Where an injury results in a PI and a veteran is entitled to compensation under section 24 of the DRCA, they are also entitled to a separate payment under section 27 of the DRCA for NEL suffered as a result of that injury. This principle is consistent with the High Court’s reasoning in Canute v Comcare [2006] HCA 47.
The combined WPI (CWPI) is a percentage figure which is the result of the combination of two or more WPI ratings using the Table 14.1 - Combined Values Chart in Chapter 14 of the DRCA PI Guide.
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.
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.
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.
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.
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.
The percentage degree of WPI is drawn from Impairment Tables in Division 1 of the DRCA PI Guide. Only figures specified in the relevant tables can be used. See Chapter 5 for information on calculation using the DRCA PI Guide.
When a delegate is considering the amount of NEL compensation payable under section 27 in respect of an injury they must take into account, among other things, the NEL scores provided in the NEL questionnaire.
The following chapter outlines the relevant policy guidance and key considerations when assessing each score under the NEL tables.
A score out of five is given for both pain and for suffering in Table B1. These two scores (under Table B1.1 and Table B1.2) are then combined with the scores given in Tables B2, B3 and B4 using the combined value calculation in Table B5.
