5.8.5 Examples

Example 1

A client claimed liability and PI for a service injury in January 2013.  His specialist advised that the condition had not stabilised at the time of his claim so the delegate decided to pay him interim PI.  As the determination of the amount payable was made prior to 1 July 2013, the calculation of his interim PI did not include a lifestyle effect.  As his condition was still unstable on 1July, the amount payable is to be recalculated as soon as practicable after that date to include a lifestyle factor with his PI increasing from 1 July 2013 to take account of the lifestyle factor.

Example 2

A client claimed liability and PI for a service injury in November 2012.  His specialist advised that the condition had not stabilised at the time of his claim so the delegate decided to pay him interim PI.  As the determination of the amount payable was made prior to 1 July 2013, the calculation of his interim PI did not include a lifestyle effect.  As his condition stabilised in May his PI was recalculated (including a lifestyle rating) and increased to his final payment rate with effect from the date of stabilisation in May.  Because his condition had stabilised the instructions under “Optional methods of Assessment” in Chapter 22 of GARP M are applied to determine his lifestyle rating rather than the steps in 5.8.4.

Example 3

A client claimed liability and PI for a service injury in January 2013.  His specialist advised that the condition had not stabilised at the time of his claim so the delegate decided to pay him interim PI.  As the determination of the amount payable was made prior to 1 July 2013, the calculation of his interim PI did not include a lifestyle effect.  In March 2013 he decided to convert the weekly payment to a lump sum.  Therefore his PI is not to be re-calculated to include a lifestyle factor for the period from 1 July 2013.  However, when his condition stabilises his whole person impairment will be adjusted to include a lifestyle rating for the newly stabilised condition.