Permanent Functional Impairment (PFI) – General
Effective date: September 1, 2010
Application: All (re) assessments for PFI or disfigurement on or after the effective date.
Policy subject: Permanent functional impairment (PFI)
To establish guidelines for assessing Permanent Functional Impairment (PFI) awards.
- The Workers’ Compensation Board (WCB) has approved POL 23/2010, Permanent Functional Impairment – General.
- The following procedure provides guidelines for assessing Permanent Functional Impairment (PFI) awards.
- Medical Services will provide PFI evaluations based on the most current edition of The American Medical Association Guides to the Evaluation of Permanent Impairment (AMA Guides).
- Where medical reports in the claimant’s file are inadequate to determine a PFI rating, Medical Services will first request that updated medical, including recent examination results, be provided by the attending caregiver(s). If updated medical reports are still inadequate to evaluate the permanent impairment, Medical Services will request that an examination be arranged by either:
- a WCB accredited community caregiver familiar with conducting injury related physical or mental health examinations; or
- a WCB consultant.
In all cases, the whole person impairment will be reviewed and rated by an experienced WCB consultant trained in the use of the AMA Guides.
- For disfigurement evaluation, the worker may be requested to provide color photographs of the affected areas. All reasonable costs associated with providing these photographs will be reimbursed to the worker.
- Payment of a PFI award is based on a percentage rating applied to the maximum award. As per points 3 and 4 of POL 23/2010, PFI – General, the amount payable is determined by the thresholds in effect at the time of the determination of the award.
- In a situation where a worker suffers multiple injuries from a single incident, the WCB consultant will apply the AMA Guides’ Combined Values Chart (CVC) to rate the impact of the injuries on the overall whole person impairment (WPI).
- Workers with a PFI rating of 10 per cent or greater are to be considered for the Independence Allowance. PFI awards for hearing loss will not be eligible. POL 31/2016, Allowance – Independence will apply.
- In cases of progressive impairment due to disease or repetitive trauma (e.g., progressive post traumatic osteoarthritis or post-surgical fibrosis), each stage of development of the impairment will not be compensated. These situations are to be handled as increases to the original injury rather than as new injuries. As a result, the difference between the former rating and the recent rating will be calculated according to the established legislation at the time of assessment.
- Where a rating falls within the minimum range and a minimum lump sum award is provided, no further award shall be paid until the condition exceeds the minimum percentage applicable.
- The lump sum award is to be expressed to the worker in terms of both dollars and percentage.
- Workers are to be informed as to how their PFI award has been calculated and that the amount they receive may differ from others with the same PFI. The amount payable is dependent on the legislation in effect when a decision is made to pay an award. This also applies in cases of a minimum award, where workers with apparently more, or less, functional impairment may have received different amounts.
- The Chief Medical Officer (CMO) will review POL 23/2010, PFI – General, and this procedure on an annual basis to ensure the correct edition of the AMA Guides is being used to determine PFI awards.
PRO 05/2007 PFI - General
PRO 10/2007 Disfigurement Awards
March 2018. Policy and procedure review completed. No changes required.
January 1, 2014. Reference updated in accordance with The Workers’ Compensation Act, 2013.
December 2012. Policy and procedure review completed. No changes required.
POL and PRO 05/2007, PFI – General (effective May 1, 2007 to August 31, 2010).
POL and PRO 10/2007, Disfigurement Awards (effective September 1, 2007 to August 31, 2010).
POL 13/2010, PFI – Occupational Disease (was to be effective February 3, 2012 but not implemented as superseded September 1, 2010)
POL 23/2010 Permanent Functional Impairment (PFI) – General
POL 31/2016 Allowance – Independence
PRO 01/2015 Disfigurement Award Assessment
POL 15/2008 Allowance – Temporary Additional Expense
POL 11/2012 Injuries – Hearing Loss
POL 03/2021 Second Injury and Re-Employment Reserve
POL 04/2017 Injuries – Occupational Disease
POL 02/2017 Injuries – Psychological
POL 03/2011 Worker’s Death Prior to Issuance of Entitlement