{"id":"civil-liability-regulations-2013","name":"Civil Liability Regulations 2013","slug":"civil-liability-regulations-2013","collection":"regulation","jurisdiction":"sa","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":235291,"registerId":"sa-civil-liability-regulations-2013-current","compilationNumber":null,"startDate":"2026-04-06","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"Sch 1","sectionType":"schedule","heading":"Ranges of injury scale values","content":"Schedule 1—Ranges of injury scale values\n\nItem No\nInjury\nRange\n","sortOrder":0},{"sectionNumber":"Part 1","sectionType":"part","heading":"Central nervous system and head injuries","content":"Part 1—Central nervous system and head injuries\nQuadriplegia\n\n\t•\tPresence and extent of pain\n\t•\tExtent of any residual movement\n\t•\tLevel of function and pre‑injury function\n\t•\tAbility to participate in daily activities, including employment\n\t•\tPresence and extent of secondary medical complications\n\t•\tLoss of reproductive or sexual function\n\t•\tBowel or bladder incontinence\n\nAn ISV at or near the top of the range will be appropriate only if the injured person has assisted ventilation, extreme physical limitation and gross impairment of ability to communicate.\n\nParaplegia \n\n\t•\tPresence and extent of pain\n\t•\tExtent of any residual movement\n\t•\tLevel of function and pre‑injury function\n\t•\tAbility to participate in daily activities, including employment\n\t•\tLoss of reproductive or sexual function\n\t•\tBowel or bladder incontinence\n\t•\tPresence and extent of secondary medical complications \nHemiplegia or severe paralysis of more than 1 limb \n\nExamples of factors affecting ISV scale for item 3\nThe same examples apply as for item 2.\n\nAdditional comment for item 3\nIncomplete paralyses causing whole person impairment of less than 40% must be assessed under orthopaedic injuries if it is the only injury or the dominant injury of multiple injuries.\n\n3.1\nComplete or nearly complete paralysis\n3.2\nOther paralysis, causing whole person impairment of at least 40% \nMonoplegia\n\nSee items 5, 6 and 7 and orthopaedic injuries section.\n\nExtreme brain injury\n\nThe injury will involve major trauma to the brain with severe permanent impairment for which there is radiological evidence\n\n\t•\tAn ISV at or near the top of the range will be appropriate only if the injured person needs full‑time nursing care and has the following—\n\t•\tgross disturbance of brain function\n\t•\tsignificant physical limitation and destruction of pre‑existing lifestyle\n\t•\tepileptic seizures\n\t•\tdouble incontinence\n\t•\tlittle or no language function\n\t•\tlittle or no meaningful response to environment\n\t•\tAn injured person with an injury for which an ISV at or near the top of the range is appropriate may have some ability to follow basic commands, recovery of eye opening, return of postural reflex movement and return to pre‑existing sleep patterns.\n\nExamples of factors affecting ISV assessment for item 5:\n\t•\tExtent of bodily impairment\n\nSerious brain injury\n\nThe injured person will be very seriously disabled and substantially depends on others for professional and other care\n\nSerious brain damage causing—\n\t(a)\tphysical impairment, for example, limb paralysis; or\n\t(b)\tcognitive impairment with marked impairment of intellect and personality\n\n\t•\tExtent of sensory impairment, for example, loss of hearing or sense of taste or smell\n\t•\tEpilepsy confirmed by EEG or evidenced through a requirement for prophylactic medication for 6 months\n\t•\tPresence of and extent of secondary medical complications\n\nAn ISV at or near the top of the range will be appropriate only if the injured person substantially depends on others and needs professional and other care, that is, passive overnight care and more than 6 hours of care per day\n\nModerate brain injury\n\nThe injured person will be seriously disabled, but the degree of the injured person's dependence on others, although still present, is lower than for an item 6 injury.\n\n\t•\tExtent of sensory limitation, for example, limitation of hearing or sense of taste or smell\n\t•\tEpilepsy or a high risk of epilepsy confirmed by EEG or requiring prophylactic medication for 6 months\n\t•\tPresence of, and extent of, secondary medical complications\n\n7.1\nAn ISV in this item will be applicable if there is no capacity for employment, and 1 or more of the following:\n\t•\tmoderate to severe cognitive impairment\n\t•\tmarked personality change\n\t•\tdramatic effect on speech, sight or other senses\n\t•\tepilepsy or a high risk of epilepsy confirmed by EEG or evidenced through a requirement for prophylactic medication for 6 months.\n7.2\nAn ISV in this item will be applicable if there is an increased risk of epilepsy confirmed by EEG requiring prophylactic medication for 6 months and—\n\t•\ta moderate cognitive impairment\n\t•\tloss of, or greatly reduced capacity for, employment\n\t•\tnoticeable interference with lifestyle\nMinor brain injury\n\nAn ISV under this item will be applicable if there is evidence of physical injury causing the brain damage. The injured person will make a good recovery and be able to take part in normal social life and to return to work. There may be minor problems persisting that prevent a restoration of normal function\n\n\t•\tSeverity of any physical injury causing the brain damage, having regard to—\n\t(a)\tany medical assessment made immediately after the injury was caused, for example, CT or MRI scans, an ambulance officer's assessment or hospital emergency unit assessment; and\n\t(b)\tsignificant post‑traumatic amnesia.\n\t•\tExtent of any ongoing, and possibly permanent, disability\n\t•\tExtent of any personality change\n\t•\tDepression\n\t•\tExtent of sensory limitation, for example, limitation of hearing or sense of taste or smell\n\t•\tPresence of, and extent of, secondary medical complications\n\nAn ISV at or near the top of the range will be appropriate if:\n\t•\tthe injured person has epilepsy or an increased risk of epilepsy confirmed by EEG and the use of prophylactic medication; and\n\t•\tthere is on‑going reduced concentration and memory, or reduced mood control, that does not significantly interfere with the person's ability to take part in normal social life or return to work.\n\nMinor head injury, other than a skeletal injury of the facial area\n\nBrain damage, if any, is minimal.\n\n\t•\tUncomplicated skull fracture\n\t•\tConcussion with transitory loss of consciousness and no residual effects\n\n\t•\tSeverity of any physical injury causing brain damage\n\t•\tLength of time to recover from any symptoms\n\t•\tExtent of ongoing symptoms\n\t•\tPresence, or absence of, headaches\n\n\t•\tAn ISV at the bottom of the range will be applicable for an injury from which the injured person fully recovers within a few weeks\n\t•\tAn ISV at or near the top of the range will be appropriate if there is an uncomplicated skull fracture and/or there are associated concussive symptoms of dizziness, headache and memory loss (usually persisting for less than 6 months)\n\n","sortOrder":1},{"sectionNumber":"Part 2","sectionType":"part","heading":"Pure mental harm","content":"Part 2—Pure mental harm \n\nThis Part includes references to ratings on the psychiatric impairment scale, Guide to the Evaluation of Psychiatric Impairment for Clinicians (GEPIC).\n\nExtreme psychiatric impairment \n\nAn ISV score in the lower part of the range will be appropriate if psychiatric impairment is assessed with a GEPIC rating of Class 5.\nSerious psychiatric impairment\n\nAn ISV under this item will be applicable if psychiatric impairment is assessed with a GEPIC rating of Class 4.\nModerate psychiatric impairment \n\nThere is generally only moderate impairment.\n\nAn ISV score in this range will be appropriate if psychiatric impairment is assessed with a moderate GEPIC rating of Class 3\n\nMinor psychiatric impairment \n\nThere is generally only mild impairment.\n\nAn ISV near the top of the range will be applicable if psychiatric impairment is assessed with a mild GEPIC rating of Class 2.\nAn ISV near the bottom of the range will be applicable if psychiatric impairment is assessed with a GEPIC rating of Class 1.\n\n","sortOrder":2},{"sectionNumber":"Part 3","sectionType":"part","heading":"Facial injuries","content":"Part 3—Facial injuries\nDivision 1—Skeletal injuries of the facial area\n\nExamples of factors affecting ISV assessment for items 14 to 22\n\t•\tExtent of skeletal or functional damage\n\t•\tDegree of cosmetic damage or disfigurement\n\t•\tAvailability of cosmetic repair\n\nExtreme facial injury\n\nThe injury will involve severe traumatic injury to the face requiring substantial reconstructive surgery.\n\n\t•\tA Le Fort I fracture or Le Fort II fracture if the degree of incapacity and disfigurement after reconstructive surgery will be very severe\n\t•\tA Le Fort III fracture causing incapacity in daily activities\n\nAdditional example of factor affecting ISV scale\nThe extent of any neurological impairment or effect on the airway\nNote—\nLe Fort I fracture, Le Fort II fracture and Le Fort III fracture are defined in regulation 3.\n\nSerious facial injury\n\nThe injury will involve serious traumatic injury to the face requiring reconstructive surgery that is not substantial.\n\n\t•\tA Le Fort I fracture or Le Fort II fracture if the degree of incapacity and disfigurement after reconstructive surgery will not be very severe\n\t•\tA Le Fort III fracture if no serious deformity will remain after reconstructive surgery\n\t•\tA serious or multiple fracture of the nasal complex either or both—\n\t(a)\trequiring more than 1 operation; and\n\t(b)\tcausing 1 or more of the following—\n\t•\tpermanent damage to the airway\n\t•\tpermanent damage to nerves or tear ducts\n\t•\tfacial deformity.\n\t•\tA serious cheekbone fracture that will require surgery and cause serious disfigurement and permanent effects despite reconstructive surgery, for example, hyperaesthesia or paraesthesia\n\t•\tA very serious multiple jaw fracture that will—\n\t(a)\trequire prolonged treatment; and\n\t(b)\tdespite reconstructive surgery, cause permanent effects, for example, severe pain, restriction in eating, paraesthesia or a risk of arthritis in the joints.\n\t•\tA severed trunk of the facial nerve (7th cranial nerve), causing total paralysis of facial muscles on 1 side of the face\n\n\t•\tAny neurological impairment or effect on the airway\n\t•\tPermanent cosmetic deformity\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if the injury causes permanent cosmetic deformity, asymmetry of 1 side of the face and limited consequential mental harm.\n\t•\tAn ISV at or near the top of the range will be appropriate if the injury causes serious bilateral deformity and significant consequential mental harm.\n\nModerate facial injury\n\n\t•\tA simple cheekbone fracture, requiring minor reconstructive surgery, from which the injured person will fully recover with little cosmetic damage\n\t•\tA fracture of the jaw causing—\n\t(a)\tpermanent effects, for example, difficulty in opening the mouth or in eating; or\n\t(b)\thyperaesthesia or paraesthesia in the area of the fracture. \n\t•\tDamaged branches of the facial nerve (7th cranial nerve) with permanent paralysis of some of the facial muscles\n\t•\tA displaced fracture of the nasal complex from which the injured person will almost fully recover after surgery\n\t•\tA severed sensory nerve of the face with minor permanent paraesthesia\nMinor facial injury\n\n\t•\tA simple cheekbone fracture, for which surgery is not required and from which the injured person will recover fully\n\t•\tA simple jaw fracture, requiring immobilisation and from which the injured person will recover\n\t•\tA stable fracture of the joint process of the jaw\n\t•\tA displaced fracture of the nasal complex requiring only manipulation\n\t•\tA simple undisplaced fracture of the nasal complex, from which the injured person will fully recover\n\t•\tA severed sensory nerve of the face, with good repair causing minimal or no paraesthesia\nInjury to teeth or gums\n\nThere will generally have been a course of treatment as a result of the injury.\n\n\t•\tExtent and degree of discomfort during treatment\n\t•\tDifficulty with eating\n\nIf protracted dentistry causes the injury, the ISV may be higher than the ISV for the same injury caused by something else.\n\n18.1\nLoss of or serious damage to more than 3 teeth, serious gum injury or serious gum infection\n18.2\nLoss of or serious damage to 2 or 3 teeth, moderate gum injury or moderate gum infection\n18.3\nLoss of or serious damage to 1 tooth, minor gum injury or minor gum infection\nDivision 2—Scarring to the face \n\nThis Division will usually apply to an injury involving skeletal damage only if the skeletal damage is minor\n\nExtreme facial scarring\n\n\t•\tWidespread area scarring, for example, over the side of the face or another whole area\n\t•\tSevere contour deformity\n\t•\tSignificant deformity of the mouth or eyelids with muscle paralysis or tic\n\n\t•\tAn ISV in the upper half of the range may be appropriate if the injured person is relatively young, the cosmetic damage is very disfiguring and the consequential mental harm is severe\n\t•\tAn ISV at or near the top of the range will be appropriate if the injury is caused by burns that resulted in loss of the entire nose, eyelids or ears.\n\nSerious facial scarring\n\n\t•\tSubstantial disfigurement and significant consequential mental harm\n\t•\tDiscoloured hypertrophic or keloid scarring\n\t•\tSerious contour defects\n\t•\tSevere linear scarring\n\t•\tExtensive atrophic scarring\nModerate facial scarring\n\nAny consequential mental harm is minor, or having been considerable at the outset, has greatly diminished.\n\n\t•\tScarring, the worst effects of which will be reduced by plastic surgery that will leave minor cosmetic damage\n\t•\tScars crossing lines of election with discoloured, indurated, hypertrophic or atrophic scarring, of moderate severity\nMinor facial scarring \n\n\t•\tA single scar able to be camouflaged\n\t•\tMore than 1 very small scar if the overall effect of the scars is to mar, but not markedly to affect, appearance and consequential mental harm is minor\n\t•\tAlmost invisible linear scarring, in lines of election, with normal texture and elevation\n","sortOrder":3},{"sectionNumber":"Part 4","sectionType":"part","heading":"Injuries affecting the senses","content":"Part 4—Injuries affecting the senses \nDivision 1—General comment\n\nInjuries mentioned in this Part are commonly symptoms of brain and nervous system injury\n\nDivision 2—Injuries affecting the eyes\nTotal sight and hearing impairment\n\nThe injury ranks with the most devastating injuries.\n\n\t•\tAge and life expectancy\n\nTotal sight impairment\n\n\t•\tAge and life expectancy\nComplete sight impairment in 1 eye with reduced vision in the other eye\n\nAn ISV at or near the top of the range will be appropriate if there is serious risk of further significant deterioration in the remaining eye.\nComplete sight impairment in 1 eye or total loss of 1 eye\n\n\t•\tThe extent to which the injured person's activities are adversely affected by the impairment or loss\n\t•\tAssociated scarring or cosmetic damage\n\nAn ISV at or near the top of the range will be appropriate if there is a minor risk of sympathetic ophthalmia.\n\nSerious eye injury\n\n\t•\tA serious but incomplete loss of vision in 1 eye without significant risk of loss or reduction of vision in the other eye\n\t•\tAn injury causing double vision that is not minor and intermittent\nModerate eye injury\n\nMinor but permanent impairment of vision in one eye, including if there is double vision that is minor and intermittent\nMinor eye injury\n\nA minor injury, for example, from being struck in the eye, exposed to smoke or other fumes or being splashed by liquids—\n\t(a)\tcausing initial pain and temporary interference with vision; and\n\t(b)\tfrom which the injured person will fully recover within a relatively short time\nDivision 3—Injuries affecting the ears\nExtreme ear injury\n\nThe injury involves a binaural hearing loss of at least 80%.\n\n\t•\tAssociated problems, for example, severe tinnitus, moderate vertigo, a moderate vestibular disturbance or headaches\n\t•\tAvailability of hearing aids or other devices that may reduce the hearing loss\n\nAn ISV at or near the top of the range will be appropriate if the injury happened at an early age so as to prevent or to seriously affect the development of normal speech\n\nSerious ear injury\n\nThe injury involves—\n\t(a)\ta binaural hearing loss of at least 50% but less than 80%; or\n\t(b)\tsevere permanent vestibular disturbance.\n\n\t•\tAn ISV in the lower half of the range will be appropriate if there is no speech impairment or tinnitus\n\t•\tAn ISV in the upper half of the range will be appropriate if there is speech impairment and tinnitus.\n\nModerate ear injury\n\nThe injury involves—\n\t(a)\ta binaural hearing loss of at least 20% but less than 50%; or\n\t(b)\tsignificant permanent vestibular disturbance.\n\nAn ISV at or near the top of the range will be appropriate if there are problems associated with the injury, for example, severe tinnitus, moderate vertigo, a moderate vestibular disturbance or headaches.\n\nMinor ear injury\n\nThe injury involves a binaural hearing loss of less than 20%.\n\n\t•\tThis item covers the bulk of hearing impairment cases\n\t•\tThe injury is not to be judged simply by the degree of hearing loss\n\t•\tThere will often be a degree of tinnitus present\n\t•\tThere may also be minor vertigo or a minor vestibular disturbance causing loss of balance\n\t•\tA vestibular disturbance may increase the level of ISV. \n\n33.1\nModerate tinnitus and hearing loss \n33.2\nMild tinnitus with some hearing loss\n33.3\nSlight or occasional tinnitus with slight hearing loss or an occasional vestibular disturbance, or both\nDivision 4—Impairment of taste or smell\nTotal loss of taste or smell, or both\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if there will be a total loss of either taste or smell\n\t•\tAn ISV at or near the top of the range will be appropriate if there will be a total loss of both taste and smell.\nPartial loss of smell or taste, or both\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if there will be a partial loss of either taste or smell\n\t•\tAn ISV at or near the top of the range will be appropriate if there will be a partial loss of both taste and smell.\n","sortOrder":4},{"sectionNumber":"Part 5","sectionType":"part","heading":"Injuries to internal organs","content":"Part 5—Injuries to internal organs\nDivision 1—Chest injuries\n\nExample of factors affecting ISV assessment for items 36 to 39\nThe level of any reduction in the capacity for employment and enjoyment of life\n\nExtreme chest injury\n\nThe injury will involve severe traumatic injury to the chest, or a large majority of the organs in the chest cavity, causing a high level of disability and ongoing medical problems.\n\nAn ISV at or near the top of the range will be appropriate if there will be total removal of 1 lung or serious heart damage, or both, with serious and prolonged pain and suffering and significant permanent scarring.\n\nSerious chest injury\n\nThe injury will involve serious traumatic injury to the chest or organs in the chest cavity, causing serious disability and ongoing medical problems.\n\nA trauma to 1 or more of the following, causing permanent damage, physical disability and impairment of function—\n\t•\tthe chest (eg the chest wall mechanics with consequent restrictive ventilatory impairment)\n\t•\tthe heart\n\t•\t1 or both of the lungs (eg scarring or restrictive pleural disease)\n\t•\tthe diaphragm (eg rupture or phrenic nerve injury)\n\t•\tan injury that causes the need for oxygen therapy for about 16 to 18 hours a day\n\nExample of factors affecting ISV scale\nThe need for a permanent tracheostomy\n\nAn ISV at or near the top of the range will be appropriate if, after recovery, there are both of the following—\n\t(a)\tserious impairment to cardio‑pulmonary function;\n\t(b)\twhole person impairment for the injury of, or of nearly, 40%.\n\nModerate chest injury\n\nThe injury will involve serious traumatic injury to the chest or organs in the chest cavity, causing moderate disability and ongoing medical problems\n\n\t•\tDuration and intensity of pain and suffering (eg chronic inter costal neuralgia)\n\t•\tThe degree of permanent impairment of lung or cardiac function, as evidenced by objective test results\n\t•\tThe need for a temporary tracheostomy for short‑term airway management\n\nAn ISV at or near the top of the range will be applicable if there are multiple rib fractures causing—\n\t(a)\ta flail segment (flail chest) requiring mechanical ventilation in the acute stage; and\n\t(b)\tmoderate permanent impairment of cardio‑pulmonary function.\nAn ISV at near the bottom of the range will be appropriate if there will be a partial loss of a breast without significant consequential mental harm.\nAn ISV in the lower half of the range will be appropriate if there was a pneumothorax, or haemothorax, requiring intercostal catheter insertion. \n\nMinor chest injury\n\nExamples of factors affecting ISV scale for items 39.1 and 39.2\n\t•\tcomplexity of any fractures\n\t•\textent of injury to underlying organs\n\t•\textent of any disability\n\t•\tduration and intensity of pain and suffering\n\n39.1\nComplicated or significant fracture, or internal organ injury, that substantially resolves\n\nThe injury will involve significant or complicated fractures, or internal injuries, that cause some tissue damage but no significant long‑term effect on organ function.\n\n\t•\tMultiple fractures of the ribs or sternum, or both, that may cause cardio‑pulmonary contusion\n\t•\tInternal injuries that cause some tissue damage but no significant long‑term effect on organ function\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if there is a fractured sternum that substantially resolves, and there is some ongoing pain and activity restriction\n\t•\tAn ISV at or near the top of the range will be appropriate if the injury causes significant persisting pain and significant activity restriction. \n\n39.2\nSoft tissue injury, minor fracture or minor internal organ injury\n\n\t•\tThe injury will involve a soft tissue injury, minor fracture, or minor and non‑permanent injury to internal organs\n\t•\tThere may be persistent pain from the chest, for example, from the chest wall or sternochondral or costochondral joints.\n\n\t•\tA single penetrating wound, causing some tissue damage but no long‑term effect on lung function\n\t•\tAn injury to the lungs caused by the inhalation of toxic fumes or smoke that will not permanently interfere with lung function\n\t•\tA soft tissue injury to the chest wall, for example, a laceration or serious seatbelt bruising\n\t•\tFractured ribs or a minor fracture of the sternum causing serious pain and disability for weeks, without internal organ damage or permanent disability\n\nAn ISV at or near the bottom of the range will be appropriate if there is a soft tissue injury from which the injured person will fully recover.\n\nDivision 2—Lung injury other than asthma\n\nThe level of an ISV for lung disease often reflects the fact that the disease is worsening and there is a risk of the development of secondary medical conditions.\n\nExamples of factors affecting ISV assessment for items 40 to 43\nConsequential mental harm may increase the level of ISV\n\nExtreme lung injury\n\n\t•\tLung disease involving serious disability causing severe pain and dramatic impairment of function and quality of life\n\t•\tA recurrent pulmonary embolism resulting in failure of the right side of the heart requiring a lung transplant, heart transplant or both\n\n\t•\tLikelihood of progressive worsening\n\t•\tDuration and intensity of pain and suffering\n\nSerious lung injury\n41.1\nSerious lung injury if progressive worsening of lung function\n\nExample of item 41.1\nLung disease, causing—\n\t•\tsignificantly reduced and worsening lung function\n\t•\tprolonged and frequent coughing\n\t•\trestriction of physical activity, employment and enjoyment of life.\n\nAdditional examples of factors affecting ISV scale for item 41.1\n\t•\tThe possibility of lung cancer developing may increase the level of ISV\n\t•\tThe need for continuous oxygen therapy\n\n41.2\nSerious lung injury if no progressive worsening of lung function\n\nExamples of item 41.2\n\t•\tLung disease causing breathing difficulties, short disabling breathlessness, requiring frequent use of inhaler\n\t•\tLung disease causing a significant effect on employment and social life, including inability to tolerate a smoky environment, with an uncertain prognosis\n\t•\tA recurrent pulmonary embolism causing pulmonary hypertension and cor pulmonale\nModerate lung injury\n\nA pulmonary embolism requiring anticoagulant therapy for at least 1 year or pulmonary endarterectomy\nMinor lung injury\n\n\t•\tLung disease causing slight breathlessness, with—\n\t(a)\tno effect on employment; and\n\t(b)\tthe likelihood of substantial and permanent recovery within a few years after the injury is caused\n\t•\tA pulmonary embolism requiring anticoagulant therapy for less than 1 year\n\nAn ISV under this item will also will be appropriate if there is lung disease causing temporary aggravation of bronchitis, or other chest problems, that will resolve within a few months.\n\nDivision 4—Injuries to male reproductive system\n\n\t•\tThis Division applies to injuries caused by physical trauma rather than as a secondary result of psychiatric impairment\n\t•\tFor psychiatric impairment that causes loss of reproductive system function, (see psychiatric impairment)\n\t•\tSterility is usually either—\n\t(a)\tcaused by surgery, chemicals or disease; or\n\t(b)\tcaused by a traumatic injury that is often aggravated by scarring.\n\nExamples of factors affecting ISV assessment for items 44 to 47\n\t•\tEffect on social and domestic life\n\nImpotence and sterility\n\n\t•\tWhether the injured person has children\n\t•\tWhether the injured person intended to have children or more children\n44.1\n\t•\tAn ISV at or near the top of the range will be appropriate if a young injured person has total impotence and loss of sexual function and sterility\n\t•\tAn ISV in the upper half of the range will be appropriate if a young injured person without children has uncomplicated sterility, without impotence or any aggravating features\n\t•\tAn ISV near the middle of the range will be appropriate if a middle‑aged injured person with children has sterility and permanent impotence\n\t•\tAn ISV in lower half of the range will be appropriate if an injured person with children may have intended to have more children and has uncomplicated sterility, without impotence or any aggravating features\n\t•\tAn ISV at or near the bottom of the range will be applicable if the sterility has little impact.\n\nLoss of part or all of the penis \n\n\t•\tExtent of penis remaining\n\t•\tAvailability of prosthesis\n\t•\tExtent to which sexual activity will be possible\nLoss of both testicles\nSee item 44 where sterility results\nLoss of 1 testicle\n\nAdditional example of factors affecting ISV scale\nAge, cosmetic damage or scarring\n\nAn ISV at or near the bottom of the range will be appropriate if the injury does not reduce reproductive capacity.\n\nDivision 5—Injuries to female reproductive system \n\n\t•\tThis Division applies to injuries caused by physical trauma rather than as a secondary result of psychiatric impairment\n\t•\tFor psychiatric impairment that causes loss of reproductive system function, (see psychiatric impairment).\n\nExamples of factors affecting ISV assessment for items 48 to 49\n\t•\tExtent of any physical trauma\n\t•\tWhether the injured person has children\n\t•\tWhether the injured person intended to have children or more children\n\t•\tScarring\n\t•\tDepression or consequential mental harm\n\t•\tEffect on social and domestic life\n\nInfertility\n48.1\nInfertility causing severe effects\n\nInfertility with severe depression, anxiety and pain\n48.2\nInfertility causing moderate effects\n\nInfertility without any medical complication if the injured person has children\n\nAn injury under this item is applicable even if there is consequential mental harm\n\n48.3\nInfertility causing minor effects\n\nInfertility if—\n\t(a)\tthe injured person was unlikely to have had children, for example, because of age; and\n\t(b)\tthere is little or no consequential mental harm\nAny other injury to the female reproductive system\n49.1\nInjury to female genitalia or reproductive organs, or both\n\n\t•\tAn ISV at or near the top of the range will be appropriate if the injury causes the early onset of menopause or irregular hormonal activity\n\t•\tAn ISV at or near the middle of the range will be appropriate if the injury causes:\n\t•\tdevelopment of a prolapse or fistula\n\t•\ta laceration or tear with good repair.\n49.2\nFemale impotence \n\nThe injury may be correctable by surgery. \n\nThe level of sexual function or the extent of any corrective surgery\n\n49.3\nAn injury causing an inability to give birth by normal vaginal delivery, for example, because of pelvic ring disruption or deformity\n\nThe injury may be correctable by surgery.\n49.4\nReduced fertility, caused by, for example, trauma to ovaries or fallopian tubes\nDivision 6—Injuries to digestive system\nSubdivision 1—Upper digestive tract\nExtreme injury to the digestive system caused by trauma\n\n\t•\tSevere permanent damage to the upper digestive system, with ongoing debilitating pain and discomfort, diarrhoea, nausea and vomiting that—\n\t(a)\tare not controllable by drugs; and\n\t(b)\tcauses weight loss of at least 15%.\n\t•\tAn injury to the throat requiring a permanent gastrostomy\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if there is an injury to the oropharynx/oesophagus (throat) requiring a temporary gastrostomy for more than 1 year and permanent dietary changes, for example, a requirement for a soft food diet\n\t•\tAn ISV at or near the top of the range will be appropriate if there is an injury to the oropharynx/oesophagus (throat) requiring a permanent gastrostomy, with significant ongoing symptoms.\n\n\t•\tthe extent of any voice or speech impairment\n\t•\tneed for ongoing endoscopic procedure\n\nSerious injury to the digestive system caused by trauma\n\nA serious injury causing long‑term complications and requiring continuous medication\n\n\t•\tThe extent of any ongoing voice or speech impairment\n\t•\tWhether a feeding tube was required, and if so, for how long it was required\n\t•\tUrgent and/or uncontrolled bowel use\nAn ISV under this item is applicable if a feeding tube is required for between 3 and 12 months\n\nModerate injury to the digestive system caused by trauma\n\n\t•\tA blunt trauma or a penetrating stab wound, causing some permanent tissue damage, but with no significant long‑term effect on digestive function\n\t•\tAn injury requiring a feeding tube for less than 3 months\n\nExample of factors affecting ISV scale\n\t•\tWhether a feeding tube was required, and if so, for how long it was required\n\t•\tWhether dietary changes are required to reduce the risk of aspiration because of impaired swallowing\n\nMinor injury to the digestive system caused by trauma\n\n\t•\tA soft tissue injury to the abdomen wall, for example, a laceration or serious seatbelt bruising to the abdomen or flank, or both\n\t•\tA minor injury to the throat or tongue causing temporary difficulties with swallowing or speech\n\t•\tA laceration of the tongue requiring suturing\nSubdivision 2—Injuries to the digestive system not caused by trauma\n\nThere is a marked difference between those comparatively rare cases having a long term or even permanent effect on quality of life and cases in which the only ongoing symptom is an allergy, for example, to specific foods, that may cause short‑term illness.\n\nExtreme injury to the digestive system not caused by trauma\n\nSevere toxicosis—\n\t(a)\tcausing serious acute pain, vomiting, diarrhoea and fever, requiring hospitalisation for days or weeks; and\n\t(b)\talso causing 1 or more of the following:\n\t•\tongoing incontinence\n\t•\thaemorrhoids\n\t•\tirritable bowel syndrome; and\n\t(c)\thaving a significant impact on the capacity for employment and enjoyment of life.\n\nAn ISV in the lower half of the range will be appropriate if the injury causes a chronic infection that requires prolonged hospitalisation that will not resolve after antibiotic treatment for a year.\n\nSerious injury to the digestive system not caused by trauma\n\nConstant abdominal pain, causing significant discomfort, for up to 18 months caused by a delay in diagnosis of an injury to the digestive system\n\n\t•\tAn ISV at or near the top of the range will be appropriate if there is an adverse response to the administration of a drug that—\n\t(a)\trequires admission to an intensive care unit; and\n\t(b)\tdoes not cause any permanent impairment; and\n\t(c)\tcauses the need for ongoing drug therapy for life.\n\t•\tAn ISV in the upper half of the range will be appropriate if a chronic infection—\n\t(a)\trequires prolonged hospitalisation and additional treatment; and\n\t(b)\twill be resolved by antibiotic treatment within 1 year.\n\t•\tAn ISV at or near the bottom of the range will be appropriate if there is an adverse response to the administration of a drug that—\n\t(a)\trequires admission to an intensive care unit; and\n\t(b)\tdoes not cause any permanent impairment; and\n\t(c)\tdoes not cause the need for ongoing drug therapy for life.\n\nModerate injury to the digestive system not caused by trauma \n\n\t•\tAn infection that is resolved by antibiotic treatment, with or without additional treatment in hospital, within 3 months after the injury is caused\n\t•\tAn adverse response to the administration of a drug, causing any of the following continuing over a period of more than 7 days, and requiring hospitalisation:\n\t(a)\tvomiting;\n\t(b)\tshortness of breath;\n\t(c)\thypertension;\n\t(d)\tskin irritation\nMinor injury to the digestive system not caused by trauma\n\n\t•\tDisabling pain, cramps and diarrhoea, ongoing for days or weeks\n\t•\tA localised infection, requiring antibiotic treatment, that heals within 6 weeks after the start of treatment\n\t•\tAn adverse response to the administration of a drug, causing any of the following continuing over a period of not more than 7 days, and not requiring hospitalisation:\n\t(a)\tvomiting;\n\t(b)\tshortness of breath;\n\t(c)\thypertension;\n\t(d)\tskin irritation\n\t•\tIntermittent abdominal pain for up to 6 months caused by a delay in diagnosis of an injury to the digestive system\nDivision 7—Kidney or ureter injuries\n\nAn injury to a ureter or the ureters alone, without loss of, or serious damage to, a kidney will generally be assessed under items 60 or 61.\n\nExamples of factor affecting ISV assessment for items 58 to 61\n\t•\tRisk of ongoing kidney or ureter problems, complications or symptoms\n\t•\tNeed for future medical procedures\n\nExtreme injury to kidneys or ureters \n58.1\nLoss of both kidneys causing loss of renal function and requiring permanent dialysis or transplant\n58.2\nSerious damage to both kidneys, requiring temporary or intermittent dialysis\n\n\t•\tThe effect of dialysis and loss of kidney function on activities of daily living\n\t•\tThe length of time for which dialysis was required or the frequency of intermittent dialysis\n\t•\tOngoing requirement for medication, for example, to control blood pressure\n\t•\tWhether the injury caused the need for dietary changes\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if dialysis was required for an initial 3 months period, with intermittent dialysis required after that\n\t•\tAn ISV at or near the top of the range will be appropriate if the injury required dialysis for about 1 year and ongoing dietary changes and medication.\n\nSerious injury to kidneys or ureters\n\nThe injury may require temporary dialysis for less than 3 months.\n\nLoss of 1 kidney if there is severe damage to, and a risk of loss of function of, the other kidney\n\nThe higher the risk of loss of function of the other kidney, the higher the ISV.\n\nModerate injury to kidneys or ureters\n\n\t•\tLoss of 1 kidney, with no damage to the other kidney\n\t•\tAn injury to a ureter or the ureters that requires surgery or placement of stents\nMinor injury to kidneys or ureters\n\nA laceration or contusion to 1 or both of the kidneys confirmed by imaging\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if there is an injury to a kidney causing a contusion\n\t•\tAn ISV at or near the top of the range will be appropriate if a partial removal of a kidney is required\n\nDivision 8—Liver, gall bladder or biliary tract injuries\n\n\t•\tWhether there are recurrent episodes of infection or obstruction\n\t•\tWhether there is a risk of developing biliary cirrhosis\n\nExtreme injury to liver, gall bladder or biliary tract\n\nLoss, or injury causing effective loss of liver function\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if there are recurrent episodes of liver failure that require hospital admission and medical management but do not require liver transplantation\n\t•\tAn ISV at or near the top of the range will be appropriate if the injury requires liver transplantation\n\nSerious injury to liver, gall bladder or biliary tract\n\nSerious damage causing physical loss of over 30% of the tissue of the liver, but with some functional capacity of the liver remaining\nModerate injury to liver, gall bladder or biliary tract \n\nA laceration, contusion or trauma damage to the liver, with a moderate permanent effect on liver function, confirmed from imaging\nThe removal of the gall bladder that causes ongoing symptoms \n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if the injury causes impaired liver function with symptoms of intermittent nausea and vomiting and weight loss\n\t•\tAn ISV at or near the bottom of the range will also be appropriate if there is a gall bladder injury with recurrent infection or symptomatic stone disease, the symptoms of which may include, for example, pain or jaundice\n\t•\tAn ISV at or near the middle of the range will be appropriate if the injury involves removal of the gall bladder causing a bile duct injury\n\t(a)\tsurgery is required to remove not more than 30% of the liver; or\n\t(b)\tbile ducts require repair, for example, placement of stents.\n\t•\tAn ISV at or near the top of the range will also be appropriate if there is an injury to the gall bladder, that despite biliary surgery, causes ongoing symptoms, infection or the need for further endoscopic surgery\n\nMinor injury to liver, gall bladder or biliary duct\n\nAn injury within this item should not require surgery to the liver.\n\nA laceration or contusion to the liver, with a minor effect on liver function and confirmed from imaging\n\nAn ISV in the lower half of the range will be appropriate if there is an uncomplicated removal of the gall bladder with no ongoing symptoms.\n\nDivision 9—Bowel injuries\n\nExamples of factors affecting ISV assessment for items 66 to 69\n\t•\tRisk of ongoing bowel problems, complications or symptoms\n\t•\tNeed for future surgery\n\t•\tThe degree to which dietary changes are required to manage chronic pain or diarrhoea caused by the injury\n\nExtreme bowel injury\n\nAn injury causing a total loss of natural bowel function and dependence on colostomy\nSerious bowel injury\n\nA serious abdominal injury causing either or both of the following:\n\t(a)\timpairment of bowel function (which often requires permanent or long‑term colostomy, leaving disfiguring scars);\n\t(b)\tpermanent restrictions on employment and diet and/or requiring nutritional supplements\nModerate bowel injury\n\n\t(a)\tthe injury requires temporary surgical diversion of the bowel, for example, an ileostomy or colostomy; and\n\t(b)\tthere is ongoing intermittent abnormal bowel function requiring medication; and\n\t(c)\tsome loss of bowel, weight loss and permanent restriction on diet and/or requiring nutritional supplements\nMinor bowel injury\n\nAn injury causing tears to the bowel, with minimal ongoing bowel problems\nDivision 10—Bladder, prostate or urethra injuries\n\nExamples of factors affecting ISV assessment for items 70 to 73\n\t•\tRisk of ongoing bladder, prostate or urethra problems, complications or symptoms\n\t•\tNeed for future surgery\n\nExtreme bladder, prostate or urethra injury\n\nAn injury causing a complete loss of bladder function and control, with permanent dependence on urostomy\nSerious bladder, prostate or urethra injury \n\nAn injury causing serious impairment of bladder control, with some incontinence\n\nAn ISV in the upper half of the range will be appropriate if there is serious ongoing pain.\n\nModerate bladder, prostate or urethra injury\n\nAn injury causing continued impairment of bladder control, with minimal incontinence and minimal pain\n\nAn ISV at or near the top of the range will be applicable if—\n\t•\tan ongoing requirement for minor surgery, for example, cystoscopy or urethral dilation; or\n\t•\tother surgery due to being unresponsive to treatment\n\nMinor bladder, prostate or urethra injury\n\nA bladder injury that may require conservative intermittent medical treatment for which surgery is not required and from which the injured person will fully recover\nDivision 11—Spleen and pancreas injuries\nInjuries to the pancreas\n\n\t•\tThe extent of any ongoing risk of internal infection and disorders, for example, diabetes\n\t•\tThe need for, and outcome of, further surgery, for example, surgery to manage pain caused by stone disease, infection or an expanding pseudocyst\n\t•\tAn ISV at or near the middle of the range will be appropriate if there are chronic symptoms, for example, pain or diarrhoea, and weight loss\n\t(a)\tthere are chronic symptoms with significant weight loss of between 10% and 20% of body weight, and pancreatic enzyme replacement is required; or\n\t(b)\tan injury to the pancreas causes diabetes.\nLoss of spleen (complicated)\n\nLoss of spleen if there will be a risk, that is not minor, of ongoing internal infection and disorders caused by the loss\n\n\t•\tAn ISV at or near the top of the range will be appropriate if the injury leads to a splenectomy, with portal vein thrombosis after the splenectomy\n\t•\tAn ISV at or near the middle of the range will be appropriate if—\n\t(a)\tthe injury leads to a splenectomy, with serious infection after the splenectomy; and\n\t(b)\tthe infection requires surgical or radiological intervention\n\nInjury to the spleen or uncomplicated loss of spleen\n\nLaceration or contusion to the spleen that—\n\t(a)\thas been radiologically confirmed;\n\t(b)\thas no ongoing bleeding;\n\t(c)\tis managed conservatively; and\n\t(d)\tresolves fully\n\nAn ISV at or near the top of the range will be appropriate if there has been removal of the spleen (splenectomy), with little or no risk of ongoing infections and disorders caused by the loss of the spleen.\n\nDivision 12—Hernia injuries\nSevere hernia\n\nAn incisional hernia if after repair there is either or both—\n\t(a)\tongoing pain; and\n\t(b)\ta restriction on physical activities, sport or employment\n\nAn ISV at the top of the range will be appropriate if—\n\t(a)\tthe incisional hernia is reoccurring; and\n\t(b)\thas a whole of person impairment of 10% or more\n\nModerate hernia\n\nAn incisional hernia that after repair has some real risk of recurring in the short‑term\nMinor hernia\n\nAn uncomplicated incisional hernia, whether or not repaired\n","sortOrder":5},{"sectionNumber":"Part 6","sectionType":"part","heading":"Orthopaedic injuries","content":"Part 6—Orthopaedic injuries\n","sortOrder":6},{"sectionNumber":"Div 1","sectionType":"division","heading":"Cervical spine injuries","content":"Division 1—Cervical spine injuries\n\nGeneral comment for items 80 to 84\nThis Division does not apply to the following injuries (that are dealt with in items 1 to 3):\n\t•\tquadriplegia\n\t•\tparaplegia\n\t•\themiplegia or severe paralysis of more than 1 limb.\nThere must be clinical findings present at the time of examination.\nClinical findings must be consistent with radiological objective evidence where present.\n\t•\tCervical spine injuries, other than those dealt with in items 1 to 3, range from cases of very severe disability to cases of a minor strain, with no time off work and symptoms only suffered for 2 or 3 weeks\n\t•\tSymptoms associated with nerve root compression or damage cannot be taken into account in assessing an ISV under items 80 to 82 unless objective signs are present of a permanent nerve root compression or damage, or other specific imaging findings as defined—\n\t•\tCT and/or MRI scans or other appropriate imaging evidence of disc herniation (as distinct from merely a disc bulge and/or annular tear), and residual and corresponding objective neurological impairment, for example—\n\t•\tsensory loss\n\t•\tloss of muscle strength and/or corresponding atrophy\n\t•\timpaired reflexes\n\nExtreme cervical spine injury\n\nThese are extremely severe injuries that cause gross limitation of movement and serious interference with performance of daily activities. The injury will involve significant upper or lower extremity impairment and may require the use of an adaptive device or prosthesis\n\n\t•\tA total neurological loss at a single level\n\t•\tSevere multilevel neurological dysfunction\n\t•\tStructural compromise of the spinal canal with extreme upper or lower extremity motor and sensory impairments\n\t•\tFractures involving more than 50% compression of a vertebral body with neural compromise\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if there is whole person impairment of about 35%\n\t•\tAn ISV at or near the top of the range will be appropriate if there is a cervical spine injury causing monoplegia of the dominant upper limb and whole person impairment of at least 60%.\n\nSerious cervical spine injury\n\n\t•\tThe injury of the cervical spine will cause serious neurological upper extremity impairment or serious permanent impairment of the cervical spine for which there is radiological evidence\n\t•\tThe injury may involve—\n\t(a)\ta change of motion segment integrity; or\n\t(b)\tbilateral or multilevel nerve root compression or damage; or\n\t(c)\ta fracture involving more than 25% compression of 1 vertebral body or a fusion (either traumatic or post‑surgical);or\n\t(d)\tan injury showing objective signs of nerve root damage after surgery.\n\nLoss of motion in a motion segment because of a surgical or post‑traumatic fusion\n\n\t(a)\tthe injured person has had surgery and symptoms persist; or\n\t(b)\tthere is a fracture involving 25% compression of 1 vertebral body.\n\t•\tAn ISV in the middle of the range will be appropriate if there is a fracture involving about 50% compression of a vertebral body, with ongoing pain\n\t(a)\tthe injured person has had a fusion of vertebral bodies that has failed, leaving objective signs of significant residual nerve root damage and ongoing pain, affecting 1 side of the body; and\n\t(b)\tthere is whole person impairment of about 28%.\n\nModerate cervical spine injury—fracture, disc prolapse (herniated disc) or nerveroot compression or damage\n\nAn ISV for this item will be appropriate if—\n\t(a)\tthere is a herniated disc for which there is radiological evidence corresponding to an anatomically correct level of objective neurological impairment; and\n\t(b)\tthere are symptoms of pain and 3 or more of the following objective signs that are anatomically localised to an appropriate spinal nerve root distribution:\n\t(i)\tsensory loss;\n\t(ii)\tloss of muscle strength and/or corresponding atrophy;\n\t(iii)\timpaired reflexes;\n\t(iv)\tunilateral atrophy; and\n\t(c)\tthe impairment has not improved after non‑operative treatment\nModerate cervical spine injury—soft tissue injury\n\nThe injury will cause moderate permanent impairment, for which there is a clinical history and examination findings that are compatible with a specific injury for which there will be 2 or more objective signs.\n\nAn ISV at the top half of the range is appropriate if there is a whole of person impairment of 8% caused by a traumatic soft tissue injury\n\nMinor cervical spine injury\n\n\t•\tInjuries within this item include a whiplash injury with minor ongoing symptoms, and/or dysfunction including symptoms, remaining for more or expected to remain more than 18 months after the injury is caused; and\n\t•\tThere are no objective signs of a neurological impairment (for example, a radiculopathy) at the time of assessment.\n\n\t•\tA low range ISV under this item will be applicable if the injury will resolve within months after the injury is caused; and\n\t•\tA high range ISV under this item will be applicable if, the injury causes persistent headaches, significant neck stiffness and some ongoing pain and/or dysfunction\n\n","sortOrder":7},{"sectionNumber":"Div 2","sectionType":"division","heading":"Thoracic spine or lumbar spine injuries","content":"Division 2—Thoracic spine or lumbar spine injuries\n\n\t•\tThis Division does not apply to the following injuries (that are dealt with in items 1 to 3):\n\t•\tquadriplegia\n\t•\tparaplegia\n\t•\themiplegia or severe paralysis of more than 1 limb.\n\t•\tThoracic or lumbar spine injuries, other than those dealt with in items 1 to 3, range from cases of very severe disability to cases of a minor strain, with no time off work and symptoms suffered only for 2 or 3 weeks\n\t•\tSymptoms associated with nerve root compression or damage cannot be taken into account in assessing an ISV under item 85 to 87 unless objective signs are present of nerve root compression or damage, for example—\n\t•\tCT or MRI scans or other radiological evidence\n\t•\tmuscle wasting\n\t•\tclinical findings of deep tendon reflex loss, motor weakness and loss of sensation.\nThere must be clinical findings present at the time of examination. \nClinical findings must be consistent with radiological objective evidence where present.\n\nExtreme thoracic or lumbar spine injury\n\nThese are extremely severe injuries causing gross limitation of movement and serious interference with performance of daily activities. There may be some motor or sensory loss, and some impairment of bladder, ano‑rectal or sexual function.\n\nA fracture involving compression of a thoracic or lumbar vertebral body of more than 50%, with neurological impairment\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if there is whole person impairment for the injury of 25%\n\t•\tAn ISV at or near the top of the range will be appropriate if there is whole person impairment for the injury of at least 45%.\n\nSerious thoracic or lumbar spine injury \n\n\t•\tThe injury will cause serious permanent impairment in the thoracic or lumbar spine\n\t•\tThe injury may involve—\n\t(a)\tbilateral or multilevel nerve root damage; or\n\t(b)\ta change in motion segment integrity, for example, because of surgery.\n\nA fracture involving at least 25% compression of 1 thoracic or lumbar vertebral body\n\n\t(a)\tthe injured person has had surgery and symptoms persist; or\n\t(b)\tthere is a fracture involving 25% compression of 1 vertebral body.\n\t•\tAn ISV in the middle of the range will be appropriate if there is a fracture involving 50% compression of a vertebral body, with ongoing pain\n\t•\tAn ISV at or near the top of the range will be appropriate if the injured person has had a fusion of vertebral bodies that has failed—\n\t(a)\tleaving objective signs of significant residual nerve root damage and ongoing pain, affecting 1 side of the body; and\n\t(b)\tcausing whole person impairment of 24%.\nModerate thoracic or lumbar spine injury—fracture, disc prolapse or nerve root compression or damage\n\nAn ISV for this item will be appropriate if—\n\t(a)\tthere is a herniated disc for which there is radiological evidence corresponding to an anatomically correct level of objective neurological impairment; and\n\t(b)\tthere are symptoms of pain and 3 or more of the following objective signs that are anatomically localised to an appropriate spinal nerve root distribution—\n\t(i)\tsensory loss;\n\t(ii)\tloss of muscle strength, and/or corresponding atrophy;\n\t(iii)\timpaired reflexes;\n\t(iv)\tunilateral atrophy; and\n\t(c)\tthe impairment has not improved after non‑operative treatment.\nModerate thoracic or lumbar spine injury—soft tissue injury\n\nThe injury will cause moderate permanent impairment, for which there is a clinical history and examination findings that are compatible with a specific injury for which there will be 2 or more objective signs.\n\nAn ISV at the top half of the range is appropriate if there is a whole of person impairment of 8% caused by a traumatic soft tissue injury \n\nMinor thoracic or lumbar spine injury\n\nA soft tissue injury of the thoracic or lumbar spine with no—\n\t•\tsignificant clinical findings\n\t•\tfractures\n\t•\tdocumented neurological impairment\n\t•\tsignificant loss of motion segment integrity\n\t•\tother objective signs of impairment relating to the injury\n\n\t•\tAn ISV at or near the top of the range will be appropriate, whether or not the injured person continues to suffer some ongoing pain, if the injury will substantially reach maximum medical improvement, with only minor symptoms, within about 18 months after the injury is caused\n\t•\tAn ISV at or near the bottom of the range will be appropriate if the injury will resolve without any ongoing symptoms within months after the injury is caused\n\n","sortOrder":8},{"sectionNumber":"Div 3","sectionType":"division","heading":"Shoulder injuries","content":"Division 3—Shoulder injuries\n\nInjuries under items 90 to 93 include subluxations or dislocations of the sternoclavicular joint, acromioclavicular joint or glenohumeral joint.\n\t•\tSoft tissue injuries may involve the musculoligamentous supporting structures of the joints\n\t•\tFractures may involve the clavicle, the scapula (shoulder blade) and the humerus\n\nComment about appropriate level of ISV for items 90 to 93\nAn ISV at or near the top of the range will generally only be appropriate if the injury is to the shoulder of the dominant upper limb.\n\nExtreme shoulder injury\n\nThese are the most severe traumatic injuries causing gross permanent impairment.\n\n\t•\tA severe fracture or dislocation, with secondary medical complications\n\t•\tJoint disruption with poor outcome after surgery\n\nAn ISV at or near the top of the range will be appropriate if there is whole person impairment of 45% and complete loss of all shoulder function of the dominant upper limb.\n\nSerious shoulder injury\n\nThe injury will involve serious trauma to the shoulder causing serious permanent impairment.\n\n\t•\tA crush injury\n\t•\tA serious fracture with secondary arthritis\n\t•\tNerve palsies from which the injured person will partially recover\n\t•\tEstablished non‑union of a clavicular or scapular fracture despite open reduction and internal fixation (ORIF)\n\t•\tEstablished non‑union of a clavicular or scapular fracture if surgery is not appropriate or not possible, and there is significant functional impairment\n\nAn ISV at or near the top of the range will be appropriate if there is whole person impairment for the injury of 25% and the injury is to the dominant upper limb.\n\nModerate shoulder injury\n92.1\nAn ISV under this item will be applicable if there is a whole of person impairment of 10—12%\n\n\t•\tTraumatic adhesive capsulitis with discomfort, limitation of movement and symptoms persisting or expected to persist for about 2 years\n\t•\tPermanent and significant soft tissue disruption, for example, from tendon tears or ligament tears\n\t•\tA fracture, from which the injured person has made a reasonable recovery, requiring open reduction and internal fixation\n\t•\tPainful persisting dislocation of the acromioclavicular joint\n\t•\tAn injury to the sternoclavicular joint causing permanent, painful instability\n\nComment about the appropriate level of ISV\n\t•\tAn ISV at or near the bottom of the range will be appropriate if the injury is to the non‑dominant upper limb\n\t•\tAn ISV at or near the top of the range will be appropriate if the injury is to the dominant upper limb\n\n92.2\nAn ISV under this item will be appropriate if there is a whole person impairment for the injury of less than 10%\n\n\t•\tTraumatic adhesive capsulitis with discomfort, limitation of movement and symptoms persisting or expected to persist for about 2 years\n\t•\tPermanent and significant soft tissue disruption, for example, from tendon tears or ligament tears\n\t•\tPainful persisting dislocation of the acromioclavicular joint\n\t•\tAn injury to the sternoclavicular joint causing permanent, painful instability\n\nComment about this level of ISV\n\t•\tAn ISV at or near the bottom of the range will be appropriate if the injury is to the non‑dominant upper limb\n\t•\tAn ISV at or near the top of the range will be appropriate if the injury is to the dominant upper limb\n\nMinor shoulder injury\n\n\t•\tSoft tissue injury with considerable pain from which the injured person makes an almost full recovery in less than 18 months\n\t•\tFracture from which the injured person has made an uncomplicated recovery\n\t•\tStrain injury of the acromioclavicular joint or sternoclavicular joint\n","sortOrder":9},{"sectionNumber":"Div 4","sectionType":"division","heading":"Amputation of upper limbs","content":"Division 4—Amputation of upper limbs\n\nComment about appropriate level of ISV for items 94 to 95\nAn ISV at or near the top of the range will generally only be appropriate if the amputation is of the dominant upper limb\n\nLoss of both upper limbs, or loss of 1 arm and extreme injury to the other arm\n\nThe effect of the injury is to reduce the injured person to a state of considerable helplessness\n\n\t•\tWhether the amputations are above or below the elbow (the loss of the elbow joint adds greatly to the disability)\n\t•\tThe length of any stump suitable for use with a prosthesis\n\t•\tSeverity of any phantom pains\n\n\t•\tAn ISV of 70 to 85 will be appropriate if—\n\t(a)\tboth upper limbs are amputated at the shoulder; or\n\t(b)\t1 arm is amputated at the shoulder, and there is a loss of function in the other arm, causing whole person impairment of 60%.\n\t•\tAn ISV of 65 to 80 will be appropriate if—\n\t(a)\tboth upper limbs are amputated through the elbow or above the elbow but below the shoulder; or\n\t(b)\t1 arm is amputated through the elbow or above the elbow but below the shoulder, and there is a loss of function in the other arm, causing whole person impairment of 57%.\n\t•\tAn ISV of 55 to 75 will be appropriate if—\n\t(a)\tboth upper limbs are amputated below the elbow; or\n\t(b)\t1 arm is amputated below the elbow, and there is a loss of function in the other arm, causing whole person impairment of 54%.\n\nLoss of 1 upper limb\n\n\t•\tWhether the amputation is above or below the elbow (the loss of the elbow joint adds greatly to the disability)\n\t•\tWhether the amputation was of the dominant arm\n\t•\tThe length of any stump suitable for use with a prosthesis\n\t•\tSeverity of any phantom pains\n\t•\tExtent of any disability in the other arm\n\n95.1\nAn upper limb amputation at the shoulder\n95.2\nAn upper limb amputation through the elbow or above the elbow but below the shoulder\n\n\t•\tAn ISV at or near the bottom of the range will generally be appropriate if there is an amputation through the elbow\n\t•\tAn ISV at or near the top of the range will be appropriate if there is a short stump because a short stump may create difficulties in the use of a prosthesis\n\n95.3\nAn upper limb amputation below the elbow \n\nAn ISV at or near the top of the range will be appropriate if there is an amputation through the forearm with residual severe pain in the stump and phantom pains\n\n","sortOrder":10},{"sectionNumber":"Div 5","sectionType":"division","heading":"Elbow injuries","content":"Division 5—Elbow injuries\n\nComment about appropriate level of ISV for items 96 to 99\nAn ISV at or near the top of the range will generally only be appropriate if the injury is to the elbow of the dominant upper limb\n\nExtreme elbow injury\n\nThe injury will involve an extremely severe elbow injury, falling short of amputation, leaving little effective use of the elbow joint\n\n\t•\tWhole person impairment for the injury of between 24% and 42%\n\t•\tA complex elbow fracture, or dislocation, with secondary complications\n\t•\tJoint disruption, with poor outcome after surgery\n\t•\tAn injury causing severe limitation of elbow movement with the joint constrained in a non‑functional position\n\nSerious elbow injury\n\nThe injury will involve significant disability and require major surgery.\n\n\t•\tA serious fracture with secondary arthritis\n\t•\tA crush injury\n\t•\tNerve palsies from which the injured person will partially recover\n\t•\tPermanent, poor restricted range of movement with the elbow constrained in a satisfactory functional position\n\nAn ISV at or near the top of the range will be appropriate if there is whole person impairment for the injury of 23% and the injury is to the elbow of the dominant upper limb.\n\nModerate elbow injury\n\nThe injury will cause moderate long‑term disability but does not require multiple surgeries.\n\n\t•\tA fracture, from which the injured person has made a reasonable recovery, requiring open reduction and internal fixation\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if there is whole person impairment for the injury of 5%\n\t•\tAn ISV at or near the top of the range will be appropriate if there is a moderately severe injury to the elbow of the dominant upper limb—\n\t(a)\trequiring prolonged treatment; and\n\t(b)\tcausing whole person impairment of 10%.\n\nMinor elbow injury\n\nThe injury will cause no permanent damage and no permanent impairment of function.\n\n\t•\tA fracture with an uncomplicated recovery\n\t•\tA soft tissue injury with pain, minor tennis elbow syndrome or lacerations\n\n","sortOrder":11},{"sectionNumber":"Div 6","sectionType":"division","heading":"Wrist injuries","content":"Division 6—Wrist injuries\n\nComment about appropriate level of ISV for items 100 to 103\nAn ISV at or near the top of the range will generally only be appropriate if the injury is to the wrist of the dominant upper limb.\n\nExtreme wrist injury\n\nThe injury will involve severe fractures, or a dislocation, causing a high level of permanent impairment.\n\n\t•\tA severe fracture or dislocation with secondary joint complications\n\t•\tJoint disruption with poor outcome after surgery\n\nAn ISV at or near the top of the range will be appropriate if there is whole person impairment for the injury of 36% and the injury is to the wrist of the dominant upper limb.\n\nSerious wrist injury\n\n\t•\tAn injury causing significant permanent loss of wrist function, for example, severe problems with gripping or pushing objects, but with some useful movement remaining\n\t•\tNon‑union of a carpal fracture\n\t•\tSevere carpal instability\n\nAn ISV at or near the top of the range will be appropriate if there is whole person impairment for the injury of 20% and the injury is to the wrist of the dominant upper limb.\n\nModerate wrist injury\n102.1\nA wrist injury, confirmed from imaging that causes some permanent disability, for example, some persisting pain and stiffness—\n\t•\tPersisting radio‑ulnar instability\n\t•\tModerate carpal instability\n\t•\tRecurrent tendon subluxation or entrapment\n\nAn ISV under this item will be appropriate if there is a whole person impairment for the injury of greater than or equal to 10%\n\n102.2\nA wrist injury, that is not serious and causes some permanent disability, for example, some persisting pain and stiffness—\n\t•\tPersisting radio‑ulnar instability\n\t•\tCarpal instability\n\t•\tRecurrent tendon subluxation or entrapment\n\nComment about this level of ISV\nAn ISV under this item will be appropriate if there is a whole person impairment for the injury of less than 10%\n\nMinor wrist injury\n\n\t•\tA fracture from which the injured person almost fully recovers\n\t•\tA soft tissue injury, for example, severe bruising\n\t•\tContinued pain following carpal tunnel release\n","sortOrder":12},{"sectionNumber":"Div 7","sectionType":"division","heading":"Hand injuries","content":"Division 7—Hand injuries\n\nGeneral comment for items 104 to 115\nHands are cosmetically and functionally the most important part of the upper limbs.\n\nComment about appropriate level of ISV for items 104 to 115 \n\t•\tThe appropriate ISV for loss of a hand is only a little less than the appropriate ISV for the loss of the relevant arm\n\t•\tAn ISV at or near the top of the range will generally be appropriate if the injury is to the dominant hand.\n\nTotal or effective loss of both hands\n\nA serious injury causing extensive damage to both hands making them little more than useless \n\n\t•\tThe level of residual capacity left in either hand\n\t•\tSeverity of any phantom pains if there has been an amputation or amputations\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if both hands remain attached to the forearms and are of some cosmetic importance\n\t•\tAn ISV at or near the top of the range will be appropriate if both hands are amputated through the wrist.\n\nSerious injury to both hands\n\nThe injury will involve significant loss of function in both hands, for example, loss of 50% or more of the use of each hand.\nTotal or effective loss of 1 hand\n\n\t•\tA crushed hand that has been surgically amputated or rendered functionally useless\n\t•\tTraumatic amputation of all fingers and most of the palm\n\nSeverity of any phantom pain if there has been an amputation\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if there has been an amputation of the fingers at the metacarpophalangeal joints, but the thumb remains, and there is whole person impairment for the injury of 32%\n\t(a)\tthere has been amputation of the dominant hand at the wrist; and\n\t(b)\tthere is residual severe pain in the stump and ongoing complications, for example, chronic regional pain syndrome or neuroma formation.\n\nAmputation of the thumb or part of the thumb\n\n\t•\tThe level of amputation, for example, at carpo metacarpal (CMC) joint, through the distal third of the thumb metacarpal, at the metacarpophalangeal (MCP) joint or thumb interphalangeal (IP) joint\n\t•\tWhether the injury is to the dominant hand\n\t•\tThe extent of any damage to the fingers\n\n\t(a)\tthere has been an amputation through the interphalangeal joint of the thumb; and\n\t(b)\tthere is whole person impairment for the injury of 11%. \n\t•\tAn ISV at or near the middle of the range will be appropriate if there has been an amputation through the proximal phalanx\n\t(a)\tthere has been an amputation at the base of the thumb at the carpometacarpal (CMC) joint level of the dominant hand; and\n\t(b)\tthere are ongoing debilitating complications.\n\nAmputation of index, middle and ring fingers, or any 2 of them\n\nThe amputation will cause complete loss or nearly complete loss of 2 or all of the following fingers of the hand:\n\t•\tindex finger\n\t•\tmiddle finger\n\t•\tring finger\n\t•\tlittle finger\n\nThe level of the amputation, for example, whether the hand has been made to be of very little use and any remaining grip is very weak\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if 2 fingers, whether index, middle or ring fingers, are amputated at the level of the proximal interphalangeal joints\n\t•\tAn ISV at or near the middle of the range will be appropriate if there is whole person impairment for the injury of 19%\n\t(a)\tthe index, middle and ring fingers are amputated at the level of the metacarpophalangeal joint (MCP joint) or there is whole person impairment for the injury of at least 27%; and\n\t(b)\tthe injury is to the dominant hand.\n\nAmputation of individual fingers\n\n\t•\tWhether the amputation was of the index or middle finger\n\t•\tThe level of the amputation\n\t•\tAny damage to other fingers short of amputation\n\n\t•\tAn ISV at or near the top of the range will be applicable if there is complete loss of the index or middle finger of the dominant hand, and serious impairment of the remaining fingers causing whole person impairment of at least 15%\n\t•\tAn ISV of not more than 10 will be applicable if—\n\t(a)\tthere has been an amputation of the index or middle finger at the proximal interphalangeal joint (PIP joint); or\n\t(b)\tthere is whole person impairment for the injury of 8%. \n\t•\tAn ISV at or near the bottom of the range will be applicable if—\n\t(a)\tthere has been an amputation at the level of the distal interphalangeal joint of the little or ring finger; or\n\t(b)\tthere is whole person impairment for the injury of 3%. \n\nAmputation of thumb and all fingers\n\nAs the injury will cause effective loss of the hand, see item 106.\n\nAny other injury to 1 or more of the fingers or the thumb\n\nComment about appropriate level of ISV for items under 111\nAn ISV of not more than 5 will be appropriate if substantial function of the hand remains.\n\nExamples of factors affecting ISV\n\t•\tWhether the injury is to the thumb, or index or middle finger\n\t•\tAny damage to other fingers\n\t•\tWhether the injury is to the dominant hand\n\n111.1\nExtreme injury to 1 or more of the fingers or the thumb\n\nTotal loss of function of 1 or more of the fingers, with the joints ankylosed in non‑functional positions\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if there is whole person impairment for the injury of 14%\n\t•\tAn ISV at or near the top of the range will be appropriate if there is an injury to the thumb of the dominant hand causing total loss of function of the thumb\n\n111.2\nSerious injury to 1 or more of the fingers or the thumb\n\n\t•\tA severe crush injury causing ankylosis of the fingers\n\t•\tA bursting wound, or an injury causing severe finger damage, causing residual scarring and dysfunction\n\t•\tAn injury leaving a digit that interferes with the remaining function of the hand\n\t•\tDivision of 1 or more of the long flexor tendons of the finger, with unsuccessful repair\n111.3\nModerate injury to 1 or more of the fingers or the thumb\n\nThere will be permanent discomfort, pain or sensitive scarring\n\n\t•\tModerate injury to the thumb or index finger causing loss of movement or dexterity\n\t•\tA crush injury causing multiple fractures of 2 or more fingers\n\t•\tDivision of 1 or more of the long flexor tendons of the finger, with moderately successful repair\n\nAn ISV under this item will be appropriate if there is whole person impairment for the injury of 8% and the injury is to the dominant hand. \n\n111.4\nMinor injury to 1 or more of the fingers or the thumb\n\nAn uncomplicated fracture or soft tissue injury that has healed with minimal residual symptoms\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if there is a straight forward fracture of 1 or more of the fingers, with complete resolution within a short time\n\t•\tAn ISV at or near the top of the range will be appropriate if there has been—\n\t(a)\ta fracture causing minor angular or rotational malunion of the thumb, or index or middle finger, of the dominant hand; or\n\t(b)\tsome adherence of a tendon following surgical repair, limiting full function of the digit\n\nExtreme hand injury\n\n\t•\tThe injury will involve a severe traumatic injury to the hand that may include amputation of part of the hand, causing gross impairment of the hand\n\t•\tA hand injury causing whole person impairment for the injury of 35% will generally fall within this item\n\n\t•\tAn injury reducing a hand's capacity to 50% or less\n\t•\tAn injury involving the amputation of several fingers that are re‑joined to the hand leaving it clawed, clumsy and unsightly\n\t•\tAn amputation of some fingers and part of the palm causing grossly reduced grip and dexterity and gross disfigurement\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if the injured hand has some residual usefulness for performing activities of daily living\n\t•\tAn ISV at or near the top of the range will be appropriate if the injured hand—\n\t(a)\thas little or no residual usefulness for performing activities of daily living; and\n\t(b)\tis the dominant hand\n\nSerious hand injury\n\n\t•\tA severe crush injury causing significantly impaired function despite surgery\n\t•\tSerious permanent tendon damage\n\t•\tSerious nerve damage\n\nAn ISV at or near the top of the range will be appropriate if there is whole person impairment for the injury of 20%\n\nModerate hand injury\n\n\t•\tA crush injury, penetrating wound or deep laceration, requiring surgery\n\t•\tModerately serious tendon or nerve damage\n\t•\tA hand injury causing whole person impairment for the injury of between 5% and 12%\nMinor hand injury\n\nA soft tissue injury, minor fracture or an injury that does not require surgery, with nearly full recovery of hand function\n","sortOrder":13},{"sectionNumber":"Div 8","sectionType":"division","heading":"Upper limb injuries other than shoulder, amputation, elbow, wrist or hand injuries","content":"Division 8—Upper limb injuries other than shoulder, amputation, elbow, wrist or hand injuries\n\nComment about appropriate level of ISV for items 116 to 119\nAn ISV at or near the top of the range will generally only be appropriate if the injury is to the dominant upper limb.\n\nExtreme upper limb injury, other than an injury mentioned in items 90 to 115\n\nThe injury will involve an extremely serious upper limb injury, falling short of amputation leaving the injured person little better off than if the whole arm had been lost.\n\n\t•\tA serious brachial plexus injury affecting peripheral nerve function\n\t•\tA non‑union of a fracture, with peripheral nerve damage to the extent that an arm is nearly useless\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if there is whole person impairment for the injury of 31%\n\t(a)\tthere is a complete brachial plexus lesion shown by a flail arm and paralysis of all muscles of the hand; and\n\t(b)\tthe injury is to the dominant limb.\n\t•\tAn ISV at or near the top of the range will also be appropriate if there is a serious crush injury that causes whole person impairment for the injury of 55%\n\nSerious upper limb injury, other than an injury mentioned in items 90 to 115\n\n\t•\tA serious fracture of the humerus, radius or ulna, or any combination of the humerus, radius and ulna, if there is significant permanent residual impairment of function\n\t•\tA brachial plexus injury requiring nerve grafts with partial recovery of shoulder and elbow function and normal hand function\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if there is whole person impairment for the injury of 16%\n\t•\tAn ISV at or near the top of the range will be appropriate if there is an injury to the dominant limb causing whole person impairment of 30%.\n\nModerate upper limb injury, other than an injury mentioned in items 90 to 115\n\n\t•\tA fracture that causes impairment of associated soft tissues, including nerves and blood vessels\n\t•\tA fracture with delayed union or infection\n\t•\tMultiple fractures of the humerus, radius or ulna, or multiple fractures of any combination of the humerus, radius and ulna\n\n118.1\nAn ISV under this item will be applicable if there is a crush injury causing significant skin or muscle loss with permanent residual impairment, or there is whole person impairment for the injury of 15%\n118.2\n\t•\tAn ISV at or near the bottom of the range will be appropriate if there is whole person impairment for the injury of 6%\n\t•\tAn ISV in the lower half of the range will be appropriate if there is a complicated fracture of the humerus, radius or ulna, or any combination of the humerus, radius and ulna—\n\t(a)\trequiring open reduction and internal fixation; and\n\t(b)\tfrom which the injured person has recovered or is expected to recover.\nMinor upper limb injury, other than an injury mentioned in items 90 to 115\n\nAn uncomplicated fracture of the humerus, radius or ulna, or any combination of the humerus, radius and ulna, from which the injured person has fully recovered within a short time\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if there are soft tissue injuries, lacerations, abrasions and contusions, from which the injured person will fully or almost fully recover\n\t•\tAn ISV at or near the top of the range will be appropriate if there is a brachial plexus injury from which the injured person has substantially recovered within a few weeks, leaving some minor functional impairment.\n\n","sortOrder":14},{"sectionNumber":"Div 9","sectionType":"division","heading":"Pelvis or hip injuries","content":"Division 9—Pelvis or hip injuries\n\nGeneral comment for items 120 to 123\n\t•\tThe most serious injuries to the pelvis or hips can be as devastating as a leg amputation and will have similar ISVs\n\t•\tHowever, the appropriate ISV for other injuries to the pelvis or hips will generally be no higher than about 20.\n\nExamples of factors affecting ISV assessment for items 120 to 123\n\t•\tExceptionally severe specific sequelae will increase the level of ISV\n\t•\tThe availability of remedies, for example, a total hip replacement is an important factor in assessing an ISV\n\nExtreme pelvis or hip injury\n\n\t•\tAn extensive pelvis fracture\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if there is whole person impairment for the injury of 40%\n\t•\tAn ISV at or near the top of the range will be appropriate if the injured person is not able to mobilise without a wheelchair and is relatively young.\n\nSerious pelvis or hip injury\n\nThere will be substantial residual disability, for example, severe lack of bladder and bowel control, sexual dysfunction, or deformity making the use of 2 canes or crutches routine.\n\n\t•\tA fracture dislocation of the pelvis involving both ischial and pubic rami\n\t•\tTraumatic myositis ossificans with formation of ectopic bone around the hip\n\t•\tA fracture of the acetabulum leading to degenerative changes and leg instability requiring an osteotomy, with the likelihood of future hip replacement surgery\n\nAn ISV at or near the bottom of the range will be appropriate for an injury causing whole person impairment for the injury of 20%.\n\nModerate pelvis or hip injury\n\n\t•\tA significant pelvis or hip injury, with no major permanent disability\n\t•\tA hip fracture requiring a hip replacement\n\t•\tA fracture of the sacrum extending into the sacro‑iliac joint causing ongoing significant symptoms and whole person impairment of at least 10%\n\nAn ISV for this item will be appropriate if there is a fracture requiring a hip replacement that is only partially successful, so that there is a clear risk of the need for revision surgery.\nAn ISV in this range will be appropriate if there is whole person impairment for the injury of 10%.\n\nMinor pelvis or hip injury\n\n\t•\tAn uncomplicated fracture of 1 or more of the bones of the pelvis or hip that does not require surgery or cause permanent impairment\n\t•\tUndisplaced coccygeal fractures\n\t•\tUndisplaced or healed pubic rami fractures\n\t•\tAn injury to the coccyx requiring surgery, that is successful.\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if there is a soft tissue injury from which the injured person fully recovers\n\t•\tAn ISV of not more than 7 will be appropriate if there is whole person impairment for the injury of 5%\n\t•\tAn ISV at or near the top of the range will be appropriate if the person has ongoing coccydynia and difficulties with sitting.\n\n","sortOrder":15},{"sectionNumber":"Div 10","sectionType":"division","heading":"Amputation of lower limbs","content":"Division 10—Amputation of lower limbs\nSubdivision 1—Amputation of both lower limbs\n\nExamples of factors affecting ISV assessment for items 124 and 125\n\t•\tThe level of each amputation\n\t•\tPain in the stumps\n\nLoss of both lower limbs above or through the knee\n\nAn ISV at or near the top of the range will be appropriate if each amputation is near the hips so neither stump can be used with a prosthesis.\nBelow the knee amputation of both lower limbs\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if there is whole person impairment for the injury of 48%\n\t(a)\tboth legs are amputated just below the knees leaving little or no stumps for use with prostheses;\n\t(b)\tthere is poor quality skin cover; and\n\t(c)\tthere is a chronic regional pain syndrome.\nSubdivision 2—Amputation of 1 lower limb\n\nExamples of factors affecting ISV assessment for items 126 and 127\n\t•\tThe level of the amputation\n\t•\tWhether there have been problems with a prosthesis, for example, pain and further damage to the stump\n\nAbove or through the knee amputation of 1 lower limb\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if the amputation is through or just above the knee\n\t•\tAn ISV at or near the top of the range will be appropriate if the amputation is near the hip and a prosthesis cannot be used.\nBelow the knee amputation of 1 lower limb\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate in a straightforward case of a below‑knee amputation with no complications\n\t•\tAn ISV at or near the top of the range will be appropriate if there is an amputation close to the knee joint, leaving little or no stump for use with a prosthesis.\n","sortOrder":16},{"sectionNumber":"Div 11","sectionType":"division","heading":"Lower limb injuries other than items 120 to 127 and 132 to 149","content":"Division 11—Lower limb injuries other than items 120 to 127 and 132 to 149\nExtreme lower limb injury, other than an injury mentioned in items 120 to 127 and 132 to 149\n\nThese are the most severe injuries short of amputation; leaving the injured person little better off than if the whole leg had been lost.\n\n\t•\tExtensive degloving of the lower limb\n\t•\tAn injury causing gross shortening of the lower limb\n\t•\tA fracture that has not united despite extensive bone grafting\n\t•\tSerious neurovascular injury\n\t•\tA lower limb injury causing whole person impairment of 40%\n\nSerious lower limb injury, other than an injury mentioned in items 120 to 127 and 132 to 149\n\n\t•\tRemoval of extensive muscle tissue and extensive scarring may have a significant enough impact to fall within this item\n\t•\tAn injury to multiple joints or ligaments causing instability, prolonged treatment and a long period of non‑weight‑bearing may have a significant enough impact to fall within this item, but generally only if those results are combined.\n\nMultiple complex fractures of the lower limb that are expected to take years to heal and cause serious deformity and serious limitation of mobility\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if there is whole person impairment for the injury of 16%\n\t•\tAn ISV at or near the top of the range will be appropriate if there is whole person impairment for the injury of 25%.\n\nModerate lower limb injury, other than an injury mentioned in items 120 to 127 and 132 to 149\n\n\t•\tA fracture causing impairment of associated soft tissues, including nerves and blood vessels\n\t•\tA fracture with delayed union or infection\n\t•\tMultiple fractures of the femur, tibia or fibula, or multiple fractures of any combination of the femur, tibia and fibula\n\n\t•\tPeriod of non‑weight‑bearing\n\t•\tPresence or risk of degenerative change\n\t•\tImperfect union of a fracture\n\t•\tMuscle wasting\n\t•\tLimited joint movement\n\t•\tUnsightly scarring\n\t•\tPermanently increased vulnerability to future damage\n\nAn ISV at or near the top of the range will be applicable if there is a deep vein thrombosis requiring treatment for life; or if there is whole person impairment for the injury of 15%.\nAn ISV at or near the bottom of the range will be applicable if there is whole person impairment for the injury of 10%. \n\nMinor lower limb injury, other than an injury mentioned in items 120 to 127 and 132 to 149\n\nAn uncomplicated fracture of the femur, tibia or fibula, from which the injured person has fully recovered\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if there is a deep vein thrombosis requiring treatment for less than 6 months, from which the injured person will fully recover\n\t•\tAn ISV at or near the bottom of the range will also be appropriate if—\n\t(a)\tthere are soft tissue injuries, lacerations, cuts, bruising or contusions, from which the injured person will fully or almost fully recover; and\n\t(b)\tany residual disability will be minor.\n\t•\tAn ISV at or near the top of the range will be appropriate if there is a deep vein thrombosis requiring treatment for at least 1 year\n\t•\tAn ISV at or near the top of the range will also be appropriate if the injured person is left with impaired mobility or a defective gait\n\t•\tAn ISV at or near the top of the range will also be appropriate if there is whole person impairment for the injury of 9%.\n\n","sortOrder":17},{"sectionNumber":"Div 12","sectionType":"division","heading":"Knee injuries","content":"Division 12—Knee injuries\n\nGeneral comment for items 132 to 135\nThe availability of remedies, for example, a total knee replacement is an important factor in assessing an ISV under this Division.\n\nExtreme knee injury\n\nA severe knee injury if there is a disruption of the joint, gross ligamentous damage, loss of function after unsuccessful surgery, lengthy treatment and considerable pain\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if there is whole person impairment for the injury of 20%\n\t•\tAn ISV at or near the top of the range will be appropriate if a total knee replacement was needed and—\n\t(a)\tit is very likely that the knee replacement will need to be repeated; or\n\t(b)\tthere are ongoing severe symptoms, poor function and whole person impairment for the injury of more than 30%.\n\nSerious knee injury\n\nThe injury may involve—\n\t(a)\tongoing pain, discomfort, limitation of movement, instability or deformity; and\n\t(b)\ta risk, in the long‑term, of degenerative changes caused by damage to the joint surfaces, muscular wasting or ligamentous or meniscal injury.\n\nA leg fracture extending into the knee joint, causing pain that is constant, permanent and limits movement or impairs agility\n\nAn ISV at or near the middle of the range will be appropriate if there is a ligamentous injury, that required surgery and prolonged rehabilitation, causing whole person impairment of 15% and functional limitation.\n\nModerate knee injury\n\nA dislocation or torn cartilage or meniscus causing ongoing minor instability, wasting and weakness\n\nAn ISV at or near the top of the range will be appropriate if there is whole person impairment for the injury of 8%\n\nMinor knee injury\n\n\t•\tA partial cartilage, meniscal or ligamentous tear, that recovers with or without surgery\n\t•\tA laceration\n\t•\tA twisting or bruising injury\n","sortOrder":18},{"sectionNumber":"Div 13","sectionType":"division","heading":"Ankle injuries","content":"Division 13—Ankle injuries\n\nComment about appropriate level of ISV for items 136 to 139\nThe appropriate ISV for the vast majority of ankle injuries is 1 or 2.\n\nExtreme ankle injury\n\n\t•\tA transmalleolar fracture of the ankle with extensive soft tissue damage causing 1 or more of the following:\n\t(a)\tsevere deformity with varus or valgus malalignment;\n\t(b)\ta risk that any future injury to the relevant leg may lead to a below‑knee amputation of the leg;\n\t(c)\tmarked reduction in walking ability with constant dependence on walking aids;\n\t(d)\tinability to place the relevant foot for even load‑bearing distribution.\n\t•\tAn ankylosed ankle in a severely misaligned position with severe ongoing pain and other debilitating complications\n\t•\tWhole person impairment for the injury of more than 20%\n\n\t•\tA failed arthrodesis\n\t•\tRegular disturbance of sleep\n\t•\tNeed for an orthosis for load bearing and walking\n\nSerious ankle injury\n\nAn injury requiring a long period of treatment, a long time in plaster or insertion of pins and plates, if—\n\t(a)\tthere is permanent significant ankle instability; or\n\t(b)\tthe ability to walk is severely limited on a permanent basis\n\n\t•\tUnsightly scarring\n\t•\tThe significance of any malunion\n\t•\tA requirement for modified footwear\n\t•\tWhether, and to what degree, there is swelling following activity\n\nAn ISV under this item will be applicable if there is whole person impairment for the injury of 10—19%\n\nModerate ankle injury\n\nA fracture, ligamentous tear or similar injury, as evidenced by imaging and causing moderate disability, for example—\n\t•\tdifficulty in walking on uneven ground\n\t•\tawkwardness on stairs\n\t•\tirritation from metal plates\n\t•\tresidual scarring\n\nAn ISV in this range will be appropriate if there is whole person impairment for the injury of 6—9%\n\nMinor ankle injury\n\nA sprain, ligamentous or soft tissue injury or minor or undisplaced fracture\n\n\t•\tWhether the injured person has fully recovered from the injury, and if not, whether there is any tendency for the ankle to give way\n\t•\tWhether there is scarring, aching or discomfort\n\n","sortOrder":19},{"sectionNumber":"Div 14","sectionType":"division","heading":"Foot injuries","content":"Division 14—Foot injuries\n","sortOrder":20},{"sectionNumber":"Subdiv 1","sectionType":"subdivision","heading":"Amputations","content":"Subdivision 1—Amputations\nAmputation of both feet\n\n\t•\tPain in the stumps\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if there are amputations of both feet at the forefoot (transmetatarsal level amputations)\n\t•\tAn ISV of about 40 will be appropriate if there are amputations of both feet at the mid foot (tarsometatarsal level or Lisfranc amputations)\n\t•\tAn ISV at or near the top of the range will be appropriate if each amputation is at the level of the ankle (Syme's amputation) and the stumps cannot be used with prostheses.\n\nAmputation of 1 foot\n\n\t•\tPain in the stump\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if the amputation is at the forefoot (transmetatarsal level amputation)\n\t•\tAn ISV of about 26 will be appropriate if the amputation is at the mid foot (tarsometatarsal level or Lisfranc amputation)\n\t•\tAn ISV at or near the top of the range will be appropriate if the amputation is at the level of the ankle (Syme's amputation) and the stump cannot be used with a prosthesis.\n\n","sortOrder":21},{"sectionNumber":"Subdiv 2","sectionType":"subdivision","heading":"Other foot injuries","content":"Subdivision 2—Other foot injuries\nExtreme foot injury\n\nThere will be permanent and severe pain or very serious permanent disability.\n\nAn unusually severe foot injury causing whole person impairment of 15% or more, for example, a heel fusion or loss of the tibia‑calcaneum angle\n\nAn ISV at or near the top of the range will be appropriate if there is subtalar fibrous ankylosis in a severely malaligned position, ongoing pain and whole person impairment for the injury of 24%.\n\nSerious foot injury\n\n\t•\tA severe midfoot deformity causing whole person impairment of 8%\n\t•\tA lower level loss of the tibia‑calcaneum angle\nModerate foot injury\n\nA displaced metatarsal fracture causing permanent deformity, with ongoing symptoms of minor severity, for example, a limp that does not prevent the injured person engaging in most daily activities\nMinor foot injury\n\nA simple metatarsal fracture, ruptured ligament, puncture wound or similar injury\n\nAn ISV of 2 or less will be appropriate if there is a straightforward foot injury, for example, a fracture, laceration or contusions, from which the injured person will fully recover.\n\n","sortOrder":22},{"sectionNumber":"Div 15","sectionType":"division","heading":"Toe injuries","content":"Division 15—Toe injuries\nExtreme toe injury\n\nExamples of factors affecting ISV assessment for items 146 to 149\n\t•\tWhether the amputation was traumatic or surgical\n\t•\tExtent of the loss of the forefoot\n\t•\tResidual effects on mobility\n\n146.1\nAmputation of all toes \n\n\t•\tAn ISV at or near the middle of the range will be appropriate if the amputation is through the metatarsophalangeal joints (MTP joints) of all toes\n\t•\tAn ISV at or near the top of the range will be appropriate if there is complete amputation of all toes and amputation of a substantial part of the forefoot.\n146.2\nAmputation of the great toe\n\nExample of factors affecting ISV\nThe level at which the amputation happens or any ongoing symptoms\n\nAn ISV at or near the top of the range will be appropriate if there is complete loss of the great toe and ball of the foot caused by an amputation through the first metatarsal bone.\n\n146.3\nAmputation of individual lesser toes \n\nExample of factors affecting ISV\nThe level at which the amputation happens or any ongoing symptoms \n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if there is an amputation of 1 lesser toe and—\n\t(a)\tthere is no ongoing pain; and\n\t(b)\tthere is little or no loss of function of the foot; and\n\t(c)\tthe cosmetic effect of the amputation is minor.\n\t•\tAn ISV at or near the top of the range will be appropriate if there is complete amputation of all lesser toes and part of the forefoot.\n\nSerious toe injury\n\nThe injury will cause serious and permanent disability.\n\n\t•\tA severe crush injury causing ankylosis of the toes\n\t•\tA bursting wound, or an injury causing severe toe damage, with significant symptoms\n\nModerate toe injury \n\nThere will be permanent discomfort, pain or sensitive scarring.\n\n\t•\tA moderate injury to the great toe\n\t•\tA crush injury causing multiple fractures of 2 or more toes\n\nAn ISV at or near the top of the range will be appropriate if there has been more than 1 unsuccessful operation, or there are persisting stabbing pains, impaired gait or similar effects.\n\nMinor toe injury\n\nA relatively straightforward fracture or soft tissue injury\n\nAn ISV of 1 will be appropriate if there is a straightforward fracture of 1 or more toes with complete resolution within a short time.\n\n","sortOrder":23},{"sectionNumber":"Div 16","sectionType":"division","heading":"Limb disorders","content":"Division 16—Limb disorders \n\nThe ISV for a limb disorder must be assessed having regard to the item of this Schedule that—\n\t(a)\trelates to the part of the body affected by the disorder; and\n\t(b)\tis for an injury that has a similar level of adverse impact to the disorder.\n\nExamples of a limb disorder\n\t•\tTenosynovitis (inflammation of synovial sheaths of tendons usually resolving with rest over a short period and sometimes leading to ongoing symptoms of loss of grip and dexterity)\n\t•\tPeripheral nerve injury (the constriction of the motor or sensory nerves or thickening of surrounding tissue, for example, carpal tunnel syndrome or sciatica)\n\t•\tEpicondylitis (inflammation around the elbow joint, for example, medially (golfer's elbow) or laterally (tennis elbow))\n\t•\tVascular disorders, for example, deep vein thrombosis\n\n\t•\tWhether the disorder is bilateral or one sided\n\t•\tThe level of pain, swelling, tenderness or crepitus or other symptoms\n\t•\tThe capacity to avoid a recurrence of symptoms\n\t•\tThe ability to engage in daily activities\n\t•\tThe availability and likely benefit of surgery\n\t•\tWhether the disorder is to a dominant or non‑dominant limb\n\n","sortOrder":24},{"sectionNumber":"Part 7","sectionType":"part","heading":"Scarring to parts of the body other than the face","content":"Part 7—Scarring to parts of the body other than the face\n\n\t•\tThis Part applies to external appearance and physical condition of the skin only, and includes scarring to the scalp, trunk and limbs\n\t•\tFacial scarring must be assessed under Part 3, Division 3\n\t•\tThis Part does not apply to adhesions, or scarring, of internal organs\n\t•\tThis Part will usually apply to an injury involving skeletal damage only if the skeletal damage is minor\n\t•\tMany of the physical injuries mentioned in this Schedule involve some scarring from the initial injury and subsequent surgery, including skin grafting, to repair the injury and this has been taken into account in fixing the range of ISVs for the injuries.\nExample—\nThe ISV range for an injury causing a closed fracture of a limb takes into account the potential need for open reduction and internal fixation of the fracture and the resulting surgical wound and scar.\n\nExamples of factors affecting ISV assessment for items 151 to 154\n\t•\tLocation of a scar\n\t•\tLikelihood of a scar fading or becoming less noticeable over time\n\nExtreme scarring to a part of the body other than the face\n\n\t•\tAn ISV at or near the bottom of the range will be appropriate if there is—\n\t(a)\textensive scarring to 1 or more of the limbs and significant cosmetic disfigurement; and\n\t(b)\teither—\n\t(i)\tthe need to keep the limb or limbs covered or wear special clothing; or\n\t(ii)\tongoing limitation in the ability to participate in activities because of cosmetic disfigurement or functional impairment.\n\t•\tAn ISV at or near the top of the range will be appropriate if there is gross permanent scarring over an extensive area or areas of the body, with ongoing pain and other symptoms.\nSerious scarring to a part of the body other than the face\n\nThere is serious scarring—\n\t(a)\trequiring extensive medical treatment or surgery; and\n\t(b)\tcausing significant ongoing limitation in the ability to participate in activities because of cosmetic disfigurement or functional impairment.\n\n\t•\tSignificant scarring over the upper and lower arm requiring skin grafting if—\n\t(a)\tthere are post‑operative complications requiring additional medical treatment for up to 18 months; and\n\t(b)\tthere is maximum medical improvement within 2 years after the scarring is caused.\n\t•\tHypertrophic (keloid) scarring caused by a burn to the front of the neck, with an intermittent sensation of burning, itching or irritation.\n\nModerate scarring to a part of the body other than the face\n\n\t•\tSeveral noticeable scars that are hypertrophic (keloid)\n\t•\tA significant linear scar in an area of major cosmetic importance, for example, the front of the neck\nMinor scarring to a part of the body other than the face\n\n\t•\tScarring caused by a superficial burn that heals within a few weeks and causes some minor change of pigmentation in a noticeable area\n\t•\tA single noticeable scar, or several superficial scars, to 1 or both of the legs, arms or hands, with some minor cosmetic damage\n","sortOrder":25},{"sectionNumber":"Part 8","sectionType":"part","heading":"Injuries affecting the hair","content":"Part 8—Injuries affecting the hair\nExtreme injury affecting head hair\n\nTotal permanent loss of head hair\nSerious injury affecting head hair\n\nDamage to head hair—\n\t(a)\tthe physical effect of the damage is—\n\t(i)\tdermatitis; or\n\t(ii)\ttingling or burning of the scalp, causing dry, brittle hair that breaks off or falls out, or both; and\n\t(b)\tthe physical effect leads to depression, loss of confidence and inhibited social life\n\nAn ISV under this item will be appropriate if—\n\t(a)\tthinning continues and prospects of regrowth are poor; or\n\t(b)\tthere is a partial loss of areas of hair and regrowth is slow.\n\nModerate injury affecting head hair or loss of body hair\n\n\t•\tHair that has been pulled out leaving bald patches\n\t•\tThe same example applies as for item 156 but with fewer or only moderate symptoms\n\nLength of time before regrowth\n\n","sortOrder":26},{"sectionNumber":"Part 9","sectionType":"part","heading":"Burn injuries","content":"Part 9—Burn injuries\n\nMapped to max body part\n\n\t•\tThe ISV for a burn injury must be assessed having regard to the item of this Schedule that—\n\t(a)\trelates to the part of the body affected by the burn injury; and\n\t(b)\tis for an injury that has a similar level of adverse impact to the burn injury.\n\t•\tBurns to the face must be assessed under the section on scarring to the face\n\t•\tIn burns cases, the ISV for an injury to a part of the body causing functional impairment will generally be at or near the top of the range for an injury to that part of the body\n\t•\tIn serious burns cases, the effects of scarring are more comprehensive and less able to be remedied than the effects of scarring from other causes.\n\nLegislative history\nNotes\n\t•\tPlease note—References in the legislation to other legislation or instruments or to titles of bodies or offices are not automatically updated as part of the program for the revision and publication of legislation and therefore may be obsolete.\n\t•\tEarlier versions of these regulations (historical versions) are listed at the end of the legislative history.\n\t•\tFor further information relating to the Act and subordinate legislation made under the Act see the Index of South Australian Statutes or www.legislation.sa.gov.au.\nLegislation revoked by principal regulations\nThe Civil Liability Regulations 2013 revoked the following:\nCivil Liability Regulations 2007\nPrincipal regulations and variations\nNew entries appear in bold.\nYear\nNo\nReference\nCommencement\nGazette 20.6.2013 p2636\n1.7.2013: r 2\nGazette 13.2.2014 p954\n1.4.2014: r 2\nGazette 10.9.2015 p4226\n2.10.2015: r 2\nProvisions varied\nNew entries appear in bold.\nEntries that relate to provisions that have been deleted appear in italics.\nProvision\nHow varied\nCommencement\nPt 1\n\nr 2\nomitted under Legislation Revision and Publication Act 2002\nr 3\n\naccredited health professional\ninserted by 58/2014 r 4(1)\ndesignated Minister\ninserted by 58/2014 r 4(2)\ninjured person\ninserted by 58/2014 r 4(3)\nPt 2\n\nr 4\n\nr 4(2)\nsubstituted by 58/2014 r 5\nr 4(3)\ninserted by 58/2014 r 5\nr 5\nvaried by 58/2014 r 6(1), (2)\nPt 4\n\nPt 4 Div 1\n\nheading\ninserted by 58/2014 r 7\nr 20\n\nr 20(1)\nvaried by 58/2014 r 8(1), (2)\nr 20(2) and (3)\ndeleted by 58/2014 r 8(3)\nr 20(4)\nvaried by 58/2014 r 8(4), (5)\nPt 4 Divs 2 and 3\ninserted by 58/2014 r 9\nPt 5\ninserted by 206/2015 r 4\n2.10.2015\nSch 2\nomitted under Legislation Revision and Publication Act 2002\nHistorical versions\n\n","sortOrder":27}],"analysis":{"issue_detection":{"absurdities":[],"contradictions":[]},"kimi_summary":{"_metrics":{"completionTokens":728},"content_quality":"ok","complexity_score":7,"scope_assessment":{"changed":false,"description":"The regulations appear to operate within their original intended scope — standardising motor vehicle injury compensation assessments in South Australia. The 2014 and 2015 amendments added procedural details (accredited health professionals, information disclosure) and a miscellaneous Part on prescribed information, but did not expand beyond the core purpose of quantifying damages for personal injury claims."},"complexity_factors":["Extensive Schedule 1 with 157 injury items across 9 Parts, each with sub-ranges, examples, and commentary","Multiple cross-references to AMA 5 (American Medical Association Guides) and GEPIC (psychiatric impairment scale)","Nested conditional logic for multiple injuries (regulations 11–12) with caps, exceptions, and written reasons requirements","Dual assessment tracks: physical injuries under Schedule 1 items vs pure mental harm under GEPIC ratings","Defined terms requiring external knowledge (e.g., 'Le Fort I/II/III fractures', 'whole person impairment', 'motion segment integrity')","Temporal triggers and phase-in rules (e.g., injuries from motor accidents 'on or after 1 July 2013')","Complex interaction between ISV ranges, whole person impairment percentages, and dominant/non-dominant limb distinctions","Multiple exceptions to standard assessment requirements (regulation 4(3)) and conditional insurer liability (regulation 5, 25)"],"plain_english_summary":"**What this legislation does:**\n\nThese regulations set out how South Australian courts calculate compensation (called \"general damages\") for people injured in motor vehicle accidents. They create a detailed, standardised system using **Injury Scale Values (ISVs)** — numerical scores from 0 to 100 that reflect how severely an injury affects someone's life.\n\n**Who it affects:**\n- **Injured people** making claims for motor vehicle accident injuries\n- **Insurers** handling those claims\n- **Courts** deciding how much compensation to award\n- **Medical professionals** assessing injuries\n\n**Key features:**\n\n- **Schedule 1** contains a massive table matching specific injuries to ISV ranges — everything from minor whiplash (0–4) to quadriplegia (80–100)\n- **ISVs must be whole numbers** (no decimals)\n- **Injuries must stabilise** before assessment, with medical reports from accredited health professionals\n- **Multiple injuries** are handled carefully — courts can't just add up individual ISVs, but must assess the overall impact with the dominant injury as the starting point\n- **Pure mental harm** (psychiatric injury without physical injury) uses a special rating system called **GEPIC**\n- **Gratuitous services** (care provided by family members) are compensated at $25/hour, indexed annually\n\n**Why it matters:**\n\nThis system tries to make compensation more predictable and consistent. Before this, similar injuries might get wildly different payouts depending on which judge heard the case. Now there's a structured framework, though courts still have discretion within the ranges based on factors like age, pain, life expectancy, and impact on daily activities.\n\nThe regulations also set rules for medical examinations, require insurers to pay for assessments they request, and establish accreditation schemes for health professionals doing these evaluations."},"summary":{"complexity_score":1,"scope_assessment":{"changed":false,"description":"Scope assessment is not possible as the legislative text was not provided. Only a website error page was submitted for analysis."},"complexity_factors":["No legislative content was retrievable — the source document is a 404 'Page Not Found' error page, not the actual legislation","Complexity cannot be meaningfully assessed without the text of the regulations","Score of 1 reflects absence of content, not simplicity of the underlying law"],"plain_english_summary":"The Civil Liability Regulations 2013 (SA) couldn’t be retrieved due to a “Page Not Found” error, so the full text wasn’t available for analysis. \n\nRegulations of this kind implement the Civil Liability Act framework — they typically set rules on damages caps, personal injury claims, professional negligence and insurance requirements. That directly affects injured claimants, insurers, medical practitioners, employers and businesses, because it shapes who can claim, how much, and what protections or obligations apply."},"flash_summary":{"complexity_score":8,"scope_assessment":{"changed":true,"description":"The instrument as published replaced the 2007 regulations and was subsequently varied: 2014 amendments inserted definitions (eg accredited health professional, designated Minister, injured person) and modified assessment rules (see legislative history: 58/2014 r 4–9), and a 2015 variation added Part 5 (prescribed information) (206/2015 r 4). These changes broadened definitional scope and added procedural/prescription elements compared with the earlier regulations."},"complexity_factors":["Extensive, highly granular Schedule 1 with many body‑part items and numeric ISV ranges requiring case‑by‑case application.","Interaction between medical evidence, whole person impairment percentages and ISV assessment (regs 10,16–17).","Multiple‑injury aggregation rules, cap and written‑reasons requirement when exceeding 25% of dominant ISV (reg 12).","Reliance on external clinical guides (AMA 5 and GEPIC) and specialist accreditation schemes administered by the designated Minister (regs 3,14,17,23(2)).","Procedural obligations and timelines for attendance, reporting and disclosure (regs 20,22–23,24).","Insurer cost‑liability, recovery and set‑off mechanics for non‑attendance (reg 25).","Cross‑references to court rules and practice directions and ministerial forms — introduces administrative discretion (reg 23(2), reg 24).","Indexing and use of external statistical series for damages calculations (regs 18–19)."],"plain_english_summary":"These regulations set out how courts must calculate injury scale values (ISVs) for motor‑vehicle accident injuries by reference to the ranges in Schedule 1 and rules in the regulations; medical assessments by accredited health professionals are required before ISV determination (reg 4; Sch 1).  They impose procedural duties and timelines for injured persons and insurers, require insurers to pay for authorised assessments, direct courts how to treat AMA‑5 and GEPIC impairment ratings, and fix the hourly rate for gratuitous services ($25 indexed) (regs 5,16–17,20,23,25,19)."},"flash_summary_failed":{"failed":true,"reason":"Unauthenticated. Configure AI_GATEWAY_API_KEY or use a provider module. Learn more: https://ai-sdk.dev/unauthenticated-ai-gateway","source":"analysis-cron"}},"importantCases":[],"_links":{"self":"/api/acts/civil-liability-regulations-2013","history":"/api/acts/civil-liability-regulations-2013/history","analysis":"/api/acts/civil-liability-regulations-2013/analysis","conflicts":"/api/acts/civil-liability-regulations-2013/conflicts","importantCases":"/api/acts/civil-liability-regulations-2013/important-cases","documents":"/api/acts/civil-liability-regulations-2013/documents"}}