Part 15

CHAPTER 15

INTERMITTENT IMPAIRMENT

Intermittent disorders are conditions:

• that remain at a low level of impairment between discrete episodes of increased impairment;

or

• where there is one basic type of impairment on which is superimposed episodes of significantly greater impairment of another type.

A sufferer from epilepsy who remains well between “fits” exemplifies the first type of intermittent disorder. A sufferer from Menière’s disease whose condition is characterised by deafness and occasional episodes of vertigo exemplifies the second type of intermittent disorder. The deafness may be regarded as the basic type of impairment and the episodes of vertigo may be regarded as the superimposed intermittent impairment. Both elements of the condition are to be assessed.

In this chapter, “attacks” refers to the episode may increased or superimposed impairment. Attacks are to be categorised by reference to their severity, duration and frequency:

• “severity of an attack” refers to the degree to which self-care and normal everyday activities are disrupted by the attack;
• “duration of an attack” refers to the average length of time for which an attack lasts, that is, seconds, minutes, hours or days; and
• “frequency of an attack” refers to the number of affected days in a year.

Intermittent disorders are also disorders that affect one or more body systems. For example, asthma is both an intermittent condition and a cardio-respiratory condition. Hence, potentially, any intermittent disorder can be assessed by either of two methods:

• by applying the system-specific tables contained in Chapters 1 to 12. Several of those tables should be used if the intermittent disorder causes multiple losses of function; or
• by applying this chapter.

In practice, except where the intermittent nature of the condition clearly overwhelms its system specific effects or vice versa, both methods are to be applied for rating the intermittent condition and the higher of those two ratings taken as the final rating for the intermittent condition.

Calculation of the impairment rating for an accepted intermittent condition

Follow the steps below to calculate the impairment rating due to an accepted intermittent condition:

(Each of these steps is elaborated in the following pages.)