In the columns of Table 19.2 headed “Impairment Rating” find the impairment rating to which partially contributing impairment is being applied. The row extending to the right of the column in which this figure is written is “The Row” for purposes of substep 3C.
Substep 3B
Take the relative contribution to the impairment by the accepted condition, determined in Step 2. In the top row of Table 19.2 find the description of that contribution.<br>(If the impairment rating used in substep 3A was between 1 and 45 inclusive, the required description of the contribution is to be found in columns 2–8 of Table 19.2. If the impairment rating used in substep 3A was between 46 and 90 inclusive, the required description of the contribution is to be found in columns 10–16 of Table 19.2.)<br>The column in which this description is written is “The Column” for purposes of substep 3C.
Substep 3C
Find the intersection of The Row and The Column. The number written on the intersection is the impairment rating for the accepted condition.
Table 19.1 extracts the highlighted information in Table 19.2 and is provided for the convenience of users.
Impairment Rating Complete About 3/4 About 2/3 About 1/2 About 1/3 About 1/4 Not at All Impairment Rating Complete About 3/4 About 2/3 About 1/2 About 1/3 About 1/4 Not at All
1 1 1 1 1 0 0 0 46 46 38 35 27 17 13 0
2 2 1 1 1 1 1 0 47 47 39 35 27 18 13 0
3 3 2 2 2 1 1 0 48 48 40 36 28 18 13 0
4 4 3 3 2 1 1 0 49 49 41 37 29 19 14 0
5 5 4 3 3 1 1 0 50 50 42 38 29 19 14 0
6 6 4 4 3 2 2 0 51 51 43 39 30 20 14 0
7 7 5 5 4 2 2 0 52 52 44 40 31 20 15 0
8 8 6 5 4 3 2 0 53 53 45 41 32 21 15 0
9 9 7 6 5 3 2 0 54 54 46 42 32 21 15 0
10 10 7 7 5 3 3 0 55 55 47 43 33 21 16 0
11 11 8 7 6 4 3 0 56 56 48 44 34 22 16 0
12 12 9 8 6 4 3 0 57 57 49 45 35 22 16 0
13 13 10 9 7 4 3 0 58 58 49 46 35 23 17 0
14 14 10 9 7 5 4 0 59 59 51 47 36 23 17 0
15 15 11 10 8 5 4 0 60 60 52 48 37 24 17 0
16 16 12 11 9 6 4 0 61 61 53 49 38 24 18 0
17 17 13 12 9 6 5 0 62 62 54 49 38 25 18 0
18 18 14 13 10 6 5 0 63 63 55 50 39 25 18 0
19 19 15 13 10 7 5 0 64 64 56 52 40 26 19 0
20 20 16 14 11 7 5 0 65 65 57 53 41 26 19 0
21 21 16 15 11 7 6 0 66 66 58 54 42 27 19 0
22 22 17 15 12 8 6 0 67 67 59 55 43 27 20 0
23 23 18 16 12 8 6 0 68 68 60 56 43 28 20 0
24 24 19 17 13 9 6 0 69 69 61 57 44 29 20 0
25 25 19 18 14 9 7 0 70 70 62 58 45 29 21 0
26 26 20 19 14 9 7 0 71 71 63 59 46 30 21 0
27 27 21 19 15 10 7 0 72 72 64 60 47 30 21 0
28 28 22 20 15 10 8 0 73 73 66 61 48 30 22 0
29 29 23 21 16 10 8 0 74 74 67 62 49 31 22 0
30 30 24 21 17 11 8 0 75 75 68 63 50 32 23 0
31 31 25 22 17 11 8 0 76 76 69 64 51 32 23 0
32 32 25 23 18 12 9 0 77 77 70 66 52 33 23 0
33 33 26 24 18 12 9 0 78 78 71 67 53 34 24 0
34 34 27 25 19 12 9 0 79 79 72 68 54 34 24 0
35 35 28 25 20 13 10 0 80 80 73 69 55 35 25 0
36 36 29 26 20 13 10 0 81 81 75 70 56 35 25 0
37 37 30 27 21 14 10 0 82 82 76 72 57 36 25 0
38 38 31 28 21 14 10 0 83 83 77 73 59 37 26 0
39 39 32 29 22 14 11 0 84 84 78 74 60 37 26 0
40 40 33 29 23 15 11 0 85 85 80 76 61 38 27 0
41 41 34 30 23 15 11 0 86 86 81 77 62 39 27 0
42 42 34 31 24 16 12 0 87 87 82 78 64 39 27 0
43 43 35 32 25 16 12 0 88 88 84 80 65 40 28 0
44 44 36 33 25 17 12 0 89 89 85 80 65 40 28 0
45 45 37 34 26 17 12 0 90 90 86 83 68 42 29 0
No age adjustment permitted for this table
CHAPTER 20
APPORTIONMENT
INTRODUCTION
Throughout this Guide, if a condition can be rated using both a functional loss table and an Other Impairment table, only the higher of the two ratings is to be given to the veteran. This is usually quite a simple thing to do.
However, in some cases, it might not be so straightforward. For example, a veteran has two accepted cardiorespiratory conditions. One is ischaemic heart disease and the other is chronic bronchitis. From METs and spirometry it is found that the veteran’s functional impairment rating is 20 points. It is also found that the veteran’s ischaemic heart disease corresponds to a rating of 10 points from Table 1.6 and the veteran’s chronic bronchitis corresponds to a rating of 5 points from Table 1.10.
Without apportionment the only applicable cardiorespiratory rating would be 20 points and the 10 and 5 point ratings would have to be disregarded because they are both less than 20. This approach would sometimes disadvantage the veteran.
A method of establishing the separate contribution of ischaemic heart disease and the chronic bronchitis to the functional impairment would enable a separation of their contributions thus allowing the comparison of functional and Other Impairments on a condition by condition basis. Such a method is called “apportionment”. Apportionment provides a method for determining whether a rating greater than 20 should be given to the veteran in the example.
Tables 20.1 to 20.13 have been constructed by finding a set of impairment ratings which have the same value as the contribution to the rating to be apportioned, and which, when combined using the Combined Values Chart in Chapter 18, are equal to the original impairment rating.
If the apportionment has to be done in ratios that are not included in Tables 20.1 to 20.13, then the apportionment may be performed by applying Table 18.1 (Combined Values Chart) in reverse. Should more than one solution be possible, that which is the best fit is to be used.
The ratings that result from the application of apportionment can never be less than those which the same conditions would have attracted had apportionment not been applied.
HOW TO USE APPORTIONMENT
INSTRUCTIONS
Follow the steps below in applying apportionment.
STEP 1
Determine if apportionment is to be used.<br>Apportionment is to be used when it is necessary, for a given accepted condition, to compare an impairment rating derived from one table with an impairment rating derived from another table, and when two or more accepted conditions contribute to the impairment ratings from either table.
STEP 2
Find the relative contribution of each contributing condition.<br>The relative contribution of each accepted condition to the impairment rating that is to be apportioned should be expressed as a simple ratio. (The ratio should always be expressed in terms of small integers, e.g. 1:2, 1:3, 1:1:2, etc.)<br>The judgement of the ratio should be based on appropriate medical advice.
STEP 3
Apportion the single impairment rating into parts.<br>Once the ratio is known the single rating is to be apportioned to all the contributing conditions. In common cases (2 or 3 contributing conditions) the apportioned ratings are to be read off Tables 20.1 to 20.13. In unusual cases that are not covered in these tables, the method described on page 197 is to be applied.
STEP 4
For each condition, compare ratings from two relevant tables.<br>For each condition, the higher of the two relevant ratings is to be selected.
STEP 5
Do not combine individual ratings until the end.<br>Individual ratings obtained from applying the apportionment process are not to be combined until the end of the overall assessment process, when ratings for all of the veteran’s assessable conditions are combined to obtain a single value representing the combined impairment rating for accepted conditions.
HOW TO USE APPORTIONMENT
Example
The apportionment process can be illustrated by using the example mentioned in the introduction.
STEP 1
Determine if apportionment is to be used.<br>When ischaemic heart disease and chronic bronchitis are both accepted conditions, apportionment has to be used because each of these conditions can be rated from separate Other Impairment tables in Chapter 1.
STEP 2
Find the relative contribution of each contributing condition.<br>Suppose that, on medical advice, it is found that the contributions by chronic bronchitis and ischaemic heart disease are in the ratio of 2:1.
STEP 3
Break up the single impairment rating into parts.<br>As the ratio is 2:1, Table 20.1 or Table 20.4 is to be used. From either of these it is found that 20 points apportioned in the ratio of 2:1 gives 14 and 7 as the two contributory impairment ratings. Thus the functional impairment rating for chronic bronchitis is 14 points and for ischaemic heart disease it is 7 points.
STEP 4
Compare ratings from two tables for each condition.<br>Compare the ratings for ischaemic heart disease (7 versus 10 from Table 1.6) and for chronic bronchitis (14 versus 5 from Table 1.10). Taking the higher rating in each case, the assessment will be: ischaemic heart disease 10 points, chronic bronchitis 14 points.
STEP 5
Do not combine individual ratings until the end.<br>If this veteran had no other accepted conditions, the final combined impairment rating would be 25 points (10 & 14 = 23, rounded to 25) instead of 20 points without apportionment.
The calculations in the above example can be conveniently set out in a worksheet format, as illustrated below.
Rating to be apportioned: 20
A
B
C
D
Accepted Conditions
Relative Contribution
Functional Rating
Other Impairment
Rating for Condition
Ischaemic Heart Disease
1
7
10
10
Chronic Bronchitis
2
14
5
14
For purposes of the above worksheet
“Accepted Conditions”
means the accepted conditions that con‑tribute to a single impairment rating to be apportioned.
“Relative Contribution”
means the ratio of the relative contributions which the conditions make to the total impairment (in the above example, the ratio is 1:2, written as “1” in the top row of column A, and “2” in the bottom row of column A).
“Functional Rating”
means the ratings for the conditions obtained after apportionment.
“Other Impairment”
means the applicable rating for the conditions obtained from an Other Impairment table.
“Rating for Condition”
means the higher of the ratings in columns B and C of the same row. This is the final impairment rating for the condition named in that row.
For convenience, Tables 20.1 and 20.2 give the apportionment for impairment ratings that are multiples of 5. Table 20.3 to 20.13 give the apportionment for all relevant integral values of impairment ratings for certain given ratios.
Table 20.1 can be applied to find the two relevant values when any impairment rating has to be apportioned between two conditions in any of the given ratios.
The top row contains the ratios into which the impairment rating needs to be apportioned. The left hand column contains the impairment ratings to be apportioned.
From Table 20.1 it will be seen that:
if a rating of 55 points is to be divided in the ratio of 3:1, one condition gets 47 points and the other gets 16; and
if a rating of 35 points is to be divided in the ratio of 3:2, one condition gets 23 points and the other gets 16.
This table shows the relevant values when any impairment rating has to be apportioned between three conditions.
No age adjustment permitted for this table
In the Apportionment tables, those solutions in bold are exact apportionments into the specified ratios. All the other solutions are the best approximations to the specified ratios.
From Table 20.2 it will be seen that:
if a rating of 55 points is to be divided in the ratio of 2:2:1, one condition gets 28 points, another gets 28, and the third gets 14 points; and
if a rating of 35 points is to be divided in the ratio of 3:2:1, one condition gets 20 points, another gets 13, and the third gets 7 points.
Table 20.3 Combined male and female symbol
APPORTIONMENT
Impairment Rating Apportioned in Ratio 1:1 Impairment Rating Apportioned in Ratio 1:1
1 1 & 0 46 27 & 26
2 1 & 1 47 27 & 27
3 2 & 1 48 28 & 28
4 2 & 2 49 29 & 28
5 3 & 2 50 29 & 29
6 3 & 3 51 30 & 30
7 4 & 3 52 31 & 31
8 4 & 4 53 32 & 31
9 5 & 4 54 32 & 32
10 5 & 5 55 33 & 33
11 6 & 5 56 34 & 34
12 6 & 6 57 35 & 34
13 7 & 6 58 35 & 35
14 7 & 7 59 36 & 36
15 8 & 8 60 37 & 37
16 9 & 8 61 38 & 37
17 9 & 9 62 38 & 38
18 10 & 9 63 39 & 39
19 10 & 10 64 40 & 40
20 11 & 10 65 41 & 41
21 11 & 11 66 42 & 42
22 12 & 11 67 43 & 42
23 12 & 12 68 43 & 43
24 13 & 13 69 44 & 44
25 14 & 13 70 45 & 45
26 14 & 14 71 46 & 46
27 15 & 14 72 47 & 47
28 15 & 15 73 48 & 48
29 16 & 16 74 49 & 49
30 17 & 16 75 50 & 50
31 17 & 17 76 51 & 51
32 18 & 17 77 52 & 52
33 18 & 18 78 53 & 53
34 19 & 19 79 54 & 54
35 20 & 19 80 55 & 55
36 20 & 20 81 56 & 56
37 21 & 20 82 57 & 57
38 21 & 21 83 59 & 59
39 22 & 22 84 60 & 60
40 23 & 22 85 61 & 61
41 23 & 23 86 62 & 62
42 24 & 24 87 64 & 64
43 25 & 24 88 65 & 65
44 25 & 25 89 67 & 67
45 26 & 26 90 68 & 68
No age adjustment permitted for this table
Table 20.4 Combined male and female symbol
APPORTIONMENT
Impairment Rating Apportioned in Ratio 2:1 Impairment Rating Apportioned in Ratio 2:1