Chapter 10 - Nose, Throat and Sinus Impairment

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Table of Contents PDF Version

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Introduction

This chapter provides criteria for assessing permanent impairment from entitled conditions of the nose, sinuses and trachea.

A rating is not given from this chapter for conditions listed below. Each bullet indicates the appropriate chapter to be used:

• Impairment from respiratory conditions is rated within Chapter 12, Cardiorespiratory Impairment.
• Impairment from conditions that affect taste and smell is rated within Chapter 20, Neurological Impairment.
• Impairment from conditions that affect speech is rated within Chapter 20, Neurological Impairment.

Impairment from malignant conditions of the nose, throat and sinuses is rated within Chapter 18, Malignant Impairment. Follow the steps contained within the Malignant Impairment chapter.

Rating Tables

This chapter contains two "Loss of Function " tables and one "Other Impairment" table.

The tables within this chapter are:

Rating Tables

Table	Loss of Function	Other Impairment
Table 10.1	Loss of Function - Nose	This table is used to rate impairment related to the nose.
Table 10.2	Loss of Function - Sinuses	This table is used to rate impairment related to the sinuses.
Table 10.3	Other Impairment - Trachea	This table is used to rate impairment from a tracheotomy.

Loss of Function - Nose

Table 10.1 is used to rate impairment of the nose, the nasal cavity and the nasopharynx. Only one rating may be selected. If more than one rating is applicable, the ratings are compared and the highest selected.

If more than one condition is to be rated from Table 10.1 the conditions are bracketed for assessment purposes.

When entitled nasal conditions result in permanent impairment of other organ systems, a consequential entitlement decision is required. If awarded, the resulting impairment of that organ system(s) will be rated using the applicable body system specific table(s).

If non-entitled conditions or conditions rated within another chapter/table of the Table of Disabilities are contributing to the overall impairment, then the Partially Contributing Table (PCT) must be applied to arrive at the rating which is due to the entitled condition(s) rated within this table.

Loss of Function - Sinuses

Table 10.2 is used to rate impairment of the paranasal sinuses which include the frontal, ethmoid, sphenoid, and maxillary sinuses. Only one rating may be selected. If more than one rating is applicable, the ratings are compared and the highest selected.

When entitled sinus conditions result in permanent impairment of other organ systems, a consequential entitlement decision is required. If awarded, the resulting impairment of that organ system(s) will be rated using the applicable body system specific table(s).

If non-entitled conditions or conditions rated within another chapter/table of the Table of Disabilities are contributing to the overall impairment, then the Partially Contributing Table (PCT) must be applied to arrive at the rating which is due to the entitled condition(s) rated within this table.

Other Impairment - Trachea

Table 10.3 is used to rate impairment resulting from a tracheotomy. Only one rating may be selected. If more than one rating is applicable, the ratings are compared and the highest selected.

When entitled tracheotomy conditions result in permanent impairment of other organ systems, a consequential entitlement decision is required. If awarded, the resulting impairment of that organ system(s) will be rated using the applicable body system specific table(s).

Table 10.1 - Loss of Function - Nose

Only one rating may be given from Table 10.1 below regardless of whether the condition is unilateral or bilateral. If more than one rating is applicable, the ratings are compared and the highest selected.

Each bullet (•) represents one criterion. In order for a rating to be established for Table 10.1, only one criterion must be met at a level of impairment for that rating to be selected.

Table 10.1 - Loss of Function - Nose

Rating	Criteria
Nil	No clinical manifestations of airway obstruction (e.g. deviated nasal septum, benign nasal polyps); or No clinical manifestations or symptoms of nasal discharge or sneezing; or Intermittent or seasonal symptoms of rhinitis and no medication is required; or Fractured nasal bones with no deformity.
Two	Intermittent airway (unilateral or bilateral) obstruction (e.g. deviated nasal septum when complicated by acute upper respiratory infection, benign nasal polyps); or Intermittent or seasonal symptoms of rhinitis requiring medication; or Fractured nasal bones with deformity.
Four	Continuous airway (unilateral or bilateral) obstruction (e.g. deviated nasal septum, benign nasal polyps); or Chronic symptoms of rhinitis requiring medication more than 4 months of the year.
Nine	Perforated nasal septum.

Table 10.2 - Loss of Function - Sinuses

Only one rating may be given from Table 10.2. If more than one rating is applicable, the ratings are compared and the highest selected.

Each bullet (•) represents one criterion. In order for a rating to be established for Table 10.2, all criteria designated beside each bullet (•) must be met.

Table 10.2 - Loss of Function - Sinuses

Rating	Criteria
Nil	Chronic symptoms of sinusitis* not requiring medication.
Two	Chronic symptoms of sinusitis* controlled by regular medications.
Four	Chronic symptoms of sinusitis* which are not fully controlled by regular medication and which occur less than 4 months of the year.
Nine	Chronic symptoms of sinusitis* which are not fully controlled by regular medication and which occur more than 4 months of the year.

* Symptoms of sinusitis may include:

• sinus pressure and tenderness
• nasal congestion
• pain in sinus area and/or tooth pain
• sinus headache
• post nasal drip.

Table 10.3 - Other Impairment - Trachea

Only one rating may be given from Table 10.3.

Each bullet (•) represents one criterion. In order for a rating to be established for Table 10.3, all criteria designated beside each bullet (•) must be met.

Table 10.3 - Other Impairment - Trachea

Rating	Criteria
One	A tracheotomy that has been closed.
Thirteen	Permanent tracheotomy.

Steps to Determine Nose, Throat and Sinus Assessment

• Step 1: Determine the rating from Table 10.1 (Loss of Function - Nose).
• Step 2: Does the Partially Contributing Table apply? If yes, then apply to rating at Step 1.
• Step 3: Determine the Quality of Life rating.
• Step 4: Add the ratings at Step 2 and Step 3.
• Step 5: If partial entitlement exists, apply to the rating at Step 4.

This is the Disability Assessment for nasal conditions.

• Step 6: Determine the rating from Table 10.2 (Loss of Function - Sinuses).
• Step 7: Does the Partially Contributing Table apply? If yes, then apply to rating at Step 6.
• Step 8: Determine the Quality of Life rating.
• Step 9: Add the ratings at Step 7 and Step 8.
• Step 10: If partial entitlement exists, apply to rating at Step 9.

This is the Disability Assessment for sinus conditions.

• Step 11: Determine the rating from Table 10.3 (Other Impairment - Trachea).
• Step 12: Does the Partially Contributing Table apply? If yes, then apply to rating at Step 11.
• Step 13: Determine the Quality of Life rating.
• Step 14: Add the ratings at Step 12 and Step 13.
• Step 15: If partial entitlement exists, apply to rating at Step 14.

This is the Disability Assessment for trachea conditions.