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12.7.12. Further guidance regarding date of effect provisions applying to transitional claims

Document
Last amended 
18 July 2019

The date of effect provisions under s77 of the MRCA provide that compensation is payable from the later of:

  • The date the claim for liability was lodged; or
  • The date the delegate determines to be the date on which the condition is permanent and stale and meets threshold.

This becomes complicated where VEA and DRCA conditions have to be considered as part of a transitional case.

Impairment points for DRCA and VEA conditions should be included in the corresponding MRCA PI assessment from the MRCA PI initial assessment date. We do not need to satisfy ourselves of a precise stability date for DRCA or VEA conditions to be included, it is enough that they were permanent and stable at the time of the MRCA assessment.

The following steps should provide some guidance:

1. The delegate confirms the accepted VEA/DRCA conditions at the time of the MRCA PI claim and determines whether they should be included in the PI assessment (per Step 1 of Chapter 25 of GARP M);

2. The delegate confirms that all DRCA conditions are permanent and stable:

  • Where it is confirmed the client has been assessed for permanent impairment compensation under the DRCA and accordingly if a payment under section 24 and 27 of the Act has been offered – the delegate can be satisfied the condition(s) is permanent and stable and proceed with the PI assessment.
  • Where the client has confirmed on file they will be unlikely to ever claim PI under DRCA, or have rejected an offer due to the offsetting impacts on their VEA DP – the delegate can proceed with the PI assessment. See CLIK Chapter 12.7.10 to see the steps on how impairment points are applied in the assessment in these cases.
  • If the client has not been assessed for DRCA PI – the delegate should contact the client to discuss having their entitlement to PI under DRCA with respect of those conditions assessed prior to completing the MRCA PI assessment. The DRCA and MRCA PI cases could continue to be investigated and assessed concurrently to reduce the processing delays, however the finalisation of the MRCA PI case would be dependent on the finalisation of the DRCA PI case in the first instance.

3. The delegate confirms the amounts of DRCA PI or VEA DP that have been awarded for each condition before proceeding with MRCA PI case.

4. The delegate includes all DRCA/VEA conditions and the corresponding impairment points in the MRCA PI assessment in accordance with Step 2 of GARP M from the first date of effect (i.e. where the client meets threshold for payment in accordance with section 77 of the MRCA). This in effect will mean that a person with MRCA, VEA and/or DRCA conditions, would meet the requirements for payment under section 68 once the client has 5 contributing MRCA impairment points to either the 10 or 5 impairment point threshold, depending if the PI case is a section 68 or section 71 assessment.

When a DRCA/VEA date will be important – date compensation awarded

The date that is relevant for DRCA and VEA conditions in a MRCA PI transitional assessment is the date on which compensation has been awarded with respect of those conditions under the respective Acts.

The effective payment date of a person’s VEA DP or DRCA PI lump sum compensation amount will be applied in the Chapter 25 assessment at Step 6 and 7.

Step 6 of Chapter 25 of GARP M requires us to consider any lump sum payments (converted to weekly) for a DRCA condition, and the DP payable with respect of any VEA conditions above the maximum weekly payment of MRCA PI, at the date of the determination.

This means that we are calculating the applicable MRCA rate of weekly compensation on the date of the determination, including any previous payments for VEA or DRCA accepted conditions regardless of the date of those payments. We then backdate the MRCA weekly payment to the effective date of payment, regardless of when VEA and/or DRCA payments commenced or were paid. The relevance of the date of the payment is to ensure the conversion to a weekly amount for DRCA lump sums and the VEA DP is indexed to a current rate.