Determine the claim based on available information

It is open for PI delegates to determine PI claims based on the available evidence, if that evidence allows them to be satisfied that the relevant MRCA provisions have been met.  That is:

• the degree of impairment (sections 68, 71(1) and 71(2)), and
• the date when weekly compensation becomes payable for each condition (section 77).  

The general rule of thumb is to ask: 

Determine the claim based on available information

It may be appropriate for an IL claim to be determined in the following scenarios. This action should only be taken once the s330 process has been followed.

Before determining a claim based on available information, consider if:

Refer to the R&C ISH - Assign Claim – QRG (CM9: 17294879E) for instructions on how to reassign claims.

 This overarching process details the minimum standard of contact required when requesting information which only the client can provide. 

Clients can request an extension of time to provide requested information. Delegates and CSOs should accommodate all reasonable requests. 

If granted:

The policy contained in this manual relates to Household Services and Attendant Care services under both the Military Rehabilitation and Compensation Act 2004 (MRCA) and the Safety, Rehabilitation and Compensation (Defence-related Claims) Act 1988 (DRCA).
 

When investigating and determining a claim, delegates must consider and weigh up the relevant evidence before them.

Delegates should base their decisions on evidence that is:

• logically relevant 

Whole Person Impairment (WPI) of the fingers and toes is assessed using Tables 16-1, 16-2 and 16-3 of the AMA Guide for the fingers and Table 17-14 of the AMA Guide for the toes. These tables are complex in nature and often require specialist opinion to determine the impairment.

Form D9484 asks clinicians to indicate the loss of active range of movement (ROM) for the thumb and/or finger, for example, “loss of less than half normal range” etc.