Injury Scale Value (ISV) in Queensland Personal Injury Claims

An injury scale value (ISV) is a statutory rating between 0 and 100 used to measure the severity of an injury and calculate general damages in a personal injury claim. In Queensland, the ISV system is established under the Civil Liability Act 2003 (Qld) and the Civil Liability Regulation 2025 (Qld), which replaced the 2014 regulation on 1 September 2025.

The ISV applies across most personal injury claims in Queensland, including motor vehicle accident claims, public liability claims, medical negligence claims, and workplace common law claims. It works by matching an injured person’s condition to statutory injury categories set out in Schedule 3 of the regulation, each of which provides a range of possible ISV values rather than a fixed number.

Where an injury falls within that range depends on its severity, the impact on daily life, and the long-term prognosis. For example, a minor cervical spine soft tissue injury may fall within an ISV range of 0–4, while catastrophic injuries such as quadriplegia fall within a range of 75–100.

The ISV applies only to general damages, being compensation for pain and suffering and loss of amenities of life. It does not apply to economic loss, medical expenses, or care costs. Once assessed, the ISV is converted into a dollar amount using a statutory formula that is indexed each year.

What is an injury scale value?

An injury scale value is a statutory numerical rating between 0 and 100 that measures the severity of an injury for the purpose of calculating general damages in a Queensland personal injury claim. Higher values on the injury scale value reflect more serious injuries with a greater overall impact on the injured person's life.

The injury scale value is established by the Civil Liability Act 2003 (Qld) and the Civil Liability Regulation 2025 (Qld). Those laws create a structured system that assigns injuries to defined categories and value ranges so that the consequences of different injuries are assessed on a consistent and comparable basis. The injury scale value system applies across personal injury claims in Queensland, including motor vehicle accident claims, public liability claims, medical negligence claims, and workplace common law claims.

General damages are the component of a personal injury claim that compensates for non-economic loss. Non-economic loss is the harm caused by an injury that does not have a direct financial value. Non-economic loss includes the physical pain, psychological distress, and reduction in the ability to carry out ordinary activities and participate in aspects of life that were previously available. The injury scale value is the mechanism used to assess that type of loss.

The injury scale value does not determine the total compensation payable in a personal injury claim. The injury scale value applies only to general damages and does not apply to financial losses such as past and future income loss, medical and rehabilitation expenses, or the cost of care and assistance. The injury scale value is also not a medical diagnosis and does not measure whole person impairment. The injury scale value is a legal assessment tool that uses medical and factual evidence to evaluate the overall impact of an injury on a person's life for the purpose of awarding general damages under Queensland law.

What does an injury scale value apply to in a personal injury claim?

An injury scale value applies to the assessment of general damages in a personal injury claim. General damages are the component of compensation that addresses non-economic loss, being harm that does not have a direct financial value but arises from the effect of the injury on the person's life.

Non-economic loss refers to the impact of an injury on a person's physical, psychological, and functional wellbeing. Non-economic loss is not measured by financial records or invoices. The injury scale value assessment instead examines how the injury affects the person's experience of life across two primary dimensions.

The first dimension is pain and suffering. Pain and suffering encompasses the physical pain and psychological distress caused by the injury, including the intensity and duration of symptoms experienced during recovery and any ongoing discomfort.

The second dimension is loss of amenities of life. Loss of amenities refers to the reduction in the person's ability to carry out ordinary activities and participate in aspects of life that were previously available. Loss of amenities includes limitations on mobility, work capacity, recreation, relationships, and independence.

The ISV system applies across all personal injury claim types in Queensland. A person injured in a motor vehicle accident claims general damages through the CTP scheme. A person injured through the negligence of a property owner, employer, or medical professional claims general damages through the relevant common law personal injury claim pathway. The same statutory injury scale value framework governs the general damages assessment in each of those claim types.

What does an injury scale value not apply to?

An injury scale value does not apply to the financial components of a personal injury claim. Economic loss, medical expenses, and care costs are assessed separately from the injury scale value and are not determined by the statutory injury scale.

The injury scale value does not apply to past or future income loss. Income loss is calculated based on the person's earnings history, earning capacity, and the period of incapacity caused by the injury. The injury scale value does not apply to medical and rehabilitation expenses. Medical expenses are assessed based on the actual and projected cost of treatment required as a result of the injury. The injury scale value does not apply to care and assistance costs, including both paid professional care and unpaid gratuitous care provided by family members. These categories sit alongside general damages as separate types of compensation within a personal injury claim.

The ISV does not apply to property damage. For a motor vehicle accident claim that includes both a personal injury component and a property damage component, the injury scale value relates only to the personal injury claim. 

Two claims with the same injury scale value can result in very different total compensation outcomes. A person with an ISV of 15 who has lost 2 years of income and requires ongoing treatment will receive substantially more total compensation than a person with the same ISV of 15 who returned to work within weeks and required minimal treatment. The injury scale value reflects only the severity and impact of the injury itself, not the full financial consequences of that injury.

How does the injury scale value system work?

The injury scale value system works by assigning a value between 0 and 100 to an injury based on its severity and impact, using statutory injury categories defined in Queensland law. That value is then used to calculate the general damages payable for pain, suffering, and loss of amenities in a personal injury claim.

The ISV system is established under the Civil Liability Regulation 2025 (Qld), which contains a schedule of statutory injury categories and corresponding value ranges. The regulation replaced the Civil Liability Regulation 2014 (Qld), which expired on 31 August 2025, in substantially the same terms. The ISV assessment rules are set out across several schedules within the regulation. Schedule 2 provides the rules a court must follow when assessing an injury scale value. Schedule 3 sets out the statutory injury categories and assigns each category a range of ISV values. Schedule 5 provides the general damages calculation provisions that convert an ISV into a dollar amount.

The ISV assessment follows a structured sequence. The injured person's medical evidence establishes the nature, severity, and functional consequences of the injury. That evidence is then compared against the statutory injury categories in Schedule 3 to identify the category that most closely corresponds to the person's condition. The ISV is then determined by selecting a position within the applicable range for that category, based on the overall impact of the injury on the individual claimant.

What is Schedule 3 of the Civil Liability Regulation?

Schedule 3 is the statutory table that assigns ISV ranges to defined categories of injury. Schedule 3 organises injuries by body region and type, with each statutory injury category describing a specific kind of injury and assigning it a range of ISV values rather than a single fixed number.

The statutory injury categories in Schedule 3 are divided into parts covering different body regions and injury types, including central nervous system injuries, brain injuries, mental disorders, cervical and thoracic spine injuries, upper and lower limb injuries, facial injuries, sensory impairment, chest and lung injuries, and skin injuries.

Each statutory injury category within Schedule 3 is graded by severity. A cervical spine soft tissue injury, for example, is divided into extreme, serious, moderate, and minor categories, each with its own ISV range. The ranges reflect the variation in how the same type of injury affects different people. A moderate cervical spine soft tissue injury has an ISV range of 5 to 10, while an extreme cervical spine injury has a range of 41 to 75. The range allows the assessment to account for individual differences in symptom severity, recovery time, and long-term limitation within a single injury type.

Schedule 3 of the Civil Liability Regulation 2025 was previously Schedule 4 of the Civil Liability Regulation 2014. References to "Schedule 4" in older legal materials, court decisions, and other websites relate to the same table of injury categories. The regulation that applies to a claim depends on when the injury occurred. Injuries before 1 September 2025 are assessed under the Civil Liability Regulation 2014. Injuries on or after 1 September 2025 are assessed under the Civil Liability Regulation 2025. The ISV ranges and assessment methodology are substantially the same under both regulations.

How are injuries matched to a statutory injury category?

An injury is matched to a statutory injury category by comparing the injured person's documented condition to the categories listed in Schedule 3 based on the nature, severity, and functional consequences of the injury.

The matching process uses the medical evidence to identify which statutory injury category most closely describes the person's condition. The match is based on how the injury presents and affects the person in practice, not solely on the diagnostic label. Two people with the same medical diagnosis may be matched to different positions within the same statutory injury category, or even to different categories, depending on how the injury affects each person's daily life and functioning.

What happens if an injury is not listed in Schedule 3?

If an injury is not specifically listed in Schedule 3, the ISV assessment is made by analogy to the most similar statutory injury category available. The Civil Liability Regulation 2025 provides that a court assessing an ISV for an injury not mentioned in Schedule 3 may have regard to the ranges prescribed for other injuries.

The analogy-based approach compares the unlisted injury to the listed category that is closest in terms of how the injury presents and its functional consequences. The comparison focuses on the practical effect of the injury on the person rather than the diagnostic classification. The analogy ensures that injuries not anticipated by the drafters of the schedule are still assessed within the same statutory framework.

What are the ISV ranges for common injuries in Queensland?

Schedule 3 of the Civil Liability Regulation 2025 assigns ISV ranges to over 150 statutory injury categories, organised by body region and graded by severity from minor to extreme.

The following table shows the ISV ranges for common injuries in Queensland based on Schedule 3 of the Civil Liability Regulation 2025.

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Spinal cord injuries resulting in quadriplegia carry an ISV range of 75 to 100, while paraplegia carries a range of 60 to 80. These catastrophic categories of spinal cord injury sit at the upper end of the ISV scale and reflect the most severe permanent impairment.

The ISV ranges in this table are a condensed summary of the major categories in Schedule 3. The full schedule contains more detailed subcategories within each body region, and the applicable ISV range for a specific injury depends on the precise statutory injury category that matches the person's condition. Each injury page in this network contains the specific Schedule 3 items and ISV ranges relevant to that injury type.

These ISV ranges do not represent dollar amounts. The ISV must first be converted into a general damages amount using the statutory conversion provisions in Schedule 5 of the regulation.

What factors determine where an injury falls within an ISV range?

Where an injury falls within its applicable ISV range is determined by evaluating the overall impact of the injury on the individual claimant across several factors that are assessed together, not in isolation. Two people with the same diagnosis and the same statutory injury category may receive different ISV assessments depending on how the injury affects each person's life. The ISV assessment considers 7 factors.

• Nature and severity of the injury: The nature of the injury identifies which statutory injury category in Schedule 3 applies. The severity of the injury determines where within that category's ISV range the assessment falls. More severe injuries involving significant structural damage, complex conditions, or multiple affected systems attract higher ISV values within the applicable range.
  
  
• Functional impact on daily life: The functional impact assessment examines how the injury affects the person's ability to carry out normal activities. Functional impact includes limitations in mobility, restrictions on work capacity, reduced independence, and difficulty performing routine tasks. Greater disruption to daily functioning places the injury toward the higher end of the ISV range.

• Pain and suffering: The pain and suffering assessment considers the intensity and duration of both physical pain and psychological distress caused by the injury. Pain and suffering includes the experience of ongoing discomfort, the emotional impact of living with the injury, and any loss of enjoyment of life. Persistent or severe pain that continues beyond the initial recovery period increases the ISV assessment within the applicable range.

• Duration and prognosis: The duration and prognosis assessment considers whether the injury is temporary or permanent and the likely course of recovery. Injuries that resolve fully within a short period attract lower ISV values. Injuries that result in ongoing symptoms, long-term impairment, or permanent limitations justify higher ISV values. The ISV assessment is usually not finalised until maximum medical improvement has been reached.

• Extent and duration of treatment: The treatment assessment considers the nature, intensity, and duration of treatment required for the injury, including surgical intervention, rehabilitation, medication, and allied health services. An injury that requires extensive or prolonged treatment reflects a more significant condition. The need for future treatment beyond the date of assessment indicates the injury has not fully resolved and supports a higher position within the ISV range.

• Psychological impact: The psychological impact assessment considers the presence and extent of psychological conditions arising from or worsened by the injury, including post-traumatic stress disorder, depression, anxiety, and adjustment disorders. Psychological injury may arise directly from the incident or develop as a consequence of a physical injury. Where the psychological impact is a reaction to a physical injury rather than a standalone mental disorder, the reaction is treated as a feature of the physical injury and may justify a higher position within the ISV range for that physical injury.

• Pre-existing conditions and aggravation: The pre-existing conditions assessment focuses on the difference between the person's baseline condition before the incident and their condition after the injury. The ISV reflects the deterioration caused by the incident, not the underlying pre-existing condition itself. A greater degree of aggravation supports a higher ISV within the applicable range. The Civil Liability Regulation 2025 specifically provides that a court may have regard only to the extent to which the pre-existing condition has been made worse by the injury.

What evidence is used in an injury scale value assessment?

An injury scale value is assessed using a combination of medical evidence, objective findings, and factual evidence about how the injury affects the claimant's daily life. The ISV assessment relies on evidence that supports both the diagnosis of the injury and the extent of its impact on the person.

• Medical reports and specialist opinions: The ISV assessment is primarily based on medical reports from treating doctors and independent medical examiners. Medical reports describe the nature of the injury, the symptoms experienced, the treatment provided, and the expected prognosis. Specialist opinions from orthopaedic surgeons, neurologists, psychiatrists, and pain medicine specialists are used to assess more complex injuries and to provide an independent evaluation of the injury's severity and long-term impact. Medical reports tendered in evidence must comply with the Uniform Civil Procedure Rules 1999, chapter 11, part 5. A medical report must not identify a specific Schedule 3 item or suggest an ISV for the injury - the ISV is a legal determination, not a medical one.

• Diagnostic imaging and objective findings: The ISV assessment considers objective medical evidence that confirms the existence and extent of the injury. Diagnostic imaging such as MRI scans, X-rays, and CT scans confirms structural damage, abnormalities, or ongoing conditions. Objective findings strengthen the ISV assessment by providing measurable evidence that supports the reported symptoms and medical opinions.

• Functional impact and daily limitations: The ISV assessment considers evidence of how the injury affects the claimant's ability to function in everyday life. Functional evidence includes the impact on work capacity, mobility, independence, and participation in routine and recreational activities. Functional evidence is drawn from the claimant's own account, employment records, a functional capacity assessment, and other factual material that demonstrates the real-world effect of the injury.

The ISV assessment sometimes involves situations where medical evidence is inconsistent or incomplete. Different medical experts provide differing opinions about diagnosis, severity, or prognosis. The assessment involves evaluating the reliability and weight of each opinion and considering the overall consistency of the evidence. The Civil Liability Regulation 2025 requires that a court give greater weight to a whole person impairment assessment based on the AMA Guides to the Evaluation of Permanent Impairment (5th edition) than to an assessment not based on those criteria. For psychiatric injuries, the court must give greater weight to a PIRS report than to another medical assessment of the permanent impairment caused by a mental disorder. The role of medical evidence in personal injury claims extends beyond the ISV assessment and is relevant to every component of compensation.

How are multiple injuries assessed under the injury scale value system?

Multiple injuries are assessed under the injury scale value system by identifying the dominant injury and using its ISV range as the starting point, rather than adding separate ISV values together. The ISV system does not allow individual ISV values for each injury to be combined into a total. The assessment produces a single injury scale value that reflects the combined effect of all injuries on the claimant's life.

What is the dominant injury approach?

The dominant injury is the injury that has the greatest overall impact on the claimant. The dominant injury determines the primary statutory injury category in Schedule 3 and the applicable ISV range. Secondary injuries do not receive their own separate ISV values. The presence of secondary injuries justifies a higher position within the dominant injury's ISV range where those injuries interact with the dominant injury and increase the overall impact on the person's daily life, pain, and functioning.

Can the ISV for multiple injuries exceed the dominant injury range?

Yes, the ISV for multiple injuries can exceed the dominant injury range where the maximum for the dominant injury does not adequately reflect the combined impact of all injuries. This increase is subject to 2 constraints. The overall injury scale value cannot exceed 100. The increase should rarely be more than 25% higher than the maximum ISV for the dominant injury. If the increase exceeds 25%, the court must provide detailed written reasons justifying the higher assessment. The court considers the ISV ranges for the non-dominant injuries when deciding whether an increase is justified.

How is an injury scale value converted into general damages?

An injury scale value is converted into general damages by applying a statutory formula that assigns progressively higher dollar amounts to each point on the ISV scale. The formula is set out in section 62 of the Civil Liability Act 2003 (Qld), with the dollar amounts fixed each year by the Civil Liability Indexation Notice. The current amounts are set by the Civil Liability Indexation Notice 2025, effective 1 July 2025.

The general damages amount increases at a steeper rate for higher ISV values. An ISV of 10 corresponds to $21,400 in general damages, while an ISV of 50 corresponds to $181,700. The maximum general damages payable for an ISV of 100 is $484,100.

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Source: Civil Liability Indexation Notice 2025 (Qld), effective 1 July 2025. Amounts apply to injuries arising on or after 1 July 2025. Earlier injury dates attract lower indexed amounts.

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The general damages amount represents only the pain and suffering component of a personal injury claim. Total compensation also includes economic loss, medical expenses, and care costs, which are assessed separately under the broader methodology of how personal injury compensation is calculated.

How are general damages amounts indexed each year?

General damages amounts are indexed each year by adjusting the statutory formula in line with changes to Average Weekly Earnings in Queensland. The indexed amounts are published in a Civil Liability Indexation Notice before 1 July each year. The adjustment is based on the percentage change in Queensland full-time adult persons' ordinary time earnings as published by the Australian Bureau of Statistics. The indexation ensures that general damages amounts keep pace with changes in economic conditions. Injuries arising in earlier financial years attract lower general damages amounts based on the indexation figures that applied at that time. A claimant can produce a rough estimate of likely general damages by entering injury type and severity into a personal injury compensation calculator, which use ISV ranges to produce rough estimates of claim value. 

When is an injury scale value assessed during a personal injury claim?

An injury scale value is assessed after the injured person's medical position has stabilised sufficiently for the nature, severity, and long-term impact of the injury to be evaluated. The ISV assessment is not carried out immediately after the accident.

The timing of the injury scale value assessment is closely linked to maximum medical improvement. Maximum medical improvement is the point at which the injured person's condition is unlikely to improve further with ongoing treatment. Assessing the ISV before maximum medical improvement has been reached risks undervaluing the injury, because the full extent of permanent limitation and ongoing symptoms is not yet clear.

The ISV assessment occurs at different stages depending on how the claim progresses. The CTP insurer assesses the ISV when formulating a settlement offer during the compulsory negotiation process. The claimant's legal representative presents their own ISV assessment as part of the claim. If the parties disagree on the ISV and the claim does not resolve at the compulsory conference, the court determines the final ISV based on the evidence before it. The same statutory framework applies at each stage, but the assessed ISV can differ between parties depending on how the medical evidence and individual circumstances are interpreted.

Who determines the final injury scale value?

The final injury scale value is determined by the court if the claim proceeds to trial, or by agreement between the parties if the claim settles. The court's ISV determination is binding. In practice, most personal injury claims in Queensland resolve through negotiation or at the compulsory conference stage rather than proceeding to a court determination. The ISV agreed between the parties during settlement reflects their respective assessments of the medical evidence and the applicable statutory injury category. Independent medical examiners provide the medical evidence that informs the ISV assessment, but the ISV itself is a legal determination - a medical practitioner does not decide the ISV.

What is the WPI threshold and how does it relate to ISV?

The WPI threshold is a minimum level of whole person impairment that an injured person must meet before general damages can be claimed in certain types of personal injury claims. Whole person impairment (WPI) is a separate medical assessment from the injury scale value, but the WPI threshold acts as a gateway to the ISV system. A person who does not meet the applicable WPI threshold is not entitled to general damages, regardless of where their injury would fall on the ISV scale.

The WPI threshold applies to motor vehicle accident claims under the Motor Accident Insurance Act 1994 (Qld). A person injured in a motor vehicle accident must meet the prescribed WPI threshold before the general damages component of the claim becomes available. The threshold is assessed by a medical practitioner using the AMA Guides to the Evaluation of Permanent Impairment (5th edition).

The WPI threshold does not apply to all personal injury claim types. Public liability claims and medical negligence claims under the Civil Liability Act 2003 (Qld) do not require a minimum WPI to access general damages. The threshold is specific to the CTP scheme and exists as a mechanism to limit general damages claims to injuries that result in a measurable level of permanent impairment.

A person who meets the WPI threshold then has their injury scale value assessed in the usual way under Schedule 3 of the Civil Liability Regulation 2025. The whole person impairment (WPI) assessment and the injury scale value assessment are separate processes that serve different purposes. The WPI assessment measures the degree of permanent physical or psychological impairment. The injury scale value assessment evaluates the overall impact of the injury on the person's life for the purpose of calculating general damages.

How is an injury scale value different from whole person impairment (WPI)?

An injury scale value and whole person impairment are two separate assessments that serve different purposes in a personal injury claim. The injury scale value is a legal assessment tool used to calculate general damages. Whole person impairment is a medical assessment of the degree of permanent impairment caused by the injury.

The injury scale value is assessed on a scale of 0 to 100 using the statutory injury categories in Schedule 3 of the Civil Liability Regulation 2025. The ISV assessment considers the overall impact of the injury on the person's life, including pain, suffering, loss of amenities, functional limitations, and psychological effects. The injury scale value is determined by an insurer, by the parties through negotiation, or by a court. The ISV is not a medical assessment and a medical practitioner does not determine the ISV.

Whole person impairment is assessed as a percentage using the AMA Guides to the Evaluation of Permanent Impairment (5th edition). The WPI assessment focuses on measurable physical or psychological impairment and is carried out by a medical practitioner trained in the AMA methodology. The WPI assessment does not directly consider pain, suffering, or quality of life. A person with significant ongoing pain and functional limitation but limited measurable impairment on the AMA criteria may have a low WPI percentage but a relatively higher ISV.

The two assessments interact in 2 ways. The WPI threshold determines whether a person is entitled to claim general damages in certain personal injury claim types, particularly CTP motor vehicle accident claims. The Civil Liability Regulation 2025 also requires that a court give greater weight to a WPI assessment based on the AMA Guides (5th edition) than to a WPI assessment not based on those criteria when assessing the injury scale value. The WPI percentage informs the ISV assessment as one piece of evidence, but the two assessments remain distinct.

How are psychiatric injuries assessed under the injury scale value system?

Psychiatric injuries are assessed under the injury scale value system using a combination of the statutory injury categories in Schedule 3 and a separate assessment tool called the Psychiatric Impairment Rating Scale (PIRS). The ISV system treats psychiatric injuries differently from physical injuries because the measurement of psychological impairment requires a specialised methodology.

Schedule 3 of the Civil Liability Regulation 2025 includes statutory injury categories for mental disorders graded by severity. An extreme mental disorder carries an ISV range of 41 to 65. A serious mental disorder carries a range of 11 to 40. A moderate mental disorder carries a range of 2 to 10. A minor mental disorder carries a range of 0 to 1. The applicable category and position within the range depend on the nature and severity of the condition and its impact on the person's functioning.

What is the Psychiatric Impairment Rating Scale (PIRS)?

The Psychiatric Impairment Rating Scale is a standardised assessment tool used to measure permanent impairment caused by a mental disorder. The PIRS is set out in Schedules 4 and 5 of the Civil Liability Regulation 2025. The PIRS consists of 6 scales, each rating a different area of functional impairment. The 6 areas are self-care and personal hygiene, social and recreational activities, travel, social functioning, concentration persistence and pace, and adaptation.

Each area of functional impairment is rated on a scale of 1 to 5, with 1 representing little or no impairment and 5 representing total impairment. A medical expert assesses the class for each area and calculates a median class score. The median class score is then converted into a percentage impairment using a conversion table in Schedule 4. The PIRS assessment is carried out by a medical expert with appropriate training in psychiatric impairment assessment.

The Civil Liability Regulation 2025 requires that a court give greater weight to a PIRS report than to another medical assessment of permanent impairment caused by a mental disorder. The PIRS rating accepted by the court informs the ISV assessment for psychological injury by providing a structured and comparable measure of the severity of the condition.

What is the difference between a mental disorder and an adverse psychological reaction?

A mental disorder and an adverse psychological reaction are two distinct categories of psychological impact that are treated differently under the ISV system. The distinction determines whether the psychological component of a claim is assessed as a standalone injury with its own ISV range or as a feature of a physical injury.

A mental disorder is a diagnosed psychiatric condition such as post-traumatic stress disorder, major depression, generalised anxiety disorder, or an adjustment disorder. A mental disorder is assessed as a separate injury under the mental disorder categories in Schedule 3 and receives its own ISV assessment using the PIRS methodology. A mental disorder exists as an independent compensable injury regardless of whether it accompanies a physical injury.

An adverse psychological reaction is a psychological response to a physical injury that does not amount to a standalone mental disorder. An adverse psychological reaction includes distress, frustration, low mood, or anxiety arising from the experience of being injured and the limitations the injury imposes. The Civil Liability Regulation 2025 requires that an adverse psychological reaction be treated merely as a feature of the physical injury. The adverse psychological reaction does not receive a separate ISV. Instead, the adverse psychological reaction justifies a higher position within the ISV range for the physical injury it accompanies.

The distinction matters in practice because a person with both a physical injury and a diagnosed mental disorder has two separate compensable injuries assessed under the dominant injury approach. A person with a physical injury and an adverse psychological reaction that does not meet the threshold for a diagnosed mental disorder has one compensable injury with the psychological component factored into the positioning within the ISV range.