Book of Quantum 2016 Ed

General

In compiling this document, the consultants examined representative samples from over 51,000
closed personal injuries claims from 2013 and 2014 based on actual figures from Court cases,
insurance company settlements, State Claims Agency cases and Personal Injuries Assessment
Board (PIAB) data.

In essence, the purpose of this publication is to distil settlement and awards data in the personal
injuries process in Ireland and to present the results in a logical and easy-to-examine format. The
result shows the prevailing range of payment for injuries based on research into real cases. The
values quoted do not represent the views of the consultants or any other parties and reflect the
reality of prevailing compensation levels.

The resulting guidelines show in more detail than the original Book of Quantum the ranges being
paid in Ireland by the various bodies in the injuries claims area in respect of compensation for pain
and suffering.

Apart from the updating of figures to reflect the prevailing level of damages in respect of various
injuries, the new Guidelines publication has been expanded. It now includes additional injuries
such as concussion, partial finger amputations, clavicle injuries, upper limb disorders, Achilles
tendon injuries, lung lacerations, food poisoning and other categories. Those injuries were not
included in the previous Guidelines because of the lack of available data at the time.

There is also improved granularity in respect of certain injuries/conditions for example cheek and
nasal injuries, neck, back and finger injuries, dermatitis, and injuries and conditions affecting the
hip, knee, ankle, foot, lung and lower leg.

The Guidelines are intended to provide an indication as to the potential range of compensation
for a particular injury. It is expected that every claim will continue to be dealt with on its individual
merits. It is hoped that the Guidelines will provide assistance to all those involved in resolving
personal injury claims by making the level of damages more predictable and consistent throughout
the injury compensation system. It is hoped that the use of this document will further progress a
less adversarial approach to the compensation of personal injury claims in Ireland.

Foreword

How to use the Book of Quantum

This book only reflects compensation for pain and suffering which is supported by appropriate medical
evidence. An assessment has a number of components, covering some or all of the following:
• A sum to compensate for pain, suffering and loss of enjoyment of life
• Specific losses such as past loss of earnings and medical bills
• Future cost of medical care
• Loss of earnings into the future caused by the injury

A claim will be assessed in its entirety including all components appropriate to the case that have been
vouched.

Follow the steps set out below to understand what assessment range may be appropriate for an injury:
1. Identify a category of injury
2. Understand the severity of the injury using the medical report on the claimant
3. Look up the value range
4. Consider the effect of multiple injuries

1. Identify a category of injury
Assessment of compensation starts by identifying that part of the body that has suffered the most significant
injury although the complete effect of all the injuries will be considered.
The Book is separated into six categories. Head Neck Back & Spinal Upper Limbs Lower Limbs Body & Internal Organs
Consult the Contents page for the specific injury category and type, which will direct you to the relevant
page. Injuries are then generally categorised into levels of severity with a range of values provided for each
level as a guide. Some ranges are quite wide, reflecting how the same injury can have very different effects
on different people. Compensation may be payable for injury types other than those that appear in this book.

2. Understanding the Severity of the injury
Generally the severity is categorised into the following broad ranges to reflect the degree of disruption to
lifestyle, pain and permanency of the condition. However, there are some injuries that by their nature may
have more, or less severity categories.
• Minor
Injuries that have substantially recovered.
• Moderate
Includes injuries from which a claimant has substantially recovered but there are ongoing symptoms that
interfere with carrying out full day to day activities. Recovery will be achieved from these types of injuries.
• Moderately Severe
Includes moderate injuries and in addition the injury has resulted in some permanent incapacity or
limitation that impacts the body part which has been injured.
• Severe and Permanent Conditions
Will apply if the injury is severe and has caused major disruption to a claimants life in a number of areas or
results in serious continuing pain and/or requires permanent medical attention.

3. Look up the value range
After identifying the category and severity of the injury go to the relevant section (as set out in the Contents
page) where the guideline values are detailed. The majority of injuries fall within that range but it is neither a
minimum nor a maximum for individual cases.

4. Consider the effect of multiple injuries
If in addition to the most significant injury as outlined above there are other injuries, it is not appropriate to
simply add up values for all the different injuries to determine the amount of compensation. Where additional
injuries arise there is likely to be an adjustment within the value range.
** Please note that all claims need to be supported by medical evidence.

How to use the Book of Quantum – flow chart
1. Identify category of injury
Identify the part of the body that suffered the most significant injury (complete effect of all injuries will be considered at a later stage):
• Head
• Neck
• Back and Spine
• Upper Limbs
• Lower Limbs
• Body and Internal Organs

2. Understand severity of injury
Generally, severity is categorised into the following broad ranges to reflect the  degree of disruption to lifestyle, pain and permanency of the condition:
• Minor
• Moderate
• Moderately severe
• Severe and Permanent

3. Look up range value
Majority of cases fall within the range but it is neither a minimum nor a maximum for individual cases

4. Consider effect of multiple injuries
If, in addition to the most significant injury, there are other injuries, it is not
appropriate to add up values to determine the amount of compensation. Where
additional injuries arise there is likely to be an adjustment within the value range
1. Head Injuries 2. Neck Injuries 3. Back and Spinal Injuries 4. Upper Limb Injuries 5. Lower Limb Injuries 6. Body and Internal Organs

Sample assessment
Claimant sustained soft tissue injuries and the award was assessed on the following basis:
General Damages for pain and suffering €7,200
Special Damages
Net loss of earnings €400
Medication €126
Physiotherapy €200
Doctors fees €150
Total settlement €8,076

1. Head Injuries

A. Head/Skull

Skull fractures are classified as being linear (most common), depressed or
comminuted fractures that are further classified as closed (simple) or open
(compound). A closed fracture is one in which there is no break in the skin.
Intracranial injuries, including brain contusions and lacerations are severe head
injuries. It is difficult to be too specific about the compensation levels for these
types of injuries due to the high number of variables involved and the number and
severity of possible outcomes (e.g. personality and behavioural disorders). As with
all injuries, each one will differ and be considered on its individual merits with the
figures being displayed here as a rough guide.
Head injuries may also be rated in accordance with the Glasgow Coma Scale (GCS)
which grades a person depending upon the level of consciousness and therefore
level of potential injury to the brain.

Concussion – Head Injury

Symptoms of a concussion injury commonly includes headaches, dizziness and
nausea. Permanent symptoms may result but most cases recover.
Minor up to €21,800

No loss of consciousness
Moderate €19,000 to €35,200
Loss of consciousness less than 24 hours
Severe €41,600 to €74,000

Loss of consciousness more than 24 hours
Skull Fracture (no loss of consciousness)/Minor Head Injuries
Under this category there will be little if any disability resulting from the head
injury.
Minor €34,700 to €60,200
Moderate €54,200 to €91,800
Severe and permanent conditions €73,400 to €105,000

1. Head Injuries

Skull Fracture (with loss of consciousness)/Moderate Head Injuries
This category will include an injury that would have had an impact on the state of consciousness
Minor €34,700 to €66,600
Moderate €54,200 to €98,200
Severe and permanent conditions €73,400 to €124,000

Skull Fracture (with loss of consciousness)/Severe Head Injuries
The severity of injury will depend on the degree of awareness and response to
surroundings, the duration of unconscious state and any impact on personality
or behaviour, once the injury has stabilised. There may be a greater risk of future
epilepsy with this level of injury, which should also be considered.
Minor €52,800 to €124,000
Moderate €68,200 to €128,000
Severe and permanent conditions (excluding brain damage) €87,400 to €144,000

B. Eye Injuries
Affecting Sight
Injuries in this category range from the most devastating where sight has been
completely lost, through to transient injury to the eye with minimal impact on vision.
Transient/Minor Eye Injuries up to €9,800
These injuries will include being struck in the eye, having an item in the eye and
being splashed with liquid, which may cause pain and have a temporary impact on sight.
Reduced Loss of Sight in One Eye €22,500 to €45,400
The amount of the assessment will need to consider the degree of sight that remains.
Total Loss of Sight in One Eye up to €138,000
The amount of the assessment will need to consider the degree of sight in the
remaining eye.
Total Blindness
Cases where total blindness has occurred would need to consider several factors
in order to assess the value.
Such factors would include, age at the time of the accident, occupation, lifestyle,
cosmetic or disfiguring features, prosthetic requirement.

C. Injuries Affecting Hearing
Cases where the hearing has been affected would need to consider several factors
in order to assess the value. Considerations would need to include, if the impact
of the injury was immediate or a gradual loss over time, the age at the time of the
loss and if balance has or will be affected by the injury. There is a separate guide
available to assist in the assessment of hearing loss. Please refer to The Report of
the Expert Hearing Group (The Green Book).

The gender and age are factors to determine the exact level of severity. Serious
injuries are likely to have an element of disfigurement attached to them and will
be considered accordingly.

Fracture of the Cheek
Cheek fractures (the zygoma bone) 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) of the face. Le Forte fractures
to the facial bones would also fall into this category.
Minor €21,200 to €42,200
Simple non-displaced fracture to the cheek bone which has substantially recovered.
Moderate €37,700 to €47,300
Fractures to the cheek bone(s) that have required surgery with either a complete
recovery expected or minimal cosmetic effect.
Severe and permanent conditions €47,500 to €55,600
Complex and multiple fractures to the cheek bones which required extensive
surgery and extended healing but may result in an incomplete union with lasting
consequences that may include numbness to the face.

Nose Fractures
Because of its prominence (and therefore vulnerability) and structural weakness,
the nose is the most frequently fractured facial bone.
Minor €18,000 to €22,100
Simple non-displaced fracture to the nose which has substantially recovered.
Moderate €22,100 to €32,200
Fracture(s) to the nasal bone that may have required surgery where a full recovery
is expected or minimal cosmetic effect.
Moderately Severe €32,400 to €46,600
Nasal fractures that have required surgery which may have had some short term
consequences on the ability to smell.
Severe and permanent conditions €44,500 to €63,900
Complex and multiple fractures to the nasal bones which required extensive
surgery and may have lasting consequences on the ability to smell.

Jaw – Soft Tissue
A jaw sprain is an unusual sprain. This category is for sprains of the joint between
the top and bottom jaws (the temporomandibular joint).
Minor €11,000 to €20,800
Minor sprains are mild injuries where there is no tearing of the ligament, and often
no jaw movement is lost, although there may be tenderness and slight swelling
which has substantially recovered.
Moderate €19,500 to €27,600
Moderate sprains are caused by a partial tear in the ligament. These sprains are
characterised by obvious swelling, extensive bruising, pain, and reduced function
of the jaw. These sprains may have caused some impact on diet but a full recovery
is expected.
Severe and permanent conditions €25,900 to €52,700
These injuries will be the most severe and will include where the movement of the
jaw is restricted due to the ligament or muscle damage. Extensive surgery may have been required.
These severe sprains will have required a change in diet and result in ongoing pain,
possibly clicking of the jaw and also a possibility of restriction on opening of the mouth.

Jaw – Dislocation
A jaw dislocation is a dislocation of the lower jawbone (mandible). Jaw dislocations
are usually reduced by closed manipulation. Analgesics and a soft diet may be
prescribed or even a cervical collar.
Minor €21,200 to €35,400
These injuries will have substantially recovered and may have required the joint to
be replaced back into the original position and has substantially recovered.
Moderate €36,100 to €63,300
These injuries will have required manipulation of the joint back into normal
position and may have taken longer to recover with extensive treatment with a
full recovery expected. These dislocations may have caused some impact on diet.
Severe and permanent conditions €52,700 to €68,600
These injuries will have required manipulation of the joint back into normal
position and may have included more invasive treatment or even surgery to keep
the joint in position. May also include ongoing pain and stiffness with some loss of
movement and the jaw being more susceptible to future dislocation. These severe
dislocations may have required a change in diet and also a possibility of restriction
on the opening of the mouth.

Jaw – Fracture
After the nose, the jaw (mandible) is the most commonly fractured facial bone.
Some jaw fractures may be very simple and require only observation and soft diet
or with just bandage immobilisation but the more severe fractures will require
internal fixation with the use of wires.
Minor €21,200 to €47,100
Simple fracture to either the top or bottom jaw bone which has substantially recovered.
Moderate €35,900 to €74,900
Fractures to the jaw bone(s) that may have required surgery with either a full
recovery expected or minimal cosmetic effect. These fractures may have caused
some impact on diet.
Severe and permanent conditions €52,700 to €80,200
Complex and multiple fractures to the jaw which required extensive surgery and
extended healing but may result in an incomplete union. These severe fractures
may have required a change in diet and also a possibility of restriction on the
opening of the mouth.

E. Damage to the Teeth
For these injuries there will generally have been a course of treatment. The level of
severity and amount will vary depending upon the degree of discomfort and the
extent of such treatment. Any difficulty with eating is also a consideration.
Loss of Milk Tooth €4,400 to €7,000
Broken Tooth €7,500 to €10,300
Loss of One Tooth €10,300 to €12,700
The impact of the loss of more than one tooth
There are several factors that need to be considered when calculating the
assessment for loss of multiple teeth. Such factors would include, the number of
teeth affected, location of the teeth, the level of previous dental hygiene, cosmetic
effect, possible impacts on the requirement to change to a softer food diet.

2. Neck Injuries

Whiplash/Soft Tissue
The most common type of neck injury is called a “whiplash” injury which is an
over extension or sprain often suffered in a motor vehicle accident or high impact
slip/trip/fall type of accidents.
Whiplash injuries can involve a very minor sprain that heals within days or weeks
or they can in extreme cases cause long lasting pain and permanent disability.
Sometimes a neck strain can irritate or aggravate a pre-existing condition that may
or may not have been treated before the accident. These can include disc lesions,
spondylosis, osteoarthritis, spondylolisthesis.
Minor – substantially recovered up to €15,700
Minor – a full recovery expected up to €19,400
These injuries are minor soft tissue, whiplash injuries. Whilst the duration of
symptoms will be of importance, there are also other factors that need to be
considered when calculating the assessment. Such factors would include the
nature of the neck injury, the intensity of the pain and extent of the symptoms,
the presence of additional symptoms in the back or shoulder areas, the impact
of the injuries on the persons ability to work and/or the extent of the treatment.
Moderate €20,400 to €30,200
These injuries would be moderate soft tissue injuries where the period of recovery
has been protracted and where there remains an increased vulnerability to further
trauma. Also within this bracket would be injuries which may have accelerated or
exacerbated a pre-existing condition over a period of time, usually no more than
five years.
Moderately Severe €34,400 to €52,200
These injuries involve the soft tissue or wrenching type injury of the more severe
type resulting in serious limitation of movement, recurring pain, stiffness and
discomfort and the possible need for surgery or increased vulnerability to further
trauma. This would also include injuries which may have accelerated and/or
exacerbated a pre-existing condition over a prolonged period of time, usually more
than five years resulting in ongoing pain and stiffness.
Severe and permanent €44,600 to €77,900
The most severe category. These injuries will have also affected the structure
of the neck and the discs, resulting in serious limitation of movement and the
requirement for surgery. Little or no movement regained on a permanent basis
resulting in ongoing pain and stiffness with the necessity to wear a collar for long
periods in the day.

3. Back Injuries and Spinal Fractures

A. Back
Serious injuries may involve partial or complete damage to the spinal nerves,
serious exacerbation of disc lesions requiring fusing of vertebra, irritation of a
spinal nerve root, and those most severe back injuries involving paralysis, or other
severe consequences such as loss of sexual function or loss or impairment of
urinary or bladder function.
Soft Tissue
These injuries would include an over extension or sprain often suffered in a motor
vehicle accident or high impact slips/trips/falls type of accidents.
Minor – substantially recovered up to €14,800
Minor – a full recovery expected up to €18,400
These injuries are minor soft tissue injuries. Whilst the duration of symptoms will
be of importance, there are also other factors that need to be considered when
calculating the assessment. Such factors would include the nature of the back
injury, the intensity of the pain and extent of the symptoms, the presence of
additional symptoms in the buttocks or hip areas, the impact of the injuries on the
person’s ability to work and/or the extent of the treatment.
Moderate €21,400 to €34,400
These injuries would be moderate soft tissue injuries where the period of recovery
has been protracted and where there remains an increased vulnerability to further
trauma. Also within this bracket would be injuries which may have accelerated or
exacerbated a pre-existing condition over a period of time, usually no more than
five years.
Moderately Severe €32,100 to €55,700
These injuries involve the soft tissue or wrenching type injury of the more severe
type resulting in serious limitation of movement, recurring pain, stiffness and
discomfort and the possible need for surgery or increased vulnerability to further
trauma. This would also include injuries which may have accelerated and/or
exacerbated a pre-existing condition over a prolonged period of time, usually more
than five years resulting in ongoing pain and stiffness.
Severe and permanent €52,300 to €92,000
The most severe category. These injuries will have also affected the structure
of the back and the discs, resulting in serious limitation of movement and the
requirement for surgery. Little or no movement regained on a permanent basis
resulting in ongoing pain and stiffness with the necessity to wear a back brace/
support for long periods in the day.

3. Back Injuries and Spinal Fractures

B. Spinal Cord Injuries
Quadriplegia is paralysis of all four limbs with paraplegia being paralysis of both
lower limbs and partial or total loss of urinary and bowel function, due to spinal
cord disease or injury.
The Courts set the maximum compensation with the exact value being based on
a number of considerations:
a) level of movement
b) level of pain and suffering
c) depression – level of achievable rehabilitation
d) age and life expectancy
The most catastrophically injured members of society suffer great pain and distress,
may never work or enjoy the benefits of a loving relationship and may remain
dependent on the care of others for years or indeed for the whole of their lifetime.
The upper range for compensation of this type rests in or around €450,000.

C. Vertebra
This category includes all types of vertebral fractures including fracture dislocations,
wedge fractures, chance fractures, burst fractures and flexion tear drop fractures.
Wedge spinal fractures are regarded as stable fractures and rarely result in
neurological complications. These occur most commonly in the thoracic spine.
Burst fractures are regarded as stable fractures but may result in spinal cord
involvement if there is bone fragmentation.
Minor €32,500 to €63,300
Simple fracture to one vertebra which has substantially recovered.
Moderate €54,900 to €92,700
May include multiple vertebra fractures that may have required surgery with either
a full recovery expected or ongoing minimal pain and stiffness which may impact
on movement of the spine.
Severe and permanent conditions €76,000 to €139,000
Multiple fractures to the vertebra with ongoing consequences, but without
paralysis.

4. Upper Limb Injuries

A. Arm or Hand Amputations
Complicated traumatic amputations are ones involving delayed treatment, delayed
healing or major infection. The necessity for stump revision or the existence of
phantom limb pains may also occur. An amputation can also be provided as a
treatment required due to a severe injury.
Loss of Single Digits •
There are several factors that need to be considered when calculating the
assessment. Such factors would include dominant hand, appearance, use of any
remaining stump, age, gender and occupation impacts.
Index Finger – partial up to €55,800
Index Finger – total up to €61,200
Middle Finger – partial up to €51,100
Middle Finger – total up to €57,200
Ring Finger – partial up to €43,300
Ring Finger – total up to €57,200
Little Finger – partial up to €41,600
Little Finger – total up to €46,400
Thumb – partial up to €44,200
Thumb – total up to €80,500
Loss of Multiple Digits
There are several factors that need to be considered when calculating the
assessment for loss of multiple digits. Such factors would include, which digits
and how many digits, dominant hand, appearance, impact on hand function, age,
gender and occupation impacts.

Loss of Arms or Hands
There are several factors that need to be considered when calculating the
assessment for loss of arms or hands. Therefore each case will need to be assessed
on its individual merits. Such factors would include, above or below elbow, above
or below wrist, dominant hand, appearance, use of prosthetic, age, gender and
occupation impacts.

4. Upper Limb Injuries

B. Shoulder/Upper Arm
Soft Tissue
This category includes all sprains to the upper arm and shoulder region including
partial and complete tears of the tendons forming the joint capsule (the rotator
cuff), which may result in substantial reduced capacity. The level and duration
of treatment as well as any complications and permanent ongoing disability will
dictate the level of compensation.
Minor up to €33,500
Minor sprains are mild injuries where there is no tearing of the ligament, and often
no elbow movement is lost, although there may be tenderness and slight swelling
which has substantially recovered.
Moderate €22,000 to €60,900
Moderate sprains are caused by a partial tear in the ligament. These sprains are
characterised by obvious swelling, extensive bruising, pain, and reduced function
of the shoulder with a full recovery expected.
Severe and permanent conditions €34,700 to €67,700
These injuries will be the most severe and will include where the movement of the
shoulder is restricted due to the ligament or muscle damage. Extensive surgery may have been required.
Dislocation
Shoulder dislocations range from simple dislocations to severe that include
ligament and nerve damage. Likewise, the level of treatment can range from
placing the arm in a sling to an operative reduction. Once dislocated, the shoulder
may be susceptible to further dislocation in the future with the increased risk of
degenerative disease as a result.
Minor €17,500 to €43,200
These injuries will have substantially recovered and may have required the joint to
be replaced back into the original position.
Moderate €33,000 to €70,600
These injuries will have required manipulation of the joint back into normal
position and may have taken longer to recover with extensive treatment with a full recovery expected.
Severe and permanent conditions €48,400 to €76,700
These injuries will have required manipulation of the joint back into normal
position and may have included more invasive treatment or even surgery to keep
the joint in position. May also include ongoing pain and stiffness with some loss of
movement and the joint being more susceptible to future dislocation.

Fracture – Humerus
Fractures of the humerus (upper arm bone) may also be described according to the
type of fracture. For example, transverse, oblique, spiral or comminuted.
They are most often treated very conservatively by non-surgical means, for example
closed reduction and/or cast and sling. Uncommonly, an open reduction operation
is necessary.
Complications of humerus fractures may include nerve palsy and delayed and nonunion and shoulder joint stiffness. Very occasionally, brachial artery complications may be seen with shaft fractures. Healing times vary with some fractures being
slow to heal although this depends upon the degree, if any, of displacement.
Minor up to €36,800
Simple non-displaced fracture to the humerus with no joint involvement which has
substantially recovered.
Moderate €34,700 to €64,500
Fractures to the humerus that may have required surgery with either a full recovery
expected or minimal low level ongoing pain but not lack of movement to the arm.
Severe and permanent conditions €50,100 to €83,900
Complex and multiple fractures to the humerus which required extensive surgery
and extended healing but may result in an incomplete union and the possibility
of having or has achieved arthritic changes and degeneration that may result in
permanent loss of function to the arm.
Fracture Clavicle – Collar Bone
Fracture Clavicle (collar bone) €22,100 to €44,000
The clavicle is known for not healing quickly or accurately. Therefore the level of
assessment will depend upon several factors which may include complicated or
simple fracture, duration of treatment, complications, and whether there is any
ongoing permanent disability.

Crush Injury – Arm or Hand
A crush injury is a serious type of soft-tissue injury and may include fracture, vein
and nerve damage.
Treatment of these major soft-tissue injuries can involve vein repair, nerve repair,
debridement, repeated wound irrigations and skin grafts. Amputation may
become necessary unless the neurovascular viability of the limb or part thereof is
restored. Any associated fractures and other soft tissue damage such as ligament
and tendon injuries will also require repair.
Minor €14,400 to €33,300
These injuries will include soft tissue related injuries and will have substantially
recovered.
Moderate €32,000 to €48,400
These injuries include more extensive damage to structures other than soft tissue
but with a full recovery expected with treatment.
Moderately Severe €43,800 to €69,100
These injuries will involve the joint of the elbow and a reduction in movement but
not of sufficient levels to require surgery.
Severe and permanent conditions €64,200 to €87,700
These injuries will include more complex and multiple injuries with ongoing
permanent pain and dysfunction to the arm.

C. Elbow/Forearm
Soft Tissue
Elbow sprains are typically treated conservatively. Rest, ice packs and heat
applications and in some cases temporary immobilisation in a sling or bandage is
usually all that is needed. In some injuries, anti-inflammatory medication may be
prescribed and physiotherapy may be of some assistance. Elbow sprains generally
heal without any residual effects and in this event will fall in either of the lower
two brackets dependent on prognosis.
Minor up to €9,200
Minor sprains are mild injuries where there is no tearing of the ligament, and often
no elbow movement is lost, although there may be tenderness and slight swelling
which has substantially recovered.
Moderate €8,000 to €29,500
Moderate sprains are caused by a partial tear in the ligament. These sprains are
characterised by obvious swelling, extensive bruising, pain, and reduced function
of the elbow with a full recovery expected.
Moderately Severe €22,000 to €59,600
Severe sprains are caused by complete tearing of the ligament or a rupture, where
there is severe pain, loss of joint function, widespread swelling and bruising and
the inability to grip or apply weight to the arm. These symptoms are similar to
those of bone fractures.
Severe and permanent conditions €39,900 to €63,900
These injuries will be the most severe and will include where the movement of the
elbow is restricted due to the ligament or muscle damage. Extensive surgery may
have been required.
Dislocation
Some injuries require open reduction of the dislocation rather than the more
common closed reduction. Complications can arise where vein damage also occurs
due to swelling and the need to hold the elbow in a flexed position following
reduction.
Minor €21,200 to €40,700
These injuries will have substantially recovered and may have required the joint to
be replaced back into the original position.
Moderate €37,400 to €70,800
These injuries will have required manipulation of the joint back into normal
position and may have taken longer to recover with treatment but with a full
recovery expected.

Severe and permanent conditions €55,400 to €75,300
These injuries will have required manipulation of the joint back into normal
position and may have included more invasive treatment or even surgery to keep
the joint in the position. May also include ongoing pain and stiffness with some
loss of movement and the joint being more susceptible to future dislocation.
Fracture – Radius and Ulna Bones
It is more common to encounter fractures of both forearm bones rather than
isolated fractures of either the ulna or radius. If caused by direct trauma the
fracture line usually occurs at the same level in both bones. If indirect trauma the
fractures can occur at different levels. Fractures that involve the joint are usually
considered more complicated than others due to the increased impact on limb
movement.
Minor €22,100 to €38,300
A simple fracture to either the radius, or the ulna, with no joint involvement which
has substantially recovered.
Moderate €37,700 to €40,000
Fractures to either bones, or more complex fracture to one of the bones or a
displaced fracture with a full recovery expected with treatment.
Moderately Severe €39,200 to €81,700
Multiple fractures that include joint which have resolved but with ongoing pain
and stiffness which impacts on movement of the elbow joint or the wrist.
Serious and permanent conditions €57,200 to €83,700
Complex and multiple fractures to the radius and ulna which required extensive
surgery and extended healing but may result in an incomplete union and the
possibility of having or has achieved arthritic changes and degeneration of the
elbow or wrist joint which may affect the ability to use the arm.

D. Wrist
Soft Tissue
Like other sprains, wrist sprains are sometimes classified in grades: mild sprains
involve some stretching of ligaments; moderate sprains involve partial rupture of a
ligament while severe sprains involve complete rupture of a ligament. Although the
injury may last for several months, a full recovery is the most common outcome.
Minor up to €27,800
Minor sprains are mild injuries where there is no tearing of the ligament and often
no wrist movement is lost, although there may be tenderness and slight swelling
which has substantially recovered.
Moderate €21,900 to €32,900
Moderate sprains are caused by a partial tear in the ligament. These sprains are
characterised by obvious swelling, extensive bruising, pain, difficulty gripping, and
reduced function of the wrist with a full recovery expected.
Severe and permanent conditions €41,200 to €67,500
Severe sprains are caused by complete tearing of the ligament or a rupture, where
there is severe pain, loss of joint function, widespread swelling and bruising, and
the inability to bear weight. These symptoms are similar to those of bone fractures.
Dislocation
The more complicated dislocations will involve serious and permanent conditions
as well as treatment such as open reduction. They may have complications such as
medial nerve compression and result in a permanent condition.
Minor €19,800 to €43,500
These injuries will have substantially recovered and may have required the joint
to be replaced back into the original position which has substantially recovered.
Moderate €35,000 to €75,500
These injuries will have required manipulation of the joint back into normal
position and will have taken longer to recover with extensive treatment but with
a full recovery expected.
Severe and permanent conditions €54,400 to €77,600
These injuries will have required manipulation of the joint back into normal
position and may have included more invasive treatment or even surgery to keep
the joint in the position. May also include ongoing pain and stiffness with some
loss of movement and the joint being more susceptible to future dislocation.

Fracture
The wrist contains many bones (radius, ulna and eight carpal bones) all of which
make up the wrist joint. In view of this complexity and variety it is difficult to
provide very specific ranges for each “wrist fracture”. Fractures that involve the
joint are usually considered more complicated than others due to the increased
impact on movement.
Minor €19,300 to €36,800
Simple non-displaced fracture to any of the bones of the wrist which has
substantially recovered.
Moderate €35,000 to €45,000
Simple or minimally displaced fractures with a full recovery expected with
treatment.
Moderately Severe €54,200 to €70,100
Multiple fractures that have resolved but with ongoing pain and stiffness which
impacts on movement of the wrist.
Severe and permanent conditions €68,400 to €78,000
Complex and multiple fractures to the bones within the wrist which required
extensive surgery and extended healing but may result in an incomplete union
and the possibility of having or has achieved arthritic changes and degeneration
of the wrist and may affect the ability to use the hand.

E. Hand
Soft Tissue
Like other sprains, hand sprains are sometimes classified in grades: mild sprains
involve some stretching of ligaments; moderate sprains involve partial rupture
of a ligament while severe sprains involve complete rupture of a ligament. The
injury may last for several weeks or several months but a full recovery is the most
common outcome.
Minor up to €21,700
Minor sprains are mild injuries where there is no tearing of the ligament, and often
no movement is lost, although there may be tenderness and slight swelling which
has substantially recovered.
Moderate €21,900 to €43,700
Moderate sprains are caused by a partial tear in the ligament. These sprains are
characterised by obvious swelling, extensive bruising, pain, difficulty gripping, and
reduced function of the wrist and a full recovery is expected.
Severe and permanent conditions €41,200 to €67,500
Severe sprains are caused by complete tearing of the ligament or a rupture, where
there is severe pain, loss of joint function, widespread swelling and bruising and
the inability to grip. These symptoms are similar to those of bone fracture.
Fractures
Fractures to the hand (the metacarpal bone(s)) are described according to the site
of the fracture. They may involve the base of the bone, the shaft, or the neck and
head.
Minor €14,600 to €32,200
Simple fracture non-displaced fracture with no joint involvement which has
substantially recovered.
Moderate €30,200 to €64,800
Fractures to multiple bones in the hand or a displaced fracture with a full recovery
expected with treatment
Severe and permanent conditions €49,600 to €67,700
Complex and multiple fractures to the bones in the hand which required extensive
surgery and extended healing but may result in an incomplete union and the
possibility of having or has achieved arthritic changes and degeneration in the
hand and may affect the ability to use the hand.

F. Thumb and Fingers
Soft Tissue
Like other sprains, hand sprains are sometimes classified in grades: mild sprains
involve some stretching of ligaments; moderate sprains involve partial rupture of
a ligament while severe sprains involve complete rupture of a ligament. Although
the injury may last for several months a full recovery is the most common outcome.
Thumb
Minor up to €21,200
Minor sprains are mild injuries where there is no tearing of the ligament, and often
no function is lost although there may be tenderness and slight swelling which has
substantially recovered.
Moderate €24,100 to €48,700
Moderate sprains are caused by a partial tear in the ligament. These sprains are
characterised by obvious swelling, extensive bruising, pain, difficulty gripping and
reduced function of the thumb with a full recovery expected.
Severe and permanent conditions €35,600 to €57,300
Severe sprains are caused by complete tearing or rupture of the ligament, where
there is severe pain, loss of thumb function, widespread swelling and bruising and
the inability to bear weight. These symptoms are similar to those of bone fractures.
Finger(s)
Minor up to €19,100
Minor sprains are mild injuries where there is no tearing of the ligament, and often
no function is lost although there may be tenderness and slight swelling which has
substantially recovered.
Moderate €21,700 to €40,100
Moderate sprains are caused by a partial tear in the ligament. These sprains are
characterised by obvious swelling, extensive bruising, pain, difficulty gripping, and
reduced function of the finger(s) with a full recovery expected.
Severe and permanent conditions €33,800 to €51,300
These injuries will include multiple fingers of one or both hands to fall within this category.
Severe sprains are caused by complete tearing or rupture of the ligament, where
there is severe pain, loss of grip, widespread swelling and bruising and the inability
to grip or have useful benefit of the fingers. These symptoms are similar to those
of bone fractures.

Dislocation
More severe dislocations may involve the head of the bone protruding into the joint
capsule and where closed reduction is not possible and surgical reduction is carried
out. Otherwise, it is most common for reduction to be attempted by closed means
where the dislocation is manipulated and pushed back into its normal place. A full
and complete recovery is the most common outcome for these injuries.
Thumb
Minor €14,400 to €26,100
These injuries will have substantially recovered and may have required the joint to
be replaced back into the original position.
Moderate €28,900 to €50,600
These injuries will have required manipulation of the joint back into normal
position and will have taken longer to recover with extensive treatment but with
a full recovery expected.
Severe and permanent conditions €41,400 to €59,000
These injuries will have required manipulation of the joint back into normal
position and may have included more invasive treatment or even surgery to keep
the joint in the position. May also include ongoing pain and stiffness with some
loss of movement and the joint being more susceptible to future dislocation.
Finger(s)
Minor €12,800 to €22,400
These injuries will have substantially recovered and may have required the joint to
be replaced back into the original position.
Moderate €17,300 to €40,700
These injuries will have required manipulation of the joint back into normal
position and will have taken longer to recover with extensive treatment but with
a full recovery expected.
Severe and permanent conditions €29,300 to €51,900
These injuries will have required manipulation of the joint back into normal
position and may have included more invasive treatment or even surgery to keep
the joint in the position. May also include ongoing pain and stiffness with some
loss of movement and the joint being more susceptible to future dislocation.
Fracture
Most thumb and finger fractures are simple fractures and are treated nonoperatively. In fact some don’t require any treatment at all. Whether the fracture
is open (breaks the skin) or closed will have a bearing on the compensation
given. Complications such as non-union of fractures are rare but mal-union
does sometimes occur with deformity and restriction of function. Post-traumatic
arthritis is also a possible late complication.

Thumb
Minor up to €30,300
Simple non-displaced fracture with no joint involvement which has substantially
recovered.
Moderate €29,600 to €46,900
Fractures to the thumb bone(s) that may have required surgery with either a full
recovery expected or minimal loss of movement of the thumb.
Moderately Severe €38,600 to €54,900
These injuries will include fractures’ that involved tendon damage that have
resolved but with ongoing pain and stiffness which impacts on movement of the
thumb.
Severe and permanent conditions €43,700 to €62,700
Complex and multiple fractures which required extensive surgery and extended
healing but may result in an incomplete union and the possibility of having or has
achieved arthritic changes and degeneration of the thumb joint(s) and may affect
the ability to use the thumb.
Finger(s)
Minor up to €16,600
Simple non-displaced no joint involvement and substantially recovered.
Moderate €19,500 to €44,900
Factures to the finger at multiple sites or more than one finger that may require
surgery with either a full recovery expected or minimal loss of movement of the
finger(s).
Moderately Severe €32,800 to €46,200
These injuries will include fractures that involve tendon damage that have resolved
but with ongoing pain and stiffness which impacts on movement of the finger(s).
Serious and permanent conditions €31,500 to €56,400
Complex and multiple fractures which required extensive surgery and extended
healing but may result in an incomplete union and the possibility of having or has
achieved arthritic changes and degeneration of the finger joint(s) and may affect
the ability to use the finger(s).

G. Upper Limb Disorders

This category should be used for specific upper Limb Disorders. These injuries may
have been caused in the work place due to repetitive movement. The severity
and range will depend upon several factors, such as one sided or double-sided
symptoms, dominant hand, the ability to work, the effect on domestic and social
life, the capacity to avoid recurrence of symptoms, surgery required or performed
and age at the time of the injury.
Tenosynovitis (an inflammation of the tendon sheaths)
Minor €22,000 to €29,400
Substantially recovered.
Moderate €25,900 to €34,400
Where the period of recovery has been protracted.
Moderately Severe €38,700 to €66,500
Continuing but fluctuating single sided symptoms, possibly having had or will
require surgery.
Severe and permanent conditions €58,000 to €68,600
Continuing double sided disability with surgery.
De Quervains Tenosynovitis
(an inflammation of the tendon of the thumb)
Minor €17,500 to €18,300
Substantially recovered.
Moderate €27,800 to €32,800
Where the period of recovery has been protracted.
Moderately Severe €33,100 to €36,100
Continuing but fluctuating single sided symptoms, possibly having had or will
require surgery.
Severe and permanent conditions €43,600 to €47,900
Continuing double sided disability with surgery.
Radial/Cubital Tunnel Syndrome
(compression of the radial or ulna nerves)
Minor €22,400 to €32,200
Substantially recovered.
50
Moderate €29,400 to €40,900
Where the period of recovery has been protracted.
Moderately Severe €42,400 to €73,300
Continuing but fluctuating single sided symptoms, possibly having had or will
require surgery.
Severe and permanent conditions €61,800 to €76,600
Continuing double sided disability with surgery.
Carpal Tunnel Syndrome (compression of the median nerve)
Minor €22,100 to €32,000
Substantially recovered.
Moderate €28,300 to €39,700
Where the period of recovery has been protracted.
Moderately Severe €41,100 to €71,700
Continuing but fluctuating single sided symptoms, possibly having had or will
require surgery.
Severe and permanent conditions €60,300 to €74,100
Continuing double sided disability with surgery.
Epicondylitis (Tennis/Golfers Elbow)
Minor €18,400 to €19,100
Substantially recovered.
Moderate €31,800 to €34,700
Where the period of recovery has been protracted.
Moderately Severe €35,600 to €37,800
Continuing but fluctuating single sided symptoms, possibly having had or will
require surgery.
Severe and permanent conditions €47,700 to €51,400
Continuing double sided disability with surgery.

H. Dermatitis – Arm/Hands
Contact allergic dermatitis is a reaction of the skin to allergens (substances which
the body is allergic to). Whilst not confined to the arm and hand, this is the most
common area affected. Allergens generally don’t cause skin reactions to most
people but some are hypersensitive to the allergens which are usually organic or
chemical in nature.
Minor up to €14,000
These injuries would cause itching, irritation and/or rashes on one or both hands
which has substantially recovered.
Moderate €14,000 to €19,800
These injuries would include dermatitis to one or both hands, with a full recovery
expected with treatment.
Severe and permanent conditions €32,800 to €53,700
These injuries would include dermatitis to both hands, with cracking of the skin
and soreness affecting the person’s employment and domestic capability, with
lasting consequences.

5. Lower Limb Injuries

A. Leg Amputations
Complicated traumatic amputations are ones involving delayed treatment, delayed
healing or major infection. The necessity for stump revision or the existence of
phantom limb pains may also occur. An amputation can also be provided as a
treatment required due to a severe injury.
Loss of Legs or Feet
When calculating the assessment amount there are several factors that need to be
considered. Therefore each case will need to be assessed on its individual merits.
Such factors would include above or below knee, above or below ankle, dominant
foot, appearance, use of prosthetic, age, gender and occupation impacts.
Loss of Toes
There are several factors that need to be considered when calculating the
assessment. Such factors would include dominant foot, appearance, balance, age,
gender and occupation impacts.
Toe (other than the Big Toe) up to €48,200
Big Toe up to €70,600

B. Hip/Pelvis
Soft Tissue
Like other sprains, hip sprains are sometimes classified in grades: mild sprains
involve some stretching of ligaments; moderate sprains involve partial rupture of
a ligament while severe sprains involve complete rupture of a ligament. Groin
sprains will also fall into this category,
Minor up to €29,600
Minor sprains are mild injuries where there is no tearing of the ligament, and often
no function is lost, although there may be tenderness and slight swelling which
has substantially recovered.
Moderate €13,400 to €60,600
Moderate sprains are caused by a partial tear in the ligament. These sprains are
characterised by obvious swelling, extensive bruising, pain, and reduced function
of the joint with a full recovery expected.
Severe and permanent conditions €60,600 to €70,000
Severe sprains are caused by complete tearing of the ligament or a rupture, where
there is severe pain, loss of balance, widespread swelling and bruising, and the
inability to bear weight. These symptoms are similar to those of bone fractures.
Dislocations
More serious injuries may involve an element of severe ongoing dysfunction as
well as a high risk of degenerative change. Severe injuries may require or have had
a hip replacement procedure.
Minor €27,100 to €45,800
These injuries will have substantially recovered and may have required the joint
to be replaced back into the original position which has substantially recovered.
Moderate €45,000 to €70,400
These injuries will have required manipulation of the joint back into normal positon
and may have taken longer to recover with extensive treatment but with a full
recovery expected.
Moderately Severe €46,300 to €86,700
These injuries will have required manipulation and possibly a replacement of the
hip joint, or have the requirement in the future for such treatment. Once treated
the joint movement would be near normal.

Severe and permanent conditions €59,800 to €94,500
These injuries will have required manipulation of the joint back into normal
position and may have included more invasive treatment or even surgery to keep
the joint in position. These may include ongoing pain and stiffness with some loss
of movement and the joint being more susceptible to future dislocation and the
onset of arthritic changes.
Fractures – Pelvis
Where the fracture is isolated, i.e. fractured in a single place, the prognosis is
usually excellent. Serious and permanent condition pelvic fractures such as those
that involve fractures in more than one place and which may cause disruption
of the pelvic ring. These may be treated with external or internal fixation via a
laparotomy. The fracture may involve complications, such as, and is quite common
in males, injuries to the bladder and urethra. In females there can be a risk of
complications in childbirth.
Other risks to be considered are degenerative changes and the possible need for
future surgery, for example hip replacement.
Minor €27,700 to €54,300
Simple non-displaced fracture to the hip or pelvis with no joint involvement and
substantially recovered.
Moderate €47,100 to €58,400
Displaced fracture(s) with a full recovery expected with treatment.
Moderately Severe €68,500 to €86,500
Multiple fractures that have resolved but with ongoing pain and stiffness which
impacts on movement of the hip/pelvis.
Severe and permanent conditions €79,300 to €94,800
Complex and multiple fractures to the pelvis where the bladder was also damaged,
which required extensive surgery and possible fusion of the bones with the
possibility of having or has achieved arthritic changes and degeneration in the
pelvic joint and may affect the ability to walk unaided.

C. Upper Leg
Fractures – Femur
Serious injuries include those where a risk of future arthritis exists and the level of
that risk, the recovery period, treatment type and duration and what complications
exist, for example fracture non-union or limb shortening. Fractures that involve a
joint are usually considered more complicated than others due to the increased
impact on limb movement.
Minor €27,700 to €59,100
Simple non-displaced fracture to the femur with no joint involvement which has
substantially recovered.
Moderate €47,000 to €84,700
Displaced fracture(s) with a full recovery expected with treatment.
Moderately Severe €60,600 to €97,700
Multiple fractures that have resolved but with ongoing pain and stiffness which
impacts on movement of the hip or knee joint.
Severe and permanent conditions €83,100 to €102,000
Complex and multiple fractures to the femur which required extensive surgery,
and where the outcome may have resulted in the leg being shorter than before
the injury, and therefore may affect the ability to walk unaided.

D. Knee
Soft Tissue
Knee sprains are sometimes classified in grades: mild sprains involve some
stretching of ligaments; moderate sprains involve partial rupture of a ligament
while severe sprains involve complete rupture of a ligament. The majority of
sprains require only conservative treatment and result in a complete resolution
of symptoms with the serious ruptures may result in surgical intervention and
possible ongoing discomfort.
Minor up to €14,800
Minor sprains are mild injuries where there is no tearing of the ligament and often
no function is lost, although there may be tenderness and slight swelling which
has substantially recovered.
Moderate €16,900 to €23,400
Moderate sprains are caused by a partial tear in the ligament. These sprains are
characterised by obvious swelling, extensive bruising, pain, and reduced function
of the knee joint and leg with a full recovery expected.
Moderately Severe €24,000 to €75,600
Moderately severe sprains are caused by incomplete tearing of the ligament
or a partial rupture, where there is moderately severe pain, loss of movement,
widespread swelling and bruising and the inability to bear weight.
Severe and permanent conditions €65,700 to €81,600
Severe sprains are caused by complete tearing or a rupture of the ligament where
there is sever pain, loss of movement, widespread swelling and bruising and the
inability to bear weight. These symptoms are similar to those of bone fractures.
These injuries will have required extensive treatment and surgery and include
where a knee replacement has been carried out.

Dislocations
Severity depends on whether the dislocation is reduced spontaneously or whether
a closed or open procedure had to be performed. Complications such as nerve and
vein damage may also arise.
Minor €22,100 to €50,400
These injuries will have substantially recovered and may have required the joint to
be replaced back into the original position.
Moderate €39,200 to €87,300
These injuries will have required manipulation of the joint back into normal
positon and will have taken longer to recover but with a full recovery expected
with treatment.
Severe and permanent conditions €55,200 to €93,400
These injuries will have required manipulation of the joint back into normal
position and may have included more invasive treatment or even surgery to keep
the joint in the position. These may also include ongoing pain and stiffness with
some loss of movement and the joint being more susceptible to future dislocation.
Fractures – Patella
More serious injuries are those involving patella fractures where a severe level of
ongoing disability exists, more common in displaced fractures. Displaced fractures
usually require surgical treatment that may take a number of forms, including
tension band wiring or removal of part or the entire knee cap (patellectomy).
Minor €20,600 to €47,200
Simple fracture to the patella which has substantially recovered.
Moderate €37,000 to €77,200
Fractures to the patella that may have required surgery with either a full recovery
expected or minimal low level ongoing pain but not lack of movement to the knee.
Severe and permanent conditions €52,800 to €89,100
Complex and multiple fractures to the patella which required extensive surgery
and extended healing but may result in an incomplete union and the possibility of
having or has achieved arthritic changes and degeneration of the knee or ankle
joint and may affect the ability to walk unaided.

E. Lower Leg Fractures – Tibia and/or
Fibula
This category includes fractures to both the tibia and fibula. A fracture to the
fibula is usually not as severe as that of a tibia. Fractures that involve a joint are
usually considered more complicated than others due to the increased impact on
limb movement. Complications may arise such as fractures of both bones, which
may include vein damage, soft tissue damage, mal-union, delayed union and nonunion and joint stiffness at either the ankle or knee or both. Open fractures (where
the bone(s) break the skin) may be further complicated by infection. Peripheral
nerve damage (peroneal nerve) may also be associated with these fractures.
Minor up to €49,400
Simple non-displaced fracture to either the tibia or the fibula with no joint
involvement which has substantially recovered.
Moderate €40,500 to €70,400
Fractures to both bones or a displaced fracture with a full recovery expected with
treatment
Moderately Severe €68,800 to €91,900
Multiple fractures that have resolved but with ongoing pain and stiffness which
impacts on movement of the knee joint or the ankle.
Severe and permanent conditions €77,700 to €96,800
Complex and multiple fractures to the tibia and fibula which required extensive
surgery and extended healing but may result in an incomplete union and the
possibility of having or has achieved arthritic changes and degeneration of the
knee or ankle joint and affects the ability to walk unaided.
F. Ankle
Soft Tissue (excluding Achilles Tendon)
Any of the ankle/foot ligaments may be partially ruptured (sprained) or involve
complete rupture. They may be injured in isolation, or together. Ankle ligament
and tendon sprains are commonly classified as minor, moderate and severe.
Minor up to €23,100
Minor sprains are mild injuries where there is no tearing of the ligament, and often
no function is lost, although there may be tenderness and slight swelling which
has substantially recovered.
Moderate €23,000 to €56,600
Moderate sprains are caused by a partial tear in the ligament. These sprains are
characterised by obvious swelling, extensive bruising, pain, difficulty walking and
reduced function of the ankle but with a full recovery expected.
Severe and permanent conditions €38,900 to €62,300
Severe sprains are caused by complete tearing of the ligament or a rupture, where
there is severe pain, loss of grip, widespread swelling and bruising and the inability
to bear weight. These symptoms are similar to those of bone fractures.
Achilles Tendon Injuries
The Achilles tendon is a major tendon that makes up the ankle joint and is
responsible for the majority of movement to the ankle joint. Damage to the
Achilles tendon will typically require surgery in order for it to resolve.
Minor up to €12,600
Minor sprains are mild injuries where there is no tearing of the ligament and often
no function is lost, although there may be tenderness and slight swelling which
has substantially recovered.
Moderate €14,600 to €25,700
Moderate Achilles tendon sprains are caused by a partial tear in the ligament.
These sprains are characterised by obvious swelling, extensive bruising, pain,
difficulty walking and reduced function of the ankle with a full recovery expected.

Moderately Severe €35,900 to €42,200
Moderately severe Achilles tendon sprains are caused by a partial tear in the
ligament. These sprains are characterised by obvious swelling, extensive bruising,
pain, difficulty walking, and reduced function of the ankle. With surgery the
tendon would have been repaired but may have resulted in a permanent loss of
movement to the ankle.
Severe and permanent conditions €41,200 to €51,600
Severe Achilles tendon ruptures are caused by complete tearing of the ligament
or a rupture, where there is severe pain, widespread swelling and bruising and
the inability to bear weight. Surgery will have been required and despite this the
tendon would still result in a permanent loss of function of the ankle.
Dislocations
Ankle dislocations normally heal without ligament instability and generally have a
good outcome with little, if any, residual disability. Where the dislocation involves
open wounds infection is a constant concern and a permanent disability may arise.
Minor €22,100 to €49,300
These injuries will have made substantially recovered and may have required the
joint to be replaced back into the original position.
Moderate €41,100 to €77,100
These injuries will have required manipulation of the joint back into normal
position and will have taken longer to recover with extensive treatment but with
a full recovery expected.
Severe and permanent conditions €56,800 to €82,800
These injuries will have required manipulation of the joint back into normal
position and may have included more invasive treatment or even surgery to keep
the joint in the position. May also include ongoing pain and stiffness with some
loss of movement and the joint being more susceptible to future dislocation.

Fractures – distal Tibia, distal Fibula and Talus
Three bones form the ankle joint; the distal (bottom end) tibia bone (known as the
medial malleolus), the distal (bottom end) fibula (known as the lateral malleolus)
and the talus bone (one of the tarsal bones in the foot). Fractures that involve the
joint are usually considered more complicated than others due to the increased
impact on limb movement. The more severe injuries involve displacement and
ligament damage (which may be treated with either open or closed reduction).
Minor up to €54,700
These injuries will include simple non-displaced fracture in the ankle which has
substantially recovered.
Moderate €39,100 to €87,600
These injuries will include displaced fractures to a single bone in the ankle, or nondisplaced fractures to multiple bones with a full recovery expected with treatment.
Moderately Severe €79,900 to €89,300
Multiple fractures that have resolved but with ongoing pain and stiffness which
impacts on movement of the ankle.
Severe and permanent conditions €80,500 to €93,300
These injuries include all three bones of the ankle structure which required
extensive surgery and extended healing but may result in an incomplete union
and the possibility of having or has achieved arthritic changes and degeneration
of the ankle joint and may affect the ability to walk unaided.

G. Foot
Foot sprains can result from twisting motions or hyperextension forces. The midfoot joints are the areas most often subject to sprains and strains. Foot sprains can be acute or chronic.
Foot sprains are treated with the application of ice, possibly the use of walking
aids during the acute phase, physiotherapy, protective taping, anti-inflammatory
medication and possibly analgesics for pain depending on the severity of the injury.
Soft Tissue
Minor up to €20,000
Minor sprains are mild injuries where there is no tearing of the ligament and often
no function is lost, although there may be tenderness and slight swelling which
has substantially recovered.
Moderate €19,900 to €38,400
Moderate sprains are caused by a partial tear in the ligament. These sprains are
characterised by obvious swelling, extensive bruising, pain, difficulty walking and
reduced function of the foot but with a full recovery expected.
Severe and permanent conditions €36,400 to €54,400
Severe sprains are caused by complete tearing of the ligament or a rupture, where
there is severe pain, loss of grip, widespread swelling and bruising, and the inability
to bear weight. These symptoms are similar to those of bone fractures.
Dislocations
Minor €16,300 to €43,700
These injuries will have substantially recovered and may have required the joint to
be replaced back into the original position.
Moderate €31,900 to €71,500
These injuries will have required manipulation of the joint back into normal
position and will have taken longer to recover with extensive treatment but with
a full recovery expected.
Severe and permanent conditions €47,700 to €77,500
These injuries will have required manipulation of the joint back into normal
position and may have included more invasive treatment or even surgery to keep
the joint in the position. May also include ongoing pain and stiffness with some
loss of movement and the joint being more susceptible to future dislocation.
Fractures
Simple foot fractures, non-displaced and even some displaced often do not need
reduction. A full recovery is usually achievable. More serious fractures are those
where prolonged treatment, permanent disability and/or future complications
such as arthritis exist.
Minor €18,000 to €34,900
These injuries will include simple non-displaced fractures to a single bone in the
foot with no joint involvement which have substantially recovered.
Moderate €34,000 to €61,200
These injuries will include displaced fractures to a single bone in the foot, or nondisplaced fractures to multiple bones with a full recovery expected with treatment.
Moderately Severe €49,800 to €83,100
These injuries will include displaced fractures or open fractures that have resolved
but with ongoing pain and stiffness which impacts on movement of the foot.
Severe and permanent conditions €65,200 to €92,900
These injuries will include several bones in the foot or the heel bone of the ankle
structure which required extensive surgery and extended healing but may result
in an incomplete union. The possibility of having or has achieved arthritic changes
and degeneration of the foot joint and may affect the ability to walk unaided, and
are so severe that an amputation may be considered.
Crush Injuries – Foot
A crush injury is a serious type of injury and may include damage to the skin, a
fracture, vein and nerve damage. Treatment of these major soft-tissue injuries may
involve vein repair, nerve repair, debridement, repeated wound irrigations and skin
grafts. Amputation may become necessary unless the neurovascular viability of
the limb or part thereof is restored. Any associated fractures and other soft tissue
damage such as ligament and tendon injuries will also require repair.
Minor €12,800 to €40,900
These injuries will have included soft tissue related injuries and a full recovery will
have occurred with treatment.
Moderate €14,500 to €73,900
These injuries may have included more extensive damage to structures other than
soft tissue and may have resulted in a degree of permanent damage.
Severe and permanent conditions €26,600 to €78,300
These injuries will include more complex and multiple injuries with ongoing
permanent pain and or dysfunction to the limb that may affect mobility.

H. Toes
Dislocation
The majority of toe dislocations are relatively minor where reduction is achieved
by manipulation and followed up with a period of foot immobilisation in a cast. If
reduction cannot be achieved by closed methods, an arthrotomy (surgical opening
of a joint) may be required to achieve reduction.
Big Toe
Minor €11,000 to €18,800
These injuries will have substantially recovered and may have required the joint to
be replaced back into the original position.
Moderate €15,500 to €42,400
These injuries will have required manipulation of the joint back into normal
position and will have taken longer to recover with extensive treatment with a full
recovery expected.
Severe and permanent conditions €27,500 to €46,800
These injuries will have required manipulation of the joint back into normal
position and may have included more invasive treatment or even surgery to keep
the joint in the position. May also include ongoing pain and stiffness with some
loss of movement and the joint being more susceptible to future dislocation.
Other Toe(s)
Minor €10,900 to €18,300
These injuries will have substantially recovered and may have required the joint to
be replaced back into the original position.
Moderate €13,000 to €30,700
These injuries will have required manipulation of the joint back into normal
position and will have taken longer to recover with extensive treatment with a full
recovery expected.
Severe and permanent conditions €25,100 to €32,600
These injuries will have required manipulation of the joint back into normal
position and may have included more invasive treatment or even surgery to keep
the joint in position. May also include ongoing pain and stiffness with some loss of
movement and the joint being more susceptible to future dislocation.

Fractures
Most toe fractures heal satisfactorily with conservative treatment. In some rare
injuries, surgical intervention is required such as open reduction or a level of
permanent disability may occur.
Big Toe
Minor €12,600 to €21,500
Simple non-displaced fracture to the toe with no joint involvement which have
substantially recovered.
Moderate €20,900 to €36,300
Displaced fracture(s) with a full recovery expected with treatment.
Severe and permanent conditions €28,000 to €41,200
Complex and multiple fractures to the big toe which required extensive surgery
and extended healing but may result in an incomplete union and the possibility of
having or has achieved arthritic changes and degeneration of the big toe joint and
may affect the ability to walk unaided.
Other Toe(s)
Minor €10,900 to €20,300
Simple non-displaced fracture to the toe with no joint involvement which have
substantially recovered.
Moderate €13,000 to €32,800
Displaced fracture(s) with a full recovery expected with treatment.
Severe and permanent conditions €25,100 to €33,700
Complex and multiple fractures to the toe(s) which required extensive surgery
and extended healing but may result in an incomplete union and the possibility of
having or has achieved arthritic changes and degeneration of the toe joint(s) and
may affect the ability to walk unaided.

6. Body and Internal Organs

A. Rib(s) or Chest Bone Fractures
Although severe pain may follow injury, most rib fractures achieve substantial
recovery in a relatively short period of time without treatment. Some may involve
ongoing residual permanent condition and some have complications such as a
punctured or collapsed lung.
Minor €13,700 to €45,900
Recovery will have occurred and will have included either the breast bone or single
rib fracture.
Moderate €29,600 to €63,400
Multiple rib fractures.
Severe and permanent conditions €49,500 to €80,000
Multiple rib and or breastbone fractures with ongoing symptoms, and may involve
complications.
6. Body and Internal Organs

B. Heart
A heart contusion is bruising of the heart muscles. It usually occurs from severe
blunt trauma to the chest causing the chest bone to compress the heart against
the spinal column. This trauma leads to an alteration in the heart cells fluid
composition which in turn leads to an alteration in the hearts electrical activity and
abnormal heart rhythm. Clinical signs of contusion are left sided chest pain, rapid
heartbeat, shortness of breath, sweating and low blood pressure. Severe heart
contusions can result in death and therefore are not included in the assessment
category below.
Heart Contusion €18,500 to €22,100
Heart contusion resulting in a full recovery.
6. Body and Internal Organs (cont’d)

C. Lung Injuries
The vast majority of lung contusion injuries occur in motor vehicle accidents. It
occurs usually from blunt trauma and severe decelerating forces. Provided there
are no complications and sufficient breathing can be maintained a satisfactory
recovery results. Lung lacerations can occur through blunt trauma, penetrating
injuries or from injuries to the rib cage. The lung has many veins and as such
lacerations may result in profuse bleeding.
Lung Contusion €15,900 to €21,900
Lung Laceration €16,000 to €31,700
Punctured/Collapsed Lung
The normal treatment is to use a tube to drain the fluid and air and to keep the
lung expanded to prevent it collapsing.
Minor €14,600 to €17,900
An uncomplicated recovery will have occurred.
Moderate €19,900 to €42,100
More complex injury with treatment and or drainage, but where a full or near full
recovery will have occurred.
Severe and permanent conditions €52,600 to €82,700
Punctured lung with fluid in the lungs and ongoing breathing problems that has
an impact on daily living.
D. Kidneys
Kidney injuries are relatively rare as they are well protected by the ribcage. Most
kidney injuries are usually classified as contusions, lacerations, haematomas and
ruptures.
Contusions are regarded as mild injuries and are treated conservatively with rest
and observation. More severe contusions might involve a period of hospitalisation.
Antibiotics may also be prescribed. Haematomas are treated conservatively where
possible along with observation to ensure the haematoma is not expanding or
haemorrhaging, in which case surgical evacuation and bleeding control is required.
Contusion or Haematoma €13,400 to €28,000
Laceration €21,300 to €35,000

E. Bowels and Digestive System
The normal treatment for injuries to the intestines is surgery to open the abdomen
(laparotomy). When the damaged area is located, lacerations or perforations
are treated by suture or in some cases with a patch. External drainage is done
simultaneously. Major damage might require removal of the damaged section and
then re-joining the ends. Injuries to the colon include lacerations and bruising
within the walls of the colon. Injury can occur to the colon itself or to its mesentery
attachment. Blunt and penetrating trauma is the most common causes of injury.
Treatment of colon injuries includes primary closure, partial removal and colostomy.
Primary closure is used mainly for smaller wounds and involves suture closure.
Colostomy is the surgical opening from the colon to the abdominal wall to create
an outlet for body waste. Colostomy may be temporary or permanent.
Moderate €21,300 to €45,900
Temporary Colostomy €56,800 to €73,000
Severe and permanent conditions €61,900 to €93,900

F. Bladder
Bladder injuries, which mostly occur from blunt trauma, are more likely to occur
when the bladder is full rather than when it is empty. When empty, the bladder
lies behind the pelvis and is therefore well protected by the pelvis but when full it
rises up into the lower abdomen and becomes vulnerable to trauma. When empty
however it is still vulnerable to injuries such as fractures of the pelvis. Bladder
contusions are bruising of the bladder wall. These may sometimes be described
as interstitial injuries. Minor bladder contusions require no specific treatment.
If blood in the urine is present (hematuria) observation or catheterisation may
be required. Severe contusions may even necessitate the use of an indwelling
catheter for a number of days. Bladder contusions resolve without any residual
urinary dysfunction.
Bladder contusion €14,200 to €28,500
Where ongoing loss of function is expected €24,600 to €86,000
Any injury to the Ureter (the tube by which urine passes) €21,400 to €44,500

G. Spleen
The spleen is a commonly injured abdominal organ being particularly susceptible
to blunt trauma and motor vehicle accidents are the leading cause of spleen
injuries. The most common types of spleen injury are laceration and rupture.
Rupture generally occurs at the time of accident but may also occur at a later
rupture. Spleen injuries often occur in association with other injuries such as rib
fractures but also frequently occur in isolation.
Haematoma/Laceration €21,300 to €44,700
Total Loss/Severe Loss of Function or Removal up to €73,100

H. Hernias
A hernia is a forcible protrusion of a body organ or body tissue through another
structure. Hernia as an injury in most cases will be encountered as a work related
injury suffered through lifting.
An inguinal hernia is a herniation in the groin area and is the most common
type of hernia; it may be unilateral or bilateral (one sided or both sides). Other
types of hernia include femoral hernias, umbilical hernias, parumbilical hernias
and ventral hernias. A hernia may also be strangulated (where the blood supply to
the protruding organ or tissue has been cut off), obstructed (blocks the intestine),
reducible (it can be reduced (pushed back) by manual manipulation) or irreducible/
incarcerated (it cannot be reduced by manual manipulation and as such requires
surgical intervention).
Minor up to €25,700
Uncomplicated single sided hernia.
Moderate €31,400 to €46,000
Complicated single sided, or uncomplicated double sided hernia or where there is
a risk that future surgery may be required.
Severe and permanent conditions €46,700 to €60,300
Continuing pain and or limitation on physical activity.

I. Food Poisoning
There are varying degrees of food poisoning and the effects will vary from person
to person. Some types of food poisoning will have short term effects whereas
other more serious types may have a lasting effect on a person’s appetite and daily
living.
Minor to Moderate up to €14,500
Uncomplicated recovery with pain, cramps and diarrhoea continuing, causing
significant discomfort, stomach cramps, altered bowel function and fatigue.
Severe and permanent conditions €23,700 to €40,300
Severe poisoning with diarrhoea and vomiting diminishing over a prolonged
period of weeks but with some remaining discomfort and bowel function over a
longer period.