C08/2004 Self-Assessed Lifestyle Ratings Outside the GARP Shaded Area

Purpose

This instruction sets out procedures that must be followed to investigate cases where a self assessed lifestyle rating does not fall within normal expectations for the assessed medical impairment rating, ie it is outside of the 'shaded area' in Scale 23.1 in the Guide to the Assessment of Rates of Veterans' Pensions (GARP)

Background

A veteran's lifestyle rating is expected to be broadly consistent with the degree of medical impairment from the accepted conditions.  In most cases, a lifestyle rating that falls within the shaded area of Scale 23.1 within the Guide to the Assessment of Rates of Veterans' Pensions is broadly consistent with the degree of medical impairment.  Accordingly GARP states:

“It is expected that the self-assessed lifestyle rating would be broadly consistent with the level of impairment. A determining authority my reject a self-assessment of lifestyle rating because it overestimates, or underestimates, the level of rating that is broadly consistent with the level of impairment from the accepted disability”

The Commission has become concerned that a significant proportion of lifestyle ratings fall outside the shaded area without confirmation that there is a reasonable basis for that assessment.

It has therefore decided to implement new processes to assist delegates in assessing the reasonableness of a self-assessment of lifestyle rating.

Procedures

When a veteran self-assesses their lifestyle rating through Option 1 in Chapter 22 of GARP and this rating falls outside of the shaded area the claims assessor will:

• send the veteran a Lifestyle Questionnaire (Form D2669) to gain further information and to clarify the basis for the self-assessment; and
• assess the reasonableness of the material provided and clarify any inconsistencies which may exist with other material provided by the veteran or the veteran's treating medical officer before determining an appropriate lifestyle rating.