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Book Review

New Guidelines For Doctors On the Assessment of Disability For Workmen's Compensation


Doctors play an important role in assessing patients who have sustained work-related injuries or diseases for any resulting permanent disability. The percentage incapacity for certain injuries eg. amputation or loss of limb are listed in the First Schedule of the Workmen’s Compensation Act. It is however not practicable to list the large variety of injuries in the legislation. Guides for the assessment of disability arising from traumatic injuries for Workmen’s Compensation have been in use for the past 20 years. While the guides have been useful, they were limited to amputations, restriction of motion or ankylosis of joints, shortening of limbs and spinal fractures. The guides have been revised in consultation with various specialists to expand the scope to include other common injuries and also other organ systems.

The result is the fourth edition of the Guide to the Assessment of Traumatic Injuries and Occupational Diseases for Workmen’s Compensation which has just been published in Feb 1999. The new guidelines would apply for cases where the date of accident falls on or after 1 March 1999.

What is New in this Guide

  • Assessment of Neurological disorders

Guidelines are provided for the assessment of sensory loss of digits, peripheral nerve injuries and injuries to the brachial and lumbosacral plexus.

  • Assessment of Other disorders of the limbs

Guidelines are provided for the assessment of joint dislocations, ligament injuries, work-related tenosynovitis, post-traumatic osteo-arthritis and certain specific fractures and their complications.

  • Some revision in percentage incapacity awarded

The impairment percentages for ankylosis of major joints have been reduced as they were found to be disproportionately high. Adjustments have also been made to the restriction of motion of the fingers and thumb.

  • Assessment of the Spine

The section on the spine has been revised to include injuries to the spinal cord, intervertebral disc and post-traumatic chronic pain syndrome.

  • Assessment of Other Organ Systems

New chapters on the assessment of hearing, respiratory, renal and hepatic function have been added. These functions may be impaired in a worker suffering from an occupational disease eg. noise induced deafness, occupational lung disease or occupational poisoning affecting the renal or hepatic system. This guide has thus been renamed to include the assessment of occupational diseases.

This latest edition of the guide should be able to provide guidance on the assessment of a much wider range of injuries and diseases for the purposes of Workmen’s Compensation. Nevertheless it is not practical to include guidelines covering all types of injuries and all organ systems. For injuries not covered in this guide, reference should be made to the latest edition of the American Medical Association’s Guides to the Evaluation of Permanent Impairment.

(Please note that the 4th edition of the Guide is to be used for accidents which occurred on or after 1 Mar 99. Please continue to refer to the previous adition for accidents that occurred before 1 Mar 99.)


DR LEE HOCK SIANG,
Specialist Medical Adviser, Department of
Industrial Health, Ministry of Manpower.