Medical Impairments

Disease of adrenal gland, characterized by atrophy of adrenal cortex with hormone deficiency.

• Cause
• Acute or chronic
• Treatment

Requirement: APS

Acute, single episode, full recovery with no residuals over 3 years: individual consideration

All others: decline

Including positive or indeterminate HIV findings.

HIV becomes AIDS when the immune system is seriously damaged. AIDS is characterized by low white blood cell counts, leaving the individual vulnerable to opportunistic infection.

Decline

Indeterminate findings: could review in 6 months

Consumption considered as abuse, dependence, at risk and/or heavy use.

• Current age
• Amount declared
• Diagnosis of abuse or dependence
• Any relapses
• Member of self-help group
• Treatment with medication
• Any co-morbid conditions
• Any medical complications
• Occupational and financial stability
• Driving record

Requirement: Alcohol/Drug Use Questionnaire, APS, paramedical, blood test, MVR

Fast Track:

• Details of treatment
• Covering letter presenting favourable aspects of case: stable employment, attendance at selfhelp groups, etc.

Abstainer 0 to 5 years: decline

Abstainer 5 to 7 years: rate, minimum 90-day Elimination Period and maximum 5-year Benefit Period

Abstainer 7+ years: standard to +50 with 90-day Elimination Period

Complete or partial loss of a limb. May be due to trauma, infection or disease.

• Careful consideration of occupational duties
• History of stable employment as evidence of successful adjustment

Requirement: APS

Single amputation, due to trauma with no limitations on ability to perform job duties: exclude and possible rating

Other: individual consideration (trial application)

Any interference with job duties: decline

Lou Gehrig’s Disease

Progressive atrophic disease of the nervous system.

Decline

Iron Deficiency

A reduction of the red blood cells in the blood (creating a deficiency of iron in the body) due to blood loss, failure of the bone marrow to produce sufficient cells or premature destruction of the cells.

• Type of anemia
• Cause, if known
• Treatment
• Details of testing, referrals to specialists
• Blood test results
• Medications
• Concurrent impairments

Requirement: APS

Fast Track:

• Complete Blood Count
• Details of ongoing surveillance

Ratings depend on type, degree and medication

Iron Deficiency (Hypochromic, Microcytic)

Present, mild to moderate, medically controlled, no other impairment: standard to +50%

Others: rated for cause, degree

Chest pain caused by reduced blood flow to the heart due to coronary artery disease.

Refer to Heart Abnormalities

Immobility and consolidation of a joint due to disease, trauma, or surgical procedures.

• Identify degree of impairment
• Cause of impairment
• Impact on performing occupational duties

Requirement: APS

Exclude affected joints and possible rating for complications and/or underlying disease

Refer to Eating Disorders

A wide-ranging variety of conditions which represent a leading cause of disability claims. Conditions may be acute, recurrent, or chronic.

Treatment often includes counseling and medication.

• Date of diagnosis
• Treatment
• Duration of treatment
• Time lost from work
• Recurrences
• Family history of psychiatric illness
• Physical symptoms such as headaches, fatigue, chest pain, palpitations, shortness of breath, stomach complaints, muscle, joint and back pain
• Underlying issues such as substance abuse, stress at work, financial criticisms, etc.

Requirement: Emotional Health Questionnaire and APS

Fast track:

• Details of date of diagnosis and onset
• Contributing factors to the onset
• Type of treatment
• Duration of treatment
• Time lost from work
• Recurrences
• Family history of psychiatric illness
• Name and title of the health practitioner who was consulted

Anxiety Disorders:

Mild Reactive Depression:

Major Depression, Bipolar Affective Disorder:

Hardening of the arteries.

A generalized thickening of arteries where they become firmer, more tortuous, and less elastic. Arterial capacity is reduced, interfering with the free flow of blood. All arteries of the body may be affected. A normal part of the aging process but appearance at an early age is significant. When present with other cardiovascular impairments, such cases are usually declined.

• Impacted arteries
• Age
• Degree

Requirement: APS

Fast track:

• ECG

If smoker: decline

If non-smoker, no other abnormalities, subject to degree, location and age at onset

Best case: rating with limited Benefit Period

Inflammation of the joints.

Arthritis is an inflammation of a joint or joints. Primarily due to trauma, infection, degeneration, toxic reaction or metabolic disorder. It may be the main feature of a disease (e.g. Rheumatoid Arthritis) or a secondary feature of a systemic illness (e.g. Inflammatory Bowel Disease). It is chronic in nature.

• Type
• Any deformity
• Degree of severity
• Joints involved
• Treatment
• Impact on occupational duties

Requirement: APS

Single joint, mild, no residual deformity: may be standard

Two or more joints: exclude

Including psoriatic arthritis.

• Confirmed by presence of rheumatoid factor in serum
• Severity
• Occupational duties
• Treatment
• Joints impacted
• Complications

Requirement: APS

Fast track:

• Results of blood test with rheumatoid factor

Mild diagnosis: exclude and rating. Possible limited Benefit Period based on occupation

Moderate, no complications: +25–50% with 90‑day Elimination Period and maximum 5‑year Benefit Period

Chronic inflammatory condition of the airways causing shortness of breath, triggered by allergens, irritants, cold air, or exercise.

• Current age
• Date of diagnosis
• Severity
• Frequency of attacks
• Type of medication
• Compliance with medication
• ER visits and hospitalizations
• Activity limitations
• Smoking history
• Concurrent impairments
• Note any occupational triggers (animals, pollens, dust)

Requirement: APS

Fast track:

• Copy of Pulmonary Function Tests, hospitalizations
• Level of activity

Mild: No interference with job duties: standard

Smokers: Best case: Exclusion, rating and 2 year Benefit Period

Moderate: Time lost from work, no hospital visits in past 2 years: 25–50% rating with minimum 90‑day Elimination Period and possible exclusion

Severe: Daily attacks, hospital admission within 2 years, or regular use of oral steroids to control asthma: decline

Any interference with job duties: individual consideration (trial application)

May be associated with increased risk‑taking activities, accidental injuries related to impulsivity, employment difficulties.

• No definitive test
• Treated with medications (stimulants) as well as environmental modification
• History of anxiety, depression or personality disorder

Requirement: APS Emotional Health Q

Mild, working full time, employment stability: individual consideration

Best case scenario: Exclude

Others: decline

Abnormal curvature resulting from a variety of musculoskeletal diseases or trauma.

Lordosis: anterior curvature (“swayback“)

Kyphosis: posterior curvature (“hunchback”)

Scoliosis: lateral curvature may be present with either of the above.

• Degree of curvature
• Absence of respiratory complications
• Impact on gait
• Occupational duties

Requirement: APS and Back Pain Questionnaire

Fast track:

• Copy of any X‑rays

Not operated:

Operated, full recovery:

Protrusion of disc material between the vertebrae against the nerve roots.

Result of trauma or degenerative process.

• Operated?
• Single episode or recurrent?
• Continuing therapy
• Physically demanding occupational duties

Requirement: APS and Back Pain Questionnaire

Fast track:

• Copy of any X‑rays

Unoperated or operated: exclude and/or rating based on time since last episode

Asymptomatic for > 5 years: potentially standard.

The most common musculoskeletal disorder, most often due to misuse of back in lifting, poor posture, overweight. Pain tends to recur.

Whiplash/Cervical strain: typically due to motor vehicle accident, due to hyperextending neck ligaments.

• Disc involvement
• Time lost from work
• Single episode or recurrent
• Treatment
• Occupational duties
• Build

Requirement: APS and Back Pain Questionnaire

Fast track:

• Copy of any X‑rays

With disc involvement: treated as “Herniated Disc”

One episode, mild, duration less than 1 week and no lost time from work, subject to occupational duties:

Otherwise, subject to occupational duties, recurrence, frequency, severity and duration of episodes and with no loss of time from work: exclude to decline.

• Cause of fracture
• Full recovery
• Amount of time lost from work
• Occupational duties

Requirement: APS and Back Pain Questionnaire

Fast track:

• Copy of any X‑rays

Due to trauma with full recovery, depending on occupation and amount of time lost from work: exclude

Due to osteoporosis: decline

Hypertension

Primary (essential) hypertension is the most common type, affecting 95% of people with hypertension. Cause is unknown, but thought to be the result of a complex interplay of factors.

Secondary hypertension results from kidney, endocrine or nervous system disorders.

• Essential or Secondary
• Age of onset
• Current age
• Medication/treatment
• Response to treatment
• Current and historical readings
• Compliance with treatment and follow up
• Concurrent impairments
• Build
• Smoking status

Requirement: Paramedical

Fast track:

• APS with record of historical blood pressure readings
• Details of any cardiac investigation
• Details of risk factor medication
• Active lifestyle

Completely controlled for 1 year, with normal readings and no adverse associated findings: standard

Other: individual consideration

Inflammation of the colon (bowel) due to bacterial infestation of gastrointestinal tract – usually of short duration with fever, cramps and diarrhea. It is important to note exact diagnosis, extent of colon involved, severity, treatment, and degree of progression.

• Cause
• Severity
• Duration
• Recurrence
• Treatment
• Age of first attack
• Weight loss
• Psychological symptoms

Requirement: APS

Acute, recovered: standard

Recurrent attacks or severe:

Inflammation of the colon (bowel), frequently in association with anxiety. Symptoms include intermittent abdominal pain, constipation and diarrhea. It is important to note exact diagnosis, extent of colon involved, severity, treatment, and degree of progression.

• Cause
• Severity
• Duration
• Recurrence
• Treatment
• Age of first attack
• Weight loss

Requirement: APS

Present and within first year: exclude

In history, over 1 year, single episode: usually standard

Recurrent, Chronic or Moderate: exclude and +50%

Chronic inflammation of the colon (bowel), of unknown cause. Symptoms include bloody diarrhea. Tendency to remission and exacerbations.

• Severity
• Duration
• Recurrence
• Treatment
• Age of first attack
• Weight loss
• Repeated episodes lead to increased risk of polyps

Requirement: APS

Fast track:

• Review of colonoscopy reports

Single occurrence 0-2 years: decline
Over 2 years, mild, unoperated, no complications, less than 15% underweight: exclude

Multiple occurrences 0–5 years: decline
Over 5 years or moderate: rated, excluded and limited Benefit Period

Operated with complete recovery, normal weight maintained and no sign of malignancy:

Inflammation of the bronchial air passageways.

Acute bronchitis is usually caused by an infection, but it can also result from inhaling irritants such as smoke or toxic gas. Common symptoms include cough, fever and sometimes chest pain. Inflammation is temporary, attacks are rarely disabling.

Chronic bronchitis predisposes to frequent attacks of acute bronchitis.

• Causes
• Acute or chronic
• Treatment
• Complications

Requirement: APS

Acute single mild Infectious attack: standard after recovery

Inflammation of a bursa between tendons and muscles or synovial sheath covering tendons or tendon itself. Cause may be unknown, follow trauma or be associated with rheumatic disease. May be due to repetitive actions.

• Cause
• Severity
• Recurrent
• Occupational duties

Requirement: APS

Ongoing symptoms: exclude

1 or 2 acute episodes, asymptomatic at least one year: possible STD.

Chronic or > 2 acute episodes: exclude and possible rating/limited BP based on occupation.

(For skin cancer, refer to Skin Tumours.)

A tumour that has the propensity to grow, invade surrounding tissues, and spread (metastasize) to other parts of the body.

• Type
• Family history
• Date of diagnosis
• Pathology
• Type of treatment
• Weight loss
• Confirmation completely excised
• Recurrence
• Staging

Requirement: APS

Fast track:

• Pathology report with staging and regular follow up

Depending on type, best case scenario, 5–7 years after termination of treatment with adequate follow up: individual consideration (trial application)

Compression of median nerve of the wrist.

May be related to repetitive actions.

• Severity
• Treatment
• Occupational duties

Requirement: APS

Generally: exclude, possibly standard one year following surgery, depending on occupation

Chronic intestinal malabsorption disorder caused by intolerance to gluten.

• Weight stability
• Family history
• Complications

Requirement: APS

Diagnosis within 1 year: postpone

Over 1 year, controlled, subject to weight: standard

Can be due to a wide variety of causes (hiatus hernia, lung disorders, panic attacks, muscular, cardiac, etc.). It is important to note the cause, duration and treatment.

• Age
• Cause of pain
• Recurrence
• Brought on by exercise/relieved by rest
• Treatment

Requirement: APS and Chest Pain Questionnaire

Fast track:

• Past and current ECG
• Cardiac investigation

Due to heart disease: decline

Cause unknown within first year: postpone

After 1 year: individual consideration, rated for cause

Ideally measured following a 12 hour fast. High levels may be primary or secondary – associated with diet, activity level, and other factors. Linked to increased risk of coronary artery disease.

• Current and historical readings
• Medication
• Compliance with medication
• Build
• Other coronary artery disease factors

Requirement: APS

Fast track:

• Fasting blood profile
• Total Cholesterol, LDL and HDL levels

Controlled for 1 year and no adverse associated findings: standard

Other: individual consideration, any combination of rating/limited Benefit Period/reduced benefits, to decline

Persistent/recurrent fatigue lasting over 6 months, severe enough to reduce daily activities by at least 50%, with other treatable diseases ruled out.

• Evidence of a complete work up to rule out other diseases
• Treatment
• Amount of time lost from work

Requirement: APS

Symptoms present or within 5 years: decline

5 years after recovery: individual consideration

Decline

Transient post traumatic loss of consciousness with no serious neurological residual impairment.

Symptoms: type and duration
Residual symptoms
Loss of consciousness > 6 hours
Multiple events

Requirement: APS

3 months after episode, depending on the severity of injury, duration of loss of consciousness, recovery time, if no residuals: likely standard

With residuals: individual consideration to decline (trial application)

Skin lesions aggravated by sun exposure.

• Consider exposure to sun
• Treatment

Requirement: APS

Within one year: postpone

In history, definitive diagnosis, no evidence of Systemic Lupus Erythematosus, after one year: exclude and minimum 90 day elimination period

A rheumatic disease with multisystem involvement.

Decline

Chronic disorder of the immune system characterized by diffuse fibroids of the skin and internal organs.

Decline

Chronic inflammatory disorder of the gastrointestinal tract – generally first diagnosed in young adults. Complications include obstruction and increased cancer risk. Complications similar to Ulcerative colitis and surgery may be required.

• Severity
• Duration
• Recurrence
• Treatment
• Age of first attack
• Weight loss
• Increased risk of cancer

Requirement: APS

Fast track:

• Evidence of regular GI surveillance
• Stable weight
• Active lifestyle

Within 2 years of last remission: postpone

After 2 years: depending on degree, exclude and possible rating/ reduced BP

Disease of adrenal gland.

Usually result of a pituitary tumour.

• Treatment
• No sequels
• Cause
• No hypertension or diabetes mellitus

Requirement: APS

Usually decline

Best case, benign cause more than 3 years ago: rating and decreased Benefit Period

Bacterial infection of the lower urinary tract.

Requirement: APS, urinalysis

Single episode, present: exclude

Single episode, recovered: standard

Recurrent episodes, depending on history: exclude to standard

Chronic metabolic disease caused by lack of insulin or lack of response to insulin, causing fluctuations in blood sugar.

Type 1 or Insulin‑Dependent Diabetes Mellitus (IDDM)
Formerly known as “Juvenile Diabetes.”

Usually diagnosed prior to age 40. Usually quick onset of symptoms.

Type 2 or Non‑Insulin Dependent Diabetes Mellitus (NIDDM)
Formerly known as “Adult Onset.”

Gestational Diabetes
Glucose intolerance with onset during pregnancy – after pregnancy these women may remain diabetic, they may revert to a non‑diabetic state, or may be at an increased risk to develop diabetes later.

• Age of onset
• Treatment
• Degree of control
• Possible complications
• Build
• Blood pressure

Requirement: APS, Blood

Fast track:

• Full records with regular follow up, monitoring and control
• Active lifestyle

Insulin-dependent:

Non-insulin-dependent:

Gestational:

Displacement of joint, may be due to trauma or disease.

Recurrence is common. Chronic cases often require surgery.

• Joint
• Treatment
• Recurrence
• Occupational duties

Requirement: APS

One acute episode
Within first year: exclude
After one year, symptom‑free: standard
2 or more episodes: exclude

Inflammation of diverticular mucosa.

Presence of pouches or pockets, particularly of the intestine.

• Complications
• Treatment

Requirement: APS

Present or operated on with recovery: usually standard with 90‑day Elimination Period

Recurrent or with complications: exclude

Rated for cause

Cannabis, Hashish, Pot

• Age
• Frequency
• Employment and financial stability
• Driving record
• No other complaints

Requirement: Drug Use Questionnaire

Non‑smoker rates if no other tobacco use

Depending on use and lifestyle factors: standard to decline

Cannabis, Hashish, Pot

• Age
• Frequency
• Employment and financial stability
• Driving record
• No other complaints

Requirement: Drug Use Questionnaire

Non‑smoker rates if no other tobacco use

Depending on use and lifestyle factors: standard to decline

Total or partial hearing loss due to trauma or disease. May be progressive.

• Cause
• Degree
• Impact on occupational duties

Requirement: APS

Fast track:

• Audiometry results

Not progressive:

Progressive or due to sustained exposure to noise: exclude, plus rated +25–50%

If an exclusion is used, loss of hearing of both ears will be removed from the Assumed Disability contract provision

Inflammation of mastoid bone – either acute or recurrent.

• Recurrent
• Hearing loss

Requirement: APS if within 2 years

Fast track:

• Audiometry results

Present: postpone

One episode, complete recovery, no residual hearing loss: standard

Recurrent or with hearing loss: rate for hearing loss

Disease of inner ear due to trauma, infection or more serious diseases such as Multiple Sclerosis.

Symptoms:

• Type and severity
• Treatment
• Co‑morbidities

Requirement: APS

Within 2 years of symptoms: postpone

After 2 years, mild symptoms: rate + 25‑50%

Characterized by distorted body image.

• Age at diagnosis
• Weight stability
• Treatment
• Length of time since last episode

Requirement: APS, Emotional Health Questionnaire

Minimum 5 years after last episode

Best case: rating, decreased Benefit Period and exclusion for psychiatric impairments

Endometrial tissue is present in sites outside the uterine cavity.

Requirement: APS

Without operation, still on treatment: exclude

Within 3 months of operation: exclude

Severe or recurring: individual consideration

Brain disorder resulting in recurrent seizures.

A seizure disorder characterized by recurrent, brief episodes of uncontrollable activity produced by an abnormal electrical stimulation in the brain.

• Type, treatment
• Number of attacks
• Frequency of attacks
• Time since last attack
• Occupation (driving and participation in some occupations and avocations may increase the accident risk)

Requirement: APS

Individual consideration (trial application)

Vision loss can be caused by trauma or disease and can be acute or progressive.

Legal blindness is vision of 20/200 or worse in the better eye.

• Cause
• Degree
• Both eyes?
• Impact on occupational duties

Requirement: APS

Due to trauma: rated

Other causes: individual consideration

Visual impairment with correction

Loss of sight of both eyes may be removed from the Assumed Disability contract provision

Clouding of lens of eye.

Most common form is a senile cataract. Others may be caused by trauma or arise from complications of diabetes or other medical problems.

• Cause
• Treatment
• Occupational duties

Requirement: APS

Unoperated

Operated with full recovery

Loss of sight of both eyes may be removed from the Assumed Disability contract provision

Increased pressure in eye.

May be acute or chronic. If chronic and not properly managed, may lead to optic nerve damage and impaired vision. May be primary or secondary to trauma or other eye disorders.

• Type
• Treatment
• Vision loss
• Occupational duties

Requirement: APS

Present: exclude

Following corrective surgery

Loss of sight of both eyes may be removed from the Assumed Disability contract provision

Inflammation of the iris.

May be acute or chronic. May be due to infection or associated with underlying disease. Severe infection may lead to loss of vision.

• Cause
• Recurrent
• Recovery
• Occupational duties
• Loss of vision

Requirement: APS

Cause known: rated for cause

Cause unknown

A partial or total separation of inner layers of retina from pigment layer, requiring urgent treatment.

• Cause
• Treatment
• Loss of vision

Requirement: APS

Unoperated: exclude

Operated, within first year: exclude

Operated, over 1 year: rated for vision loss

Characterized by cyst formation causing pain and tenderness, differentiated by mammogram or biopsy.

• Status
• Family history of breast cancer

Requirement: APS

Fast track:

• Surgical report with pathology

Present, definitely benign

In history, benign: standard with 90‑day Elimination Period

Mammogram or biopsy pending: postpone

Fibrositis/Myofascial Pain Syndrome/Chronic Pain Syndrome

Generalized aching and stiffness with characteristic “tender points”. Mechanical neck and back pain, sleep impairment, and depression/anxiety are often complaints.

The condition tends to be chronic (although it is NOT Chronic Fatigue Syndrome).

• Date of onset
• Type of treatment
• Residual impairment
• Other complaints

Requirement: APS

Symptoms present or within 5 years: decline

5 years after recovery: individual consideration

Break or rupture of the bone which may be simple (closed) or compound (open). Usually caused by trauma but may be secondary to other disease.

Some fractures require installation of pins, screws, plates which may increase risk of infection or a need for further procedures to remove/replace.

• Cause
• Residual impairment

Requirement: APS

After full recovery, no residuals, with or without hardware in place: standard with 90‑day Elimination Period

Cholelithiasis

• Definitive diagnosis
• Treatment

Requirement: APS

After surgery, recovery 6 months: standard to exclude

Unoperated: exclude

Varied complaints due to reflux of stomach and duodenal contents (acid and bile) into esophagus.

Requirement: APS

Cause known: rated for cause

Cause not known, mild symptoms: standard

Cause not known, moderate to severe symptoms: exclude

Characterized by elevated uric acid with attacks of acute arthritis and sometimes kidney stones.

A metabolic disorder that predominantly affects middleaged males. Hypertension and obesity often accompany gout.

• Number of attacks
• Symptoms
• Build
• Blood pressure
• Other cardiovascular impairments

Requirement: APS

No cardiovascular or renal abnormalities

Present

In history

Decline

Decline

• Age
• Degree

Requirement: APS

Fast track:

• EKG
• X‑ray

Depending on age, degree and assuming no other cardiac or ECG abnormality, cause of enlargement: individual consideration (trial application)

Usually benign and asymptomatic.

• Symptoms
• No other signs of cardiac disease

Requirement: APS

Fast track:

• Echocardiogram

Asymptomatic, no other evidence of cardiac disease, systolic murmur grade 1/6 or 2/6: standard

Symptomatic: individual consideration (trial application)

Abnormal heart sounds caused by blood flow.

• Functional or Organic
• Age
• Level of investigation
• Cause
• Complications
• Progression

Requirement: APS

Fast track:

• Echocardiogram

Functional/Innocent: standard

Organic: individual consideration

Rapid pulse.

• Evidence of cardiac diseases
• Other symptoms
• Pulse

Requirement: APS

Fast track:

• EKG

Depending on frequency and duration of episodes and degree of control: standard to decline

Myocardial infarction

• Age when MI occurred
• Build
• Blood pressure and other cardiac factors
• Limitations
• Treatment

Requirement: APS, Chest Pain Questionnaire

Fast track:

• EKG
• X‑ray

Under age 40: decline

Over age 40 at time of diagnosis

Excessive accumulation of iron in the body (iron overload) which may lead to organ damage.

• Type
• Gender
• Symptoms
• Complications
• Treatment
• Control

Requirement: APS, Blood iron and liver function tests

Best case scenario: asymptomatic, normal iron studies and liver function tests, no co‑morbidities: possible standard.

Other: individual consideration

Inflammation of the liver often evidenced by elevated liver enzymes.

There are several causes and it may be acute or chronic. Several viruses may cause a short‑term illness. Long‑term chronic problems arise when a person fails to clear the offending virus from the body.

• Type
• Current level of liver enzymes

Requirement: APS

Fast track:

• Liver Function Tests
• Hepatitis screen

Present, all types: decline

In history, with full recovery, normal liver and hepatitis blood studies

Protrusion of tissues or organs.

A protrusion of part or all of an organ or body structure through a weakness or defect in the wall of its normal confines. It is important to note the type and location.

• Type
• Treatment
• Complications

Requirement: APS

Unoperated: standard with a 90‑day Elimination Period subject to occupational duties

Operated: > 3 months, surgically corrected, complete recovery: Standard

A hereditary disease causing involuntary muscle movements.

Decline

Low blood sugar.

• Diabetes?
• Cause
• Control
• Treatment

Requirement: APS

With Diabetes: refer to Diabetes

Reactive, adequately treated, asymptomatic

Surgical removal of the uterus.

• Reason
• Recovery
• Complications

Requirement: APS

Fast track:

• Pathology Report

Cause not malignant, full recovery with no residuals and returned to work: standard with 90‑day Elimination Period

Malignant: Refer to Cancer

Difficulty initiating or maintaining sleep.

Transient sleep disturbances are a normal part of life. Prolonged insomnia may indicate an underlying physical or adjustment disorder.

• Degree
• Duration
• Treatment
• Interference with function
• Occupational duties

Requirement: APS

Cause known: rated for cause in addition to ratings below

Mild, infrequent: usually standard

Otherwise: individual consideration

Inherited disease in which numerous cysts gradually develop, eventually destroying normal kidney tissue.

• Family history
• Fully investigated

Requirement: APS

Fast track:

• Negative ultrasound

Decline

Family history of polycystic Kidney Disease

Including Bright’s.

• Acute
• Recurrent
• Chronic
• Stability
• Normal blood pressure

Requirement: APS

Individual consideration (trial application)

Best case scenario: One acute episode > 5 years ago, no residuals, normal urine, KFTs, and Blood pressure: Standard.

Other: I.C.

Surgical removal of kidney.

• Cause
• Status of other kidney
• No urinary system impairment
• No hypertension
• Not due to malignancy

Requirement: APS

Fast track:

• Urinalysis
• Surgical report

Due to congenital abnormality, trauma, benign tumour, or lone cyst; remaining kidney normal; normal urinalysis; no current urinary system impairment or hypertension

0–6 months: postpone
After 6 months: standard, 90‑day Elimination Period

Others: individual consideration

Kidney stone.

• One or both kidneys?
• Single or multiple episodes?
• Normal kidney function tests

Requirement: APS

Fast track:

• Urinalysis

Normal kidney function, urinalysis, Blood pressure, no other renal problems

Present

Passed or removed

Impaired kidney function – may be acute following shock, crushing injuries, infection or poisons. Full recovery may occur or may become chronic.

• Cause
• Complete recovery
• Single episode

Requirement: APS

Fast track:

• Urinalysis
• Kidney function tests

Acute episode, complete recovery, normal urine, normal blood pressure

Within 1 year: postpone
1–2 years: rated for cause plus +50% rating
Over 2 years: rated for cause
Others: decline

Requirement: APS

Recipient: decline

Donor: refer to Nephrectomy

The knee is a major weight bearing joint of complex design, vulnerable to injury. Strains are most common. Ligament injuries and meniscus tears are more serious.

• Cause
• Type
• Treatment
• Recovery
• Occupational duties

Requirement: APS

Single episode with little lost time from work, no cartilage/ligament damage: usually standard with 90‑day Elimination Period subject to occupational duties

Recurrent episode, lost time from work, or damaged cartilage/ligament: exclude subject to occupational duties

Surgery, under 1 year: exclude subject to occupational duties

Surgery, more than 1 year ago: usually standard subject to occupational duties

An obstruction of the airways. Often associated with a history of smoking.

• Type
• Severity
• Smoking status

Requirement: APS

Mild to moderate, applicant a
Non‑smoker: +25–50%
Smoker: +75%, 5‑year Benefit Period

Severe: decline

An inflammation of the membrane lining the inside of the chest wall and the surface of the lungs. It may be related to an acute pulmonary infection (i.e. pneumonia, flu) or it may be associated with more serious illnesses (congestive heart failure, malignant tumours, pancreatitis, etc).

Effusion refers to accumulation of fluid in pleural cavity.

• Type
• Cause
• Single attack?
• Recurrent

Requirement: APS

Fast track:

• Chest X‑ray

Dry Pleurisy
Cause unknown, single attack

Other: I.C.

An acute lung infection caused by bacteria, viruses, or fungi.

• Recurrence
• Complications

Requirement: APS

Fast track:

• Chest X‑ray
• Pulmonary function tests if recent

Present: postpone

Single occurrence with full recovery: standard

More than 2 episodes in 12 months: decline

Collapsed lung.

May be spontaneous, due to trauma or artificially induced.

• Cause
• Recurrence
• Full recovery

Requirement: APS

Fast track:

• Chest X‑ray

Present: postpone

Un-operated, traumatic, recovered: standard

Spontaneous, no sign of underlying disease, 1–2 attacks, recovered 3 months: standard

More than 2 attacks:

An infectious disease that is increasing in Canada due to immigration and HIV exposure. It can usually be controlled with proper medical treatment, although drug resistant strains have developed. It is important to note the number of sites and extent to which an organ is infected, the medication, progressions, and any complications.

• Type
• Degree of involvement
• Complications

Requirement: APS

Fast track:

• Chest X‑ray
• Pulmonary tests

Present: decline

Pulmonary, treated with full recovery and no residual impairment

Other: individual consideration
(trial application)

Lung disease secondary to inhalation of mineral or organic dust.

Decline

Inflammation of the brain or spinal cord.

• Cause
• Recovery
• Complications

Requirement: APS

Fast track:

• HIV test

Acute bacterial or viral, full recovery for at least 6 months, no residuals, no secondary to other disease: standard

Otherwise: individual consideration (trial application)

A severe vascular headache caused by alterations in the diameter of the blood vessels within and outside the head. Visual abnormalities (blind spots, flashing lights), difficulty speaking, paralysis, a severe pounding headache and nausea often characterize a migraine.

• Cause
• Severity
• Frequency

Requirement: APS

Mild, occasional: standard

Moderate, recurrent: standard 90‑day Elimination Period

Severe, disabling more than 7 days, recurrent: individual consideration

Interruption of pregnancy before fetus is capable of living outside the uterus.

Requirement: APS

1–2 within past year: exclude

1–2 more than 1 year ago: standard

More than 2, no normal childbirth since: exclude

Decline

Inflammation of muscles.

• Cause
• Recurrence
• Recovery
• Residual impairment
• Occupational duties

Requirement: APS

Single attack, no deformity, full recovery, 90-day Elimination Period:

Recurrent attacks, no deformity, full recovery, 90‑day Elimination Period:

Characterized by excessive daytime sleepiness leading to sleep attacks.

• Cause
• Response to medication
• Occupational hazards
• Driving offences

Requirement: APS

Episode within 3 years: postpone

Over 3 years, depending on severity, occupation and driving record: individual consideration

Refer to Build Table.

Acceleration of the normal aging process, leading to degenerative joint disease.

• Severity
• Single or multiple joints
• Physical demands of occupational duties

Incidental findings, mild to moderate, asymptomatic: Standard with a 90 day EP

Other: Depends on symptoms, occupation, severity: IC: Exclusion to Decline

• Treatment
• Benign

Requirement: APS

Fast track:

• Pathology Report

Benign: standard 90‑day Elimination Period

Inflammation of the pancreas.

• Acute
• Recurrent
• Treatment
• Complications
• No alcohol offences

Requirement: APS

Acute, no alcohol concerns

Mild, last episode within 1 year: postpone
After 1 year: standard to rate

Single severe

Recurrent mild

Recurrent, severe: Decline

A progressive, degenerative central nervous system disorder.

Decline

Inflammation of a vein blood clot in a vein.

• Recurrent
• Treatment
• Residuals
• Complications

Requirement: APS

Present: postpone

In history
Single episode, full recovery

Recurrent, on chronic anti‑coagulation: individual consideration

A gland surrounding the neck of the bladder and urethra in the male. Disorders may include inflammation (acute or chronic), enlargement, or cancer of the prostate.

• Cause
• Degree
• Recurrence
• Normal urine

Requirement: APS

Fast track:

• Pathology report if done
• Urinalysis

Present, no symptoms, no malignancy, normal PSA: Standard with a 90 day EP.

Other: IC: Exclusion to Postpone

• Recurrent
• Urinalysis
• Absence of hematuria

Requirement: APS

Fast track:

• Urinalysis if within past year

One episode, full recovery: usually standard

Chronic: exclude

Disturbances of circulation in extremities, causing numbness and pallor.

• Symptoms
• Treatment
• Limitations
• Occupational duties
• Complications

Requirement: APS

Raynaud’s disease

Fully investigated, diagnosis confirmed, mild symptoms causing no limitations or impairments: Standard

Other: IC

Raynaud’s Phenomenon: IC depending on any underlying disorder

Herpes zoster.

Nerve infection with skin rash.

Requirement: APS

With complete recovery, no residual pain or evidence of immune compromise: standard

Most skin eruptions are transient and related to viral infection or an allergic reaction. It is important to note any impact the skin disorder may have on the client’s occupation.

• Acute
• Recurrent
• Interference with occupational duties
• Severity
• Residuals
• Type

Requirement: APS

Mild, no interference with occupation: standard

Otherwise: likely exclude

Exfoliative Dermatitis Present: Postpone

Complete recovery for at least one year, no residuals, no systemic disease: Minimum 90 day EP

Most common nonmelanomas:
Basal Cell Carcinoma and Squamous Cell Carcinoma. Non‑melanoma rarely spreads.

Melanoma:
Often characterized by a change in size, shape or colour. Less common but more aggressive.

• Type
• Family history of melanoma
• Atypical (dysplastic) moles
• Date of diagnosis
• Pathology
• Type of treatment
• Confirmation completely excised
• Recurrence
• Staging

Requirement: APS

Fast track:

• Pathology report with staging
• Details of follow up

Benign:

Non-melanoma:

Melanoma: typically decline

Cessation of breathing during sleep. Causes daytime fatigue, leading to increased accident risk. Commonly associated with excess weight and alcohol excess. Diagnosis is made by a sleep study.

• Type
• Degree
• Treatment
• Response to/compliance with treatment
• Occuaptional hazard
• No driving offences
• Build
• Cardiac arrhythmia
• Smoker

Requirement: APS

Fast track:

• Sleep Study

Obstructive, no cardiac arrhythmia, no treatment or treated with evidence of good response:

Mild: standard to +25%

Moderate, treated with evidence of good response

Moderate, no treatment or noncompliant with CPAP: decline

Severe: decline

Removal of the spleen, usually due to trauma.

• Cause
• Complications

Requirement: APS

Fast track:

• Chest X‑ray
• Complete Blood Count

Due to injury, fully recovered:, no residual: standard

Other causes

Inflammation of the stomach.

• Acute
• Recurrent
• Cause

Requirement: APS

Acute, single attack: standard, 90‑day Elimination Period

Chronic or recurrent, cause unknown:

Dyspepsia, Acid Stomach, Hyperacidity

Impairment of the digestive function, usually controlled by diet and medication.

• Acute
• Recurrent
• Cause

Requirement: APS

Acute, single attack: standard

Chronic or recurrent, cause unknown:

Peptic, Duodenal, Gastric, etc.

Peptic ulcer disease is a common impairment in which ulcerations develop in the esophagus, stomach, or duodenum. Previously the cause of ulcers was thought to be due to the secretions of stomach acid. Although this is still significant in ulcer formation, a bacteria called H. Pylori is thought to be the leading cause of ulcer disease. Antibiotics have proven to heal the ulcers and prevent recurrence. Another major cause of ulcers is the chronic use of anti‑inflammatory medications.

• Type
• Treatment
• Complications
• Smoking status
• Symptoms
• Recurrence

Requirement: APS

Fast track:

• Operative report
• Upper gastrointestinal series

Unoperated, under treatment, no bleeding or time loss

Others: individual consideration

Stroke
Diminished blood supply to brain causing a neurological deficit.

Transient Ischemic Attack (TIA)
Partial interference with diminished blood supply – symptoms last less than 24 hours.

• Recurrence
• Residual impairment
• Neurological sequels
• No Diabetes
• No cardiovascular renal disease
• No hypertension
• Non‑smoker

Requirement: APS

Stroke
Single episode, complete recovery, no other rateable impairment, minimal sequels, working full time at regular occupation

TIA

Sudden transient loss of consciousness, of varying length and duration, not due to trauma or seizure.

• Cause
• Recurrence

Requirement: APS

Cause known: rated for cause

Cause unknown, well investigated, cardiac and neurological disease ruled out

Recurrent, severe or not well investigated: postpone

Decline

Inherited anemia.

• Type

Requirement: APS

IC based on type.

APS required.

Gland is overactive in secreting a hormone that controls the body’s metabolism.

• Treatment
• Control

Requirement: APS

Present, control not yet established: decline

In history, operated or treated, under control

Uncontrolled: decline

Gland is underactive in secreting a hormone that controls the body’s metabolism.

• Treatment
• Control

Requirement: APS

Treated, under control: generally standard

Uncontrolled: individual consideration

Overactivity of thyroid which enlarges into goiter.

• Treatment
• Control

Requirement: APS

Controlled, less than 2 years: rate/exclude

Controlled for 2 years or more: generally standard

• Type

Requirement: APS

Fast track:

• Pathology Report
• Ultrasound

Present, fully investigated, benign, asymptomatic: standard to exclude

Uninvestigated: Postpone

Refer to Build Table.

Abnormally enlarged veins with functionally insufficient valves. They may develop because of a benign disorder (obesity, pregnancy, frequent standing) or be the result of a serious disorder (cirrhosis, tumours, clots, etc.)

• Location
• Cause
• Treatment
• Complications
• Occupational duties

Requirement: APS

Present, no ulcer, no swelling, not disabling

Operated, complete recovery