Book of Quantum
The Book of Quantum. The Book of Quantum was compiled on behalf of the Personal Injuries Assessment Board by independent consultants. The Book of Quantum was first published in 2004. A second edition was published in 2016. There had been some judicial criticism of the delay in updating the Book.
The Book of Quantum is designed as an aid in the assessment of compensation, where a claimant has suffered injury in circumstances where he may have a civil claim, by reason of the fault or liability of a third-party. It is a guideline in respect of possible levels of compensation. It seeks to give an indication of the likely range of compensation for particular types of injury. It is intended to encourage negotiated settlements in cases, where liability is accepted.
The categories of injury are based on the World Health Organization classification of diseases and injuries. They follow the structure of body, by region, body part and injury type. Many of the value ranges are wide, reflecting the fact that the severity of injuries within the relevant categories may vary very considerably. The effect of the injury on particular claimants may differ from case to case.
The Book of Quantum deals with compensation for pain and suffering. Effectively, it covers general damages. It does not apply to actual quantifiable losses matters such as loss of earnings, medical care and claims under other headings. Effectively, it applies to special damages for past and future loss which may arise.
Injuries Board assessments are made in line with levels of compensation in the Book of Quantum. Assessments are not rigid and mechanical, and the Board takes account of the individual circumstances of the case.
The list of injury types is no way definitive. The figures in the Book of Quantum are neither maximum or minimum. Everything will depend on the particular injury suffered and how it impacts up on the person concerned.
The Book requires that claims for pain and suffering should be based on appropriate medical evidence. The assessment of a typical personal injury claim has a number of elements covering one or more of the following:
- compensation for pain and suffering and loss of enjoyment (general damages);
- specific losses such as past loss of earnings and medical bills; future medical care; loss of earnings into the future (special damages).
The Book recommends identification of a category of injury. The injury must be understood in the context of its severity, with reference to the medical evidence and report. The value ranges must be considered. Regard must be had to multiple injuries. The overall affect of the injury on the body should be considered.
The Book is divided into a number of categories: head, arms, neck, back and trunk and legs. Injuries are categorized into three hypothetical ranges of severity, with a range of value for each as a guide.
The categorisation of injuries into three bands of severity, follows the following broad criteria.
- “Substantially Recovered” refers to injuries where the claimant has substantial recovered, but there are ongoing symptoms that interfere with carrying out full day today activity;
- “Significant Ongoing” includes the above and in addition, that the injury has caused some permanent incapacity or limitation that restricts or alters the claimant’s lifestyle significantly;
- “Serious and Permanent Conditions” are where the injury is very severe and has caused a major disruption to the claimant’s life in a number of areas, results in serious continuing pain or requires permanent medical attention.
Skull fractures are classified as being linear which are most common, depressed, or comminuted fractures, that are classified further as open or closed.
Intracranial injuries including brain lacerations and contusions are severe head injuries. Because of the number of variables, it is difficult to be specific regarding the approporiate compensation levels because of the range and severity of the outcomes in terms of the effect on person. The individual merits are must be considered and the following figures are a rough guide.
Skull fracture with no loss of consciousness:
- Substantially recovered €23,300 to €35,700;
- Significant ongoing €28,500 to €69,200;
- Serious and permanent €61,000 to €96,700
Skull fracture with intracranial injury (without loss of consciousness)
- Substantially recovered €31,300 to €39,500;
- Significant ongoing €37,900 to €75,700;
- Serious and permanent conditions €70,400 to €103,000
Skull fractures with loss of consciousness:
- Substantially recovered €23,300 to €107,000;
- Significant ongoing €28,500 to €113,000;
- Serious and permanent conditions €61,000 to €129,000
Nose Injuries
Serious nose injuries may involve an element of facial disfigurement and will be considered accordingly. The Book of Quantum sets out a figure for substantially recovered injuries of € 14,900 to €19,600.
Cheek fractures tend to be unilateral (i.e. one-side only), and result in flattening of the cheek. Eye socket fractures often accompany cheek fractures resulting in changes in appearance of the eyeball such as a sunken appearance. Nerve injuries are also often seen with cheek fractures sometimes leaving ongoing symptoms (e.g.tingling sensation) and will be considered accordingly.
- Substantially recovered €16,500 to €25,400
Two categories of jaw sprain are included. The category is for sprains of the joint between the top and bottom jaws.
- Substantially recovered up to €35,100
- Serious and permanent conditions €33,900 to €65,800
A jaw dislocation is a dislocation of the lower jawbone. They are usually reduced by manipulation. Pain killers and a neck collar may be prescribed.
- Substantially recovered €16,500 to €25,600;
- Significant ongoing €25,100 to €53,700
- Serious and permanent conditions €49,200 to €73,800
Jaw fractures may be simple and require observation and soft diet. However most require internal fixation by use of wires.
- Substantially recovered €16,500 to €27,900;
- Significant ongoing €25,000 to €58,000;
- Serious and permanent conditions €49,200 to €78,000
Teeth
- Loss of milk tooth €3,600 to €5,700;
- Broken teeth €6,000 to €11,100
- Loss of tooth €5,300 to €12,800
Arm Amputations
Arm injuries and amputations.
Complicated traumatic amputations involve delayed treatment / healing and major infection. There may be phantom limb pains. Stump revision may be required. Amputations of fingertips are included in the individual finger ranges.
- Loss of both arms €141,000 to €197,000;
- Loss of both hands (below elbow amputation) €136,000 to €192,000;
- Loss of one arm above elbow €111,000 to €145,000
- Loss of one hand (below elbow amputation) €108,000 to €142,000;
- Loss of Thumb €33,900 to €80,800;
- Loss of Ring, Index or Middle Finger €28,800 to €69,300;
- Loss of Little Finger €28,800 to €50,400
Shoulder Upper Arm injuries.
The level and duration of treatment, possible complications and permanent disability will determine the level of compensation. The category includes sprains to upper arms and the shoulder region, including partial or complete tears of the tendons forming the joint capsule, which may result in substantial reduced capacity.
- Substantially recovered up to €22,600;
- Significant ongoing €14,800 to €51,500;
- Serious and permanent conditions €41,000 to €71,600
Dislocations of shoulders
Shoulder dislocations may range from simple dislocations to more severe dislocations with ligament and nerve damage. Ttreatment can range from placing the arm in a sling to operative reduction. A shoulder once dislocated may be susceptible to further dislocation in the future with greater risk of degenerative disease as a result.
- Substantially recovered €14,600 to €25,600;
- Significant ongoing €20,200 to €54,600
- Serious and permanent conditions €46,400 to €74,500
Fractures
Fractures of the upper arm bone are categorized with reference to the type of fracture including transverse, oblique, spiral or comminuted. They are generally treated conservatively by non-surgical means. Sometimes , open reduction is necessary.
Complications of humerus fractures may include nerve palsy and delayed and non-union and shoulder joint stiffness. Brachial artery complications may be seen with shaft fractures.
- Substantially recovered €15,400 to €29,300;
- Significant ongoing €21,000 to €72,400;
- Serious and permanent conditions €46,900 to €82,900
Elbow / Forearm
Elbow sprains are generally treated conservatively. Rest, ice packs and heat applications and in some cases temporary immobilization in a sling or bandage is usually sufficient. In some cases, anti-inflammatory medication may be prescribed and physiotherapy may assist.
Elbow sprains generally heal without any residual effects and will fall in either of the two lower brackets below depending on the prognosis.
- Substantially recovered €20,600;
- Significant ongoing €15,500 to €52,100;
- Serious and permanent conditions €44,900 to €72,300
Dislocations. Some cases require reduction of the dislocation rather than the more common closed reduction. Complications may arise when vein damage also occurs due to swelling and the need to hold the elbow in a flexed position following reduction.
- Substantially recovered €16,500 to €25,100;
- Significant ongoing €23,100 to €57,000;
- Serious and permanent conditions €52,400 to €76,300
Fractures
Fractures of both forearm bones are more common to isolated fractures of either the ulna or radius. If they are caused by direct trauma, the fracture line usually occurs at the same level in both bones. In the case of indirect trauma, the fractures may occur at different levels. Fractures involving the joint are usually more complicated than others due to increased impact on limb movement.
- Substantially recovered €17,100 to €29,500;
- Significant ongoing €23,800 to €65,500;
- Serious and permanent conditions €53,400 to €82,800
Wrist. The category includes general wrist sprains, which often recover. It also extends to cover specific wrist injuries of Repetitive Strain Injury, Carpal Tunnel Syndrome, Cubital Tunnel Syndrome and Radial Tunnel Syndrome.
- Substantially recovered up to €26,200;
- Significant ongoing €15,500 to €70,100;
- Serious and permanent conditions €26,000 to €88,600
Dislocation. The more complicated dislocations will involve serious and permanent conditions treatment such as open reduction. There may be complications including medial nerve compression which have permanent results.
- Substantially recovered €15,800 to €25,800;
- Significant ongoing €22,600 to €62,400;
- Serious and permanent conditions €55,300 to €79,100
Fractures. The wrist contains several bones including the radius, ulna and eight carpal bones). The complexity and variety of injuries make it difficult to provide specific ranges for wrist fracture. Fractures involving the joint are more complicated due to increased impact on limb movement.
- Substantially recovered €15,600 to €25,200;
- Significant ongoing €22,400 to €61,800;
- Serious and permanent conditions €55,400 to €79,500.
Hand. Hand sprains are graded from mild sprains involving some stretching of ligaments, moderate sprains involving partial rupture of a ligament to severe sprains involving complete rupture of a ligament. Although the injuries may last several months, there is usually full recovery.
- Substantially recovered up to €26,200;
- Significant ongoing €15,500 to €70,100;
- Serious and permanent conditions €26,000 to €88,600
Hand fractures are categorized in accordance with the site of the fracture. They may involve the base of the bone, shaft, the neck and head.
- Substantially recovered €13,200 to €22,000;
- Significant ongoing €20,200 to €67,500;
- Serious and permanent conditions €60,500 to €86,600
Crush Injuries is a serious type of soft tissue injury. It include fractures, vein and nerve damage.
Treatment may involve vein and nerve repair, repeated wound irrigations and skin grafts. Amputation may be necessary unless the neurovascular viability of the limb is restored.
- Substantially recovered €13,100 to €25,000;
- Significant ongoing €14,800 to €69,800;
- Serious and permanent conditions €23,100 to €88,400
Thumbs and Fingers
Hands sprains range from mild sprain involving some stretching of ligaments, moderate sprains involving partial ruptures of a ligament and severe sprains with complete rupture of a ligament. Full recovery is the common outcome, although the injury may last several months.
Thumb
- Substantially recovered up to €18,200
- Significant ongoing €14,500 to €40,800;
- Serious and permanent conditions €36,500 to €63,400
Fingers
- Substantially recovered up to €16,800;
- Significant ongoing €10,300 to €29,800;
- Serious and permanent conditions €17,900 to €47,800
Dislocation may involve the head of the bone protruding into the joint capsule. Closed reduction is probably not possible and surgical reduction is commonly carried out. Otherwise, it is most common for reduction to be attempted by closed means and the fingers splinted. Substantial recovery is the most common outcome.
Thumb
- Substantially recovered €13,100 to €18,900;
- Significant ongoing €17,400 to €43,000;
- Serious and permanent conditions €39,300 to €65,200
Fingers
- Substantially recovered €12,200 to €17,500;
- Significant ongoing €13,700 to €31,300;
- Serious and permanent conditions €22,000 to €49,100
Fractures
Most thumb and finger fractures are simple fractures and are treated non-operatively. They may not require treatment. Others, where the skin is broken or closed will bear on the amount of compensation. Complications are uncommon, but may occur with deformity and restriction of functions. Post traumatic arthritis is a possible later complication.
Thumb
- Substantially recovered €14,000 to €20,700;
- Significant ongoing €18,600 to €44,800;
- Serious and permanent conditions €40,500 to €66,800
Fingers
- Substantially recovered €13,100 to €19,100;
- Significant ongoing €14,800 to €33,100;
- Serious and permanent conditions €23,200 to €50,800
Skin Disorders Arm and Hand. Contact allergic dermatitis is a reaction of skin to allergens is the most commonly found in relation to arm and hand.
- Substantially recovered €12,300 to €14,900;
- Serious and permanent conditions €28,800 to €70,400