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5.8.6 Recalculation of whole PI payment when interim condition stabilised

Once the impairment(s) for which interim compensation has been paid stabilises, PI compensation is recalculated at the final assessed rate (i.e. the weekly rate applicable at the date the final assessment is undertaken).  If the final weekly rate of payment has increased, the ongoing periodic payment to the claimant is increased by the difference between the two.

When an interim payment has been made as a lump sum, the amount of PI payable is calculated by converting the lump sump paid to a current weekly amount and subtracting this from the total weekly amount of PI payable at final assessment.  The difference is the new weekly amount payable (which can be converted to a lump sum or taken as an ongoing weekly entitlement).

In either case, the new rate is subject to the rules for conversion to a lump sum set out in section 78 of the MRCA as discussed below.

In cases where multiple impairments are being considered as part of the PI assessment (and interim compensation has previously been paid), a final amount of PI compensation becomes payable once all of the service injuries or diseases concerned have stabilised.  If the final weekly rate of PI payment is greater than the weekly interim rate, the increase in the rate is backdated to the date on which the delegate is satisfied that all of the person's service injuries or diseases stabilised.

5.8.6.1 Date of effect for interim payments – single conditions

Where a determination is made that interim PI is payable in respect of a single condition the PI is payable from the later of:

  • the date the claim for liability was lodged; and
  • the date the impairment suffered by the person:
    • where the claim for PI constituted 10 IPs (or 5 for those conditions that require a lower threshold);
    • where the claimant has previous compensable conditions under the MRCA – contributed at least 5 additional impairment points to the person’s overall impairment rating.

 

5.8.6.2 Date of effect for interim payments – multiple conditions

Where a determination is made that interim PI is payable in respect of multiple conditions the PI for each condition may be payable from different dates because the date of effect for each condition is the later of

  • the date the claim for liability for that condition was lodged; and
  • the date the impairment suffered by the person as a result of that condition (either separately or in conjunction with another condition):
    • where the claim for PI was made prior to 1 July 2013 – constituted 10 IPs;
    • where the claim for PI was made on or after 1 July 2013 and the claimant has no previous compensable conditions under the MRCA – constituted 10 IPs;
    • where the claim for PI was made on or after 1 July 2013 and the claimant has previous compensable conditions under the MRCA – contributed at least 5 additional impairment points to the person’s overall impairment rating.

 

Example

Client is receiving PI for several stable conditions. On 12 September 2013 he claims PI for one new condition. Medical advice is that whilst the condition is permanent it is not yet stable and that at the time of the claim for PI it increased this person’s overall impairment rating by more than 5 impairment points. The delegate decides to pay him interim PI. The date of effect for payment of the interim PI is the date of claim on 12 September 2013.