C34/2007 LIFESTYLE RATINGS

Purpose

To clarify how Chapter 22: Lifestyle Effects in the Guide to the Assessment of Rates of Veterans' Pensions (GARP) and the Guide to Determining Impairment and Compensation (known as GARP M) is to be applied.

Introduction

Chapter 22 of GARP sets out three methods of determining a veteran's Lifestyle Rating under the Veterans' Entitlements Act 1986, as follows:

Option 1 comprises a self-assessment conducted by the veteran;

Option 2 involves the determining authority allocating a lifestyle rating using information held by the authority; and

Option 3 involves the veteran filling out a Lifestyle Questionnaire which is then used by the determining authority to allocate a lifestyle rating.

Chapter 22 of GARP M provides the same for permanent impairment compensation claims under the Military Rehabilitation and Compensation Act 2004 (MRCA).

For Options 1 and 2, there are requirements around what rating is acceptable.  If Option 1 is chosen, the determining authority may reject the self-assessed rating if it is over- or under-estimated in relation to the information available to the determining authority.

If Option 2 is chosen, the rating given must be no less than the higher rating inside the shaded area of the Conversion to Degree of Incapacity Table on the back of the GARP book or on Table 23.1 or Table 23.2 of GARP M, when the impairment rating is also taken into account.

Issues

A number of questions have been put to Compensation Policy Group concerning the lifestyle rating requirements.  These relate to what is considered to be an over- or under-estimation of a rating under Option 1, and what choices the claimant must be given around the rating options.

When is an Option 1 rating over- or under- estimated?

Any self-assessed lifestyle rating under Option 1 is considered to be an over- or under-estimation if it is outside the shaded area in the Conversion to Degree of Incapacity Table of GARP, or Table 23.1 or Table 23.2 of GARP M, even if it is only one outside the shaded area.

The reasons for this requirement have already been set out in DI C08/2004 and they have not changed since that time.  This policy was adopted for the administration of claims under the MRCA when Chapter 5 of the MRCA Manual was issued on 14 May 2006 (see paragraph 5.15.4).  MRCA/Procedure Manual/5/5.15/5.15.4

What do I do if the rating is over- or under-estimated?

If the self-assessed rating is outside the shaded area, the Delegate must reject it and offer the claimant the option to complete a Lifestyle Questionnaire.  If the claimant chooses not to complete the Lifestyle Questionnaire, the Delegate may determine the lifestyle rating as described in Option 2 using information available to the Delegate.

Claimants unhappy with filling out two forms

Some Delegates have indicated that claimants have been unhappy when their self-assessed lifestyle rating under Option 1 has been rejected and they have been asked to fill out a Lifestyle Questionnaire, only to be given the same lifestyle rating they had originally identified.

While this is unfortunate, GARP and GARP M are legislative instruments and it requires that the claimant be given a choice of all three options for assessing their lifestyle rating.  If the claimant does not wish to fill out the Questionnaire after his or her self-assessment is rejected, the claimant has the right to refuse, and then the Delegate can implement Option 2.

Claimant MUST be given choice

Compensation Policy Group has received legal advice confirming that in ALL cases, the claimant must be given the choice of all three lifestyle rating options.  The Delegate does NOT have the power to decide for the claimant, even if the Delegate suspects that the claimant's Option 1 rating would be rejected.

Contact

Any enquiries about this instruction or clarification on this issue should be directed to Veterans' Compensation Policy Section or Military Compensation Policy Section at the ACT location.