5.2.5 If None of the Tables in the Guide Apply - AMA Guides

If the impairment under investigation is of a kind that cannot be assessed in accordance with the provisions of the Approved Guide, the Introduction to the Approved Guide authorises reference to the provisions of the current American Medical Association's Guides to the Evaluation of Permanent Impairment (the AMA Guides) in making the assessment. Note, however, that the AMA Guides are to be used only in very rare cases where it is not possible for a person's condition to be assessed under the Approved Guide.

3.5.1 Definition

Non-Economic Loss (NEL)

NEL is a subjective concept of the effects of the impairment on the veteran’s life (‘lifestyle effect’). It includes pain and suffering, loss of amenities of life, loss of expectation of life and any other real inconveniences caused by the impairment. NEL is assessed in accordance with Division 2 of the DRCA PI Guide. Under the DRCA PI Guide, NEL includes:

3.3.2.1 When should an old Act injury be assessed under the 1988 Act?

The date an injury occurred and the resulting impairment became permanent, is crucial in deciding if an impairment should be assessed under the DRCA or under the predecessor Acts.

Delegates should consider the following questions:

  1. When did the injury first occur?
  2. When did the impairment become permanent, i.e. likely to continue indefinitely?

In most cases, question 1 will be pre-determined by the liability determination.  The opinion of the medical practitioner should be used to determine question 2.

5.8.2 NEL Table B2 - Loss of Amenities

Table B2 requires an assessment of the impact of the injury on Mobility, Social Relationships and for Recreation and Leisure Activities. A score out of five is given for each of the following:

  • mobility undedr Table B2.1
  • social relationships under Table B2.2
  • recreation and leisure activities under Table B2.3

These are scores are then combined with the scores from Tables B1, B3 and B4 using the combined value calculation in Table B5.

Table B2.1 Mobility

3.6.6 Advice to Recipients

The authorised delegate of the Secretary must give notice of any decision to authorise, or not to authorise, a payment of an amount of SIA in relation to a member.

The notice must include statement of reasons for making the decision, and also include the appeal rights available to the member if they are dissatisfied with the decision. Failure to comply with the requirement to provide appeal rights in relation to the decision does not affect the validity of the decision.