| (1) | Permanent Cervical and Cervico-Dorsal Impairments |
| | Category | 1
2
3
4
5 | 0%
10%
20%
25%
35% | |
| (2) | Permanent Dorsal Region Impairments |
| | Category | 1
2
3 | 0%
10%
20% | |
| (3) | Permanent Dorso-Lumbar and Lumbosacral Impairments |
| | Category | 1
2
3
4
5
6
7
8 | 0%
5%
10%
15%
25%
40%
60%
75% | |
| (4) | Permanent Impairments of the Pelvis |
| | Category | 1
2
3
4
5
6
7
8
9 | 0%
2%
5%
5%
5%
5%
10%
10%
15% | |
| (5) | Permanent Convulsive Neurologic Impairments |
| | Category | 1
2
3
4 | 0%
10%
35%
60% | |
| (6) | Permanent Mental Health Impairments |
| | Category | 1
2
3
4
5 | 0%
10%
25%
45%
70% | |
| (7) | Permanent Cardiac Impairments |
| | Category | 1
2
3
4
5
6 | 0%
10%
20%
35%
50%
65% | |
| (8) | Permanent Respiratory Impairments |
| | Category | 1
2
3
4
5
6 | 0%
15%
25%
40%
65%
75% | |
| (9) | Permanent Variable Respiratory Impairment with Normal Baseline Spirometry |
| | Category | 1
2
3
4 | 0%
5%
10%
15% | |
| (10) | Permanent Air Passage Impairments |
| | Category | 1
2
3
4
5
6 | 0%
5%
15%
25%
35%
60% | |
| (11) | Permanent Air Passage Impairments Due to Nasal Septum Perforations |
| | Category | 1
2 | 0%
2% | |
| (12) | Permanent Loss of Taste and Smell |
| | Category | 1
2 | 3%
3% | |
| (13) | Permanent Speech Impairments |
| | Category | 1
2
3
4
5
6 | 0%
5%
10%
20%
30%
35% | |
| (14) | Permanent Skin Impairments |
| | Category | 1
2
3
4
5
6 | 0%
5%
10%
25%
40%
60% | |
| (15) | Permanent Impairments of Upper Digestive Tract, Stomach, Esophagus or Pancreas |
| | Category | 1
2
3
4
5 | 0%
5%
10%
35%
60% | |
| (16) | Permanent Impairments of Lower Digestive Tract |
| | Category | 1
2
3
4 | 0%
5%
15%
30% | |
| (17) | Permanent Impairments of Anal Function |
| | Category | 1
2
3
4 | 0%
5%
15%
25% | |
| (18) | Permanent Impairments of Liver and Biliary Tract |
| | Category | 1
2
3
4
5 | 0%
5%
20%
40%
60% | |
| (19) | Permanent Impairments of the Spleen, Loss of One Kidney, and Surgical Removal of Bladder with Urinary Diversion |
| | Category | 1
2
3 | 15%
10%
20% | |
| (20) | Permanent Impairments of Upper Urinary Tract |
| | Category | 1
2
3
4
5 | 0%
10%
25%
45%
65% | |
| (21) | Additional Permanent Impairments of Upper Urinary Tract Due to Surgical Diversion |
| | Category | 1
2 | 10%
15% | |
| (22) | Permanent Impairments of Bladder Function |
| | Category | 1
2
3
4
5 | 0%
10%
20%
30%
50% | |
| (23) | Permanent Anatomical or Functional Loss of Testes |
| | Category | 1
2
3
4
5 | 0%
5%
10%
25%
35% | |