Document ID: chunk:federal_register_of_legislation:F2016L01332:reg:114:p2
Version: federal_register_of_legislation:F2016L01332
Segment Type: reg
Provision Reference: reg 114 (pt 2/8)
Character Range: 187845–191069

complete independence, and needs some supervision.

   No age adjustment permitted for this table

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 Functional Loss Table 5.1 (cont'd)

      LOSS OF NEUROLOGICAL FUNCTION: COGNITION (continued)

      Impairment
      Ratings Criteria

                  * Severe impairment:  has difficulty in carrying out basic activities such as sequencing   the steps needed for dressing and for preparing meals.

                  * Planning/organisational ability is reduced.  Is unable to function independently in new or complex situations. Shows markedly reduced initiative and spontaneity and perseverative thinking.

                  * Severe memory deficiency: is unable to retain any information about recent experiences.  New learning is not possible after attention has been directed elsewhere. Is unable to work or live independently, needing supervision to avoid harm, eg from fire caused by forgetting to put out cigarettes or to turn off appliances. Has extreme difficulty in keeping track of finances, scheduled activities, social relationships, etc.

                  * Gross impairment: is unable to initiate and sustain activities without supervision. Supervision and prompting are required for virtually all daily activity. Is unable to plan a course of action for the simplest activity.

                  * Gross amnesic syndrome: is unable to acquire or recall new information. Constant supervision and care are required.  Unable to recognise family, own reflection in mirror, etc. Is disoriented in familiar surroundings.

               Ratings from one Functional Loss table may be combined with ratings from any other table for a different loss of function. Ratings from Functional Loss tables are not to be combined with ratings from Other Impairment tables for the same condition.

 No age adjustment permitted for this table

Table 5.1 addresses memory and new learning ability as well as reasoning and problem-solving abilities. This requires:
+ adequate levels of motivation and attention;
+ restraint of impulsive tendencies;
+ ability to organise, categorise and shift responses;
+ use of feedback to modify behaviour; and
+ capacity to evaluate final performance.

    The ratings reflect increasing grades of severity.

    Communication

    Communication has two elements: comprehension and expression.  "Compre- hension" means "understanding".  It includes understanding of speech and gestures, recognition of sights and sounds, spatial and temporal orientation. "Expression" is the capacity to convey the content of one's mind to others.

    Comprehension and expression are to be rated separately, by applying Tables
5.2 and 5.3 respectively. Impairment ratings from these tables are to be combined when criteria from both are applicable. Impairment ratings from these tables are not to include communication deficits that were present before the onset of the condition.

    Tables 5.2 and 5.3 are to be applied to rate neurological or neuromuscular conditions as well as local lesions involving the mechanisms of speech production. Communication may also be restricted by vision loss, hearing loss, or loss of hand function.  Ratings are then to be made from