Of course, many occupations overlap, and a person may be injured in more ways than one. The method of dealing with such is discussed in the following: ILLUSTRATIVE CASES. Case 1.-A blacksmith, 40 years old, earning $2.23 per diem, contracts aortic stenosis, the result of rheumatic fever. What is his economic loss? According to the schedule of disability ratings, the functional loss for aortic stenosis is 0.24. Aortic stenosis, while not the worst of the valvular heart lesions, is still a very serious handicap for one engaged in manual labor. Such a person is liable not only to dyspnea on exertion, but to a passive congestion of all the viscera, inducing disordered functions and bodily weakness. The weakness will, of course, interfere with his power of competing with other blacksmiths. The occupation of a blacksmith calls for not only a certain skill in handicraft, but for a decided amount of physical (or bodily) labor. If his hand had been mutilated, the handicraft side of his calling would alone have had to be considered, but with his heart damaged, it is his ability to perform physical labor which is uppermost. Hence his rating is to be sought for in the column headed "Bodily labor." This is found to be line XIII, Table C. Upon turning to this table, there is found to be no age 40 given. The nearest age is 39. Hence the rating for 39 is selected, which is 0.36. This represents the total economic loss. If remuneration takes the form of a pension, this means 0.36 of his weekly wage. If a lump sum is to be given, it means 0.36 of his economic value. According to the discount table, the value of a man 40 years old, earning $2.23 per day, would be $11,674.05 (at 3 per cent discount). Therefore, $11,674.05×0.36 $4,202.66, and his economic loss = $4,202.66. Case 2.-The same blacksmith, already damaged by an aortic stenosis, loses his left index finger (he is right handed). What is his economic loss? According to the "Schedule of disability ratings," the functional loss for a left index finger is 0.06. To find the loss due to age and occupation, we turn to the handicraft column. The reference here is to line IV, Table C. Under age 39 this is found to be 0.10. He is rated at 0.36 for his aortic stenosis and 0.10 for his lost forefinger, or 0.46 in all. If he had been rated for these disabilities simultaneously and had been given a lump sum, it would have been 0.46 of his economic value (viz, $11,674.05), or $5,371.06. But his economic value shrank with the development of the aortic stenosis. Assuming that he could work at all at his trade, it would be at a lower wage than formerly. If, for instance, he could earn $1.50 per diem, his economic value at age 40, reckoned at 3 per cent, would be $7,852.50 (as against his former value of $11,674.05). Therefore, the sum to be given him for his lost left index finger would be 0.10 of $7,852.50, or $785.25. Case 3.-A farmer, 55 years old, earning $762 per annum, is found to have hypertrophied heart, arteriosclerosis, and chronic interstitial nephritis. What is his economic loss? Hypertrophy of the heart makes itself known by dyspnea, on exertion. The same is true of arteriosclerosis and interstitial nephritis. Both diseases, moreover, predispose to apoplexy. Shall the rating be for the symptom common to all these conditions or for the diseases which cause the symptom? A little reflection will show that it is not equitable to rate for the dyspnea alone, for the man has three pathological conditions, any one of which may cause dyspnea. Moreover, these conditions are, as a rule, all found in chronic interstitial nephritis. Therefore, as this is the gravest of his disabilities, and includes the others in its symptom complex, it is quite sufficient to rate for this alone. According to the "Schedule of disability ratings" the functional loss for chronic interstitial nephritis is 0.40, and the age and occupational loss will be found on line XXI, Table C (for the farmer's occupation comes under the heading "Bodily labor"). The nearest age to 55 given in the table is 54, and the percentage named is 0.595. According to the discount table the economic value of a man 55 years old earning $762 per year is $9,776.46. Therefore $9,776.46 x 0.595-$5,816.99, and his economic loss is $5,816.99. Case 4.-A surgeon 35 years old, right-handed, and in good health and earning $7,000 per year, was thrown from his automobile and injured his right wrist and left ring finger so that they became ankylosed. What is his economic loss? According to the "Schedule of disability ratings" the functional loss for ankylosis of right wrist is 0.18 and for ankylosis of left ring finger is 0.01, or, if added together, the total functional loss is 0.19. The manual skill of a surgeon places him in the handicraft class. His mental attainments place him in the mental labor class. The mental attainments have not been injured by his fall to any permanent degree, but only his hands. Therefore his age loss and occupational loss are to be sought for in handicraft column. This is found on line X, Table C, and proves to be 0.285. When we come to consider his economic value, the question arises, How much of his income was derived from operative cases and how much from nonoperative? This, of course, is a question of fact to be determined by his account books. For the purpose of this example, however, let us assume that half of his income, or $3,500, is derived from operative work. That gives an economic value of $65,135 for his operative skill, and $65,135× 0.285 $18,563.48. = Therefore his economic loss is $18,563.48. Loss of all the fingers of left hand, the thumb and palm remaining.. 36 XIX BBBBBBABBBBBB B В Loss of index, middle, and ring fingers of right hand. Loss of leg at knee joint...... Loss of foot.. Loss of both feet... Loss of all the toes of one foot... Loss of great toe.. XVI B Loss of great, second, and third toes. B Loss of great toe and metatarsal bone. B Loss of great and second toes.. Loss of great and second toes and metatarsal bone. .18 Loss of any other toe.. .03 Loss of any other toe and metatarsal bone. III crutch or cane.... .1 VI B C B B |