PERSONAL INJURY LAW
In addition to compensating claimants for their financial losses arising from personal injury, the courts make an award for for pain, suffering or loss of the amenities of life (commonly referred to as 'general damages'). The amounts of this award varies greatly and judges are required to follow guidelines.
These guidelines are set out below (and are current at the date of publication):
1 Injuries Involving Paralysis
(a) Quadriplegia £188,250 to £235,000
The level of the award within the bracket will be affected by the following
considerations:
(i) the extent of any residual movement;
(ii) the presence and extent of pain;
(iii) depression;
(iv) age and life expectancy.
The top of the bracket will be appropriate only where there is significant
effect on senses or ability to communicate. It will also often involve
significant brain damage.
(b) Paraplegia £127,250 to £165,500
The level of the award within the bracket will be affected by the following
considerations:
(i) the presence and extent of pain;
(ii) the degree of independence;
(iii) depression;
(iv) age and life expectancy.
2 Head Injuries
(A) Brain Damage
(a) Very Severe Brain Damage £165,500 to £235,000
In cases at the top of this bracket the injured person will have a degree of
insight. There may be some ability to follow basic commands, recovery of eye
opening and return of sleep and waking patterns and postural reflex movement.
There will be little, if any, evidence of meaningful response to environment,
little or no language function, double incontinence and the need for full-time
nursing care.
The level of the award within the bracket will be affected by:
(i) the degree of insight;
(ii) life expectancy;
(iii) the extent of physical limitations.
The top of the bracket will be appropriate only where there is significant
effect on the senses and severe physical limitation.
Where there is a persistent vegetative state and/or death occurs very soon after
the injuries were suffered and there has been no awareness by the injured person
of his or her condition the award will be solely for loss of amenity and will
fall substantially below the above bracket.
(b) Moderately Severe Brain Injury £127,250 to £165,500
The injured person will be very seriously disabled.
There will be substantial dependence on others and a need for constant
professional and other care. Disabilities may be physical, for example, limb
paralysis, or cognitive, with marked impairment of intellect and personality.
Cases otherwise within (a) above may fall into this bracket if life expectancy
has been greatly reduced.
The level of the award within the bracket will be affected by the following
considerations:
(i) the degree of insight;
(ii) life expectancy;
(iii) the extent of physical limitations;
(iv) the degree of dependence on others;
(v) ability to communicate;
(vi) behavioural abnormality;
(vii) epilepsy or a significant risk of epilepsy (unless a
provisional damages order provides for this risk).
(c) Moderate Brain Damage
This category is distinguished from (b) by the fact that the degree of
dependence is markedly lower.
(i) Cases in which there is moderate to severe intellectual
deficit, a personality change, an effect on sight, speech and senses
with a significant risk of epilepsy and no prospect of employment.
£87,500 to £127,250
(ii) Cases in which there is a moderate to modest intellectual
deficit, the ability to work is greatly reduced if not removed and
there is some risk of epilepsy (unless a provisional damages order
provides for this risk). £52,950 to £87,500
(iii) Cases in which concentration and memory are affected, the
ability to work is reduced, where there is a small risk of epilepsy
and any dependence on others is very limited. £25,000 to £52,950
(d) Minor Brain Damage £9,000 to £25,000
In these cases the injured person will have made a good recovery and will be
able to take part in normal social life and to return to work. There may not
have been a restoration of all normal functions so there may still be persisting
problems such as poor concentration and memory or disinhibition of mood, which
may interfere with lifestyle, leisure activities and future work prospects.
At the top of this bracket there may be a small risk of epilepsy.
The level of the award within the bracket will be affected by:
(i) the extent and severity of the initial injury;
(ii) the extent of any continuing, and possibly permanent,
disability;
(iii) the extent of any personality change;
(iv) depression.
(B) Minor Head injury
£1,300 to £7,425
In these cases brain damage, if any, will have been minimal.
The level of the award will be affected by the following considerations:
(i) the severity of the initial injury;
(ii) the period taken to recover from any symptoms;
(iii) the extent of continuing symptoms;
(iv) the presence or absence of headaches.
The bottom of the bracket will reflect full recovery within a few weeks.
(C) Epilepsy
(a) Established Grand Mal £58,500 to £87,500
(b) Established Petit Mal £32,000 to £76,350
The level of the award within these brackets will be affected by the following
factors:
(i) whether attacks are successfully controlled by medication and
the extent to which the need for medication is likely to persist;
(ii) the extent to which the appreciation of life is blunted by
such medication;
(iii) the effect on working and/or social life;
(iv) the existence of associated behavioural problems;
(v) the prognosis.
(c) Other Epileptic Conditions £6,100 to £15,250
Cases where there are one or two discrete epileptic episodes, or a temporary
resurgence of epilepsy, but there is no risk of further recurrence beyond that
applicable to the population at large.
The level of the award within the bracket will be affected by the extent of any
consequences of the attacks on, for example, education, sporting activities,
working and social life, and their duration.
3 Psychiatric Damage
In part (A) of this chapter some of the brackets contain an element of
compensation for posttraumatic stress disorder. This is of course not a
universal feature of cases of psychiatric injury and hence a number of the
awards upon which the brackets are based did not reflect it. Where it does
figure any award will tend towards the upper end of the bracket. Cases where
posttraumatic stress disorder is the sole psychiatric condition are dealt with
in part (B) of this chapter. Where cases arise out of sexual and/or physical
abuse in breach of parental, family or other trust, involving victims who are
young and/or vulnerable, awards will tend to be at the upper end of the relevant
bracket to take into account (A)(vii) below.
Part (C) of this chapter deals with various conditions under the generic heading
'Chronic Pain'. These are cases where there are symptoms of pain without any, or
any commensurate, organic basis. Questions of causation inevitably arise in such
cases, but it is not the function of the Guidelines to consider them, and the
figures given in the various sections are on the basis that causation is
established. While the conditions dealt with in part (C) do not necessarily
arise out of psychiatric injury, they are dealt with here partly because they
almost always include an element of psychological damage and partly for the
convenience of users of the Guidelines, because symptoms caused by these
conditions can affect a variety of areas of an injured person's anatomy. The
figures given include compensation for any physical injury and for any physical
disability resulting from the chronic pain.
(A) Psychiatric Damage Generally
The factors to be taken into account in valuing claims of this nature are as
follows:
(i) the injured person's ability to cope with life and work;
(ii) the effect on the injured person's relationships with family,
friends and those with whom he or she comes into contact;
(iii) the extent to which treatment would be successful;
(iv) future vulnerability;
(v) prognosis;
(vi) whether medical help has been sought;
(vii)
(a) whether the injury results from sexual and/or physical abuse
and/or breach of trust;
(b) if so, the nature of the relationship between victim and
abuser, the nature of the abuse, its duration and the symptoms
caused by it.
(a) Severe £32,000 to £67,200
In these cases the injured person will have marked problems with respect to
factors (i) to (iv) above and the prognosis will be very poor.
(b) Moderately Severe £11,200 to £32,000
In these cases there will be significant problems associated with factors (i) to
(iv) above but the prognosis will be much more optimistic than in (a) above.
While there are awards which support both extremes of this bracket, the majority
are somewhere near the middle of the bracket. Cases of work-related stress
resulting in a permanent or long-standing disability preventing a return to
comparable employment would appear to come within this category.
(c) Moderate £3,450 to £11,200
While there may have been the sort of problems associated with factors (i) to
(iv) above there will have been marked improvement by trial and the prognosis
will be good.
(d) Minor £840 to £3,450
The level of the award will take into consideration the length of the period of
disability and the extent to which daily activities and sleep were affected.
Awards have been made below this bracket in cases of temporary 'anxiety'.
(B) Post-traumatic Stress Disorder
Cases within this category are exclusively those where there is a specific
diagnosis of a reactive psychiatric disorder in which characteristic symptoms
are displayed following a psychologically distressing event which causes intense
fear, helplessness and horror. The guidelines below have been compiled by
reference to cases which variously reflect the criteria established in the 4th
edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR).
The symptoms affect basic functions such as breathing, pulse rate and bowel
and/or bladder control.
They also involve persistent re-experience of the relevant event, difficulty in
controlling temper, in concentrating and sleeping, and exaggerated startle
response.
(a) Severe £36,650 to £58,500
Such cases will involve permanent effects which prevent the injured person from
working at all or at least from functioning at anything approaching the
pre-trauma level. All aspects of the life of the injured person will be badly
affected.
(b) Moderately Severe £13,500 to £33,800
This category is distinct from (a) above because of the better prognosis which
will be for some recovery with professional help. However, the effects are still
likely to cause significant disability for the foreseeable future. While there
are awards which support both extremes of this bracket, the majority are between
£20,000 and £25,000.
(c) Moderate £4,825 to £13,500
In these cases the injured person will have largely recovered and any continuing
effects will not be grossly disabling.
(d) Minor £2,300 to £4,825
In these cases a virtually full recovery will have been made within one to two
years and only minor symptoms will persist over any longer period.
(C) Chronic Pain
(a) Chronic Pain Syndrome
(i) Severe £24,450 to £37,150
(ii) Moderate £6,350 to £19,100
(b) Fibromyalgia £19,850 to £37,150
(c) Chronic Fatigue Syndrome In the region of £28,750
(d) Reflex Sympathetic Dystrophy
(Also called complex regional pain syndrome)
(i) Severe £29,750 to £58,500
(ii) Moderate £14,750 to £22,400
(e) Somatoform Disorder In the region of £26,500
4 Injuries Affecting the Senses
(A) Injuries Affecting Sight
(a) Total Blindness and Deafness In the region of £235,000
Such cases must be considered as ranking with the most devastating injuries.
(b) Total Blindness In the region of £155,250
(c) Loss of Sight in One Eye with Reduced Vision in the Remaining
Eye
(i) Where there is serious risk of further deterioration in the
remaining eye, going beyond some risk of sympathetic ophthalmia.
£56,000 to £104,500
(ii) Where there is reduced vision in the remaining eye and/or
additional problems such as double vision. £37,150 to £61,500
(d) Total Loss of One Eye £32,000 to £38,175
The level of the award within the bracket will depend on age and cosmetic
effect.
(e) Complete Loss of Sight in One Eye £28,750 to £32,000
This award takes account of some risk of sympathetic ophthalmia. The upper end
of the bracket is appropriate where there is scarring in the region of the eye
which is not sufficiently serious to merit a separate award.
(f) Cases of serious but incomplete loss of vision in one eye
without significant risk of loss or reduction of vision in the
remaining eye, or where there is constant double vision. £13,750 to
£22,650
(g) Minor but permanent impairment of vision in one eye, including
cases where there is some double vision, which may not be constant.
£7,375 to £12,200
(h) Minor Eye Injuries £2,300 to £5,100
In this bracket fall cases of minor injuries, such as being struck in the eye,
exposure to fumes including smoke, or being splashed by liquids, causing initial
pain and some temporary interference with vision.
(i) Transient Eye Injuries £1,300 to £2,300
In these cases the injured person will have recovered completely within a few
weeks.
(B) Deafness
The word 'deafness' is used to embrace total and partial hearing loss. In
assessing awards for hearing loss regard must be had to the following:
(i) whether the injury is one that has an immediate effect,
allowing no opportunity to adapt, or whether it occurred over a period
of time, as in noise exposure cases;
(ii) whether the injury or disability is one which the injured
person suffered at an early age so that it has had or will have an
effect on his or her speech, or is one that is suffered in later life;
(iii) whether the injury or disability affects balance;
(iv) in cases of noise-induced hearing loss (NIHL) age is of
particular relevance as noted in paragraph (d) below.
(a) Total Deafness and Loss of Speech £63,625 to £81,500
Such cases arise, for example, where deafness has occurred at an early age (for
example, rubella infection) so as to prevent or seriously to affect the
development of normal speech.
(b) Total Deafness £52,950 to £63,625
The lower end of the bracket is appropriate for cases where there is no speech
deficit or tinnitus.
The higher end is appropriate for cases involving both of these.
(c) Total Loss of Hearing in One Ear £18,325 to £26,500
Cases will tend towards the higher end of the bracket where there are associated
problems, such as tinnitus, dizziness or headaches.
(d) Partial Hearing Loss/Tinnitus
This category covers the bulk of deafness cases which usually result from
exposure to noise over a prolonged period. The disability is not to be judged
simply by the degree of hearing loss; there is often a degree of tinnitus
present. Age is particularly relevant because impairment of hearing affects most
people in the fullness of time and impacts both upon causation and upon
valuation.
(i) Severe tinnitus/hearing loss. £17,300 to £26,500
(ii) Moderate tinnitus/hearing loss. £8,650 to £17,300
(iii) Mild tinnitus with some hearing loss. £7,375 to £8,650
(iv) Slight or occasional tinnitus with slight hearing loss.
£4,300 to £7,375
(C) Impairment of Taste and Smell
(a) Total Loss of Taste and Smell In the region of £22,650
(b) Total Loss of Smell and Significant Loss of Taste £19,100 to
£22,650
It must be remembered that in nearly all cases of loss of smell there is some
impairment of taste.
Such cases fall into the next bracket.
(c) Loss of Smell £14,500 to £19,100
(d) Loss of Taste £11,200 to £14,500
5 Injuries to Internal Organs
(A) Chest Injuries
This is a specially difficult area because the majority of awards relate to
industrial disease (see (B) below) as distinct from traumatic injury.
Cases of traumatic damage to, or loss of, a lung are comparatively rare: the
range is as wide as £1,300 to £87,500.
The levels of awards within the brackets set out below will be affected by:
(i) age and gender;
(ii) scarring;
(iii) the effect on the capacity to work and enjoy life;
(iv) the effect on life expectancy.
(a) The worst type of case will be of total removal of one lung and/or
serious heart damage with serious and prolonged pain and suffering and permanent
significant scarring. £58,500 to £87,500
(b) Traumatic injury to chest, lung(s) and/or heart causing permanent
damage, impairment of function, physical disability and reduction of life
expectancy. £38,175 to £58,500
(c) Damage to chest and lung(s) causing some continuing disability. £18,325
to £32,000
(d) A relatively simple injury (such as a single penetrating wound) causing
some permanent damage to tissue but with no significant long-term effect on lung
function. £7,375 to £10,500
(e) Toxic fume/smoke inhalation, leaving some residual damage, not serious
enough to interfere permanently with lung function. £3,175 to £7,375
(f) Injuries leading to collapsed lungs from which a full and uncomplicated
recovery is made. £1,300 to £3,175
(g) Fractures of ribs, causing serious pain and disability over a period of
weeks only. Up to £2,300
(B) Lung Disease
The level of the appropriate award for lung disease necessarily, and often
principally, reflects the prognosis for what is frequently a worsening condition
and/or the risk of the development of secondary sequelae.
Most of the reported cases are of asbestos-related disease (as to which see (C)
below) but, save for asthma (which is also dealt with separately in (D) below),
the brackets set out are intended to encompass all other lung disease cases
irrespective of causation. In many cases falling under this head provisional
awards will be appropriate. At the upper end of the range where serious
disabling consequences will already be present and the prognosis is likely to be
relatively clear such an award may not be appropriate. Furthermore, in some
cases awards may be enhanced where classifiable psychiatric illness is present.
(a) For a young person with serious disability where there is a probability
of progressive worsening leading to premature death. £58,500 to £79,000
(b) Lung cancer (typically in an older person) causing severe pain and
impairment both of function and of quality of life. The duration of pain and
suffering accounts for variations within this bracket. See also paragraph (C)(b)
below. £45,800 to £58,500
(c) Disease, eg emphysema, causing significant and worsening lung function
and impairment of breathing, prolonged and frequent coughing, sleep disturbance
and restriction of physical activity and employment. £32,000 to £46,300
(d) Breathing difficulties (short of disabling breathlessness) requiring
fairly frequent use of an inhaler; where there is inability to tolerate a smoky
environment and an uncertain prognosis but already significant effect on social
and working life. £18,325 to £32,000
(e) Bronchitis and wheezing not causing serious symptoms; little or no
serious or permanent effect on working or social life; varying levels of anxiety
about the future. £12,200 to £18,325
(f) Some slight breathlessness with no effect on working life and the
likelihood of substantial and permanent recovery within a few years of the
exposure to the cause or the aggravation of an existing condition. £6,100 to
£12,200
(g) Provisional awards for cases otherwise falling within (f), or the least
serious cases within (e) where the provisional award excludes any risk of
malignancy. £3,175 to £6,100
(h) Temporary aggravation of bronchitis or other chest problems resolving
within a very few months. £1,300 to £3,175
(C) Asbestos-related Disease
Mesothelioma, lung cancer and asbestosis are the most serious of these.
Mesothelioma is typically of shorter duration than either of the other two and
often proves fatal within a matter of months from first diagnosis. Lung cancer
and asbestosis are likely to have a fatal outcome but the symptoms often endure
for several years. Where damages for pleural plaques are concerned, note that
entitlement to and quantification of damages are under appeal to the House of
Lords at the date of publication.
(a) Mesothelioma causing severe pain and impairment of both function and
quality of life. This may be of the pleura (the lung lining) or of the
peritoneum (the lining of the abdominal cavity); the latter being typically more
painful. The duration of pain and suffering accounts for variations within this
bracket. For periods of up to 18 months, awards in the bottom half of the
bracket may be appropriate; for longer periods of four years or more, an award
at the top end. £47,850 to £74,300
(b) Lung cancer, again a disease proving fatal in most cases, the symptoms
of which may not be as painful as those of mesothelioma, but more protracted.
See also paragraph (B)(b) above. £45,800 to £58,500
(c) Asbestosis, causing impairment of the extremities of the lungs so that
oxygen uptake to the blood stream is reduced. In the early stages the disease
may be symptomless but progresses to cause severe breathlessness. Mobility is
likely to become seriously impaired and quality of life reduced. Respiratory
disability of between 10 and 20 per cent will probably attract an award in the
region of £40,750. £28,000 to £61,500
(d) Pleural thickening, typically causing progressive symptoms of
breathlessness by inhibiting expansion of the lungs (the so-called cuirasse
restriction). Disease may gradually progress to cause more serious respiratory
disability. £22,400 to £45,800
(e) Pleural plaques, being localised areas of pleural thickening, do not
normally cause any symptoms. May be accompanied by psychological injury causing
disability. £6,100 to £7,125
(f) Provisional awards for cases otherwise falling within (e) or the least
serious cases within (d) where the provisional award excludes any risk of the
development of mesothelioma, lung or other cancer or asbestosis. £4,000 to
£6,100
(D) Asthma
(a) Severe and permanent disabling asthma, causing prolonged and regular
coughing, disturbance of sleep, severe impairment of physical activity and
enjoyment of life and where employment prospects, if any, are grossly
restricted. £25,000 to £38,175
(b) Chronic asthma causing breathing difficulties, the need to use an
inhaler from time to time and restriction of employment prospects, with
uncertain prognosis. £15,250 to £25,000
(c) Bronchitis and wheezing, affecting working or social life, with the
likelihood of substantial recovery within a few years of the exposure to the
cause. £11,200 to £15,250
(d) Relatively mild asthma-like symptoms often resulting, for instance, from
exposure to harmful irritating vapour. £6,100 to £11,200
(e) Mild asthma, bronchitis, colds and chest problems (usually resulting
from unfit housing or similar exposure, particularly in cases of young children)
treated by a general practitioner and resolving within a few months. Up to
£3,000
(E) Reproductive System: Male
(a) Impotence
(i) Total impotence and loss of sexual function and sterility in
the case of a young man. In the region of £86,500
The level of the award will depend on:
(1) age;
(2) psychological reaction and the effect on social and
domestic life.
(ii) Impotence which is likely to be permanent, in the case of a
middle-aged man with children. £25,000 to £46,300
(b) Cases of sterility usually fall into one of two categories: surgical,
chemical and disease cases (which involve no traumatic injury or scarring) and
traumatic injuries (frequently caused by assaults) which are often aggravated by
scarring.
(i) The most serious cases merit awards approaching £81,500
(ii) The bottom of the range is the case of the much older man and
merits an award of about £10,700
(c) An uncomplicated case of sterility without impotence and without any
aggravating features for a young man without children. £32,800 to £41,250
(d) A similar case but involving a family man who might have intended to
have more children. £13,750 to £18,100
(e) Cases where the sterility amounts to little more than an 'insult'. In
the region of £3,800
(F) Reproductive System: Female
The level of awards in this area will typically depend on:
(i) whether or not the affected woman already has children and/or
whether the intended family was complete;
(ii) scarring;
(iii) depression or psychological scarring;
(iv) whether a foetus was aborted.
(a) Infertility whether by reason of injury or disease, with severe
depression and anxiety, pain and scarring. £67,200 to £98,500
(b) Infertility without any medical complication and where the injured
person already has children.
The upper end of the bracket is appropriate in cases where there is significant
psychological damage. £10,500 to £21,350
(c) Infertility where the injured person would not have had children in any
event (for example, because of age). £3,800 to £7,425
(d) Failed sterilisation leading to unwanted pregnancy where there is no
serious psychological impact or depression. In the region of £5,850
(G) Digestive System
The risk of associated damage to the reproductive organs is frequently
encountered in cases of this nature and requires separate consideration.
(a) Damage Resulting from Traumatic Injury
(i) Severe damage with continuing pain and discomfort. £25,000 to
£36,125
(ii) Serious non-penetrating injury causing long-standing or
permanent complications, for example, severe indigestion, aggravated
by physical strain. £9,700 to £16,300
(iii) Penetrating stab wounds or industrial laceration or serious
seat-belt pressure cases. £3,800 to £7,375
(b) Illness/Damage Resulting from Non-traumatic Injury, eg Food
Poisoning
There will be a marked distinction between those, comparatively rare, cases
having a long-standing or even permanent effect on quality of life and those in
which the only continuing symptoms may be allergy to specific foods and the
attendant risk of short-term illness.
(i) Severe toxicosis causing serious acute pain, vomiting,
diarrhoea and fever, requiring hospital admission for some days or
weeks and some continuing incontinence, haemorrhoids and irritable
bowel syndrome, having a significant impact on ability to work and
enjoyment of life. £22,400 to £30,500
(ii) Serious but short-lived food poisoning, diarrhoea and
vomiting diminishing over two to four weeks with some remaining
discomfort and disturbance of bowel function and impact on sex life
and enjoyment of food over a few years. Any such symptoms having these
consequences and lasting for longer, even indefinitely, are likely to
merit an award between the top of this bracket and the bottom of the
bracket in (i) above. £5,600 to £11,200
(iii) Food poisoning causing significant discomfort, stomach
cramps, alteration of bowel function and fatigue. Hospital admission
for some days with symptoms lasting for a few weeks but complete
recovery within a year or two. £2,300 to £5,600
(iv) Varying degrees of disabling pain, cramps and diarrhoea
continuing for some days or weeks. £550 to £2,300
(H) Kidney
(a) Serious and permanent damage to or loss of both kidneys. £98,500 to
£122,000
(b) Where there is a significant risk of future urinary tract infection or
other total loss of natural kidney function. Up to £37,150
Such cases will invariably carry with them substantial future medical expenses,
which in this field are particularly high.
(c) Loss of one kidney with no damage to the other. £18,100 to £25,000
(I) Bowels
(a) Total loss of natural function and dependence on colostomy, depending on
age. Up to £87,500
(b) Severe abdominal injury causing impairment of function and often
necessitating temporary colostomy(leaving disfiguring scars) and/or restriction
on employment and on diet. £26,000 to £40,750
(c) Penetrating injuries causing some permanent damage but with an eventual
return to natural function and control. £7,375 to £14,000
(J) Bladder
It is perhaps surprising that awards in cases of loss of bladder function have
often been higher than awards for injury to the bowels. This is probably because
bladder injuries frequently result from carcinogenic exposure. The reported
decisions are seriously out of date and merely increasing them to reflect
inflation may be misleading.
(a) Complete loss of function and control. Up to £81,500
(b) Serious impairment of control with some pain and incontinence. £37,150
to £46,300
(c) Where there has been almost a complete recovery but some fairly
long-term interference with natural function. £13,500 to £18,100
The cancer risk cases still occupy a special category and can properly attract
awards at the top of the ranges even where natural function continues for the
time being. However, these cases will now more appropriately be dealt with by
provisional awards at a low level (£5,600) unless the foreseeable outcome is
clear. Once the prognosis is firm and reliable the award will reflect any loss
of life expectancy, the level of continuing pain and suffering and most
significantly the extent to which the injured person has to live with the
knowledge of the consequences which his or her death will have for others. The
appropriate award for the middle-aged family man or woman whose life expectancy
is reduced by 15 or 20 years is £30,500 to £44,500.
(K) Spleen
(a) Loss of spleen where there is continuing risk of internal infection and
disorders due to the damage to the immune system. £12,200 to £15,250
(b) Where the above risks are not present or are minimal. £2,550 to £5,100
(L) Hernia
(a) Continuing pain and/or limitation on physical activities, sport or
employment, after repair. £8,650 to £14,000
(b) Direct (where there was no pre-existing weakness) inguinal hernia, with
some risk of recurrence, after repair. £4,000 to £5,350
(c) Uncomplicated indirect inguinal hernia, possibly repaired, and with no
other associated abdominal injury or damage. £2,000 to £4,300
6 Orthopaedic Injuries
(A) Neck Injuries
There is a very wide range of neck injuries. Many are found in conjunction with
back and shoulder problems.
At the highest level are injuries which shatter life and leave claimants very
severely disabled. These may have a value of up to £86,500.
At the lowest level, claimants may suffer a minor strain, may not have time o.
work, and may suffer symptoms for a few weeks, justifying as little as £750.
(a) Severe
(i) Neck injury associated with incomplete paraplegia or resulting
in permanent spastic quadriparesis or where the injured person,
despite wearing a collar 24 hours a day for a period of years, still
has little or no movement in the neck and suffers severe headaches
which have proved intractable. In the region of £86,500
(ii) Injuries which give rise to disabilities which fall short of
those in (a)(i) above but which are of considerable severity; for
example, permanent damage to the brachial plexus. £38,175 to £76,350
(iii) Injuries causing severe damage to soft tissues and/or
ruptured tendons. They result in significant disability of a permanent
nature. The precise award depends on the length of time during which
the most serious symptoms are ameliorated, and on the prognosis. In
the region of £32,000
(iv) Injuries such as fractures or dislocations which cause severe
immediate symptoms and which may necessitate spinal fusion. They leave
markedly impaired function or vulnerability to further trauma, and
some limitation of activities. £14,500 to £19,100
(b) Moderate
(i) Cases involving whiplash or wrenching-type injury and disc
lesion of the more severe type resulting in cervical spondylosis,
serious limitation of movement, permanent or recurring pain, stiffness
or discomfort and the possible need for further surgery or increased
vulnerability to further trauma. £8,150 to £14,500
(ii) Injuries which may have exacerbated or accelerated some
pre-existing unrelated condition. There will have been a complete
recovery or recovery to 'nuisance' level from the effects of the
accident within a few years. This bracket will also apply to moderate
whiplash injuries where the period of recovery has been fairly
protracted and where there remains an increased vulnerability to
further trauma. £4,575 to £8,150
(c) Minor
Minor soft tissue and whiplash injuries and the like where symptoms are
moderate:
(i) and a full recovery takes place within about two years; £2,550
to £4,575
(ii) with a full recovery between a few weeks and a year. £750 to
£2,550
(B) Back Injuries
Relatively few back injuries which do not give rise to paralysis command awards
above about £25,000. In those that do there are special features.
(a) Severe
(i) Cases of the most severe injury which do not involve paralysis
but where there may be very serious consequences not normally found in
cases of back injury, such as impotence or double incontinence.
£58,500 to £98,500
(ii) Cases which have special features taking them outside any
lower bracket applicable to orthopaedic injury to the back. Such
features include impaired bladder and bowel function, severe sexual
difficulties and unsightly scarring and the possibility of future
surgery. In the region of £46,300
(iii) Cases of disc lesions or fractures of discs or of vertebral
bodies where, despite treatment, there remain disabilities such as
continuing severe pain and discomfort, impaired agility, impaired
sexual function, depression, personality change, alcoholism,
unemployability and the risk of arthritis. £22,650 to £40,750
(b) Moderate
(i) Cases where any residual disability is of less severity than
that in (a)(iii) above. The bracket contains a wide variety of
injuries. Examples are a case of a crush fracture of the lumbar
vertebrae where there is a substantial risk of osteoarthritis and
constant pain and discomfort with impairment of sexual function; that
of a traumatic spondylolisthesis with continuous pain and a
probability that spinal fusion will be necessary; or that of a
prolapsed intervertebral disc with substantial acceleration of back
degeneration. £16,300 to £22,650
(ii) Many frequently encountered injuries to the back such as
disturbance of ligaments and muscles giving rise to backache, soft
tissue injuries resulting in exacerbation of an existing back
condition or prolapsed discs necessitating laminectomy or resulting in
repeated relapses. The precise figure depends upon the severity of the
original injury and/or whether there is some permanent or chronic
disability. £7,125 to £16,300
(c) Minor
Strains, sprains, disc prolapses and soft tissue injuries from which a full
recovery or recovery to 'nuisance' level has been made without surgery:
(i) within about five years; £4,575 to £7,125
(ii) within about two years. Up to £4,575
(C) Shoulder Injuries
(a) Severe £11,200 to £28,000
Often associated with neck injuries and involving damage to the brachial plexus
(see (A)(a)(ii)) resulting in significant disability.
(b) Serious £7,375 to £11,200
Dislocation of the shoulder and damage to the lower part of the brachial plexus
causing pain in shoulder and neck, aching in elbow, sensory symptoms in the
forearm and hand, and weakness of grip.
(c) Moderate £4,575 to £7,375
Frozen shoulder with limitation of movement and discomfort with symptoms
persisting for about two years.
(d) Minor
Soft tissue injury to shoulder with considerable pain but almost complete
recovery:
(i) in less than two years; £2,550 to £4,575
(ii) within a year. Up to £2,550
(e) Fracture of Clavicle £3,000 to £7,125
The level of the award will depend on extent of fracture, level of disability,
residual symptoms, and whether temporary or permanent, and whether union is
anatomically displaced.
(D) Injuries to the Pelvis and Hips
The most serious of injuries to the pelvis and hip can be as devastating as a
leg amputation and accordingly will attract a similar award of damages. Such
cases apart, the upper limit for these injuries will generally be in the region
of £38,175. Cases where there are specific sequelae of exceptional severity
would call for a higher award.
(a) Severe
(i) Extensive fractures of the pelvis involving, for example,
dislocation of a low back joint and a ruptured bladder, or a hip
injury resulting in spondylolisthesis of a low back joint with
intolerable pain and necessitating spinal fusion. Inevitably there
will be substantial residual disabilities such as a complicated
arthrodesis with resulting lack of bladder and bowel control, sexual
dysfunction or hip deformity making the use of a calliper essential;
or may present difficulties for natural delivery. £46,300 to £76,350
(ii) Injuries only a little less severe than in (a)(i) above but
with particular distinguishing features lifting them above any lower
bracket. Examples are: (a) fracture dislocation of the pelvis
involving both ischial and pubic rami and resulting in impotence; or
(b) traumatic myositis ossificans with formation of ectopic bone
around the hip. £36,125 to £46,300
(iii) Many injuries fall within this bracket: a fracture of the
acetabulum leading to degenerative changes and leg instability
requiring an osteotomy and the likelihood of hip replacement surgery
in the future; the fracture of an arthritic femur or hip necessitating
hip replacement; or a fracture resulting in a hip replacement which is
only partially successful so that there is a clear risk of the need
for revision surgery. £22,650 to £30,500
(b) Moderate £15,500 to £22,650
Significant injury to the pelvis or hip but any permanent disability is not
major and any future risk not great.
(c) Injuries of Limited Severity £7,375 to £15,500
These cases may involve hip replacement. Where it has been carried out wholly
successfully the award will tend to the top of the bracket, but the bracket also
includes cases where hip replacement may be necessary in the foreseeable future.
(d) Lesser Injuries
(i) Cases where despite significant injury there is little or no
residual disability. £2,175 to £7,375
(ii) Minor injuries with complete recovery. Up to £2,175
(E) Amputation of Arms
(a) Loss of Both Arms £140,500 to £174,500
There is no recent case to offer guidance but the effect of such an injury is to
reduce a person with full awareness to a state of considerable helplessness.
(b) Loss of One Arm
(i) Arm Amputated at the Shoulder. Not less than £79,000
(ii) Above-elbow Amputation. £63,625 to £76,350
A shorter stump may create difficulties in the use of a prosthesis.
This will make the level of the award towards the top end of the
bracket. Amputation through the elbow will normally produce an award
at the bottom end of the bracket.
(iii) Below-elbow Amputation. £56,000 to £63,625
Amputation through the forearm with residual severe organic and phantom pains
would attract an award at the top end of the bracket.
The value of such an injury depends upon:
(i) whether the amputation is above or below the elbow. The loss
of the additional joint adds greatly to the disability;
(ii) whether or not the amputation was of the dominant arm;
(iii) the intensity of any phantom pains.
(F) Other Arm Injuries
(a) Severe Injuries £56,000 to £76,350
Injuries which fall short of amputation but which are extremely serious and
leave the injured person little better o. than if the arm had been lost; for
example, a serious brachial plexus injury.
(b) Injuries resulting in Permanent and Substantial Disablement
£22,650 to £34,850
Serious fractures of one or both forearms where there is significant permanent
residual disability whether functional or cosmetic.
(c) Less Severe Injury £11,200 to £22,650
While there will have been significant disabilities, a substantial degree of
recovery will have taken place or will be expected.
(d) Simple Fractures of the Forearm £3,800 to £11,200
Uncomplicated fractures of the radius and/or ulna with a complete recovery
within a short time would justify an award of £3,700. Injuries resulting in
modest residual disability or deformity would merit an award towards the upper
end of this bracket.
(G) Injuries to the Elbow
(a) A Severely Disabling Injury £22,650 to £32,000
(b) Less Severe Injuries £9,150 to £18,325
Injuries causing impairment of function but not involving major surgery or
significant disability.
(c) Moderate or Minor Injury Up to £7,375
Most elbow injuries fall into this category. They comprise simple fractures,
tennis elbow syndrome and lacerations; ie, those injuries which cause no
permanent damage and do not result in any permanent impairment of function.
(H) Wrist Injuries
(a) Injuries resulting in complete loss of function in the wrist, for
example, where an arthrodesis has been performed. £27,750 to £34,850
(b) Injury resulting in significant permanent disability, but where some
useful movement remains. £14,250 to £22,650
(c) Less severe injuries where these still result in some permanent
disability as, for example, a degree of persisting pain and stiffness. £7,375 to
£14,250
(d) An uncomplicated Colles' fracture. In the region of £4,300
(e) Very minor undisplaced or minimally displaced fractures and the like
necessitating application of plaster or bandage for a matter of weeks and a full
or virtual recovery within a matter of months. £2,000 to £2,800
Where recovery from fracture or soft tissue injury takes longer but is complete,
the award will rarely exceed £5,850.
(I) Hand Injuries
The hands are cosmetically and functionally the most important component parts
of the upper limbs. The loss of a hand is valued not far short of the amount
which would be awarded for the loss of the arm itself. The upper end of any
bracket will generally be appropriate where the injury is to the dominant hand.
(a) Total or Effective Loss of Both Hands £81,500 to £117,000
Serious injury resulting in extensive damage to both hands such as to render
them little more than useless will justify an award of £80,000 or more. The top
of the bracket is applicable where no effective prosthesis can be used.
(b) Serious Damage to Both Hands £32,000 to £49,350
Such injuries will have given rise to permanent cosmetic disability and
significant loss of function.
(c) Total or Effective Loss of One Hand £56,000 to £63,625
This bracket will apply to a hand which was crushed and thereafter surgically
amputated or where all fingers and most of the palm have been traumatically
amputated. The upper end of the bracket is indicated where the hand so damaged
was the dominant one.
(d) Amputation of Index and Middle and/or Ring Fingers £36,125 to
£52,950
The hand will have been rendered of very little use and such grip as remains
will be exceedingly weak.
(e) Serious Hand Injuries £16,800 to £36,125
Such injuries will, for example, have reduced the hand to about 50 per cent
capacity. Included would be cases where several fingers have been amputated but
rejoined to the hand leaving it clawed, clumsy and unsightly, or amputation of
some fingers together with part of the palm resulting in gross diminution of
grip and dexterity and gross cosmetic disfigurement.
(f) Less Serious Hand Injury £8,400 to £16,800
Such as a severe crush injury resulting in significantly impaired function
without future surgery or despite operative treatment undergone.
(g) Moderate Hand Injury £3,800 to £7,625
Crush injuries, penetrating wounds, soft tissue type and deep lacerations. The
top of the bracket would be appropriate where surgery has failed and permanent
disability remains.
(h) Minor Hand Injuries £500 to £2,550
Injuries similar to but less serious than (g) above with recovery within a few
months.
(i) Severe Fractures to Fingers Up to £21,350
These may lead to partial amputations and result in deformity, impairment of
grip, reduced mechanical function and disturbed sensation.
(j) Total Loss of Index Finger In the region of £10,700
(k) Partial Loss of Index Finger £7,125 to £10,700
This bracket also covers cases of injury to the index finger giving rise to
disfigurement and impairment of grip or dexterity.
(l) Fracture of Index Finger £5,350 to £7,125
This level is appropriate where a fracture has mended quickly but grip has
remained impaired, there is pain on heavy use and osteoarthritis is likely in
due course.
(m) Total Loss of Middle Finger In the region of £8,900
(n) Serious Injury to Ring or Middle Fingers £8,650 to £9,400
Fractures or serious injury to tendons causing stiffness, deformity and
permanent loss of grip or dexterity will fall within this bracket.
(o) Loss of the Terminal Phalanx of the Ring or Middle Fingers
£2,300 to £4,575
(p) Amputation of Little Finger £5,100 to £7,125
(q) Loss of Part of the Little Finger £2,300 to £3,450
This is appropriate where the remaining tip is sensitive.
(r) Amputation of Ring and Little Fingers In the region of £12,725
(s) Amputation of the Terminal Phalanges of the Index and Middle
Fingers In the region of £14,500
Such injury will involve scarring, restriction of movement and impairment of
grip and fine handling.
(t) Fracture of One Finger £1,775 to £2,800
Depending upon recovery time.
(u) Loss of Thumb £20,350 to £32,000
(v) Very Serious Injury to Thumb £11,450 to £20,350
This bracket is appropriate where the thumb has been severed at the base and
grafted back leaving a virtually useless and deformed digit, or where the thumb
has been amputated through the interphalangeal joint.
(w) Serious Injury to the Thumb £7,375 to £9,700
Such injuries may involve amputation of the tip, nerve damage or fracture
necessitating the insertion of wires as a result of which the thumb is cold and
ultra-sensitive and there is impaired grip and loss of manual dexterity.
(x) Moderate Injuries to the Thumb £5,600 to £7,375
These are injuries such as those necessitating arthrodesis of the
interphalangeal joint or causing damage to tendons or nerves. Such injuries
result in impairment of sensation and function and cosmetic deformity.
(y) Severe Dislocation of the Thumb £2,300 to £4,000
(z) Minor Injuries to the Thumb In the region of £2,300
Such an injury would be a fracture which has recovered in six months except for
residual stiffness and some discomfort.
(aa) Trivial Thumb Injuries In the region of £1,250
These may have caused severe pain for a very short time but will have resolved
within a few months.
(J) Vibration White Finger and/or Hand-Arm Vibration Syndrome
Vibration White Finger and/or Hand--Arm Vibration Syndrome, caused by exposure
to vibration, is a slowly progressive condition, the development and severity of
which are affected by the degree of exposure, in particular the magnitude,
frequency, duration and transmission of the vibration. The symptoms are similar
to those experienced in the constitutional condition of Raynaud's phenomenon.
The Stockholm Workshop Scale is now the accepted table for grading the severity
of the condition. The Scale classifies both the vascular and sensorineural
components in two complementary tables. Individual assessment is made separately
for each hand and for each finger. Any interference with work or social life is
disregarded.
Accordingly, depending on individual circumstances, a lower award might be made
despite significant disablement where, eg, employment is unaffected, whilst a
higher award might be attracted where there is a lesser disability but a
consequential inability to pursue working life.
The vascular component is graded between Stage 0 (no attacks) through mild,
moderate and severe to 4V (very severe) where there are frequent attacks
affecting all phalanges of most fingers with atrophic changes in the fingertips.
The sensorineural component is graded between Stage 0SN (no symptoms) and 3SN
(intermittent or persistent numbness, reduced tactile discrimination and/or
manipulative dexterity).
The grade of disorder is indicated by the stage and number of affected fingers
on both hands. The assessment of damages depends upon the extent of the symptoms
and their impact upon work and social life. In a severe case, the injury may be
regarded as damaging a hand rather than being confined to the fingers.
The brackets can best be defined and valued as follows:
(i) Most Serious £18,325 to £22,400
(ii) Serious £9,700 to £18,325
(iii) Moderate £5,100 to £9,700
(iv) Minor £1,775 to £5,100
(K) Work-Related Upper Limb Disorders
This section covers a range of upper limb injury in the form of the following
pathological conditions:
(a) Tenosynovitis: inflammation of synovial sheaths of tendons
usually resolving with rest over a short period. Sometimes this
condition leads to continuing symptoms of loss of grip and dexterity.
(b) De Quervain's tenosynovitis: a form of tenosynovitis, rarely
bilateral, involving inflammation of the tendons of the thumb.
(c) Stenosing tenosynovitis: otherwise, trigger finger/thumb:
thickening tendons.
(d) Carpal tunnel syndrome: constriction of the median nerve of
the wrist or thickening of surrounding tissue. It is often relieved by
a decompression operation.
(e) Epicondylitis: inflammation in the elbow joint: medial =
golfer's elbow; lateral = tennis elbow.
The brackets below apply to all these conditions but the level of the award is
affected by the following considerations regardless of the precise condition:
(i) are the effects bilateral or one sided?
(ii) the level of symptoms, ie, pain, swelling, tenderness,
crepitus;
(iii) the ability to work;
(iv) the capacity to avoid the recurrence of symptoms;
(v) surgery.
(a) Continuing bilateral disability with surgery and loss of employment.
£12,725 to £13,500
(b) Continuing, but .uctuating and unilateral symptoms. £8,650 to £9,400
(c) Symptoms resolving in the course of two years. £5,100 to £5,600
(d) Complete recovery within a short period. £1,300 to £2,000
(L) Leg Injuries
(a) Amputations
(i) Total Loss of Both Legs £140,500 to £165,500
This is the appropriate award where both legs are lost above the knee
and particularly if near to the hip leaving one or both stumps less
than adequate to accommodate a useful prosthesis.
(ii) Below-knee Amputation of Both Legs £117,000 to £157,750
The top of the bracket is appropriate where both legs are amputated
just below the knee. Amputations lower down result in a lower award.
(iii) Above-knee Amputation of One Leg £56,000 to £81,500
The area within the bracket within which the award should fall will
depend upon such factors as the level of the amputation; the severity
of phantom pains; whether or not there have been any problems with a
prosthesis and any side effects such as depression or backache.
(iv) Below-knee Amputation of One Leg £52,950 to £76,350
The straightforward case of a below-knee amputation with no
complications would justify an award at the bottom of this bracket. At
or towards the top of the range would come the traumatic amputation
which occurs in a devastating accident, where the injured person
remained fully conscious, or cases where attempts to save the leg led
to numerous unsuccessful operations so that amputation occurred years
after the event.
(b) Severe Leg Injuries
(i) The Most Serious Injuries Short of Amputation £56,000 to
£79,000
Some injuries, although not involving amputation, are so severe that
the courts have awarded damages at a comparable level. Such injuries
would include extensive degloving of the leg, where there is gross
shortening of the leg or where fractures have not united and extensive
bone grafting has been undertaken.
(ii) Very Serious £32,000 to £49,350
Injuries leading to permanent problems with mobility, the need for
crutches for the remainder of the injured person's life; injuries
where multiple fractures have taken years to heal and have led to
serious deformity and limitation of movement, or where arthritis has
developed in a joint so that further surgical treatment is likely.
(iii) Serious £22,650 to £32,000
Serious injuries to joints or ligaments resulting in instability,
prolonged treatment, a lengthy period of non-weightbearing, the near
certainty that arthritis will ensue; injuries involving the hip,
requiring arthrodesis or hip replacement, extensive scarring. To
justify an award within this bracket a combination of such features
will generally be necessary.
(iv) Moderate £16,300 to £22,650
This bracket includes severe, complicated or multiple fractures. The
level of an award within the bracket will be influenced by the period
o. work; the presence or risk of degenerative changes; imperfect union
of fractures, muscle wasting; limited joint movements; instability in
the knee; unsightly scarring or permanently increased vulnerability to
future damage.
(c) Less Serious Leg Injuries
(i) Fractures from which an Incomplete Recovery is Made £10,500 to
£16,300
The injured person will be left with a metal implant and/or defective
gait, a limp, impaired mobility, sensory loss, discomfort or an
exacerbation of a pre-existing disability.
(ii) Simple Fracture of a Femur with No Damage to Articular
Surfaces £5,350 to £8,150
(iii) Simple Fractures and Soft Tissue Injuries Up to £5,350
At the top of the bracket will come simple fractures of the tibia or
fibula from which a complete recovery has been made. Below this level
fall a wide variety of soft tissue injuries, lacerations, cuts,
bruising or contusions, all of which have recovered completely or
almost so and any residual disability is cosmetic or of a minor
nature.
(M) Knee Injuries
Knee injuries fall within a bracket extending from a few hundred pounds for a
simple twisting injury up to £50,000 or so.
(a) Severe
(i) Serious knee injury where there has been disruption of the
joint, gross ligamentous damage, lengthy treatment, considerable pain
and loss of function and an arthrodesis or arthroplasty has taken
place or is inevitable. £40,750 to £56,000
(ii) Leg fracture extending into the knee joint causing pain which
is constant, permanent, limiting movement or impairing agility and
rendering the injured person prone to osteoarthritis and the risk of
arthroplasty. £30,500 to £40,750
(iii) Less severe injuries than those in (a)(ii) above and/or
injuries which result in less severe disability. There may be
continuing symptoms by way of pain and discomfort and limitation of
movement or instability or deformity with the risk that degenerative
changes may occur in the long term as a result of damage to the
kneecap, ligamentous or meniscal injury or muscular wasting. £15,500
to £25,000
(b) Moderate
(i) Injuries involving dislocation, torn cartilage or meniscus or
which accelerate symptoms from a pre-existing condition but which
additionally result in minor instability, wasting, weakness or other
mild future disability. £8,400 to £15,500
(ii) This bracket includes injuries similar to those in (b)(i)
above, but less serious, and also lacerations, twisting or bruising
injuries. Where recovery has been complete the award is unlikely to
exceed £3,500. Where there is continuous aching or discomfort, or
occasional pain, the award will be towards the upper end of the
bracket. Up to £8,150
(N) Ankle Injuries
The vast majority of ankle injuries are worth significantly less than £12,500.
(a) Very Severe £29,000 to £40,750
Examples of injuries falling within this bracket are limited and unusual. They
include cases of a transmalleolar fracture of the ankle with extensive
soft-tissue damage resulting in deformity and the risk that any future injury to
the leg might necessitate a below-knee amputation, or cases of bilateral ankle
fractures causing degeneration of the joints at a young age so that arthrodesis
is necessary.
(b) Severe £18,325 to £29,000
Injuries necessitating an extensive period of treatment and/or a lengthy period
in plaster or where pins and plates have been inserted and there is significant
residual disability in the form of ankle instability, severely limited ability
to walk. The level of the award within the bracket will be determined in part by
such features as a failed arthrodesis, regular sleep disturbance, unsightly
scarring and any need to wear special footwear.
(c) Moderate £7,625 to £15,500
Fractures, ligamentous tears and the like which give rise to less serious
disabilities such as difficulty in walking on uneven ground, awkwardness on
stairs, irritation from metal plates and residual scarring.
(d) Modest Injuries Up to £8,150
The less serious, minor or undisplaced fractures, sprains and ligamentous
injuries. The level of the award within the bracket will be determined by
whether or not a complete recovery has been made and, if recovery is incomplete,
whether there is any tendency for the ankle to give way, and whether there is
scarring, aching or discomfort or the possibility of later osteoarthritis. Where
recovery is within a year, the award is unlikely to exceed £3,300.
(O) Achilles Tendon
(a) Most Serious In the region of £22,900
Severance of the tendon and the peroneus longus muscle giving rise to cramp,
swelling and restricted ankle movement necessitating the cessation of active
sports.
(b) Serious £14,500 to £17,550
Where complete division of the tendon has been successfully repaired but there
is residual weakness, a limitation of ankle movements, a limp and residual
scarring and where further improvement is unlikely.
(c) Moderate £8,650 to £10,500
Complete division of the tendon but where its repair has left no significant
functional disability.
(d) Minor £4,300 to £5,850
A turning of the ankle resulting in some damage to the tendon and a feeling of
being unsure of ankle support.
(P) Foot Injuries
(a) Amputation of Both Feet £98,500 to £117,000
This injury is treated similarly to below-knee amputation of both legs because
the common feature is loss of a useful ankle joint.
(b) Amputation of One Foot £48,850 to £63,625
This injury is also treated as similar to a below knee amputation because of the
loss of the ankle joint.
(c) Very Severe £48,850 to £63,625
To fall within this bracket the injury must produce permanent and severe pain or
really serious permanent disability. Examples would include the traumatic
amputation of the forefoot where there was a significant risk of the need for a
full amputation and serious exacerbation of an existing back problem, or cases
of the loss of a substantial portion of the heel so that mobility was grossly
restricted.
(d) Severe £26,500 to £39,200
Fractures of both heels or feet with a substantial restriction on mobility or
considerable or permanent pain. The bracket will also include unusually severe
injury to a single foot resulting, for example, in heel fusion, osteoporosis,
ulceration or other disability preventing the wearing of ordinary shoes. It will
also apply in the case of a drop foot deformity corrected by a brace.
(e) Serious £14,500 to £22,650
Towards the top end of the bracket fall cases such as those of grievous burns to
both feet requiring multiple operations and leaving disfiguring scars and
persistent irritation. At the lower end of the bracket would be those injuries
less severe than in (d) above but leading to fusion of foot joints, continuing
pain from traumatic arthritis, prolonged treatment and the future risk of
osteoarthritis.
(f) Moderate £8,150 to £14,500
Displaced metatarsal fractures resulting in permanent deformity and continuing
symptoms.
(g) Modest Up to £8,150
Simple metatarsal fractures, ruptured ligaments, puncture wounds and the like.
Where there are continuing symptoms, such as a permanent limp, pain or aching,
awards between £4,000 and £8,150 would be appropriate. Straightforward foot
injuries such as fractures, lacerations, contusions etc. from which complete or
near complete recovery is made would justify awards of £4,000 or less.
(Q) Toe Injuries
(a) Amputation of All Toes £21,350 to £32,800
The position within the bracket will be determined by, for example, whether or
not the amputation was traumatic or surgical and the extent of the loss of the
forefoot together with the residual effects on mobility.
(b) Amputation of the Great Toe In the region of £18,325
(c) Severe Toe Injuries £8,150 to £11,200
This is the appropriate bracket for severe crush injuries, falling short of the
need for amputation or necessitating only partial amputation. It also includes
bursting wounds and injuries resulting in severe damage and in any event
producing significant continuing symptoms.
(d) Serious Toe Injuries £5,600 to £8,150
Such injuries will be serious injuries to the great toe or crush and multiple
fractures of two or more toes. There will be some permanent disability by way of
discomfort, pain or sensitive scarring to justify an award within this bracket.
Where there have been a number of unsuccessful operations or persisting stabbing
pains, impaired gait or the like the award will tend towards the top end of the
bracket.
(e) Moderate Toe Injuries Up to £5,600
These injuries include relatively straightforward fractures or the exacerbation
of a pre-existing degenerative condition. Only £3,300 or less would be awarded
for straightforward fractures of one or more toes with complete resolution
within a short period of time and less still for minor injuries involving
lacerations, cuts, contusions and bruises, in respect of all of which there
would have been a complete or near complete recovery.
7 Facial Injuries
The assessment of general damages for facial injuries is an extremely difficult
task, there being three elements which complicate the award.
First, while in most of the cases dealt with below the injuries described are
skeletal, many of them will involve an element of disfigurement or at least some
cosmetic effect.
Second, in cases where there is a cosmetic element the courts have invariably
drawn a distinction between the awards of damages to males and females, the
latter attracting the higher awards.
Third, in cases of disfigurement there may also be severe psychological
reactions which put the total award at the top of the bracket, or above it
altogether.
The subject of burns is not dealt with separately. Burns of any degree of
severity are particularly painful and disfiguring, and awards are invariably at
the upper ends of the brackets, or above them altogether. The very worst burns
may lead not only to considerable disfigurement and pain but to a variety of
continuing physical and psychological injuries meriting very high awards.
(A) Skeletal Injuries
(a) Le Fort Fractures of Frontal Facial Bones £14,000 to £21,350
(b) Multiple Fractures of Facial Bones £8,650 to £14,000
Involving some facial deformity of a permanent nature.
(c) Fractures of Nose or Nasal Complex
(i) Serious or multiple fractures requiring a number of operations
and/or resulting in permanent damage to airways and/or nerves or tear
ducts and/or facial deformity. £6,100 to £13,500
(ii) Displaced fracture where recovery complete but only after
surgery. £2,300 to £3,000
(iii) Displaced fracture requiring no more than manipulation.
£1,400 to £1,775
(iv) Simple undisplaced fracture with full recovery. £1,000 to
£1,400
(d) Fractures of Cheekbones
(i) Serious fractures requiring surgery but with lasting
consequences such as paraesthesia in the cheeks or the lips or some
element of disfigurement. £5,850 to £9,150
(ii) Simple fracture of cheekbones for which some reconstructive
surgery is necessary but from which there is a complete recovery with
no or only minimal cosmetic effects. £2,550 to £3,800
(iii) Simple fracture of cheekbone for which no surgery is
required and where a complete recovery is effected. £1,400 to £1,725
(e) Fractures of Jaws
(i) Very serious multiple fractures followed by prolonged
treatment and permanent consequences, including severe pain,
restriction in eating, paraesthesia and/or the risk of arthritis in
the joints. £17,800 to £26,500
(ii) Serious fracture with permanent consequences such as
difficulty in opening the mouth or with eating or where there is
paraesthesia in the area of the jaw. £10,500 to £17,800
(iii) Simple fracture requiring immobilisation but from which
recovery is complete. £3,800 to £5,100
(f) Damage to Teeth
In these cases there will generally have been a course of treatment as a result
of the initial injury. The amounts awarded will vary according to the extent
and/or the degree of discomfort of such treatment. Any difficulty with eating
increases the award. These cases may overlap with fractures of the jaw, meriting
awards in the brackets for such fractures. Awards may be greater where the
damage results in or is caused by protracted dentistry.
(i) Loss of or serious damage to several front teeth. £5,100 to
£6,600
(ii) Loss of or serious damage to two front teeth. £2,550 to
£4,300
(iii) Loss of or serious damage to one front tooth. £1,300 to
£2,300
(iv) Loss of or damage to back teeth: per tooth: £630 to £1,000
(B) Facial Disfigurement
In this class of case the distinction between male and female and the subjective
approach are of particular significance. Larger awards than those indicated may
be justified if there have been many operations.
(a) Females
(i) Very Severe Scarring £28,000 to £56,500
In a relatively young woman (teens to early 30s) where the cosmetic
effect is very disfiguring and the psychological reaction severe.
(ii) Less Severe Scarring £17,550 to £28,000
Where the disfigurement is still substantial and where there is a
significant psychological reaction.
(iii) Significant Scarring £10,500 to £17,550
Where the worst effects have been or will be reduced by plastic
surgery leaving some cosmetic disability and where the psychological
reaction is not great or, having been considerable at the outset, has
diminished to relatively minor proportions.
(iv) Less Significant Scarring £2,300 to £8,150
In these cases there may be but one scar which can be camouflaged or,
though there is a number of very small scars, the overall effect is to
mar but not markedly to affect the appearance and the reaction is no
more than that of an ordinarily sensitive young woman.
(v) Trivial Scarring £1,000 to £2,000
In these cases the effect is minor only.
(b) Males
(i) Very Severe Scarring £17,550 to £38,175
These are to be found especially in males under 30, where there is
permanent disfigurement even after plastic surgery and a considerable
element of psychological reaction.
(ii) Less Severe Scarring £10,500 to £17,550
This will have left moderate to severe permanent disfigurement.
(iii) Significant Scarring £5,350 to £10,500
Such scars will remain visible at conversational distances.
(iv) Less Significant Scarring £2,300 to £5,350
Such scarring is not particularly prominent except on close
inspection.
(v) Trivial Scarring £1,000 to £2,000.
In these cases the effect is minor only.
8 Scarring to Other Parts of the Body
This is an area in which it is not possible to offer much useful guidance. The
principles are the same as those applied to cases of facial disfigurement. It
must be remembered that many of the physical injuries already described involve
some element of disfigurement and that element is of course taken into account
in suggesting the appropriate bracket. There remain some cases where the element
of disfigurement is the predominant one in the assessment of damages. Where the
scarring is not to the face or is not usually visible then the awards will tend
to be lower than those for facial or readily visible disfigurement.
A large proportion of awards for a number of noticeable laceration scars, or a
single disfiguring scar, of leg(s) or arm(s) or hand(s) or back or chest (male),
fall in the bracket of £4,500 to £8,200.
In cases where an exploratory laparotomy has been performed but no significant
internal injury has been found, the award for the operation and the inevitable
scar is in the region of £5,000.
A single noticeable scar, or several superficial scars, of leg(s) or arm(s) or
hand(s), with some minor cosmetic deficit justifies £1,300 to £2,300.
9 Damage to Hair
(a) Damage to hair in consequence of defective permanent waving, tinting or
the like, where the effects are dermatitis or tingling or 'burning' of the scalp
causing dry, brittle hair, which breaks of and/or falls out, leading to
distress, depression, embarrassment and loss of confidence, and inhibiting
social life. In the more serious cases thinning continues and the prospects of
regrowth are poor or there has been total loss of areas of hair and regrowth is
slow. £4,300 to £6,350
There may be a larger award in cases of psychological disability.
(b) Less serious versions of the above where symptoms are fewer or only of a
minor character; also, cases where hair has been pulled out leaving bald
patches. The level of the award will depend on the length of time taken before
regrowth occurs. £2,300 to £4,300
10 Dermatitis
Apart from dermatitis of the scalp most of the reported cases
relate to dermatitis of the hands.
(a) Dermatitis of both hands, with cracking and soreness, affecting
employment and domestic capability, possibly with some psychological
consequences, lasting for some years, perhaps indefinitely. £8,150 to £11,200
(b) Dermatitis of both hands, continuing for a significant period, but
settling with treatment and/or use of gloves for specific tasks. £5,100 to
£6,600
(c) Itching, irritation of and/or rashes on one or both hands, but resolving
within a few months with treatment. £1,000 to £2,300