Substantive functional limitations; One or more moderate to severe diseases.

Examples include (but not limited to):

• poorly controlled DM or HTN
• COPD
• morbid obesity (BMI ≥40)
• active hepatitis
• alcohol dependence or abuse
• implanted pacemaker
• moderate reduction of ejection fraction
• ESRD undergoing regularly scheduled dialysis
• premature infant PCA < 60 weeks
• history (>3 months) of MI, CVA, TIA, or CAD/stents.

Examples include (but not limited to):

• recent ( <3 months) MI, CVA, TIA, or CAD/stents
• ongoing cardiac ischaemia or severe valve dysfunction
• severe reduction of ejection fraction
• sepsis
• DIC, ARD or ESRD not undergoing regularly scheduled dialysis.

Examples include (but not limited to):

• ruptured abdominal/thoracic aneurysm
• massive trauma
• intracranial bleed with mass effect
• ischaemic bowel in the face of significant cardiac pathology or multiple organ/system dysfunction.