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9.8.8 GARP Chapter 10 Sexual Function, Reproduction, and Breasts
GARP V and M - Chapter 10 – Sexual Function, Reproduction, and Breasts
Part 10.1 of GARP relates to the assessment of impairment associated with an accepted loss of sexual function.
- For the purpose of obtaining a rating of the impairment due to erectile dysfunction, medical and surgical therpaies are considered equivalent.
- Successful treatment of sexual dysfunction in a female does not preclude awarding an impairment rating.
- Successful treatment of erectile dysfunction in a male is awarded the lower of the two 'impotence' impairment ratings in Table 10.1.1, not nil.
- In general, if no reasonable treatment has been attempted, the lower impairment rating should apply.
Therapies for Sexual Dysfunction for the purposes of GARP
GARP (V/M) was written prior to the introduction of medical therapies for the treatment of sexual dysfunction. Where medical treatment has been used successfully, this should be considered equivalent to “impotence ameliorated by surgical treatment”. Where medical treatment has been used unsuccessfully, is associated with limiting side effects, or is contraindicated, this should be considered equivalent to “impotence not ameliorated by surgical treatment”. That is, for the purpose of obtaining a rating of the impairment due to sexual dysfunction, medical and surgical therapies are equivalent.
Assessment under GARP for sexual dysfunction conditions and the impairment
Based on the above policy, it follows that in the case of successful treatment with medical therapy, a rating should still be selected from the relevant Table (Table 10.1.1) for erectile dysfunction in males. For consistency, in the case of successfully treated female sexual dysfunction, a rating should still be applied from Table 10.1.2, or scope given to allow an appropriate over-ride impairment rating.
Table 10.1.1 of the GARP describes the impairment rating associated with various degrees of loss of sexual function in a male. The table provides for a different rating for impotence which is ameliorated by surgical treatment to that which is not so ameliorated. It is important to note that successful treatment does not result in a rating of zero (with one exception). This position recognises that, by the nature of the condition, the impairment associated with erectile dysfunction is not limited to the physical aspect alone.
Implicit in Table 10.1.1 is that the rating for “impotence not ameliorated by surgical treatment” should be applied only when therapy has been tried and has been unsuccessful, is associated with limiting side effects, or is contraindicated. In addition, given the availability and ease-of-use of current therapies, lack of treatment may reflect a lower subjective level of impairment. Therefore, in most cases, the lower impairment rating should be awarded in the absence of a trial of reasonable treatment.
If there is complete resolution of the condition, for example following treatment of an underlying medical condition, a rating of negligible may be appropriate.