Circular 22/2019/TT-BYT the percentage of bodily injury used in forensic examination

CIRCULAR

Prescribing the percentage of bodily injury used in forensic examination and forensic psychiatric assessment

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Pursuant to the June 20, 2012 Law No. 13/2012/QH13 on Judicial Expertise;

Pursuant to the Government’s Decree No.75/2017/ND-CP of June 20, 2017, defining the functions, tasks, powers and organizational structure of the Ministry of Health;

At the proposal of the Director General of the Department of Medical Examination and Treatment Management,

The Minister of Health promulgates the Circular prescribing the percentage of bodily injury used in forensic examination and forensic psychiatric assessment.

Article 1. Percentage of bodily injury

Being issued together with this Circular, the table of percentages of bodily injury or health impairment, below collectively referred to as the percentage of bodily injury (abbreviated as % BI) used in forensic examination and forensic psychiatric assessment, includes:

1. Table 1: Percentage of bodily injury due to injuries used in forensic examination;

2. Table 2: Percentage of bodily injury due to diseases or disabilities used in forensic examination;

3. Table 3: Percentage of bodily injury due to sequelae of mental and behavioral disorders following trauma or brain injury used in forensic psychiatric assessment;

4. Table 4: Percentage of bodily injury due to mental and behavioral disorders used in forensic examination.

Article 2. Principles of assessment

1. The assessment to determine the percentage of bodily injury must be conducted directly on the individual requiring assessment, except in cases prescribed in Clause 2 of this Article.

2. The assessment to determine the percentage of bodily injury shall be conducted based on documentation in cases that the individual requiring assessment has died, is missing, or in other circumstances according to law regulations.

When conducting an assessment based on documentation, the percentage of bodily injury is determined at the lowest level within the corresponding range of percentages for bodily injury.

3. The percentage of bodily injury is determined at the time of conducting the assessment.

Article 3. Principles for determining the percentage of bodily injury

1. The total percentage of bodily injury for an individual must be less than 100%.

2. Each injured body part is counted for the percentage of bodily injury only once. In cases that an injured body part causes complications or sequelae affecting a second body part that has been identified, an additional percentage of bodily injury is calculated for the complications or sequelae affecting the second body part.

3. If multiple bodily injuries are symptoms of a syndrome or a disease listed in the tables of bodily injury percentages, the percentage of bodily injury is determined based on that syndrome or disease.

4. When calculating the percentage of bodily injury, only two decimal places are considered, rounding the final result to ensure the total percentage of bodily injury to be a whole number (if the decimal value is equal to or greater than 0.5, it is rounded up by 1 unit).

5. When calculating the percentage of bodily injury for a symmetrical or functionally synergistic body part, if one side is injured or has a pre-existing condition that has been identified, the percentage of bodily injury for the injured or pre-existing condition is also included in the calculation.

For example, if a person had previously undergone the removal of their right kidney and, due to an injury, now requires the removal of their left kidney, the percentage of bodily injury is calculated as the loss of both kidneys.

6. During the assessment, based on the actual injury and the extent of its impact on the individual's life and occupation, the examiner evaluates and determines the percentage of bodily injury within the corresponding range outlined in the table of bodily injury percentages.

7. For body parts that have already lost their function and are now injured, the percentage of bodily injury is calculated as 30% of the bodily injury percentage for that body part.

8. In cases that the same individual requires both forensic examination and forensic psychiatric assessment (according to the decision for assessment/request), the assessment organization performs a combined evaluation, summing up the percentage of bodily injury for the individual in accordance with the method for determining the percentage of bodily injury as prescribed in Article 4 of this Circular.

Article 4. Method for determining the percentage of bodily injury

1. The determination of the percentage of bodily injury is calculated by the additive method as follows:

Total percentage of bodily injury = T1 + T2 + T3 + ... + Tn, in which:

a) T1: Represents the percentage of bodily injury for the first injury (as specified within the ranges of injuries outlined in this Circular).

b) T2: Represents the percentage of bodily injury for the second injury:

T2 = (100 - T1) x the percentage of bodily injury of the second injury / 100.

c) T3: Represents the percentage of bodily injury for the third injury:

T3 = (100 - T1 - T2) x the percentage of bodily injury of the third injury / 100.

d) Tn: Represents the percentage of bodily injury for the ‘n’th injury:

Tn = {100 - T1 - T2 - T3 - ... - T(n-1)} x the percentage of bodily injury of the ‘n’^th injury / 100.

dd) The final total percentage of bodily injury, after being rounded, is considered the final result.

2. For example:

a) An individual with multiple injuries:

Mr. Nguyen Van A is identified with three injuries as follows:

- Amputation of the middle third of the right arm, with a bodily injury percentage range of 61 - 65%;

- Blindness in the left eye without enucleation, with a bodily injury percentage of 41%;

- Moderate hearing loss in both ears at level I, with a bodily injury percentage range of 21 - 25%.

Applying the above method, the total percentage of bodily injury for Mr. Nguyen Van A is calculated as follows:

- T1 = 63% (The bodily injury percentage for the amputation of the middle third of the right arm, as prescribed in this Circular, ranges from 61–65%. The assessor can determine the bodily injury percentage to be 61%, 62%, 63%, 64%, or 65%. In this case, the assessor assigns the bodily injury percentage of 63%).

- T2 = (100 - 63) x 41 / 100% = 15.17%

- T3: Moderate hearing loss in both ears at level I has a bodily injury percentage range of 21 - 25%. The assessor can determine the bodily injury percentage within the range of 21 - 25%. In this case, the assessor assigns the bodily injury percentage of 22%, so the bodily injury percentage of Mr.A is calculated as:

T3 = (100 - 63 - 15.17) x 22 / 100% = 4.80%

Total percentage of bodily injury for Mr. Nguyen Van A is calculated as: 63% + 15.17% + 4.80% = 82.97%, rounded to 83%.

Conclusion: The total percentage of bodily injury for Mr. Nguyen Van A is 83%.

b) An individual requiring assessment at two organizations of: (1) forensic examination and (2) forensic psychiatric assessment:

Mr. Nguyen Van B (Mr. B) has been assessed by the organization of forensic examination, which concluded that his total percentage of bodily injury is 45% (T1).

Then Mr. B underwent an evaluation at the organization of forensic psychiatric assessment, which concluded that his bodily injury percentage was 37%. This organization of forensic psychiatric assessment summarized the total percentage of Mr. B’s bodily injury as follows:

T1 was determined to be 45%; T2 was calculated as follows:

T2 = (100 - 45) x 37 / 100 = 20.35%.

The total percentage of Mr. B's bodily injury is calculated as: Total percentage of bodily injury = (T1 + T2).

Thus, the total percentage of Mr. Nguyen Van B's bodily injury is: 45% + 20.35% = 65.35%.

Conclusion: The total percentage of Mr. Nguyễn Văn B's bodily injury is 65%.

Article 5. Effect

This Circular takes effect from November 01, 2019.

The Minister of Health’s Circular No. 20/2014/TT-BYT of June 12, 2014 prescribing the percentage of bodily injury used in forensic examination and forensic psychiatric assessment shall cease to be effective from the date this Circular takes effect.

Article 6. Transitional provisions

For cases occurring before the effective date of this Circular, including requests or referrals made after the effective date of this Circular but related to events occurring before its effective date, the Minister of Health’s Circular No. 20/2014/TT-BYT of June 12, 2014 shall be applied.

Article 7. Organization of implementation

1. The Department of Medical Examination and Treatment Management - the Ministry of Health shall organize the implementation of this Circular.

2. The Chief of the Ministry Office, Chief of the Inspectorate, directors and general directors of departments and general departments of the Ministry of Health, Directors of provincial-level Departments of Health, the organizations of forensic examination and forensic psychiatric assessment and relevant agencies, organizations, and individuals shall implement this Circular.

Any difficulty and problem arising in the course of implementation should be promptly reported to the Ministry of Health (the Department of Medical Examination and Treatment Management) for consideration and settlement./.

* All Appendices are not translated herein.