscle guarding1%

Maxilla

87   If the insured sustains a permanent maxilla impairment, the percentage in column 2 corresponds to the insured's impairment described opposite in column 1.

ItemColumn 1
Maxilla impairment
Column 2
Percentage
1Loss of hard palate and dental arch20%
2Loss of hard palate10%
3Loss of soft palatewith severe rhinolalia10%
with minor rhinolalia3%
with tubal dysfunction3%
without rhinolalia dysfunction or tubal dysfunction1%
4Loss of dental archloss of edentulous supporting tissues, precluding successful use of a removable prosthesis 10%
allowing a complex prosthesis to be worn4%
allowing a simple prosthesis to be worn3%
5Malalignment of the palate and dental archwith serious malocclusion and temporomandibular joint dysfunction5%
with obstruction to the nasopharynx and tubal dysfunction3%
with minor malocclusion2%
6Periodontal problems despite adequate consolidation of the palate and dental arch5%
7Non-union or malunion of the palate and dental arch4%

Mandible

88   If the insured sustains a permanent mandible impairment, the percentage in column 2 corresponds to the insured's impairment described opposite in column 1.

ItemColumn 1
Mandible impairment
Column 2
Percentage
1Body or ramusloss of tissue with non-union10%
mal-union with malocclusion and temporomandibular joint dysfunction6.5%
mal-union with malocclusion, but without temporomandibular joint dysfunction2%
2Loss of dental arch and loss of edentulous supporting tissuesprecluding successful use of a removable prosthesis10%
allowing a complex prosthesis to be worn5%
allowing a simple prosthesis to be worn 4%

Teeth — alteration and loss

89   (1) In this section, "damage" means alteration or loss of a tooth.

(2) If the insured sustains tooth damage and

(a) the damaged tooth was healthy before the accident, the percentage in column 2 corresponds to the insured's damaged tooth described opposite in column 1, or

(b) the damaged tooth was unhealthy before the accident, the percentage in column 3 corresponds to the insured's damaged tooth described opposite in column 1.

ItemColumn 1
Damaged tooth
Column 2
Percentage if previously healthy
Column 3
Percentage if previously unhealthy
1Central incisor1%0.5%
2Lateral incisor1%0.5%
3Canine2%0.5%
4First premolar1%0.5%
5Second premolar1%0.5%
6First molar2%0.5%
7Second molar2%0.5%
8Third molar1%0.5%

Division 2 — Fronto-Orbito-Nasal Area

Orbit — impairment of orbital wall causing displacement of eye

90   If the insured sustains a permanent impairment of the orbital wall causing displacement of an eye, the percentage in column 2 corresponds to the insured's impairment described opposite in column 1.

Item Column 1
Impairment of orbital wall causing displacement of the eye
Column 2
Percentage
1Unilateralmild1%
moderate2%
severe3%
2Bilateralmild2%
moderate4%
severe6%

Orbit — disruption of medial and lateral canthus

91   If the insured sustains a permanent disruption of the medial or lateral canthus, the percentage in column 2 corresponds to the insured's disruption described opposite in column 1.

ItemColumn 1
Disruption of medial or lateral canthus
Column 2
Percentage
1Unilateralminor1%
major2%
2Bilateralminor1.5%
major3%

Orbit — disruption of lacrimal apparatus

92   If the insured sustains a permanent disruption of the lacrimal apparatus, the percentage in column 2 corresponds to the insured's disruption described opposite in column 1.

Item Column 1
Disruption of lacrimal apparatus
Column 2
Percentage
1Unilateral1%
2Bilateral2%

Orbit — malar bone and zygoma

93   If the insured sustains a permanent malar bone or zygoma impairment, the percentage in column 2 corresponds to the insured's impairment described opposite in column 1.

Item Column 1
Malar bone or zygoma impairment
Column 2
Percentage
1Non-specified abnormal healing1% per side

Nasal — airflow obstruction

94   If the insured sustains permanent airflow obstruction, the percentage in column 2 corresponds to the insured's obstruction described opposite in column 1.

Item Column 1
Airflow obstruction
Column 2
Percentage
1Unilateral1%
2Bilateral2%

Nasal — mucosal dysfunction

95   If the insured sustains permanent mucosal dysfunction, the percentage in column 2 corresponds to the insured's dysfunction described opposite in column 1.

Item Column 1
Mucosal dysfunction
Column 2
Percentage
1Unilateral mucosal dysfunction causing bleeding, crusting and discomfort1%
2Bilateral mucosal dysfunction causing bleeding, crusting and discomfort2%

Nasal — septal perforation

96   If the insured sustains permanent septal perforation, the percentage in column 2 corresponds to the insured's perforation described opposite in column 1.

Item Column 1
Septal perforation
Column 2
Percentage
1Less than 2 cm0.5%
22 cm or more1%

Nasal — paranasal sinus

97   If the insured sustains a permanent paranasal sinus impairment, the percentage in column 2 corresponds to the insured's impairment described opposite in column 1.

Item Column 1
Paranasal sinus impairment
Column 2
Percentage
1Alteration of the walls and mucosa of an ethmoid or sphenoid sinus1.5%
2Alteration of the walls and mucosa of a frontal or maxillary sinus1%
3Alteration of a craniofacial bony structure not referred to in item 1 or 2 of this section1%

Salivary gland

98   If the insured sustains a permanent salivary gland impairment, the percentage in column 2 corresponds to the insured's impairment described opposite in column 1.

Item Column 1
Salivary gland impairment
Column 2
Percentage of maximum
1Hyposalivation, as evidenced by disruption of salivation significant enough to cause
(a) discomfort,
(b) problems with deglutition, and
(c) problems with articulation
1%

Tongue — anatomic loss and alteration

99   If the insured sustains an anatomical loss or alteration of the tongue, the percentage in column 2 corresponds to the insured's loss or alteration described opposite in column 1.

Item Column 1
Tongue loss or alteration
Column 2
Percentage
1Loss of tongue10%
2Alteration of the tongue due to loss of the lateral edge and tip3%

Division 3 — Throat and Related Structures

Calculation and determination of multiple impairments in Division

100   If the insured sustains multiple permanent impairments in this Division, the following steps apply in the following order to determine the applicable percentage for the Division:

(a) add the percentages that correspond to the insured's impairments, as set out in the tables in this Division;

(b) multiply the total determined in accordance with paragraph (a) by 0.7.

Air passage deficits — upper airway

101   (1) If the insured sustains a permanent air passage deficit in relation to the upper airway, the percentage in column 2 corresponds to the insured's deficit described opposite in column 1.

(2) In respect of item 1, the insured is not excluded from Class 1 if the insured preventatively avoids strenuous competitive sport.

ItemColumn 1
Upper airway deficit
Column 2
Percentage
1Subject to subsection (2), Class 1 as evidenced by the following:
(a) a recognized air passage defect exists;
(b) dyspnea does not occur at rest;
(c) dyspnea is not produced in any of the following circumstances:

(i) walking or climbing stairs freely;
(ii) performance of one or more of the other activities of daily living;
(iii) stress;
(iv) prolonged exertion;
(v) hurrying;
(vi) hill climbing;
(vii) recreation requiring intensive effort;
(viii) similar activity to subparagraphs (i) to (vii);


(d) partial obstruction of the oropharynx, upper trachea to the fourth ring, lower trachea or bronchi, or complete bilateral obstruction of the nose or nasopharynx
5%
2Class 2 as evidenced by the following:
(a) a recognized air passage defect exists;
(b) dyspnea does not occur at rest;
(c) dyspnea is not produced in any of the following circumstances:

(i) walking freely on a level surface;
(ii) climbing at least one flight of ordinary stairs;
(iii) performance of one or more of the other activities of daily living;

(d) partial obstruction of the oropharynx, laryngopharynx, larynx, upper trachea to the fourth ring, lower trachea to the fourth ring, bronchi, or complete bilateral obstruction of the nose or nasopharynx
10%
3Class 3 as evidenced by the following:
(a) a recognized air passage defect exists;
(b) dyspnea does not occur at rest;
(c) dyspnea is produced by one or more of the following circumstances:

(i) stress;
(ii) prolonged exertion;
(iii) hurrying;
(iv) hill climbing;
(v) recreation except sedentary forms;
(vi) similar activity to subparagraphs (i) to (v);


(d) partial obstruction of the oropharynx, laryngopharynx, larynx, upper trachea to the fourth ring, lower trachea or bronchi
15%
4Class 4 as evidenced by the following:
(a) a recognized air passage defect exists;
(b) dyspnea occurs at rest and the insured may or may not be bedridden;
(c) dyspnea is produced by one or more of the following circumstances:

(i) walking more than one or two blocks on a level surface;
(ii) climbing one flight of ordinary stairs even with periods of rest;
(iii) performance of one or more of the other activities of daily living;
(iv) stress;
(v) hurrying;
(vi) hill climbing;
(vii) recreation;
(viii) similar activity to subparagraphs (i) to (vii);


(d) partial obstruction of the oropharynx, laryngopharynx, larynx, upper trachea to the fourth ring, lower trachea or bronchi
20%
5Class 5 as evidenced by the following:
(a) a recognized air passage defect exists;
(b) severe dyspnea occurs at rest, spontaneous respiration is inadequate, respiratory ventilation is required;
(c) dyspnea is aggravated by the performance of any of the activities of daily living other than personal hygiene and self-care;
(d) partial obstruction of the oropharynx, laryngopharynx, larynx, upper trachea to the fourth ring, lower trachea or bronchi
25%
6Permanent tracheostomy or stoma25%

Mastication and deglutition

102   If the insured sustains a permanent impairment related to mastication or deglutition, the percentage in column 2 corresponds to the insured's dietary restriction described opposite in column 1.

Item Column 1
Dietary restriction
Column 2
Percentage
1Diet is limited to semi-solid or soft foods5%
2Diet is limited to liquid foods10%
3Ingestion of food requires tube feeding or gastrostomy 25%

Loss of taste

103   If the insured sustains a permanent loss of taste, the percentage in column 2 corresponds to the insured's loss of taste described opposite in column 1.

Item Column 1
Loss of taste
Column 2
Percentage
1Minor loss of taste0.5%
2Major loss of taste1%

Speech impairment

104   (1) If an insured sustains a permanent speech impairment, the percentage in column 5 corresponds to the class of the speech impairment determined in accordance with subsection (2).

(2) The insured's class of speech impairment is determined as follows:

(a) in the case of an insured sustaining an impairment described by one criterion in column 2, column 3 or column 4, the class in column 1 that is opposite to the criterion sustained by the insured is the applicable class of speech impairment;

(b) in the case of an insured sustaining an impairment described by more than one criterion in column 2, column 3 or column 4, the class in column 1 that is opposite to the most severe criteria sustained by the insured is the applicable class of speech impairment.

ItemColumn 1
Class of impairment
Column 2
Audibility
Column 3
Intelligibility
Column 4
Functional efficiency
Column 5
Percentage
1Class 1Can produce speech of intensity sufficient for most of the needs of everyday speech communication although this sometimes may require effort and may be beyond the insured's capacityCan perform most of the articulatory acts necessary for everyday speech communication although listeners occasionally ask the insured to repeat and the insured may find it difficult or impossible to produce a few phonetic unitsCan meet most of the demands of articulation and phonation for everyday speech communication with adequate speed and ease, although occasionally the insured may hesitate or speak slowly5%
2Class 2Can produce speech of intensity sufficient for most of the needs of everyday speech communication, the insured is usually heard under average conditions; however, may have difficulty in vehicles, trains, buses, train stations or ferry terminals, restaurants or similar placesCan perform many of the necessary articulatory acts necessary for everyday speech communication, the insured can speak name, address and similar information and be understood by a stranger but may have numerous inaccuracies, the insured sometimes appears to have difficulty articulating(a) can meet many of the demands of articulation and phonation for everyday communication with adequate speed and ease, but sometimes gives impression of difficulty, or
(b) speech may sometimes be discontinuous, interrupted hesitant or slow
10%
3Class 3(a) can produce speech of intensity sufficient for some of the needs of everyday speech communication such as close conversation; however, the insured has considerable difficulty in places described in column 2 of item 2, or
(b) the voice tires rapidly and tends to become inaudible after a few seconds
Can perform some of the necessary articulatory acts for everyday speech communication, the insured can usually converse with family and friends; however, strangers may find it difficult to understand the insured, who often may be asked to repeat (a) can meet some of the demands of articulation and phonation for everyday speech communication with adequate speed and ease, but often can sustain consecutive speech only for brief periods, or
(b) may give the impression of being rapidly fatigued
15%
4Class 4(a) can produce speech of intensity sufficient for a few of the needs of everyday speech communication,
(b) the insured can barely be heard by a close listener or over the telephone, or
(c) the insured may be able to whisper audibly but does not have a louder voice
(a) can perform a few of the necessary articulatory acts for everyday speech communication,
(b) the insured can produce some phonetic units, or
(c) the insured may have approximations for a few words such as names of own family members, however the insured is unintelligible out of context
(a) can meet a few of the demands of articulation and phonation for everyday speech communication with adequate speed and ease, such as single words or short phrases but insured cannot maintain uninterrupted speech flow, or
(b) speech is laboured, rate of speech is impractically slow
20%
5Class 5Speech intensity insufficient for everyday speech communicationArticulatory acts insufficient for everyday speech communicationArticulation and phonation insufficient for everyday speech communication with adequate speed and ease25%

Part 4 — Vision

Definitions for Part

105   In this Part:

"aphakia" means absence of the lens of an eye, occurring congenitally or as a result of trauma or surgery;

"pseudophakia" means replacement of a naturally occurring lens of an eye with an artificial lens.

Vision loss

106   If the insured sustains permanent vision loss, the percentage in column 2 corresponds to the insured's loss described opposite in column 1.

ItemColumn 1
Vision loss
Column 2
Percentage
1Bilateral loss of vision80%
2Alteration of vision(a) homonymous,
(b) bitemporal quadrantanopsia, or
(c) hemianopsia
35%
aphakia12%
pseudophakia6%
3Unilateral loss of vision with enucleation30%
without enucleation25%
4Paralysis of accommodation or loss of near vision 3%
5Iridoplegia or fixed mydriasis causing
(a) photophobia,
(b) disturbance of close-up vision, or
(c) dizziness
1.5%
6Impairment of colour vision0.5%
7Other impairments to vision(a) the percentage in relation to a single eye must not exceed 30%, and
(b) other impairments to vision are calculated and determined in accordance with section 107

Calculation and determination of percentage for other impairments to vision

107   (1) The percentage that corresponds to a deficit for the entire visual system is the difference between the percentage of visual efficiency of binocular vision represented in variable C in subsection (2) and 100%.

(2) If the insured sustains a permanent loss of visual efficiency, the percentage of efficiency of binocular vision is determined by the following formula:

3A

4
 +  B 

4
 = C
where
A=the percentage of visual efficiency determined as variable G in the formula in subsection (3) in respect of the better eye;
B=the percentage of visual efficiency determined as variable G in the formula in subsection (3) for the other eye;
C=the percentage of visual efficiency of binocular vision.

(3) For the purposes of variables A and B in the formula set out in subsection (2), the visual efficiency of each eye is determined in accordance with the following formula:

D × E × F = G
where
D=the percentage of visual acuity retained, calculated and determined in accordance with section 109 [central visual acuity — percentage for variable D];
E=the percentage of visual field retained, calculated and determined in accordance with section 112 [visual field — percentage for variable E];
F=the percentage of ocular motility retained, calculated and determined in accordance with section 114 [ocular motility — percentage for variable F];
G=the percentage of visual efficiency of the eye in the formula in subsection (1).

Central visual acuity — testing methods

108   (1) Central visual acuity must be measured in accordance with the following specifications:

(a) a measurement must be taken for near vision

(i) without correction, and

(ii) with the best spectacle correction or with the best contact lens correction, if contact lenses are usually worn;

(b) a measurement must be taken for distance vision

(i) without correction, and

(ii) with the best spectacle correction or with the best contact lens correction, if contact lenses are usually worn.

(2) For the purposes of near vision testing,

(a) near vision must be tested at 40 cm,

(b) illumination must be diffused onto the test card at a minimum illumination level of 500 lux and no more than 600 lux, and

(c) one of the following charts must be used:

(i) Snellen test chart with non-serif block letters or numbers;

(ii) Sloan Reading Cards;

(iii) Baily-Lovie Word Reading Charts;

(iv) MNREAD Charts.

(3) For the purposes of distance vision testing,

(a) distance vision must be tested to simulate infinity at 6 m or no less than 4 m, and

(b) one of the following charts must be used:

(i) Snellen test chart with non-serif block letters or numbers;

(ii) E chart;

(iii) Landott's broken-ring chart.

Central visual acuity — percentage for variable D

109   (1) For the purpose of variable D in section 107, the insured's percentage of central visual acuity, without allowance for monocular pseudophakia and tested in accordance with section 108, is the percentage at the intersection of

(i) the Snellen rating for near vision on the horizontal axis, and

(ii) the Snellen rating for distance vision on the vertical axis.

Approximate Snellen rating for near vision in inches
Snellen
rating for
distance
vision in
feet
16
16
16
20
16
24
16
28
16
32
16
40
16
46
16
50
16
68
16
80
16
90
16
100
16
128
16
160
20
15
0%0%3%4%5%25%27%30%40%43%44%46%48%49%
20
20
0%0%3%4%5%25%27%30%40%43%44%46%48%49%
20
25
3%3%5%6%8%28%30%32%33%43%45%48%50%52%
20
30
5%5%8%9%10%30%32%35%45%48%49%50%53%54%
20
40
8%8%10%11%13%33%35%38%48%50%51%53%55%57%
20
50
13%13%15%16%18%38%40%43%53%55%56%58%60%62%
20
60
16%16%18%20%22%41%44%46%56%59%60%61%64%65%
20
70
18%18%21%22%23%43%46%48%56%59%60%61%64%65%
20
80
20%20%23%24%25%45%47%50%60%63%64%65%68%69%
20
100
25%25%28%29%30%50%52%55%65%68%69%70%73%74%
20
125
30%30%33%34%35%55%57%60%70%73%73%75%78%79%
20
150
34%34%37%38%39%59%61%64%74%77%78%79%82%83%
20
200
40%40%43%44%45%65%67%70%80%83%84%85%88%89%
20
300
43%43%45%46%48%68%70%73%83%85%86%88%90%92%
20
400
45%45%48%49%50%70%72%75%85%88%89%90%93%94%
20
800
48%48%50%51%53%73%75%78%88%90%91%93%95%97%

(2) For the purpose of variable D in section 107, the insured's percentage of central visual acuity, with allowance for monocular pseudophakia or monocular aphaskia and tested in accordance with section 108, is the percentage at the intersection of

(i) the Snellen rating for near vision on the horizontal axis, and

(ii) the Snellen rating for distance vision on the vertical axis.

Approximate Snellen rating for near vision in inches
Snellen
rating for
distance
vision in
feet
16
16
16
20
16
24
16
28
16
32
16
40
16
46
16
50
16
68
16
80
16
90
16
100
16
128
16
160
20
15
50%50%52%52%53%63%64%65%70%72%72%73%74%75%
20
20
50%50%52%52%53%63%64%65%70%72%72%73%74%75%
20
25
52%52%53%53%54%64%65%66%67%72%73%74%75%76%
20
30
53%53%54%54%55%65%66%68%73%74%74%75%76%77%
20
40
54%54%55%56%57%67%68%69%74%75%76%77%78%79%
20
50
57%57%58%58%59%69%70%72%77%78%78%79%80%81%
20
60
58%58%59%60%61%70%72%73%78%79%80%81%82%83%
20
70
59%59%61%61%62%72%73%74%78%79%80%81%82%83%
20
80
60%60%62%62%63%73%74%75%80%82%82%83%84%85%
20
100
63%63%64%64%65%75%76%78%83%84%84%85%87%87%
20
125
65%65%67%67%68%78%79%80%85%87%87%88%89%90%
20
150
67%67%68%69%70%80%81%82%87%88%89%90%91%92%
20
200
70%70%72%72%73%83%84%85%90%91%92%93%94%95%
20
300
72%72%73%73%74%84%85%87%91%93%93%94%95%96%
20
400
73%73%74%74%75%85%86%88%93%94%94%95%97%97%
20
800
74%74%75%76%77%87%88%89%94%95%96%97%98%99%

Visual field — testing methods

110   For the purpose of testing the extent of the visual field, one of the following standard perimetry set out in column 1 must be used in accordance with column 2 or column 3 opposite it, as applicable.

ItemColumn 1
Column 2
Phakic
Column 3
Aphakic
1Goldmann (kinetic) III-4e IV-4e
2Zeiss Humphrey® Field Analyzer (HFA 2 or newer)24-2 Sita-Fast or Sita-Faster, if normal, then proceed to suprathreshold peripheral test patternssuprathreshold peripheral test patterns
3HaagStreit OctopusFor software version i9 or newer, use Octopus Kinetic Examination "Demo Kinetic Examination"
For software version prior to i9, use Octopus "III 4e" test
Octopus Statis Full Field "07 General Screening" test for all software versions

(2) In the case of a binocular field test, the Esterman 120 binocular field test must be used.

(3) For certainty, the results of this section may be transferred to the chart in section 114 [ocular motility].

Vision meridians

111   (1) For certainty, the extent of the normal visual fields for the eight principal meridians are set out in the table.

ItemColumn 1
Direction of vision
Column 2
Degrees of field
1Temporally85°
2Down temporally85°
3Direct down65°
4Down nasally50°
5Nasally60°
6Up nasally55°
7Direct up45°
8Up temporally55°
9Total directions in items 1 to 8500° total degrees of vision

(2) Any scotomata within the field must be subtracted from the maximum number of degrees for that meridian.

(3) For the purposes of section 112,

(a) an additional 5% must be included for an inferior quadrantic loss, and

(b) an additional 10% must be included for an inferior hemianopic loss.

(4) In the case of a normal result for an automated central field test, a full field test does not need to be tested, unless there is evidence that suggests that the results of the automated central field test are not representative of the entire field.

Deficit in visual field — percentage for variable E

112   (1) The percentage representing the insured's permanent deficit in visual field in column 3 corresponds to

(a) the insured's degrees of visual field lost, tested in accordance with section 110 [visual field — testing methods], in column 1 opposite column 3, and

(b) the insured's degrees of visual field retained, tested in accordance with section 110, in column 2 opposite column 3.

(2) If the central visual field is impaired, the percentage of deficit is that of the concomitant loss of visual acuity.

(3) If the visual acuity is normal, the percentage of deficit is calculated on the basis of the degrees lost.

Table: Deficit of visual field

ItemColumn 1
Total degrees lost
Column 2
Total degrees retained
Column 3
Percentage
10500° 0
2495° 1%
310° 490° 2%
415° 485° 3%
520° 480° 4%
625° 475° 5%
730° 470° 6%
835° 465° 7%
940° 460° 8%
1045° 455° 9%
1150° 450° 10%
1255° 445° 11%
1360° 440° 12%
1465° 435° 13%
1570° 430° 14%
1675° 425° 15%
1780° 420° 16%
1885° 415° 17%
1990° 410° 18%
2095° 405° 19%
21100° 400° 20%
22105° 395° 21%
23110° 390° 22%
24115° 385° 23%
25120° 380° 24%
26125° 375° 25%
27130° 370° 26%
28135° 365° 27%
29140° 360° 28%
30145° 355° 29%
31150° 350° 30%
32155° 345° 31%
33160° 340° 32%
34165° 335° 33%
35170° 330° 34%
36175° 325° 35%
37180° 320° 36%
38185° 315° 37%
39190° 310° 38%
40195° 305° 39%
41200° 300° 40%
42205° 295° 41%
43210° 290° 42%
44215° 285° 43%
45220° 280° 44%
46225° 275° 45%
47230° 270° 46%
48235° 265° 47%
49240° 260° 48%
50245° 255° 49%
51250° 250° 50%
52255° 245° 51%
53260° 240° 52%
54265° 235° 53%
55270° 230° 54%
56275° 225° 55%
57280° 220° 56%
58285° 215° 57%
59290° 210° 58%
60295° 205° 59%
61300° 200° 60%
62305° 195° 61%
63310° 190° 62%
64315° 185° 63%
65320° 180° 64%
66325° 175° 65%
67330° 170° 66%
68335° 165° 67%
69340° 160° 68%
70345° 155° 69%
71350° 150° 70%
72355° 145° 71%
73360° 140° 72%
74365° 135° 73%
75370° 130° 74%
76375° 125° 75%
77380° 120° 76%
78385° 115° 77%
79390° 110° 78%
80395° 105° 79%
81400° 100° 80%
82405° 95° 81%
83410° 90° 82%
84415° 85° 83%
85420° 80° 84%
86425° 75° 85%
87430° 70° 86%
88435° 65° 87%
89440° 60° 88%
90445° 55° 89%
91450° 50° 90%
92455° 45° 91%
93460° 40° 92%
94465° 35° 93%
95470° 30° 94%
96475° 25° 95%
97480° 20° 96%
98485° 15° 97%
99490° 10° 98%
100495° 99%
101500° 0100%

Ocular motility — testing

113   (1) To determine the impairment of ocular motility, the field of binocular single vision, represented in the diagram, is plotted in accordance with this section.

Diagram: Field of binocular single vision for an uninjured eye illustrated

(2) The test to plot the field of binocular single vision is conducted

(a) using an arc perimeter, or

(b) if an arc perimeter is not available, a tangent screen for evaluating the central 40°.

(3) For the purposes of the test to plot the field of binocular single vision, the following apply in respect of the insured:

(a) the insured must not wear spectacle corrective lenses, unless the corrective lenses are single vision and do not contain prisms;

(b) the insured must not wear spectacles with progressive lenses;

(c) the insured may wear contact lenses.

(4) For the purposes of the test to plot the field of binocular single vision, the following apply in respect of the test:

(a) the extent of diplopia in the various directions of gaze is determined on the arc perimeter at 33 cm;

(b) examination is made in each of the 8 principal meridians by using

(i) a small test light, or

(ii) the projected light of approximately Goldmann III-4e;

(c) the presence of diplopia must be plotted along the 8 principal meridians on a suitable visual field chart consistent with the diagram in section 114;

(d) a field of binocular single vision must be plotted on a suitable visual field chart consistent with the diagram in section 114;

(e) diplopia within 20° from the centre is considered to be a 100% impairment of ocular motility, in respect of the injured eye, and is shaded in grey in the diagram in section 114 entitled "percentage of deficit of ocular motility of an eye in the field of diplopia";

(f) beyond 20° from the centre, the diagram in section 114 entitled "percentage of deficit of ocular motility of an eye in the field of diplopia" is used to determine the impairment percentage.

Ocular motility — percentage for variable F

114   (1) If the insured sustains diplopia along one meridian, tested in accordance with section 113, the percentage for that meridian as set out in the diagram corresponds to that diplopia.

(2) If the insured sustains diplopia along more than one meridian, tested in accordance with section 113, the percentage for each meridian as set out in the diagram are added together.

Diagram: Percentage of deficit of ocular motility of an eye in the field of diplopia

Part 5 — Urogenital System and Related

Kidney impairment

115   If the insured sustains a permanent kidney impairment, the percentage in column 2 corresponds to the insured's impairment described opposite in column 1.

ItemColumn 1
Kidney impairment
Column 2
Percentage
1Removal of both kidneys, including renal transplantation40%
2Loss of function or removal of one kidney10%

Ureteric impairment

116   If the insured sustains a permanent ureteric impairment, the percentage in column 2 corresponds to the insured's impairment described opposite in column 1.

ItemColumn 1
Ureteric impairment
Column 2
Percentage
1Any ureteric diversion10%

Bladder impairment

117   If the insured sustains a permanent bladder impairment, the percentage in column 2 corresponds to the insured's impairment described opposite in column 1.

ItemColumn 1
Bladder impairment
Column 2
Percentage
1Bladder removal, including the resulting loss of control of urination or urinary bypass35%
2Incontinence or urinary retentioncomplete loss of sphincter control20%
partial loss of sphincter control10%
dysfunction in the form of frequency or hesitancy3%
3Alteration of the bladder with enterocystoplasty10%
4Alteration of the bladder without enterocystoplasty3%

Urethral impairment

118   If the insured sustains a permanent urethral impairment, the percentage in column 2 corresponds to the insured's impairment described opposite in column 1.

ItemColumn 1
Urethral impairment
Column 2
Percentage
1Surgically uncorrectable fistula7.5%
2Stenosisrequiring monthly treatments6%
requiring quarterly treatments3%

Tissue alteration — posterolumbar and laparotomy

119   If the insured sustains a permanent alteration of tissue following a posterolumbar incision or a laparotomy, the percentage in column 2 corresponds to the insured's alteration of tissue described opposite in column 1.

ItemColumn 1
Tissue alteration in relation to posterolumbar incision or laparotomy
Column 2
Percentage
1Alteration of tissue following a posterolumbar incision or a laparotomy2%

Renal functional impairment

120   If the insured sustains a permanent renal functional impairment, the percentage in column 2 corresponds to the insured's impairment described opposite in column 1.

ItemColumn 1
Renal functional impairment
Column 2
Percentage
1Class 1 means
(a) creatinine clearance of 31 to 80 mL/minute,
(b) intermittent symptoms and signs of upper urinary tract dysfunction are present that do not require continuous treatment or surveillance, or
(c) glomerular filtration rate of 60 to 80 mL/minute/1.73m2
15%
2Class 2 means
(a) creatinine clearance of 10 to 30 mL/minute,
(b) creatinine clearance that is more than 30 mL/minute, but symptoms and signs of upper urinary tract dysfunction are incompletely controlled by continuous treatment or surveillance, or
(c) glomerular filtration rate of 30 to 59 mL/minute/1.73m2
50%
3Class 3 means
(a) creatinine clearance is less than 10 mL/minute, or
(b) creatinine clearance is more than 10 mL/minute, but symptoms and signs of upper urinary tract dysfunction persist despite continuous medical treatment or repeated surgery, or
(c) glomerular filtration rate of 0 to 29 mL/minute/1.73m2
75%

Reproductive system — organ tissue disruption

121   (1) In this section, except in item 12, "loss" means

(a) loss of the use of the reproductive system organ tissue, or

(b) removal of the reproductive system organ tissue.

(2) If the insured sustains a permanent reproductive system organ tissue disruption, the percentage in column 2 corresponds to the insured's disruption described opposite in column 1.

ItemColumn 1
Reproductive system organ tissue disruption
Column 2
Percentage
1Loss of both ovaries, including fallopian tubesbefore the end of puberty20%
after puberty10%
2Loss of single ovary, with or without fallopian tube5%
3Loss of uterus, including cervixbefore the end of menopause10%
after menopause 5%
4Alteration of cervix without loss of uterus2%
5Loss of clitoris5%
6Loss of vulva5%
7Loss of vagina5%
8Alteration of clitoris2.5%
9Alteration of vulva2.5%
10Alteration of vagina2.5%
11Alteration of tissues following a caesarean section, necessitated by accident2%
12Loss of a fetusif the fetus is under 20 weeks7%
if the fetus is 20 weeks and over10%
13Loss of penis15%
14Post-traumatic alteration of penis10%
15Loss of both testicles, including epididymides and spermatic cordsbefore the end of puberty20%
after puberty10%
16Loss of single testicle, including epididymis and spermatic cord5%
17Alteration of prostate, including seminal vesicles5%
18Loss of prostate, including seminal vesicles10%

Sexual dysfunction

122   If the insured sustains permanent sexual dysfunction, the percentage in column 2 corresponds to the insured's dysfunction described opposite in column 1.

ItemColumn 1
Sexual dysfunction
Column 2
Percentage
1Class 1 means sexual functioning is possible with lack of awareness, excitement, or lubrication or difficulty of erection or ejaculation5%
2Class 2 means reflex sexual functioning is possible but there is no awareness10%
3Class 3 means
(a) infertility,
(b) total absence of sexual functioning, or
(c) both infertility and a total absence of sexual functioning
15%

Part 6 — Respiratory System

Respiratory system tissue disruption

123   If the insured sustains a permanent respiratory system tissue disruption, the percentage in column 2 corresponds to the insured's disruption described opposite in column 1.

ItemColumn 1
Respiratory system tissue disruption
Column 2
Percentage
1Loss of a lung20%
2Loss of a pulmonary lobe3%
3Loss of a pulmonary segment0.6%
4Alteration of tissue following thoracotomy2%
5Alteration of tissue following
(a) thoracostomy, or
(b) one or more penetrating chest wounds
1%
6Phrenic nerve injury2%
7Alteration of tissue following a tracheotomy or penetrating throat wound, without a tracheostomy2%
8Alteration of tissue following a tracheotomy or penetrating throat wound, with a tracheostomy3%

Respiratory functional impairment

124   (1) In this section:

"DCO" means diffusion capacity of carbon monoxide and is a measure of the efficiency of gas transfer across the lung;

"FEV1" means forced expiratory volume in one second and is the volume of air exhaled in the first second of a forced expiratory manoeuvre;

"FVC" means forced vital capacity and is the volume of air one can exhale with a forced expiratory manoeuvre;

"predicted value" means the standard value for an average healthy person of the same age, race, height and sex as the insured.

(2) If the insured sustains a permanent respiratory functional impairment, the percentage in column 2 corresponds to the insured's impairment described opposite in column 1.

ItemColumn 1
Respiratory functional impairment
Column 2
Percentage
1Class 1 means
(a) DCO is more than 70% of predicted value,
(b) both FEV1 and FVC are more than 80% of predicted value, and
(c) the result of FEV1 divided by FVC is more than 70% of predicted value
0%
2Class 2 means
(a) DCO is at least 60% but no more than 80% of predicted value, or
(b) one of FEV1 or FVC are at least 60% but no more than 80% of predicted value
15%
3Class 3 means
(a) DCO is at least 40% but no more than 59% of predicted value,
(b) FEV1 is at least 40% but no more than 59% of predicted value, or
(c) FVC is at least 50% but no more than 59% of predicted value
35%
4Class 4 means
(a) DCO is less than 40% of predicted value,
(b) FEV1 is less than 40% of predicted value, or
(c) FVC is less than 50% of predicted value
75%

Part 7 — Digestive Tract

Application regarding tissue disruption and functional loss

125   In this Part, the percentage that corresponds to the description of the impairment considers both tissue disruption and functional loss together.

Upper gastrointestinal tract disorder

126   If the insured sustains a permanent upper gastrointestinal tract disorder, the percentage in column 2 corresponds to the insured's disorder described opposite in column 1.

Item Column 1
Upper gastrointestinal tract disorder
Column 2
Percentage
1Class 1 means
(a) symptoms or signs of upper digestive tract disease are present or anatomic loss or alteration of tissue,
(b) continuous treatment is not required, and
(c) weight can be maintained at an appropriate weight for the insured
2.5%
2Class 2 means
(a) symptoms and signs of upper digestive tract disease are present or anatomic loss or alteration of tissue,
(b) dietary restrictions or medical treatments are required for control of symptoms, signs or nutritional deficiency, and
(c) weight loss is not more than 10% below an appropriate weight for the insured
7.5%
3Class 3 means
(a) symptoms and signs of upper digestive tract disease are present or anatomic loss or alteration of tissue, and
(b) dietary restrictions or medical treatments do not completely control symptoms, signs or nutritional deficiency or weight loss is 10% to 20% below an appropriate weight for the insured
25%
4Class 4 means
(a) symptoms and signs of upper digestive tract disease are present or anatomic loss or alteration of tissue, and
(b) symptoms are uncontrolled by treatment or weight loss is more than 20% below an appropriate weight for the insured
40%

Lower gastrointestinal tract disorder — colon and rectum

127   If the insured sustains a permanent lower gastrointestinal tract disorder in relation to the colon or rectum, the percentage in column 2 corresponds to the insured's disorder described opposite in column 1.

Item Column 1
Lower gastrointestinal tract disorder
Column 2
Percentage
1Class 1 means
(a) symptoms or signs of lower digestive tract disease are present or anatomic loss or alteration of tissue,
(b) continuous treatment is not required, and
(c) weight can be maintained at an appropriate weight for the insured
2.5%
2Class 2 means
(a) symptoms and signs of upper digestive tract disease are present or anatomic loss or alteration of tissue,
(b) dietary restrictions or medical treatments are required for control of symptoms, signs or nutritional deficiency, and
(c) weight loss is not more than 10% below an appropriate weight for the insured
7.5%
3Class 3 means
(a) symptoms and signs of lower digestive tract disease are present or anatomic loss or alteration of tissue, and
(b) dietary restrictions or medical treatments do not completely control symptoms, signs or nutritional deficiency or weight loss is 10% to 20% below an appropriate weight for the insured
25%
4Class 4 means
(a) symptoms and signs of lower digestive tract disease are present or anatomic loss or alteration of tissue, and
(b) symptoms are uncontrolled by treatment or weight loss is more than 20% below an appropriate weight for the insured
40%

Lower gastrointestinal tract — anal impairment

128   If the insured sustains a permanent anal impairment, the percentage in column 2 corresponds to the insured's impairment described opposite in column 1.

ItemColumn 1
Anal impairment
Column 2
Percentage
1Class 1 means
(a) evidence of anatomic loss, alteration of tissue or mild incontinence of stool, and
(b) symptoms can be controlled by treatment
2.5%
2Class 2 means there is evidence of anatomic loss or alteration of tissue and either
(a) there is moderate incontinence of stool, requiring continual treatment, or
(b) symptoms are incompletely controlled by treatment
7.5%
3Class 3 means there is evidence of anatomic loss or alteration of tissue and either
(a) complete fecal incontinence is present, or
(b) symptoms are unresponsive to treatment
20%

Liver and biliary tract — liver tissue disruption

129   If the insured sustains a permanent liver tissue disruption, the percentage in column 2 corresponds to the insured's disruption described opposite in column 1.

ItemColumn 1
Liver tissue disruption
Column 2
Percentage
1Liver trauma not requiring surgery5%
2Blunt trauma or laceration requiring surgery20%

Liver and biliary tract — residual hepatic functional impairment

130   If the insured sustains a permanent residual hepatic functional impairment, the percentage in column 2 corresponds to the insured's impairment described opposite in column 1.

Item Column 1
Residual hepatic functional impairment
Column 2
Percentage
1Class 1 means
(a) objective evidence of persistent liver disease,
(b) no symptoms or signs of ascites, jaundice, or other significant hepatic complications, and
(c) biochemical studies indicate minimal disturbance in hepatic function
5%
2Class 2 means
(a) objective evidence of chronic liver disease,
(b) no symptoms, or signs of ascites, jaundice, or esophageal bleeding, and
(c) biochemical studies indicate severe disturbance in hepatic function
15%
3Class 3 means
(a) objective evidence of progressive chronic liver disease,
(b) a history of jaundice, ascites, or bleeding of upper gastrointestinal varices, or
(c) intermittent hepatic encephalopathy
40%
4Class 4 means
(a) objective evidence of progressive chronic liver disease or persistent jaundice or bleeding, esophageal varices, and
(b) central nervous system manifestations of hepatic insufficiency
70%

Liver and biliary tract — biliary tract dysfunction

131   If the insured sustains a permanent biliary tract dysfunction, the percentage in column 2 corresponds to the insured's dysfunction described opposite in column 1.

Item Column 1
Biliary tract dysfunction
Column 2
Percentage
1Class 1 means occasional biliary tract dysfunction with documented biliary tract disease5%
2Class 2 means recurrent biliary tract dysfunction despite ongoing treatment20%
3Class 3 means obstruction of the biliary tract with recurrent cholangitis40%
4Class 4 means persistent jaundice and progressive liver disease due to obstruction of the common bile duct75%

Hernia-related impairment

132   If the insured sustains a permanent hernia-related impairment, the percentage in column 2 corresponds to the hernia-related impairment described opposite in column 1.

ItemColumn 1
Hernia-related impairment
Column 2
Percentage
1Class 1 means
(a) palpable defect in the supporting structures of the abdominal wall, and
(b) slight protrusion at the site of defect with increased abdominal pressure where defect is readily reducible
5%
2Class 2 means
(a) palpable defect in the supporting structures of the abdominal wall where frequent or persistent protrusion at the site of defect may increase with intra-abdominal pressure, and
(b) is manually reducible
15%
3Class 3 means palpable defect in the supporting structures of the abdominal wall where persistent, irreducible, or irreparable protrusion at the site of defect has occurred causing limitation in normal activities25%

Post-operative abdominal wall-related impairment

133   If the insured sustains a permanent post-operative abdominal wall-related impairment, the percentage in column 2 corresponds to the post-operative abdominal wall-related impairment described opposite in column 1.

ItemColumn 1
Post-operative abdominal wall-related impairment
Column 2
Percentage
1Alteration of tissue following a laparotomy2%
2Alteration of tissue following a laparoscopy or penetrating abdominal wound1%

Part 8 — Cardiovascular System

Thoracic arterial lesion

134   If the insured sustains a permanent thoracic arterial lesion, the percentage in column 2 corresponds to the insured's lesion described opposite in column 1.

ItemColumn 1
Thoracic arterial lesion
Column 2
Percentage
1Surgically corrected alteration of the ascending thoracic aorta4%
2Surgically corrected alteration of the descending thoracic aorta3%

Functional limitation — cardiovascular lesion

135   If the insured sustains a permanent functional limitation related to a cardiovascular lesion, the percentage in column 2 corresponds to the insured's functional limitation described opposite in column 1.

Item Column 1
Functional limitation related to cardiovascular lesion
Column 2
Percentage
1Class 1, with more than 7 metabolic equivalents, as evidenced by a cardiovascular lesion
(a) without angina with strenuous, rapid or prolonged exertion or when undergoing a maximum stress test, and
(b) without shortness of breath with strenuous, rapid or prolonged exertion or when undergoing a maximum stress test
2.5%
2Class 1, with more than 7 metabolic equivalents, as evidenced by a cardiovascular lesion
(a) without angina when performing ordinary physical activities, including walking or climbing stairs, and
(b) with angina with strenuous, rapid or prolonged exertion or when undergoing a maximum stress test
7.5%
3Class 2, with 5 to 7 metabolic equivalents, as evidenced by a cardiovascular lesion
(a) without angina when performing ordinary physical activities, including walking or climbing stairs, and
(b) without shortness of breath when performing ordinary physical activities, including walking or climbing stairs
15%
4Class 2, with 5 to 7 metabolic equivalents, as evidenced by a cardiovascular lesion with minor limitation characterized by, in any of the following circumstances, angina or shortness of breath:
(a) walking at a brisk pace, walking uphill or similar physical activities;
(b) walking or stair climbing after meals, in cold or in wind;
(c) when the insured is under emotional stress;
(d) in the morning after waking;
(e) when walking more than 2 blocks on a level surface;
(f) climbing a flight of ordinary stairs at a fast pace or more than one flight of ordinary stairs at a normal pace and in normal conditions
30%
5Class 3, with 2 to 4 metabolic equivalents, as evidenced by moderate limitation characterized by, for physical activities, angina or shortness of breath, including in any of the following circumstances:
(a) walking 1 to 2 blocks on a level surface;
(b) climbing one flight of ordinary stairs at a normal pace and in normal conditions
45%
6Class 4, with less than 2 metabolic equivalents, as evidenced by severe limitation characterized by, for physical activities, angina or shortness of breath, including in any of the following circumstances:
(a) walking a few steps;
(b) while performing movements needed for personal hygiene and self-care;
(c) at rest or during sleep
80%

Peripheral arterial lesion

136   If the insured sustains a permanent peripheral arterial lesion, the percentage in column 2 corresponds to the insured's lesion described opposite in column 1.

Item Column 1
Peripheral arterial lesion
Column 2
Percentage
1Surgically corrected alteration of the abdominal aorta3%
2Surgically corrected alteration of a peripheral artery1%
3Functional alteration following a unilateral sympathectomy2%
4Alteration of a blood vessel corrected by transluminal angioplasty2%

Functional limitation — peripheral arterial lesion following lower limb vascular lesion

137   If the insured sustains a permanent functional limitation related to a peripheral arterial lesion following a lower limb vascular lesion, the percentage in column 2 corresponds to the insured's functional limitation described opposite in column 1.

ItemColumn 1
Functional limitation related to peripheral arterial lesion
Column 2
Percentage
1Severe arterial insufficiency with trophic skin changes and ulceration, with inability to walk45%
2Intermittent claudication occurring when walking at an ordinary pace over a distance of less than 75 metres30%
over a distance of 75 to 120 metres20%
over a distance of more than 120 metres but less than 300 metres10%
3Slightly inhibiting intermittent claudication, occurring when walking at an ordinary pace over a distance of 300 to 500 metres5%

Functional limitation — peripheral arterial lesion following upper limb vascular lesion

138   If the insured sustains a permanent functional limitation in relation to a peripheral arterial lesion following an upper limb vascular lesion, the percentage in column 2 corresponds to the insured's functional limitation described opposite in column 1.

Item Column 1
Functional limitation related to peripheral arterial lesion
Column 2
Percentage
1Severe arterial insufficiency, with trophic skin changes and ulceration, inhibiting exertion or causing ischemic pain at rest45%
2Arterial insufficiency causing significant intermittent ischemic pain that occurs with light exertion30%
3Arterial insufficiency causing intermittent ischemic painthat occurs with moderate exertion15%
that occurs with heavy exertion5%

Venous and lymphatic lesion

139   If the insured sustains a permanent venous or lymphatic lesion, the percentage in column 2 corresponds to the insured's lesion described opposite in column 1.

Item Column 1
Venous and lymphatic lesions
Column 2
Percentage
1Post-traumatic venous insufficiency or lymphatic insufficiencyminor, well controlled by medical treatment3%
moderate, not completely controlled by medical treatment5%
severe, not controlled by medical treatment, with trophic problems, but without recurring ulceration8%
very severe, not controlled by medical treatment, with trophic problems and recurring ulceration12%
2Superficial venous insufficiency1%

Part 9 — Endocrine System

Hypothalamus, pituitary, thyroid and parathyroid gland dysfunction

140   If the insured sustains a permanent hypothalamus, pituitary, thyroid or parathyroid gland dysfunction, the percentage in column 2 corresponds to the insured's gland dysfunction described opposite in column 1.

ItemColumn 1
Hypothalamus, pituitary, thyroid or parathyroid gland dysfunction
Column 2
Percentage
1Total hypopituitarism, including diabetes insipidus as a symptom of total hypopituitarism60%
2Partial hypopituitarism, excluding diabetes insipidus, requiring replacement ofthyroid hormone5%
glucocorticoids10%
estrogen, progesterone or testosterone when fertility is not an issue10%
hormones when there is a loss of fertility20%
growth hormone in a child or adolescent20%
growth hormone in an adult2%
3Diabetes insipidus, except as described in item 110%
4Impairment of the parathyroid glands10%
5Alteration of the thyroid gland not requiring hormone therapy2%
6Alteration or loss of the thyroid gland requiring hormone therapy5%

Diabetes mellitus

141   If the insured sustains permanent diabetes mellitus, the percentage in column 2 corresponds to the insured's diabetes mellitus described opposite in column 1.

ItemColumn 1
Diabetes mellitus
Column 2
Percentage
1Controlled without the use of insulin, non-insulin injected medication or oral medication5%
2Control requiring the use of non-insulin injected medication or oral medication10%
3Control requiring insulin therapy30%
4Difficult to control with insulin therapy40%

Adrenal gland

142   If the insured sustains a permanent adrenal gland loss, the percentage in column 2 corresponds to the insured's loss described opposite in column 1.

ItemColumn 1
Adrenal gland loss
Column 2
Percentage
1Loss of one adrenal gland2%
2Loss of both adrenal glands requiring hormone therapy15%

Part 10 — Hematopoietic System

Tissue disruption — spleen

143   If the insured sustains a permanent spleen tissue disruption, the percentage in column 2 corresponds to the insured's disruption described opposite in column 1.

ItemColumn 1
Spleen tissue disruption
Column 2
Percentage
1Injury not requiring surgery 1%
2Injury requiring splenic repair or partial splenectomy5%
3Injury resulting in total splenectomy 10%

Tissue disruption — thymus

144   If the insured sustains a permanent thymus tissue disruption, the percentage in column 2 corresponds to the insured's disruption described opposite in column 1.

Item Column 1
Thymus tissue disruption
Column 2
Percentage
1Injury not requiring surgery 0%
2Injury requiring partial thymectomy 1%
3Injury resulting in total thymectomy 2%

Functional impairment — red blood cells

145   (1) If the insured sustains a permanent functional impairment of the red blood cells, the percentage in column 2 corresponds to the insured's symptoms, hemoglobin level and transfusion requirement described opposite in column 1.

(2) For certainty, in respect of items 3 and 4, the hemoglobin level is measured prior to transfusion.

ItemColumn 1
Symptoms, hemoglobin level and transfusion requirement
Column 2
Percentage
1(a) No symptoms,
(b) 100 to 120 g/L hemoglobin level, and
(c) no transfusion requirement
0%
2(a) Minimal symptoms,
(b) 80 to 100 g/L hemoglobin level, and
(c) no transfusion requirement
15%
3(a) Moderate symptoms,
(b) 50 to 80 g/L hemoglobin level, and
(c) transfusion requirement of 2 to 3 units of blood every 4 to 6 weeks
40%
4(a) Severe symptoms,
(b) 50 to 80 g/L hemoglobin level, and
(c) transfusion requirement of 2 to 3 units of blood every 2 weeks
75%

Functional impairment — white blood cells

146   If the insured sustains a permanent functional impairment in relation to decreased white blood cells, the percentage in column 2 corresponds to the insured's symptoms, hemoglobin level and treatment requirement described opposite in column 1.

ItemColumn 1
Symptoms, hemoglobin level and treatment requirements
Column 2
Percentage
1(a) No symptoms,
(b) 3 to 10 g/L white blood cell level, and
(c) no treatment requirement
0%
2(a) Minimal symptoms,
(b) 1 to 3 g/L white blood cell level, and
(c) no treatment requirement
15%
3(a) Moderate symptoms,
(b) 0.5 to 1 g/L white blood cell level, and
(c) treatment requirement of administration of white blood cell growth factor
40%
4(a) Severe symptoms,
(b) less than 0.5 g/L white blood cell level, and
(c) treatment requirement of administration of white blood cell growth factor
75%

Part 11 — Psychiatric Condition, Syndrome and Phenomenon

Psychiatric condition, syndrome and phenomenon

147   If an insured sustains a permanent psychiatric condition, syndrome or phenomenon, the percentage in column 2 corresponds to the description opposite in column 1 of the insured's class of psychiatric condition, syndrome or phenomenon.

Item Column 1
Class of psychiatric condition, syndrome or phenomenon
Column 2
Percentage
1Class 1 psychiatric condition, syndrome or phenomenon, including adverse effects of medication, that impairs the insured's
(a) ability to perform the activities of daily living,
(b) ability to function socially, or
(c) sense of well-being,
to the extent that the insured requires continuous supervision in an institutional or controlled setting
100%
2Class 2 psychiatric condition, syndrome or phenomenon, including adverse effects of medication, that impairs the insured's
(a) ability to perform the activities of daily living,
(b) ability to function socially, or
(c) sense of well-being,
to the extent that the insured requires periodic supervision in an institutional or controlled setting for 50% or more of the time
70%
3Class 3 psychiatric condition, syndrome or phenomenon, including adverse effects of medication, that impairs the insured's
(a) ability to perform the activities of daily living,
(b) ability to function socially, or
(c) sense of well-being,
to the extent that the insured requires periodic supervision in an institutional or controlled setting for less than 50% of the time
35%
4Class 4 psychiatric condition, syndrome or phenomenon, including adverse effects of medication, that impairs the insured's
(a) ability to perform the activities of daily living,
(b) ability to function socially, or
(c) sense of well-being,
to the extent that the insured requires psychiatric follow-up on a monthly basis
15%
5Class 5 psychiatric condition, syndrome or phenomenon, including adverse effects of medication, that impairs the insured's
(a) ability to perform the activities of daily living,
(b) ability to function socially, or
(c) sense of well-being,
to the extent that the insured requires regular medication, psychiatric intervention or both on an occasional basis of less than once per month
5%

Part 12 — Vestibulocochlear Apparatus

Formula to determine percentage for sections 149 to 152

148   For the purposes of sections 149 to 152, the percentage for the purpose of determining the permanent impairment component is determined by the following formula:

P = (H × 0.8) + (V × 0.9) + (T × 0.8)
where:
P = the percentage for sections 149 to 152 for the purposes of determining the permanent impairment component;
H = the percentage for hearing loss calculated and determined in accordance with section 149 or, if the insured did not sustain hearing loss determined in accordance with section 149, 0;
V = the sum of the percentages for vestibular function determined in accordance with sections 150 and 151 or, if the insured did not sustain hearing loss determined in accordance with sections 150 and 151, 0;
T = the percentage for tinnitus determined in accordance with section 152 or, if the insured did not sustain tinnitus determined in accordance with section 152, 0.

Hearing loss — percentage for variable H

149   (1) If the insured sustains permanent hearing loss, the insured's reduction of hearing in decibels described in column 1 corresponds to the sum of

(a) in respect of the most impaired ear, the percentage opposite in column 2, and

(b) in respect of the less impaired ear, the percentage opposite in column 3.

(2) For the purposes of this section,

(a) hearing loss is measured without the insured using a hearing aid or similar device, and

(b) the reduction of hearing in decibels in column 1 is measured by the average obtained by an audiogram on frequencies of 500, 1 000 and 2 000 cycles per second.

(3) For the purposes of items 1 to 9, the percentage in column 2 is multiplied by 2 if the insured sustains a speech discrimination score of 80% or less.

(4) The maximum percentage that may be determined in accordance with this section is 30%.

Item Column 1
Reduction of hearing in decibels
Column 2
Percentage (most impaired ear)
Column 3
Percentage (less impaired ear)
11 – 25 ISO subject to subsections (3) and (4), 0.5%subject to subsection (4), 2.5%
226 – 29 ISOsubject to subsections (3) and (4), 1%subject to subsection (4), 5%
330 – 34 ISOsubject to subsections (3) and (4), 1.5%subject to subsection (4), 7.5%
435 – 39 ISOsubject to subsections (3) and (4), 2%subject to subsection (4), 10%
540 – 44 ISOsubject to subsections (3) and (4), 2.5%subject to subsection (4), 12.5%
645 – 49 ISOsubject to subsections (3) and (4), 3%subject to subsection (4), 16%
750 – 54 ISOsubject to subsections (3) and (4), 3.5%subject to subsection (4), 17.5%
855 – 59 ISOsubject to subsections (3) and (4), 4%subject to subsection (4), 20%
960 ISO or moresubject to subsections (3) and (4), 5%subject to subsection (4), 25%

Vestibular functional impairment — percentage for variable V

150   If the insured sustains a permanent vestibular functional impairment, the percentage in column 2 corresponds to the insured's impairment described opposite in column 1.

ItemColumn 1
Vestibular functional impairment
Column 2
Percentage
1Class 1, evidenced by peripheral or central vertigo that does not affect the insured's capacity to perform the activities of daily living 2.5%
2Class 2, evidenced by peripheral or central vertigo that does not affect the insured's capacity to perform most of the activities of daily living, but certain activities, including driving a vehicle or riding a bicycle, may endanger the safety of the insured or others7.5%
3Class 3, evidenced by peripheral or central vertigo that necessitates continuous supervision for the performance of most of the activities of daily living 30%
4Class 4, evidenced by peripheral or central vertigo that requires continuous supervision for the performance of most of the activities of daily living and confinement of the insured in an institutional or controlled setting50%

Vestibular functional impairment — loss of labyrinth — percentage for variable V

151   If the insured sustains a permanent vestibular functional impairment in relation to loss of labyrinth, the percentage in column 2 corresponds to the insured's loss of labyrinth described opposite in column 1.

Item Column 1
Loss of labyrinth
Column 2
Percentage
1Loss of labyrinth complete loss of one labyrinth5%
complete loss of both labyrinths10%

Tinnitus — percentage for variable T

152   (1) If the insured sustains permanent tinnitus, the percentage in column 2 corresponds to the insured's tinnitus described opposite in column 1.

(2) For certainty, the percentage in column 2 applies if the tinnitus is unilateral or bilateral.

ItemColumn 1
Tinnitus symptoms and conditions
Column 2
Percentage
1Class 1, means tinnitus that
(a) is intermittent and noticeable only in a quiet environment, and
(b) does not disturb sleep
0.5%
2Class 2, means tinnitus that
(a) is constantly present and bothersome in a quiet environment,
(b) disturbs concentration, and
(c) disturbs sleep
2%
3Class 3, means tinnitus that
(a) is constantly present and bothersome in most environments,
(b) disturbs concentration,
(c) disturbs sleep, and
(d) disturbs one or more of the other activities of daily living
5%

External ear canal impairment

153   If the insured sustains a permanent external ear canal impairment, the percentage in column 2 corresponds to the insured's impairment described opposite in column 1.

Item Column 1
External ear canal impairment
Column 2
Percentage
1Unilateralmild0.5%
moderate 1%
severe2%
2Bilateral3%

Part 13 — Skin

Interpretation for Part

154   In this Part:

"alteration in form and symmetry" means a skin or surface disfigurement that results in a change in any of the following but does not refer to the presence of a scar:

(a) tissue bulk;

(b) tissue consistency;

(c) tissue length;

(d) tissue texture;

"conspicuous" means a skin disfigurement that is readily discernable with the unaided eye;

"faulty scar" means a scar that is misaligned, irregular, depressed, deeply adhering, pigmented, scaly, retractile, keloidal or hypertrophic;

"flat scar" means a scar that is

(a) almost linear,

(b) at the same level as the adjoining tissue,

(c) almost the same colour as the adjoining tissue, and

(d) causes no contraction or distortion of neighbouring structures;

"inconspicuous" means a skin disfigurement that is not readily discernable with the unaided eye.

Division 1 — Facial Disfigurement

Facial disfigurement

155   (1) The following are the anatomical elements of the face:

(a) forehead and glabella;

(b) the orbits, also known as the periorbital area, excluding the eyelids;

(c) the eyelids;

(d) the visible part of the ocular globes;

(e) the cheeks;

(f) the nose;

(g) the lips;

(h) the ears;

(i) the chin.

(2) If the insured sustains permanent facial disfigurement, the following steps are to be taken in the following order to determine the percentage:

(a) determine the class of facial disfigurement in column 1 of Table 1 or 2 according to,

(i) in Table 1,

(A) the physical description of the insured's disfigurement described in columns 2, 3 and 5 opposite column 1, and

(B) if applicable, if the description of the alteration in form and symmetry in column 3 and the description of the scarring of the anatomical elements of the insured's face in column 5 are not in the same class, the class in column 1 that is opposite the most severe criteria sustained by the insured is the applicable class for both the alteration in form and symmetry and scarring, or

(ii) in Table 2, the physical description of the insured's disfigurement described in column 2 opposite column 1;

(b) if the class is listed

(i) in Table 1,

(A) the percentage in column 4 of Table 1 corresponds to the alteration in form and symmetry of the anatomical elements of the insured's face described opposite in column 3 of Table 1;

(B) the percentage in column 6 of Table 1 corresponds to the scarring of the anatomical elements of the insured's face described opposite in column 5 of Table 1;

(C) if applicable, the percentages determined in accordance with clauses (A) and (B) are added together;

(D) the percentage determined in accordance with clause (A), (B) or (C) must not exceed the maximum percentage set out in column 7 of Table 1 opposite the class determined in paragraph (a), and

(ii) in Table 2, the percentage in column 3 of Table 2 corresponds to the class described in column 1 of Table 2.

Table 1: Class 1, no impairment to Class 4, moderate impairment

ItemColumn 1
Class of impairment
Column 2
Physical description of impairment
Column 3
Alteration in form and symmetry
Column 4
Percentage
Column 5
Scarring
Column 6
Percentage
Column 7
Maximum percentage
1Class 1no impairmentinconspicuous changesubject to subsection (2) (b) (i) (D), 0%inconspicuoussubject to subsection (2) (b) (i) (D), 0%0%
2Class 2very minor impairmentinconspicuous changesubject to subsection (2) (b) (i) (D), 0%conspicuous subject to subsection (2) (b) (i) (D), 1% per cm23%
3Class 3minor impairmentconspicuous change affecting one anatomical element in subsection (1)subject to subsection (2) (b) (i) (D), 3%conspicuous and flat scar subject to subsection (2) (b) (i) (D), 1% per cm27%
conspicuous change affecting 2 anatomical elements in subsection (1)subject to subsection (2) (b) (i) (D), 4%conspicuous and faulty scarsubject to subsection (2) (b) (i) (D), 2% per cm2
conspicuous change affecting more than 2 anatomical elements in subsection (1)subject to subsection (2) (b) (i) (D), 7%
4Class 4moderate impairmentconspicuous change that holds one's attention and affects one anatomical element in subsection (1)subject to subsection (2) (b) (i) (D), 10%conspicuous and flat scar subject to subsection (2) (b) (i) (D), 1% per cm215%
conspicuous change that holds one's attention and affects 2 anatomical elements in subsection (1)subject to subsection (2) (b) (i) (D), 12%conspicuous and faulty scarsubject to subsection (2) (b) (i) (D), 3% per cm2
conspicuous change that holds one's attention and affects more than 2 anatomical elements in subsection (1)subject to subsection (2) (b) (i) (D), 15%

Table 2: Class 5, severe impairment to Class 6, disfigurement

ItemColumn 1
Column 2
Class and physical description of impairment
Column 3
Alteration in form and symmetry and scarring
Column 4
Percentage
1Class 5severe impairmentinvolving several anatomic elements in subsection (1) 20%
2Class 6disfigurementinvolving all anatomic elements in subsection (1)30%

[am. B.C. Reg. 117/2021, App. 7, s. 2.]

Division 2 — Disfigurement of Skin Overlaying Rest of Body

Disfigurement of skin, other than facial disfigurement

156   (1) In this section:

"arms, shoulders and elbows" means the skin overlaying the body region extending from the acromion process and axillary folds to the olecranon process and cubital fossa;

"forearms" means the skin overlaying the body region beginning at the distal aspect of the elbow and extending to the wrist crease;

"lower limbs" means the skin overlaying the distal aspect of the trunk and extending distally to the tips of the toes, including the buttocks;

"neck" means the skin overlaying the body region C1 to C7 posteriorly and the cricoid cartilage to the sternal notch anteriorly;

"scalp and skull" means the skin overlaying the skull beginning at the normal hairline in front and following the normal hairline around the side to the back;

"trunk" includes the skin overlaying the scapulae, supraspinous fossa, supras-capular and supraclavicular fossa body region and extends distally to the anterior inguinal ligaments and the posterior iliac crests;

"wrists and hands" means the skin overlaying the body region beginning at the wrist crease and extending distally to the fingertips.

(2) If the insured sustains permanent disfigurement of the skin overlaying body regions other than the face, the percentage is determined, subject to subsection (3), as follows:

(a) the percentage in column 3 corresponds to the insured's alteration in form and symmetry in column 2 described opposite the applicable body region in column 1;

(b) the percentage in column 5 corresponds to the insured's scarring in column 4 described opposite the applicable body region in column 1;

(c) if applicable, if the insured sustains an alteration in form and symmetry and scarring of a body region, the percentage is the higher of the percentages determined in accordance with paragraphs (a) and (b).

(3) The percentage determined in accordance with paragraph (b) or (c) must not exceed the percentage set out in column 6 that corresponds to the body region opposite it in column 1.

ItemColumn 1
Body region
Column 2
Alteration in form and symmetry
Column 3
Percentage
Column 4
Scarring
Column 5
Percentage
Column 6
Maximum percentage
1Scalp and skullminor changesubject to subsections (2) (c) and (3), 2%conspicuoussubject to subsections (2) (c) and (3), 0.5% per cm25%
moderate changesubject to subsections (2) (c) and (3), 2%
severe changesubject to subsections (2) (c) and (3), 5%
2Neckminor changesubject to subsections (2) (c) and (3), 3%conspicuoussubject to subsections (2) (c) and (3), 1% per cm28%
moderate changesubject to subsections (2) (c) and (3), 3%
severe changesubject to subsections (2) (c) and (3), 8%
3Arms, shoulders and elbowsminor changesubject to subsections (2) (c) and (3), 1%conspicuoussubject to subsections (2) (c) and (3), 0.5% per cm24% per left or right, to a maximum of 8%
moderate changesubject to subsections (2) (c) and (3), 1%
severe changesubject to subsections (2) (c) and (3), 4%
4Forearmsminor changesubject to subsections (2) (c) and (3), 1%conspicuoussubject to subsections (2) (c) and (3), 1.0% per cm25% per left or right, to a maximum of 10%
moderate changesubject to subsections (2) (c) and (3), 1%
severe changesubject to subsections (2) (c) and (3), 5%
5Wrists and handsminor changesubject to subsections (2) (c) and (3), 2%conspicuoussubject to subsections (2) (c) and (3), 1.0% per cm26% per left or right, to a maximum of 12%
moderate changesubject to subsections (2) (c) and (3), 2%
severe changesubject to subsections (2) (c) and (3), 6%
6Trunkminor changesubject to subsections (2) (c) and (3), 2%conspicuoussubject to subsections (2) (c) and (3), 0.5% per cm26% per front or back, to a maximum of 12%
moderate changesubject to subsections (2) (c) and (3), 2%
severe changesubject to subsections (2) (c) and (3), 6%
7Lower limbsminor changesubject to subsections (2) (c) and (3), 3%conspicuoussubject to subsections (2) (c) and (3), 1.0% per cm28% per left or right, to a maximum of 16%
moderate changesubject to subsections (2) (c) and (3), 3%
severe changesubject to subsections (2) (c) and (3), 8%

Facial or other body region disfigurement due to discolouration

157   (1) In this section, "discolouration of the skin" does not include the following:

(a) pigmented scars;

(b) pigmented amputation stumps;

(c) pigmented skin due to venous or lymphatic insufficiency.

(2) If the insured sustains permanent discolouration of the skin, the percentage in column 2 corresponds to the insured's discolouration described opposite in column 1.

ItemColumn 1
Discolouration of skin
Column 2
Percentage
1Class 1, as evidenced by conspicuous discolouration that affects a body region other than the face1%
2Class 2, as evidenced by conspicuous discolouration that is conspicuous and affecting the face2%

Division 3 — Disfigurement from Partial or Total Amputation

Application for Division

158   If an insured sustains an amputation, the insured is only entitled to receive a percentage corresponding to the insured's disfigurement from the amputation described in this Division and not from Divisions 1 or 2 of this Part.

Disfigurement from amputation — eye

159   If the insured sustains an eye amputation, the percentage in column 2 corresponds to the insured's permanent disfigurement from the amputation described opposite in column 1.

ItemColumn 1
Eye amputation disfigurement
Column 2
Percentage
1Enucleation with or without replacement by prosthesis, including impairment inherent in the resulting appearance 5%

Disfigurement from amputation — upper limb

160   If the insured sustains an upper limb amputation, the percentage in column 2 corresponds to the insured's permanent disfigurement from the amputation described opposite in column 1.

ItemColumn 1
Upper limb amputation disfigurement
Column 2
Percentage
1Forequarter disarticulation 12%
2Shoulder disarticulation 11%
3Above-elbow amputation 10%
4Elbow disarticulation 9%
5Below-elbow amputation 8%
6Wrist disarticulation 8%
7Amputation of a thumb1.5% per phalanx
8Amputation of a finger other than the thumb0.5% per phalanx, up to a maximum of 6%
9Amputation of a metacarpal 0.5% per metacarpal, up to a maximum of 2%

Disfigurement from amputation — lower limb

161   If the insured sustains a lower limb amputation, the percentage in column 2 corresponds to the insured's permanent disfigurement from the amputation described opposite in column 1.

ItemColumn 1
Lower limb amputation disfigurement
Column 2
Percentage
1Hemipelvectomy12%
2Hip disarticulation 10%
3Above-knee amputation 8%
4Knee disarticulation 7%
5Below-knee amputation 6%
6Ankle amputation, also known as a Symes amputation5%
7Midtarsal amputation, also known as a Chopart amputation4%
8Tarsometatarsal amputation, also known as a Lisfranc amputation3%
9Transmetatarsal amputation 2%
10Amputation of a big toe0.5% per phalanx
11Amputation of a metatarsal0.25% per metatarsal, up to a maximum of 1%
12Amputation of a toe other than the big toe0.1% per phalanx

[Provisions relevant to the enactment of this regulation: Insurance (Vehicle) Act, R.S.B.C. 1996, c. 231, ss. 113, 129, 169 and 181.]