Paired Limbs

[gryphonv]

I'm having trouble figuring this out, how awards are determined. With the current table of disabilities they list examples of paired limbs, they set a minimum threshold for the rule of 50% of the 2nd limb's award to be added.

My confusion is I can't see anything regarding paired limbs and determining rewards when both limbs are under the threshold amount.

For example, for example if two arms or legs have an award rating of say 5% +8%. Do they give you the full 13% or just the highest of the two?

 

[TCM621]

I'll be following this. I'm curious to know as I will be putting in a bilateral claim in the near future.

 

[TCM621]

Any word on this yet?

 

[gryphonv]

Nope I have nothing. My assessment was done and my determined award will be the same on both my legs. how it is calculated in the end I probably won't know until I get my decision letter. It'll probably be 14 more weeks until I see a letter though. Will update when I know more.

 

[blackberet17]

Sorry, gryphonnv, just seeing the question now.

Did you look at Chapter 4?

The loss of the second limb or loss of use or impairment of the second limb is no less disabling and is assessable in its own right, subject to the principle that the overall or combined assessments for all entitled conditions, including awards under section 36 of the Pension Act or section 47 of the Canadian Forces Members and Veterans Re-establishment and Compensation Act, may not exceed 100%.

The following example demonstrates how paired limb assessments are established for paired limbs under section 36 of the Pension Act or section 47 of the Canadian Forces Members and Veterans Re-establishment and Compensation Act:

•Upper and Lower Limbs: Example IX.5.(i)

Example IX.5.(i): Member/Veteran/Client holds entitlement for mid-thigh amputation right leg with a Disability Assessment of 83% under section 21 of the Pension Act or section 45 of the Canadian Forces Members and Veterans Re-establishment and Compensation Act. The Member/Veteran/Client subsequently is entitled under section 36 of the Pension Act or section 47 of the Canadian Forces Members and Veterans Re-establishment and Compensation Act for osteoarthritis of the left knee.
◦Step 1: Assume the entire Disability Assessment for osteoarthritis left knee is 20% (18 +2). Level 1 QOL used in this example.
◦Step 2: To determine the disability assessment for osteoarthritis left knee under paired limb section 36 of the Pension Act or section 47 of the Canadian Forces Members and Veterans Re-establishment and Compensation Act: 1/2 x 20% = 10%.

This is your paired limb Disability Assessment under the paired limb provisions of the Pension Act or the Canadian Forces Members and Veterans Re-establishment and Compensation Act.

If this doesn't help or isn't clear, please let me know.

 

[gryphonv]

Thank you blackberet17,

I've seen that before. Unfortunately it adds more confusion. The issue I am running into all the examples set the minimum threshold level for the paired limbs rule to be in effect. The limb or organ has to be labled a total loss or total loss of use.

"To be eligible for entitlement under section 36 of the Pension Act (paired organs/limbs), or section 47 of the Canadian Forces Members and Veterans Re-establishment and Compensation Act the primary condition must meet the minimum disability requirements for the total loss of or total loss of use of that organ/limb."

"Total loss of or total loss of use of an organ or limb Minimum Disability Assessment (total loss of) for the primary condition 
                      Ear                 10
                      Eye                 29
                      Kidney          15
                      Ovary              5
                      Testes              5
                      Limb (lower) 48
                      Limb (upper)
                      Dominant         58
                      Non-Dominant  47
"

The confusion I am having is what happens when one of the paired limbs/organs fall under that minimum threshold. I have a claim in for my legs that is approved and reassessed. Both legs have been determined to be equal in the % for the award determination. But neither limb will be above that min threshold.

Thanks again.

 

[blackberet17]

It's not my area of strength, as paired organ or limb cases rarely cross my desk, but I can try to help. At worst, I can ask colleagues.

Based on "III. Application" in Chapter 4, the primary condition (loss of, or loss of use of) must have a minimum disability assessment as per the table you've quoted above, before the secondary condition can be "brought in", and the two considered as paired organs.

From what I understand of that, if neither the primary nor the secondary condition meets the minimum disability assessment threshold, then the two conditions are not considered paired organs.

As you say neither the left leg nor the right leg will meet the minimum threshold of 48% to be deemed "paired organs", the conditions affecting each leg will be assessed separately. You will receive a % for the left, and a % for the right.

Does that sound about right? I'm digging through our toolbox to see if I can find more information.

 

[gryphonv]

That's what I think will happen. I'll update when I actually get my letter to see how they do the math. Still up to 13 weeks for that.

 

[TCM621]

Sorry, gryphonnv, just seeing the question now.

Did you look at Chapter 4?

If this doesn't help or isn't clear, please let me know.

Is that saying because he only has one leg he gets half? That is pretty messed up. I have to be reading that wrong.

 

[gryphonv]

Ok my claim was completed today. And after speaking with my VAC account manager (she is pretty amazing and reliable), I had a claim of 10% awarded.

I initially thought it would be 10 + 10 for a 20% award.

I was unsure how the paired limbs would apply. But then I seen this little statement in the Table of disabilities.

When using the musculoskeletal lower limb (Table 17.9), this table considers the lower limbs as a unit. The Partially Contributing Table, therefore, would need to be applied to determine the rating for one limb.

So by that rule it would be 5 +5 = 10%.

Which seems to line up perfectly with my initial guess. I just failed to apply that rule.

Hope this helps anyone who may have questions.