Under subsection 77(1) of the MRCA, if PI compensation is payable under section 68 of the MRCA for a single accepted condition, that compensation is payable from the later of:
- the date the claim for liability was lodged; and
- the date that the delegate determines to be the date on which all of the following applied:
- as a result of the accepted condition, the person has suffered an impairment; and
- the impairment is likely to continue indefinitely; and
- the accepted condition has stabilised; and
- the requirements of section 69 (or section 70 for an aggravation) have been satisfied regarding the level of impairment.
5.7.1.1 Date compensation payable for more than one condition where person became entitled prior to 1 July 2013
If PI compensation is payable under section 68 of the MRCA for more than one accepted condition from a date prior to 1 July 2013, that compensation is payable from the later of:
- the date the most recent claim for liability was lodged for one of the conditions; and
- the date that the delegate determines to be the date on which all of the following applied:
- as a result of the accepted conditions, the person has suffered an impairment; and
- the impairment is likely to continue indefinitely; and
- all of the accepted conditions have stabilised; and
- the requirements of section 69 (or section 70 for an aggravation) have been satisfied regarding the level of impairment.
5.7.1.2 Date compensation payable for more than one condition where person became entitled on or after 1 July 2013
If PI compensation is payable under section 68 of the MRCA for more than one accepted condition and 5.7.1.1 does not apply because the date of effect is not earlier than 1 July 2013, the date that compensation is payable may vary for each of the conditions.
In such cases the date of effect for each condition to which section 68 applies is the later of:
- the date liability for each condition was claimed; and
- the date that the delegate determines to be the date on which all of the following applied:
- as a result of the accepted conditions, the person has suffered an impairment; and
- the impairment is likely to continue indefinitely; and
- the accepted condition has stabilised; and
- the requirements of section 69 (or section 70 for an aggravation) have been satisfied regarding the level of impairment.
Example 1 Client claims liability and PI for a condition on 12 June 2013. On the date of the claim all of the criteria for payment of PI are met. Subsequently, on 5 July 2013, the client claims liability and PI for a second condition which is permanent and stable. It is assessed at 3 impairment points. The two claims are determined together in August 2013.
5.7.1.1 does not apply as the date of effect for payment of additional PI for these two conditions would, under the former rules, be in July 2013 . Therefore in this example there are two dates of effect. They are:
- the first condition is payable from 1 July 2013 (the earliest date possible because the separate date of effect rules only apply from 1 July 2013); and
- the second condition is payable from 5 July 2013.
Example 2 Client claims liability and PI for a condition on 12 June 2013. On the date of the claim all of the criteria for payment of PI under section 68 are met except that the number of impairment points (4) does not meet the threshold. Subsequently, on 7 July 2013 and before a determination has been made, a revised assessment of the level of impairment is received from the doctor. As of 5 July the condition is assessed at 10 impairment points. Another condition is claimed on 25 July. This condition meets all of the criteria so that when, in August, a determination on the two conditions is made, the dates of effect for the two conditions are:
- the first condition is payable from 5 July 2013; and
- the second condition is payable from 25 July 2013.
Example 3 Client claims liability and PI for a condition on 24 August 2013. On the date of the claim all of the criteria for payment of PI under section 68 are met. On 2 September 2013 the client claims a second condition which is not yet stable. However by the time the two conditions are determined in December the second condition has stabilised. The delegate determines that the second condition stabilised on 25 November 2013. The dates of effect for the two conditions are:
- the first condition is payable from 24 August 2013; and
- the second condition is payable from 25 November 2013
Note the MRCA specifies it is the section 319 claim for acceptance of liability that sets one of the dates under section 77, not the claim for PI compensation. This can be especially important when calculating arrears for a person who elects to take periodic payments.