Permanent Physical Impairment Policy 21-250 | Effective Date: July 1, 2024

Policy

Under the Workers’ Compensation Act (WC Act), injured workers are entitled to a lump sum payment in recognition of loss of opportunity when they suffer a permanent physical impairment (PPI) as a result of a compensable accident or occupational disease on or after January 1, 1982.

WorkSafeNB will only provide an impairment award (PPI award) upon determining that an impairment is:

  • Permanent;
  • A physical impairment, which is a loss of an anatomical structure or physical body function; and
  • A result from a compensable injury.

The PPI award is based on the injured worker’s impairment rating, measured in accordance with an approved rating schedule as outlined in Regulation 82-165 Permanent Physical Impairment Rating Schedule (Regulation 82-165). This regulation directs WorkSafeNB to use other approved rating guides (such as the most recent edition of the American Medical Association Guides to Evaluation of Permanent Impairment (AMA Guides)) when they are necessary for determining the impairment rating.

Receipt of a PPI award does not affect an injured worker’s entitlement to other benefits and is not intended to be:

  • Settlement of a claim;
  • Compensation for loss of earnings; or
  • Compensation for pain, suffering, or loss of enjoyment of life.

Interpretation

Determining if a PPI exists

1. A PPI may exist for injured workers who sustain a physical injury. Prior to determining if a PPI exists for the injured worker, WorkSafeNB determines if the:

  • Medical condition has stabilized or plateaued, meaning that there are no major interventions pending or planned; and
  • Minimum time intervals as specified in Regulation 82-165 have elapsed between the injury or surgery, and the assessment of the PPI.

2. Once WorkSafeNB is satisfied that the injury is reasonably stable and meets the minimum time intervals specified in Regulation 82-165, a WorkSafeNB-approved medical examiner determines whether the evidence supports that a physical impairment exists and is likely to be permanent. This evidence may consist of:

  • Information related to the mechanism, nature, and intensity of injury;
  • Medical information specific to the injured worker’s injury, which may include objective clinical and investigative findings;
  • Peer-reviewed medical literature that indicates the expected level of impairment; or
  • Other evidence supporting that the physical impairment is a result of the compensable injury.

3. If the evidence supports that a PPI may exist, WorkSafeNB proceeds to assess the degree of impairment and assigns an impairment for the purpose of calculating the PPI award.

Adjusting the timing of the PPI award

4. WorkSafeNB may, at its discretion, adjust the timing of a PPI assessment, or perform a reassessment as needed, where medical evidence warrants doing so. The minimum waiting time (prescribed in regulation) may be waived if the severity of the injury or occupational disease is such that:

  • The impairment rating is medically evident (for example, in brain or spinal cord injuries causing total impairment); and/or
  • The medical condition has stabilized, with no major intervention intended or planned, and further treatment will not improve the condition.

Paying a PPI award to an injured worker’s estate

5. If the injured worker dies prior to receiving a PPI award, WorkSafeNB will pay the award to the injured worker’s estate provided that:

  • The injured worker, prior to death, was assessed by WorkSafeNB as having a PPI as a result of the workplace accident or occupational disease; or
  • There is sufficient medical information available, after the injured worker dies, for WorkSafeNB’s medical examiner to conduct a paper review and determine that the injured worker lived with an impairment and the degree of that impairment.

6. In both cases there must be evidence to demonstrate that the injured worker lived with the PPI prior to death.

Assessing the degree of PPI

7. A WorkSafeNB-approved medical examiner completes an assessment to determine the degree of the PPI resulting from a work-related injury or occupational disease. WorkSafeNB requires the medical examiner to:

  • Be designated as a Certified Independent Medical Examiner by the American Board of Independent Medical Examiners or its equivalent; and
  • Have no physician-patient relationship with the injured worker.

8. In consultation with WorkSafeNB, the WorkSafeNB-approved medical examiner determines whether an assessment will consist of a paper review or a physical examination.

9. A paper review may be sufficient to assess the degree of PPI when the evidence confirms that:

  • The impairment rating can be assigned to the work-related injury or occupational disease based on the evidence provided in the file (e.g. brain or spinal cord injuries, finger amputation); or
  • Sufficient information exists to establish the degree of PPI (e.g. hearing or vision loss).

10. To appropriately assign the impairment rating, a physical examination may be required when the evidence on file is insufficient to establish the degree of PPI or when Regulation 82-165 assigns a range to the impairment rating according to the body part.

Assigning an impairment rating

11. WorkSafeNB relies on the assessment (paper review or physical examination) to identify the degree of PPI, in order to assign an impairment rating. WorkSafeNB assigns an impairment rating using Regulation 82-165 or alternate authorities, including the AMA Guides, as needed.

12. When alternate authorities are consulted to assign an impairment rating, WorkSafeNB ensures that the assigned rating is consistent and does not exceed the ratings outlined in Regulation 82-165 for the same body part.

13. The rating schedule outlined in Regulation 82-165 assigns a percentage value to the impairment rating. This percentage of impairment is then used in calculating the PPI award.

14. With the exception of the special rating schedules for loss of hearing and loss of vision (found in Regulation 82-165), the minimum impairment rating required for a PPI award is 1% of total body impairment. the minimum impairment rating required for a PPI award is 1% of total body impairment. The maximum impairment rating cannot exceed 100%.

Calculating the PPI award

15. WorkSafeNB calculates the PPI award by multiplying the injured worker’s impairment rating by the maximum annual earnings that were applicable in the accident year.

16. The minimum award is $500 and the maximum award cannot exceed the maximum annual earnings that were applicable in the year of the work-related accident.

Whole-body PPI

17. Regulation 82-165 defines physical impairment in terms of percentage of total or whole-body impairment.

18. When assigning an impairment rating for more than one body area, the WorkSafeNB-approved medical examiner assigns a rating to each individual body area, and then combines both ratings using the combined value charts in the AMA Guides to determine the whole-body impairment rating of the injured worker. The maximum PPI award cannot exceed 100%.

Pre-existing conditions

19. When a pre-existing condition is aggravated by a workplace injury, WorkSafeNB determines the injured worker’s PPI award taking into account the impairment resulting from the aggravation of the pre-existing condition. Impairment resulting from an existing non-compensable condition is not included in the determination of the injured worker’s PPI award. For more information on pre-existing conditions, see Policy 21-101 Pre-existing Conditions.

Reassessing the PPI award

20. In certain cases, injured workers may be eligible to have their PPI award reassessed if:

  • A change has occurred in the level of physical impairment of the compensable injury or disease since the last assessment;
  • An additional body part has been affected by the original work-related injury; or
  • The compensable injury or disease has aggravated the prior non-compensable condition.

21. If the reassessment results in a higher percentage of impairment, WorkSafeNB recalculates the PPI award based on the new impairment rating and multiples it by the maximum annual earnings that were applicable for the year in which the accident occurred. The difference between the original assessed award and the new assessment is paid to the injured worker.

Previous versions

  • Policy 21-250 Permanent Physical Impairment, release 6, effective November 29, 2018
  • Policy 21-250 Permanent Physical Impairment, release 5, effective February 8, 2018
  • Policy 21-250 Permanent Physical Impairment, release 4, effective February 28, 2008

Authority

Workers’ Compensation Act

Sections 7(5)34(1), 34(2), 38.101(9), 38.101(10)38.11(17), 38.11(18), 38.2(8), 38.2(9)85(1.1)

Regulation 82-165 – Permanent Physical Impairment Rating Schedule

Case Law

Scribner v. Workplace Health, Safety and Compensation Commission (1997, NBCA)

Impairment – a significant deviation, loss, or loss of use of any body structure or body function in an individual with a health condition, disorder, or disease (American Medical Association Guides to the Evaluation of Permanent Impairment, 6th edition). It represents a deviation from certain generally accepted population standards in the biomedical status of the body and its functions (Taber’s Cyclopedic Medical Dictionary, 20th edition).

Maximum annual earnings – the New Brunswick Industrial Aggregate Earnings, as set by the Commission as of the first day of January of each year, multiplied by 1.5 for accidents occurring prior to July 1, 2024, and multiplied by 1.6 for accidents occurring on or after July 1, 2024 (adapted from the Workers’ Compensation Act).

E-News Sign-up