83

83         Underlying cardiac disease can be assessed using other tables in Chapter 1 – The cardiovascular system.

84         Functional class (assessed under Figure 1-C: Definitions of functional class), and therapy (see Table 1.3: Arrhythmias), are used to assess the WPI rating.

Figure 1-C: Definitions of functional class

| Functional class | Symptoms (all required) | | I | No limitation of physical activity. | | II | Slight limitation of physical activity.<br>Comfortable at rest and with ordinary, light activities of daily living.<br>Greater activity causes symptoms. | | III | Marked limitation of physical activity.<br>Comfortable at rest.<br>Ordinary activity causes symptoms. | | IV | Inability to carry out any physical activity without discomfort. |

Table 1.3: Arrhythmias

See note to Table 1.3 for explanation of symbols used in the final column (therapy).

| %WPI | Functional class | Therapy | | 5 | I | Nil | | 10 | I | Drug(s) | | 15 | I | Surgery/cath/PPM/Device | | 20 | II | Nil | | 30 | II | Drug(s) | | 40 | II | Surgery/cath/PPM/Device | | 45 | III | Nil | | 50 | III | Drug(s) | | 55 | III | Surgery/cath/PPM/Device | | 60 | IV | Not applicable |

Note to Table 1.3

1. Therapy – final column of Table 1.3:

‘cath’ means either catheter ablation or catheter-associated therapy for arrhythmia.

‘PPM’ means permanent pacemaker.

‘Device’ means implanted defibrillator.

1.4        Peripheral vascular disease of the lower extremities

85         Amputees should not be assessed under Table 1.4: Peripheral vascular disease of the lower extremities. They should be assessed under Table 9.5: Lower extremity amputations (see Chapter 9 – The musculoskeletal system).

86         A WPI rating from Table 1.4: Peripheral vascular disease of the lower extremities may not be combined with a WPI rating from Table 13.4: Thrombotic disorders (see Chapter 13 – The haematopoietic system).

Table 1.4: Peripheral vascular disease of the lower extremities

| %WPI | Signs and symptoms | | 0 | The employee experiences neither intermittent claudication nor ischaemic pain at rest. | | 5 | The employee has no difficulty with distances but experiences ischaemic pain on climbing either steps or gradients. | | 10 | The employee experiences claudication on walking 200m or more at an average pace on level ground. | | 20 | The employee experiences claudication on walking more than 100m but less than 200m at average pace on level ground. | | 30 | The employee experiences claudication on walking more than 75m but less than 100m at average pace on level ground. | | 40 | The employee experiences claudication on walking more than 50m but less than 75m at average pace on level ground. | | 50 | The employee experiences claudication on walking more than 25m but less than 50m at average pace on level ground. | | 60 | The employee experiences claudication on walking less than 25m at average pace on level ground. | | 70 | The employee experiences ischaemic pain at rest. |

1.5        Peripheral vascular disease of the upper extremities

87         Amputees should not be assessed under Table 1.5: Peripheral vascular disease of the upper extremities. They should be assessed under Table 9.12.1: Upper extremity amputations or Table 9.12.2: Amputation of digits (see Chapter 9 – The musculoskeletal system).

88         A WPI rating from Table 1.5: Peripheral vascular disease of the upper extremities may not be combined with a WPI rating from Table 13.4: Thrombotic disorders (see Chapter 13 – The haematopoietic system).

Table 1.5: Peripheral vascular disease of the upper extremities

| %WPI | Symptoms | Signs | | 5 | Either no claudication or transient oedema. | Calcification of arteries on X-ray. | | 10 | Either no claudication or persistent oedema controlled by support. | Dilatation of either arteries or veins. | | 15 | As above. | Either loss of pulse or healed ulcer or surgery. | | 20 | Either claudication on strenuous exercise or persistent oedema uncontrolled by support. | Either calcification of arteries on X-ray or dilatation of either arteries or veins. | | 30 | As above. | Superficial ulcer. | | 40 | As above. | Either deep or widespread ulcer or surgery. | | 45 | Claudication on mild-moderate exertion. | Either calcification of arteries on X-ray or dilatation of either arteries or veins. | | 50 | As above. | Superficial ulcer. | | 55 | As above. | Either deep or widespread ulcer or surgery. | | 60 | Rest pain or unable to exercise. | Not applicable |

1.6        Raynaud’s disease

89         Functional class (assessed in accordance with Figure 1-C: Definitions of functional class) is the primary criterion for assessment. Signs of vasospastic disease and therapy (see Table 1.6: Raynaud’s disease) are secondary criteria for assessment.

Figure 1-C: Definitions of functional class

See note to Figure 1-C for further information.

| Functional class | Symptoms (all required) | | I | No limitation of physical activity. | | II | Slight limitation of physical activity.<br>Comfortable at rest and with ordinary, light activities of daily living.<br>Greater activity causes symptoms. | | III | Marked limitation of physical activity.<br>Comfortable at rest.<br>Ordinary activity causes symptoms. | | IV | Inability to carry out any physical activity without discomfort. |

Note to Figure 1-C

1. Figure 1-C also appears in Section 1.3 (Arrhythmias). It is repeated here for ease of reference

Table 1.6: Raynaud’s disease

See note to Table 1.6 for further information.

| %WPI | Functional class | Signs | Therapy | | 5 | I | Nil. | Nil. | | 10 | I | Nil. | Drug(s). | | 15 | I | Nil. | Surgery. | | 20 | II | Neither ulceration nor trophic changes. | Drug(s). | | 25 | II | Either ulceration or trophic changes. | Drug(s). | | 30 | II | Not applicable | Surgery. | | 35 | III | Neither ulceration nor trophic changes. | Drug(s). | | 40 | III | Either ulceration or trophic changes. | Drug(s). | | 45 | III | Not applicable | Surgery. | | 50 | IV | Not applicable | Not applicable |

Note to Table 1.6

1. Therapy – final column of Table 1.6:

‘Surgery’ includes sympathectomy and local debridement.

‘Drug(s)’ means continuous therapy with one or more drugs.

CHAPTER 2 – THE RESPIRATORY SYSTEM

2.0        Introduction

90         In conducting an assessment, the assessor must have regard to the Principles of Assessment and the definitions contained in the Glossary.