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![]() New Table of DisabilitiesApril 2006 EditionChapter 18
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Table 18.1 | Loss of Function – Malignant Conditions | This table is used to rate impairment from loss of function due to malignant conditions. |
Table 18.2 | Other Impairment – Life Expectancy – Malignant Conditions | This table is used to rate impairment with regard to predicted survival estimates. |
Table 18.1 is used to rate impairment from entitled malignant conditions. One rating may be selected for each entitled condition. If more than one rating is applicable for an entitled condition, the ratings are compared and the highest selected.
For the purposes of Table 18.1, "symptoms" encompass the symptoms (including pain) of both the malignant condition itself and the symptoms of the effects of its treatment.
If non-entitled conditions or conditions rated within another chapter/table of the Table of Disabilities are contributing to the overall impairment, then the Partially Contributing Table (PCT) must be applied to arrive at the rating which is due to the entitled condition(s) rated within this chapter.
Table 18.2 is used to rate impairment from entitled malignant conditions with regard to life expectancy and prognosis. Only one rating may be selected for each entitled condition.
Whenever possible, the rating from Table 18.2 is to be based on a survival estimate from an oncologist or other treating physician. If such an estimate is unavailable, supporting evidence from a recognized standard medical reference is to be applied to provide an estimate. Estimates are to be based on malignancies of the same type and degree of spread as that in the specific case being rated. The estimate or predicted life expectancy used in Table 18.2 is projected from the time of diagnosis, or from the time of any major staging procedure or operation.
Once a Table 18.2 rating has been established it is not to be changed unless subsequent findings indicate that an earlier prognosis was based on incorrect clinical information.
The rating is not to be modified posthumously to reflect the actual duration for which the Member/Veteran/Client survived after diagnosis or staging. The life expectancy estimate can be based only on predicted probability of survival, not actual survival time.
A Table 18.2 rating is not to be updated to account for the natural progression of the condition. As the disease progresses, it is expected that ratings from Table 18.1 will exceed ratings from Table 18.2.
A rating from Table 18.2 may not be reduced because of favourable response to treatment or because of better than anticipated survival.
If the condition is being rated for the first time more than five years after diagnosis and the condition is in remission or may be cured, the malignant impairment rating is nil.
Only one rating may be given for each entitled condition from Table 18.1. If more than one rating is applicable for an entitled condition, the ratings are compared and the highest selected.
Each bullet () represents one criterion. In order for a rating to be established for Table 18.1, all criteria designated at that rating level must be met.
Table 18.1 – Loss of Function – Malignant Conditions
Rating | Criteria |
Nil |
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One |
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Nine |
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Eighteen |
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Forty-three |
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Sixty-three |
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Eighty-one |
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Only one rating may be given for each entitled condition from Table 18.2.
Each bullet () represents one criterion. In order for a rating to be established for Table 18.2, all criteria designated at that rating level must be met.
Table 18.2 – Other Impairment – Life Expectancy – Malignant Conditions
Rating | Predicted Life Expectancy at Time of Diagnosis or Staging Procedure |
Nil |
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Four |
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Nine |
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Eighteen |
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Forty-three |
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Sixty-three |
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Eighty-one |
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Step 1: | Determine the rating from Table 18.1 (Loss of Function – Malignant Conditions). |
Step 2: | Does the Partially Contributing Table apply? If yes, apply to the rating at Step 1. |
Step 3: | Determine the rating from Table 18.2 (Other Impairment – Life Expectancy – Malignant Conditions). |
Step 4: | Compare the ratings at Step 2 and Step 3 and select the highest. |
Step 5: | Determine the rating(s) from the relevant impairment table(s) using the appropriate Table of Disabilities chapter. |
Step 6: | Does the Partially Contributing Table apply? If yes, apply to the rating at Step 5. |
Step 7: | Compare the ratings at Step 4 and Step 6 and select the highest. |
Step 8: | Determine the Quality of Life rating. |
Step 9: | Add the ratings at Step 7 and Step 8. |
Step 10: | If partial entitlement exists, apply to the rating at Step 9. |
This is the Disability Assessment. |