Circular No. 22/2019/TT-BYT stipulates the percentage rate of bodily injury used in forensic medical examination and forensic psychiatric examination.

CIRCULAR

REGULATIONS ON PERCENTAGE RATIOS OF BODY INJURY

FOR MEDICO-LEGAL AND PSYCHIATRIC FORENSIC EXAMINATIONSILEGAL MEDICAL EXAMINATION AND PSYCHIATRIC FORENSIC ASSESSMENT

Pursuant to Law on Forensic Appraisal No. 13/2012/QH13 dated June 20, 2012;

Pursuant to the Government's Decree No. 75/2017/NĐ-CP dated June 20, 2017 stipulating the functions, tasks, powers, and organizational structure of the Ministry of Health;

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

The Minister of Health issues this Circular regulating percentage ratios of body injury for use in medico-legal and psychiatric forensic examinations.

Article 1. Percentage Ratios of Body Injury

Attached to this Circular is the table of percentage ratios of body injury or health impairment hereinafter referred to as percentage ratios of body injury (hereinafter abbreviated as percentage ratio of body injury %) for use in medico-legal and psychiatric forensic examinations, including:

1. Table 1: Percentage ratio of body injury % due to injuries for use in medico-legal examinations;

2. Table 2: Percentage ratio of body injury % due to diseases and disabilities for use in medico-legal examinations;

3. Table 3: Percentage ratio of body injury % due to sequelae of mental disorders and behavioral disorders following head trauma and brain wounds for use in psychiatric forensic examinations;

4. Table 4: Percentage ratio of body injury % due to mental disorders and behavioral disorders for use in medico-legal examinations.

Article 2. Principles of Appraisal

1. Appraisal to determine the percentage ratio of body injury must be conducted on the person to be appraised, except in cases provided for in Clause 2 of this Article.

2. Appraisal to determine the percentage ratio of body injury shall be conducted based on records in cases where the person to be appraised has died, disappeared, or in other cases as prescribed by law. When conducting appraisal based on records, the percentage ratio of body injury shall be determined at the lowest level within the corresponding range of percentage ratios.

3. The percentage ratio of body injury shall be determined at the time of appraisal.

Article 3. Principles for Determining Percentage Ratios of Body Injury

1. The total percentage ratio of body injury of a person must be less than 100%.

2. Each body part injured may only be counted once for the percentage ratio of body injury. In cases where the injury causes complications or sequela affecting a second body part that has already been determined, the percentage ratio of body injury due to complications or sequela from the second body part shall be added.

3. If multiple injuries are symptoms of a syndrome or disease listed in the tables of percentage ratios of body injury, the percentage ratio of body injury shall be determined according to the syndrome or disease.

4. When calculating the percentage ratio of body injury, only two decimal places shall be taken, and rounding shall be applied to ensure the total percentage ratio of body injury is a whole number (if the decimal place is equal to or greater than 0.5, it shall be rounded up to one unit).

5. When appraising a body part with symmetrical and cooperative functions, if one side is injured or has a pre-existing condition, the percentage ratio of body injury for both sides shall be calculated. For example, if a person had a left kidney removed previously and now suffers an injury requiring removal of the right kidney, the percentage ratio of body injury shall be calculated as the loss of both kidneys.

6. During appraisal, based on actual injuries and the impact of those injuries on the life and profession of the person to be appraised, the appraiser evaluates and determines the percentage ratio of body injury within the corresponding range of percentage ratios according to the tables of percentage ratios of body injury.

7. For body parts that have lost function and are now injured, the percentage ratio of body injury shall be calculated as 30% of the percentage ratio of body injury of that part.

8. In cases where the same person requires both medico-legal and psychiatric forensic examinations (as decided/requested), the appraisal organization shall conduct a combined (additive) determination of the percentage ratio of body injury of the person to be appraised according to the method for determining the percentage ratio of body injury stipulated in Article 4 of this Circular.

Article 4. Method for Determining the Percentage of Body Damage Rate

1. The determination of the percentage of body damage rate is calculated according to the addition method as follows:

Total percentage of body damage rate = T1 + T2 + T3 + ... + Tn; where:

a) T1: Is determined as the percentage of body damage rate of the first body damage (within the range of percentages of body damage rates prescribed in this Circular).

b) T2: Is the percentage of the second body damage rate: T2 = (100 - T1) x percentage of the second body damage rate / 100;

c) T3: Is the percentage of the third body damage rate: T3 = (100 - T1 - T2) x percentage of the third body damage rate / 100;

d) Tn: Is the percentage of the nth body damage rate: Tn = {100 - T1 - T2 - T3 - ... - T(n-1)} x percentage of the nth body damage rate / 100.

e) The total percentage of body damage rate after rounding off is the final result.

2. Example:

a) An individual with multiple damages:

Mr. Nguyen Van A is determined to have three damages:

- Amputation of one-third of the middle arm on the right side, within the range of percentage of body damage rate from 61% to 65%;

- Blindness in the left eye without enucleation, the percentage of body damage rate is 41%;

- Moderate hearing loss in both ears at level I, within the range of percentage of body damage rate from 21% to 25%.

Applying the above method, the total percentage of body damage rate of Mr. Nguyen Van A is calculated as follows:

- T1 = 63% (the percentage of body damage rate prescribed in this Circular from 61% to 65%, the appraiser may assess and determine the percentage of body damage rate as 61%, 62%, 63%, 64%, or 65%. In this case, the appraiser determines the percentage of body damage rate as 63%);

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

- T3: Moderate hearing loss in both ears at level I, within the range of percentage of body damage rate from 21% to 25% as prescribed in this Circular. The appraiser may assess and determine the percentage of body damage rate within the range of 21% to 25%. In this case, if the appraiser determines the percentage of body damage rate as 22%, then the percentage of body damage rate of Mr. A is calculated as:

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

The total percentage of body damage rate of Mr. Nguyen Van A is: 63% + 15.17% + 4.80% = 82.97%, rounded off to 83%.

Conclusion: The total percentage of body damage rate of Mr. Nguyen Van A is 83%.

b) A person who needs to be appraised at two organizations: (1) Forensic Medical Appraisal and (2) Forensic Mental Health Appraisal:

Mr. Nguyen Van B (Mr. B) was appraised by the forensic medical organization with a conclusion of the total percentage of body damage rate being 45% (T1).

Subsequently, Mr. B was appraised at the forensic mental health organization, which concluded that the percentage of body damage rate of Mr. B is 37%. This organization combined the total percentage of body damage rate of Mr. B as follows:

T1 has been determined as 45%; T2 is determined as follows:

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

The total percentage of body damage rate of Mr. B is = (T1 + T2).

The total percentage of body damage rate of Mr. Nguyen Van B is: 45% + 20.35% = 65.35%.

Conclusion: The total percentage of body damage rate of Mr. Nguyen Van B is 65%.

Article 5. Effective Date

This Circular takes effect from November 1, 2019. Circular No. 20/2014/TT-BYT dated June 12, 2014, of the Minister of Health prescribing the percentage of body damage rate used in forensic medical and forensic mental health appraisals shall cease to be effective from the date this Circular comes into force.

Article 6. Transitional Provisions

Cases occurring before the date this Circular takes effect, including requests and commissions made after the date this Circular takes effect but the events occurred before the date this Circular takes effect, shall be governed by the provisions of Circular No. 20/2014/TT-BYT dated June 12, 2014, of the Minister of Health.

Article 7. Implementation Organization

1. The Department of Medical Examination and Treatment under the Ministry of Health is responsible for organizing the implementation of this Circular.

2. The Heads of the Office of the Ministry, the Inspectorate of the Ministry, the Heads of Departments, Directors of the Bureaus, General Directors under the Ministry of Health, Directors of Provincial and Municipal Health Services directly under the Central Government, forensic medical and forensic mental health appraisal organizations, and other relevant agencies, organizations, and individuals are responsible for implementing this Circular.

During the implementation, if there are difficulties or obstacles, it is recommended that agencies, organizations, and individuals promptly reflect these issues to the Ministry of Health (Department of Medical Examination and Treatment) for consideration and resolution./.