Permanent Functional Impairment (PFI) – General
Effective date: September 1, 2010
Last updated: August 26, 2010
Application: All (re) assessments for PFI on or after the effective date.
Policy subject: Permanent functional impairment (PFI)
To establish guidelines for assessing Permanent Functional Impairment (PFI) awards.
Functional Impairment means any adverse reaction in a worker as a result of a work injury which interferes with the normal performance of the worker’s body or mind.
Disfigurement means a conspicuous alteration or abnormal change in the features of the face, neck, hands, torso, and upper and lower extremities and/or substantial and permanent scarring of these areas. It is related to the cosmetic appearance of the body and not the loss of bodily function.
- Section 66 of The Workers’ Compensation Act, 2013 (the “Act”) authorizes the Workers’ Compensation Board (WCB) to establish a rating schedule to calculate a Permanent Functional Impairment (PFI) award.
- Section 66 also establishes the minimum and maximum awards payable for PFI, subject to the legislation in effect on the date of the determination of the award. For those decisions made:
- Prior to January 1, 2003, Section 66(2)(a) states the minimum amount awarded will be at least $1,100 and the maximum not more than $22,600; and
- On or after January 1, 2003, Section 66(2)(b) states the minimum award will be no less than $2,200 and the maximum not more than $45,200.
- Section 66(4) of the Act dictates that a PFI benefit will not be awarded to a worker who suffers a fatal injury. This legislation does not exclude a worker from receiving an award in situations where an occupational disease, although ultimately fatal, results in a period of permanent impairment prior to death.
- Section 76(1) declares that “a permanent award established pursuant to any former Workers’ Compensation Act must not be reduced except pursuant to that Act”.
- In the past, impairment evaluations were determined using a rating schedule constructed by the Workers’ Compensation Board (WCB). However, to be consistent with other jurisdictions and the most current practices in impairment evaluation, the WCB has established The American Medical Association Guides to the Evaluation of Permanent Impairment (AMA Guides) as its new rating schedule.
- PFI will be assessed when the WCB consultant determines it is medically appropriate.
- The WCB provides a PFI award to a worker for any measurable permanent functional impairment or disfigurement resulting from a compensable injury arising out of and in the course of employment.
- A worker will receive a single lump sum PFI award based on a percentage rating applied to the maximum award. Section 66 of the Act defines the minimum and maximum PFI awards.
- No PFI award is payable until it exceeds the minimum rating percentage applicable. Ratings of 0.5% to 4.87% are eligible for the minimum payment.
- In accordance with the AMA Guides, an injury will be assessed alone or as part of a multiple injury rating that considers the overall whole person impairment (WPI).
- In a situation where a worker suffers multiple injuries or disfigurement from one incident, a PFI will be assessed as a multiple injury rating using the AMA Guides’ Combined Values Chart (CVC).
- Where a worker suffers multiple injuries or disfigurement from various incidents, the AMA Guides’ CVC will be applied, despite there being separate claim numbers and potentially many years between each injury.
- The application of the CVC will not reduce a previous impairment rating.
- Canada Disability Plan payments are not taken into account when determining this award.
- Workers awarded a PFI for functional impairment may qualify for an Independence Allowance (POL 31/2016). PFI awards for hearing loss will not be considered when establishing entitlement to the Independence Allowance.
- In the case of a terminal occupational disease, the maximum PFI award will be granted once it is medically confirmed that the disease has resulted in any degree of functional impairment. POL 04/2017, Injuries – Occupational Disease will apply.
- Where a worker dies prior to entitlement, the PFI award will be paid to the worker’s estate except where Sections 81 and 93 of the Act apply. In these situations benefits are to be paid to a dependent.
- A PFI assessed prior to the adoption of the AMA Guides will have any reassessment rated according to the most advantageous methodology for the injured worker from either the AMA Guides or the previously utilized WCB rating schedule.
- No further PFI award for functional impairment is payable unless, following reassessment, there is an increase in the original level of impairment awarded.
- Where upon re-assessment, the PFI award is reduced (e.g., the worker’s condition has improved), WCB will review qualification for other entitlements such as Independence Allowance on a prospective basis. Retroactive recovery of the prior PFI will not be made. However, when it is applicable, Independence Allowance will be reduced or discontinued effective the first of the month following the date of re-assessment.
- Where the PFI award is the result of the acceleration of a prior measurable impairment, cost relief under POL 03/2021, Second Injury and Re-employment Reserve, is to be considered.
- PFI awards for injuries are to be made in accordance with the established legislation at the time of assessment.
Act Sec #
Act Sec #
POL 05/2007 PFI - General
POL 10/2007 Disfigurement Awards
POL 13/2010 PFI – Occupational Disease
POL 04/2008 PFI – Occupational Disease
POL 25/90 PFI Award for Substance Allergy or Sensitization
POL 07/2000 PFI – Raynaud’s Phenomenon
PRO 23/2010 Permanent Functional Impairment (PFI) – General
POL 31/2016 Allowance – Independence
PRO 31/2016 Allowance – Independence
PRO 01/2015 Disfigurement Award Assessment
POL 15/2008 Allowance – Temporary Additional Expense
POL 11/2012 Injuries – Hearing Loss
PRO 11/2012 Injuries – Hearing Loss
POL 03/2021 Second Injury and Re-Employment Reserve
PRO 03/2021 Second Injury and Re-Employment Reserve
POL 04/2017 Injuries – Occupational Disease
PRO 04/2017 Injuries – Occupational Disease
POL 02/2017 Injuries – Psychological
POL 03/2011 Worker’s Death Prior to Issuance of Entitlement
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