1. | 10 | Fractured heels of both feet causing permanent significant functional limitation and restriction. |
2. | 10 | Fractures or dislocations or both of both hips, both ankles, both shoulders, both elbows or both wrists causing permanent significant functional limitation and restriction. |
3. | 10 | Multiple face fractures causing permanent significant cosmetic effect and functional limitation and restriction despite treatment. |
4. | 11 | Fractures or dislocations or both of both hips, both ankles, both shoulders, both elbows or both wrists which have caused, or are expected to cause, significant functional limitation and restriction at 26 weeks, from which the claimant has made, or is expected to make a substantial recovery beyond that date. |
5. | 11 | Fractured heel of one foot, causing permanent significant functional limitation and restriction. |
6. | 11 | Fractured heel of each foot which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
7. | 11 | Fracture of pelvis which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
8. | 11 | Fracture or dislocation or both of great toe, of each foot, which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
9. | 11 | Fractured tarsal bones of each foot which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
10. | 11 | Fractures of both femurs, both tibiae, both humeri, both ulnae or both radii which have caused, or are expected to cause, continuing significant functional limitation and restriction beyond 26 weeks. |
11. | 11 | Multiple fractures to face, or face and neck where treatment has led, or is expected to lead, to a good cosmetic and functional outcome. |
12. | 11 | Fracture or dislocation or both of one hip, elbow, wrist, ankle or shoulder causing permanent significant functional limitation and restriction. |
13. | 12 | Fracture of one humerus, femur, radius, ulna or tibia which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
14. | 12 | Fracture of mandible or maxilla which has required or is expected to require operative treatment and which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
15. | 12 | Fracture of each hand which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
16. | 12 | Fracture of each clavicle or each scapula which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
17. | 12 | Fracture of the skull with sub-dural or extra-dural haematoma which has required evacuation, from which the claimant has made, or is expected to make, a substantial functional recovery within 26 weeks. |
18. | 12 | Fracture or dislocation or both of thumb of each hand which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
19. | 12 | Fracture or dislocation or both of one hip, elbow, wrist, ankle or shoulder which has caused, or is expected to cause, significant functional limitation and restriction at 26 weeks with recovery thereafter. |
20. | 12 | Fracture or dislocation or both of index finger on each hand which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
21. | 12 | Fracture or dislocation or both of great toe on one foot which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
22. | 12 | Fractured tarsal bones on one foot which have caused, or are expected to cause, significant functional limitation and restriction beyond 26 weeks. |
23. | 12 | Fractured heel of one foot which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
24. | 12 | Fractured heel of each foot from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
25. | 12 | Dislocated patella on each knee which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
26. | 12 | Fractured metatarsal bones on each foot which have caused, or are expected to cause, significant functional limitation and restriction beyond 26 weeks. |
27. | 12 | Fractures of both femurs, both ulnae, both tibiae, both humeri or both radii from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
28. | 13 | Fractured tarsal or metatarsal bones on each foot from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
29. | 13 | Fractured metatarsal bones on one foot which have caused, or are expected to cause, significant functional limitation and restriction beyond 26 weeks. |
30. | 13 | Fracture or dislocation or both of great toe of each foot from which the claimant has made or is expected to make a substantial functional recovery within 26 weeks. |
31. | 13 | Fracture of one femur, ulna, tibia, humerus or radius from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
32. | 13 | Fracture of skull with sub-dural or extra-dural haematoma which has not required evacuation. |
33. | 13 | Fracture of ethmoid which has required or is expected to require operative treatment. |
34. | 13 | Fracture of zygoma which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
35. | 13 | Fracture or dislocation or both of one hip, ankle, shoulder, elbow or wrist from which the claimant has made or is expected to make a substantial recovery within 26 weeks. |
36. | 13 | Fracture of one hand which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
37. | 13 | Fractured heel of one foot, from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
38. | 13 | Fracture of each hand from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
39. | 13 | Blow-out fracture of orbit which has required, or is expected to require, operative treatment. |
40. | 13 | Dislocated jaw which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
41. | 13 | Fracture of scapula or clavicle which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
42. | 13 | Fracture of each clavicle or each scapula from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
43. | 13 | Fracture of pelvis from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
44. | 13 | Fracture of sternum which has, or is expected to have, symptoms continuing beyond 26 weeks. |
45. | 13 | Fractures or dislocations or both of two or more toes, other than great, of each foot which have caused, or are expected to cause, significant functional limitation and restriction beyond 26 weeks. |
46. | 13 | Fracture or dislocation or both of thumb on one hand which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
47. | 13 | Fracture or dislocation or both of thumb of each hand which has caused, or is expected to cause, significant functional limitation and restriction at 13 weeks from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
48. | 13 | Fracture or dislocation or both of index finger on each hand, which have caused, or are expected to cause, significant functional limitation and restriction at 13 weeks, from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
49. | 13 | Fractures or dislocations or both of two or more fingers, other than index, on each hand, which have caused, or are expected to cause, significant functional limitation and restriction beyond 26 weeks. |
50. | 13 | Fracture or dislocation or both of index finger on one hand which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
51. | 13 | Dislocated patella of one knee which has caused, or is expected to cause significant functional limitation beyond 26 weeks. |
52. | 14 | Dislocated jaw from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
53. | 14 | Fractured zygoma from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
54. | 14 | Fractured ethmoid which has not, or is not expected to require operative treatment. |
55. | 14 | Fracture of mandible or maxilla from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
56. | 14 | Fracture of hand from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
57. | 14 | Deviated nasal septum requiring corrective surgery. |
58. | 14 | Displaced fracture of nasal bones. |
59. | 14 | Simple skull fracture with no brain injury. |
60. | 14 | Fractured fibula which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
61. | 14 | Fracture or dislocation or both of thumb on one hand which has caused, or is expected to cause, significant functional limitation and restriction at 13 weeks, from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
62. | 14 | Fracture or dislocation or both of index finger, on one hand, which has caused, or is expected to cause, significant functional limitation and restriction at 13 weeks, from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
63. | 14 | Fracture or dislocation or both of one finger, other than index, on each hand, which has caused, or is expected to cause, significant functional limitation and restriction beyond 26 weeks. |
64. | 14 | Fractures or dislocations or both of two or more fingers, other than index, on one hand, which have caused, or are expected to cause significant functional limitation and restriction beyond 26 weeks. |
65. | 14 | Fractures or dislocations or both of two or more fingers, other than index, on each hand which have caused, or are expected to cause, significant functional limitation and restriction beyond 13 weeks from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
66. | 14 | Fractures or dislocations or both of two or more toes, other than great toe, on one foot, which have caused, or are expected to cause significant functional limitation and restriction beyond 26 weeks. |
67. | 14 | Fractures or dislocations or both of one toe other than great toe, on each foot, which have caused, or are expected to cause significant functional limitation and restriction beyond 26 weeks. |
68. | 14 | Fractures or dislocations or both of two or more toes, other than great toe, on each foot, from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
69. | 14 | Fracture or dislocation or both of great toe from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
70. | 14 | Fracture or dislocation or both of index finger on each hand, from which the claimant has made or is expected to make, a substantial recovery within 13 weeks. |
71. | 14 | Fracture or dislocation or both of thumb on each hand, from which the claimant has made or is expected to make, a substantial recovery within 13 weeks. |
72. | 14 | Dislocated acromio-clavicular joint from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
73. | 14 | Fracture of coccyx from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
74. | 14 | Fracture of clavicle or scapula from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
75. | 14 | Fracture of sternum from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
76. | 14 | Fractured tarsal or metatarsal bones on one foot which have caused, or are expected to cause significant functional limitation and restriction at 13 weeks from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
77. | 14 | Dislocated patella of each knee which has caused, or is expected to cause, significant functional limitation and restriction at 6 weeks, from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
78. | 15 | Fracture of mastoid. |
79. | 15 | Undisplaced fracture of nasal bones. |
80. | 15 | Deviated nasal septum which has not required or is not expected to require operative treatment. |
81. | 15 | Dislocated patella of one knee which has caused, or is expected to cause, significant functional limitation and restriction at 6 weeks, from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
82. | 15 | Fracture of three or more ribs. |
83. | 15 | Fractures or dislocations or both of two or more toes, on one foot, which have caused, or are expected to cause significant functional limitation and restriction at 13 weeks from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
84. | 15 | Fractures or dislocations of one toe, other than great toe, on each foot, which have caused, or are expected to cause significant functional limitation and restriction at 13 weeks from which the claimant has made, or is expected to make a substantial recovery within 26 weeks. |
85 | 15 | Fracture or dislocation or both of thumb from which the claimant has made, or is expected to make, a substantial recovery within 13 weeks. |
86. | 15 | Fractured tarsal or metatarsal bone on one foot, which has caused or is expected to cause significant functional limitation and restriction at 6 weeks, from which the claimant has made, or is expected to make, a substantial recovery within 13 weeks. |
87. | 15 | Stress fracture where symptoms have lasted, or are expected to last, for more than 6 weeks, where the claimant has made, or is expected to make, a substantial recovery within 13 weeks. |
88. | 15 | Fracture or dislocation or both of two or more fingers, other than index, on one hand which has caused, or is expected to cause, significant functional limitation and restriction at 13 weeks, from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
89. | 15 | Fracture or dislocation or both of two or more fingers, other than index, on each hand, from which the claimant has made, or is expected to make, a substantial recovery within 13 weeks. |
90. | 15 | Fracture or dislocation or both of one finger, other than index, on each hand, which has caused, or is expected to cause, significant functional limitation and restriction at 13 weeks from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
91. | 15 | Fracture or dislocation or both of index finger on one hand, from which the claimant has made, or is expected to make, a substantial recovery within 13 weeks. |
92. | 15 | Fracture or dislocation or both of one finger, other than index, on one hand, which has caused or is expected to cause significant functional limitation and restriction beyond 26 weeks. |
93. | 15 | Fractured fibula from which the claimant has made, or is expected to make, a substantial recovery within 26 weeks. |
94. | 15 | Fractured patella of one knee. |