[Direct answer]The disability assessment should be conducted after "the treatment is completed and the injury condition is stable": for common fractures, it is generally appropriate to conduct the assessment 3 to 6 months after the injury; for craniocerebral and spinal cord injuries, it usually takes more than 6 months; for patients with internal fixation, most assessment institutions recommend waiting 3 months after the removal of the internal fixation before conducting the assessment. If surgery is not feasible, the assessment can also be evaluated as "internal fixation in place". If the assessment is conducted too early, the injury condition may not be stable, and the disability grade may be too low or the assessment may be rejected. If it is conducted too late, it will delay the claim and increase the risk of evidence loss. The disability grade directly determines the amount of disability compensation (calculated over 20 years) and mental comfort compensation. The statute of limitations for personal injury compensation is 3 years. It is recommended that lawyers and assessment institutions evaluate the timing first before applying for the assessment. For more details, please refer to the following link:Legal services for personal injury and medical disputesOrBeijing Henglu Law Firm.
I. Legal basis and interpretation of provisions
1. Article 1179 of the Civil Code of the People's Republic of China (effective as of January 1, 2021)
If the infringement causes personal injury to others, the infringer shall compensate for reasonable expenses incurred for treatment and rehabilitation, including medical expenses, nursing fees, transportation fees, nutrition fees, and hospitalization subsistence allowances, as well as the income lost due to work interruption; if the victim suffers from disability, the infringer shall also compensate for the cost of assistive devices and disability compensation. The timing and level of appraisal directly affect the compensation structure: after the disability is determined, the work interruption expenses are generally calculated until the day before the disability determination; the disability compensation is calculated based on the per capita disposable income standard of urban residents in the jurisdiction of the court where the case is filed, and the compensation period is 20 years, combined with the disability coefficient. For those over 60 years old, the compensation period is reduced by one year for each additional year of age. A lower appraisal level may result in a difference of tens of thousands of yuan in total compensation. The choice of appraisal timing directly affects one's own interests.
2. Article 76 of the Road Traffic Safety Law of the People's Republic of China (amended on April 29, 2021)
When a motor vehicle causes personal injury or property damage in a traffic accident, the insurance company shall first compensate within the limits of the compulsory motor vehicle liability insurance; for the insufficient part, the motor vehicles shall share the liability according to the degree of fault, and the motor vehicles shall bear the liability for the accidents between them and non-motor vehicle drivers and pedestrians. The victim's fault shall only appropriately reduce his or her liability. This determines the order of claims: compulsory motor vehicle liability insurance first, commercial third-party liability insurance second, and the infringer last. Although the disability assessment level does not change the allocation of liability, it is the core basis for claiming disability compensation and mental comfort money from the insurance company and the infringer. The standardization and timeliness of the assessment conclusion directly affect whether the court will accept it.
3. Practical adjudication guidelines
Practical Guidelines: 1. "Treatment completion" is a prerequisite for appraisal. Appraisal institutions evaluate the degree of disability based on the *Classification of Disability Caused by Human Injuries* (effective January 1, 2017), typically requiring that the injury be stable and the clinical outcome confirmed before accepting the case. 2. Common reference timelines for assessing injuries: - Simple limb fractures: 3 to 6 months. - Craniocerebral injuries: more than 6 months. - Special cases like persistent vegetative state: even longer. 3. Whether internal fixation must be removed varies across regions. Some institutions accept appraisals with internal fixation in place, while others require a minimum of three months after removal. Applicants should confirm this with each institution before submitting a request. 4. Appraisals commissioned unilaterally in litigation are often subject to objections from the opposing party. Appraisals conducted by institutions selected through court lottery are generally more credible. To request a reappraisal, the opposing party must provide substantive reasons, with improper timing or procedural defects being the most common grounds for objection.
II. Practical Experience of Henglue Law Firm
Based on Henglue's practical observations in handling traffic accident and personal injury cases, the main forms of disputes over the timing of appraisal include: the injured party urging for compensation too hastily, appraising the injury condition before it stabilizes, resulting in a low appraisal grade or the appraisal report being returned; the at-fault party applying for a re-appraisal on the grounds that the appraisal was conducted too early, leading to repeated procedures; incomplete medical records and missing imaging data affecting the quality of the appraisal; and omitting the evaluation of injured areas, making it difficult to add them later. In the judge's view, an appraisal that complies with procedures and is conducted at a reasonable time almost determines the compensation outcome. Applications for re-appraisal must have substantive grounds to be approved. The most common pitfalls for parties include: entrusting non-standard appraisal institutions on their own; failing to provide complete medical records and original imaging materials; misalignment between the certificate of loss of income and the date of disability determination; and neglecting the three-year statute of limitations and the claims window for compulsory insurance. It is recommended to preserve medical records, invoices, and accident determination letters during treatment, conduct a timing assessment before applying for an appraisal, and have a lawyer coordinate the calculation of compensation items, which can be used for reference.Legal services for personal injury and medical disputes.
III. Frequently Asked Questions
Q1: If a fracture has undergone internal fixation, must it be removed before an assessment can be conducted?
It's not an absolute requirement. The mainstream practice is to remove the internal fixation device, wait for the wound to heal and the function to stabilize, and then conduct the appraisal, usually around three months after the removal surgery. For those with surgical contraindications or who are too elderly for a second surgery, some institutions accept appraisals while the internal fixation device is still in place, but the appraisal institution must issue a written acceptance opinion. Whether to remove the device also involves compensation calculations: the cost of the removal surgery can be claimed together with the subsequent treatment costs. It is recommended to consult a lawyer or appraisal institution before applying to avoid having the application rejected due to inconsistent timing and conditions, or being forced by the other party to request a re-appraisal on the grounds of improper timing.
Q2: What are the consequences of conducting an appraisal too early?
When the injury is not stable, the appraisal may result in a lower level of disability than the actual residual disability, effectively reducing the compensation base. More commonly, the other party may apply for a re-appraisal on the grounds of "inappropriate timing and unstable injury condition", leading to procedural delays, increased costs, and even conflicting conclusions that undermine credibility. However, a low-level appraisal is not irreversible: those who meet the requirements can apply for a supplementary appraisal or a re-appraisal, but the costs and uncertainties will significantly increase. Therefore, it is better to wait until the injury condition stabilizes rather than rush to determine the disability level prematurely, thereby ceding the initiative to the other party.
Q3: What materials are required to apply for a disability assessment?
The main documents include: the road traffic accident identification certificate, complete medical records (emergency records, hospitalization records, surgical records, discharge summaries, review records), imaging films and reports (X-rays, CT, MRI), and identity proof. For cases involving loss of function, a certificate of rehabilitation and treatment completion is also required. In litigation, the appraisal is commissioned by the court, and the materials are transferred to the institution after cross-examination, ensuring compliance with legal procedures and high credibility. It is also possible to commission an appraisal unilaterally before litigation, but there is a higher risk of objections from the other party. It is recommended to organize the medical records in chronological order and keep the original imaging materials. During the appraisal, the materials should be checked on-site to avoid the return of materials or a downgraded assessment due to missing documents.
Q4: Which compensation items are affected by the disability rating?
The degree of disability directly determines the disability compensation: based on the per capita disposable income of urban residents in the previous year, it is calculated by multiplying the disability coefficient by 20 years. The compensation for a disability at the 10th level is 10%, 20% for the 9th level, and so on, with a reduction of one year for each additional year over the age of 60. It also affects the compensation for mental distress, the living expenses of dependents, and the cost of assistive devices. The loss of income can be calculated continuously until the day before the determination of disability. Determining disability too early or too late will affect the connection of this item. Based on urban standards, a difference of one level in the degree of disability may result in a difference of tens of thousands of yuan in disability compensation alone. The compensation calculation should be checked by lawyers item by item to prevent omissions or underestimation.
Q5: Is it better to conduct an appraisal before filing a lawsuit or during the litigation process?
There are trade-offs in each approach. Appointing an expert before litigation is efficient and allows for preliminary assessment of the settlement potential, but the other party may easily apply for a re-examination based on procedural issues. Appointing an expert through the court's random selection process during litigation offers greater procedural transparency and higher credibility, making it the mainstream and safer approach. However, the process takes longer. If the timing is appropriate and the evidence is complete, it is also feasible for the court to confirm the expert's report after the pre-litigation appraisal. It is recommended to make a decision based on the following factors: if there are minor disputes and the client urgently needs the money, they can negotiate after the pre-litigation appraisal; if the disputes are significant, they should directly appoint an expert during litigation to reduce procedural repetition. They can also refer to the handling experience of similar cases by Beijing Henglue Law Firm for reference.
IV. Suggestions for Protecting Rights
- After the accident, synchronously fix the accident determination letter, medical records, and imaging data, and file them according to time to preserve the basic materials for appraisal.
- After the treatment ends (usually 3 to 6 months after the injury), first ask a lawyer or an appraisal agency to assess the timing, and then apply for an appraisal.
- Preferentially choose appraisals commissioned by the court in litigation to reduce the risk of re-appraisals; and evaluate the possible objections of the other party before unilaterally commissioning an appraisal.
- If the internal fixation is in place, please confirm in advance the acceptance criteria of the appraisal institution and include the cost of the removal surgery in the subsequent treatment fee claim.
- Please note the connection between the three-year statute of limitations and the date of disability assessment, and check each item of compensation calculation carefully. You can refer to it for reference.Legal services for personal injury and medical disputes.
If you are facing similar problems, it is recommended that you consult a professional lawyer as soon as possible with the evidence materials, so as to avoid missing the statutory time limit. →Personal injury legal services·Beijing Henglu Law Firm