4.3.2 Criteria for making an interim assessment

4.3.2 Criteria for making an interim assessment

The veteran suffers from a permanent impairment as a result of an injury

An interim payment of compensation may be payable in cases where a veteran’s impairment is permanent, but the final degree of impairment is not yet known. This may be due to the veteran undergoing active medical treatment and/or the natural healing process of the injury or disease, and is commonly referred to as the ‘stable’ status of the injury or disease.

5.7.2 Investigation of NEL

How NEL scores are assessed

When assessing NEL compensation in relation to a specific injury or impairment, the delegate must assign a score against NEL tables B1 - B4 in the DRCA PI Guide.

NEL scores will usually be determined on basis of the information provided by the claimant in their NEL questionnaire and any relevant medical evidence before the delegate. The delegate should request further information from the claimant if they require clarification or further information about the specific losses suffered.

5.8.6 NEL Questionnaire

The NEL questionnaire is an important tool for the delegate to obtain necessary information from the veteran about the subjective physiological, psychological and other impacts the injury that is being assessed has on their lifestyle. As a general rule, the NEL questionnaire should be provided to the veteran for completion for each injury that is being assessed.

2.1 SRCA - S24, 25, 26, 27, 124

The above five sections of the SRCA are relevant in day to day dealings with PI claims. This chapter outlines the contents of the various sections. A complete version of the sections is in Part II of the SRCA .

 

Detailed writings on the Guide to the Assessment of the Degree of Permanent Impairment (the Approved Guide as per section 28 of the SRCA) are at Chapter 5 of this manual.

 

5.2.4 Choice of tables in Division 1 of the DRCA PI Guide

Division 1 - Impairment tables

Where there is a choice between two tables for the same impairment, the table which is most favourable to the client must be selected. This principle is drawn from the Federal Court decision in Whittaker v Comcare (1998) FCA 1099, where the same impairment from a soft tissue injury involving a joint was assessable under both table 9.2 and table 9.5.

5.5.1 American Medical Association's (AMA) Guides to the Evaluation of Permanent Impairment

The AMA Guides are the original source documents upon which the DRCA PI Guide and the previous versions of the Approved Guides are based. 

The AMA Guides provide a standard framework and method of analysis through which doctors can evaluate, report on, and communicate information about the impairments of any human organ system. They are used as a guide to estimating the degree of long-standing or permanent impairments, which are defined as adverse conditions that are stable and unlikely to change.

5.3.7 Ear, Nose and Throat Disorders - Table 7

The relevant Tables in Chapter 7 'Ear, nose and throat disorders' are:

  • Table 7.1 – Hearing
  • Table 7.2 – Miscellaneous Ear Nose and Throat Disorders

Hearing impairment under Table 7.1 must be distinguished from loss of the capacity to comprehend spoken language i.e. the ability to receive auditory signals must be distinguished from the ability to interpret such signals. Loss of hearing comprehension is assessed under Table 12.2 'Comprehension – Hearing and Reading'.