VEA → [2]
This chapter gives an overview of the Guide to the Assessment of Rates of Veterans' Pensions (GARP) and how it is used to assess Disability Compensation Payment.
Guide to the Assessment of Rates of Veterans' Pensions
Guide to the Assessment of Rates of Veterans' Pension - GARP 5 [3]
Chapter 4.1 Disability Compensation Payment Eligibility [4]
GARP [8] is designed to provide accurate and equitable assessment of incapacity [8] from war-caused injuries [8] and diseases [8], in order to ensure that veterans [8] receive their rightful entitlement under the VEA [8].
More → [9]
The two elements of assessing incapacity are:
The overall medical impairment and lifestyle ratings are combined to determine the degree of incapacity. The degree of incapacity and other eligibility criteria determines the rate of Disability Compensation Payment.
More → [12]
Guide to the Assessment of Rates of Veterans' Pensions.
According to subsection 5D(2), incapacity from a war or defence-caused disease or injury is a reference to the effects of that injury or disease, and not a reference to the injury or disease itself.
According to subsection 5D(1), an injury means any physical or mental injury (including the recurrence of a physical or mental injury) but does not include:
According to subsection 5D(1), disease means:
but does not include:
the normal physiological state, or
the accepted ranges of physiological or biochemical measures,
that results from normal physiological stress (for example, the effect of exercise on blood pressure) or the temporary effect of extraneous agents (for example, alcohol on blood cholesterol levels).
For the purposes of Part VI of the VEA [21], a reference to a veteran is taken to be a reference to:
For the purposes of Part VII of the VEA [21], according to subsection 5C(1), veteran means a person (including a deceased person):
Veterans' Entitlements Act 1986.
GARP [8] is the legislative instrument used by decision-makers to determine the amount of Disability Compensation Payment [8] to pay a veteran [8] in respect of incapacity [8] from war-caused or defence-caused injuries [8] and diseases [8]. It looks at the medical impairment suffered as a result of war-caused disabilities and the effect on the veteran's lifestyle. Its provisions are binding on the Repatriation Commission [8], the Veterans' Review Board [8] and the Administrative Appeals Tribunal [8].
More → [23]
VEA → [24]
GARP contains:
The two elements of the assessment of the degree of incapacity using GARP are:
Guide to the Assessment of Rates of Veterans' Pensions.
Disability compensation payment (known before 2022 as disability pension), for the purposes of service pension, income support supplement and veteran payment, means:
Please note that the Disability Compensation Payment is legally a pension by way of compensation under the VEA so that concessional benefits under state, territory and local government legislation to pensioners/pensions under the VEA are not denied.
For the purposes of Part VI of the VEA [21], a reference to a veteran is taken to be a reference to:
For the purposes of Part VII of the VEA [21], according to subsection 5C(1), veteran means a person (including a deceased person):
According to subsection 5D(2), incapacity from a war or defence-caused disease or injury is a reference to the effects of that injury or disease, and not a reference to the injury or disease itself.
According to subsection 5D(1), an injury means any physical or mental injury (including the recurrence of a physical or mental injury) but does not include:
According to subsection 5D(1), disease means:
but does not include:
the normal physiological state, or
the accepted ranges of physiological or biochemical measures,
that results from normal physiological stress (for example, the effect of exercise on blood pressure) or the temporary effect of extraneous agents (for example, alcohol on blood cholesterol levels).
According to Section 179 [21]of the VEA [21], the Commission is a body corporate under the name of Repatriation Commission.
The Veterans' Review Board is an independent statutory authority that has the power to review decisions made by the Repatriation Commision [8] for the Disability Compensation Payment [8], war widow's/widower's pension [8], orphan's pension [8] and attendant allowance.
The Administrative Appeals Tribunal is an independent body established by the Administrative Appeals Tribunal Act 1975, which reviews certain administrative decisions of specified Departments and Government agencies. The Tribunal is headed by a judge of the Federal Court of Australia who may sit with other tribunal members who are either judges, lawyers or persons who may possess some experience relevant to the subject of the review.
This section outlines the two elements of the assessment of degree of incapacity [8] using GARP [8].
According to subsection 5D(2), incapacity from a war or defence-caused disease or injury is a reference to the effects of that injury or disease, and not a reference to the injury or disease itself.
Guide to the Assessment of Rates of Veterans' Pensions.
Medical impairment is the
Physical loss is the loss of, or disturbance to, any body part or system. Examples of physical loss include discomfort, pain and poor prognosis.
More ? [36]
Functional loss is measured by reference to an individual's performance efficiency compared with that of an average, healthy person of the same age and sex. This comparison is made using defined vital functions in the vital functions' tables in GARP [8]. The vital functions identified are:
Each functional loss associated with an accepted condition is identified and rated individually.
More ? [37]
Medical impairment is measured in [glossary:impairment points:], out of a maximum rating of 100. On this scale zero corresponds to nil or negligible impairment from accepted conditions [8], and 100 points corresponds to death. The impairment points are percentages of the impairment of the whole person. The final impairment rating is a combination of all ratings from all accepted conditions.
More ? [38]
If it is not possible to assess the impairment of an accepted condition that has previously been assessed using an earlier edition of GARP, then the impairment rating that was last given for the accepted condition would be used. If the impairment had not been previously assessed, and it is impossible to assess the impairment using GARP, then a best estimate must be made using whatever medical and other evidence is available concerning the extent of the impairment.
CCPS Research Library
Guide to the Assessment of Rates of Veterans' Pension - GARP 5 [40]
CCPS Research Library
Guide to the Assessment of Rates of Veterans' Pension - GARP 5 [40]
CCPS Research Library
Guide to the Assessment of Rates of Veterans' Pension - GARP 5 [40]
CCPS Research Library
Guide to the Assessment of Rates of Veterans' Pension - GARP 5 [40]
CCPS Research Library
Guide to the Assessment of Rates of Veterans' Pension - GARP 5 [40]
A lifestyle effect is a disadvantage, resulting from an accepted condition [8] that limits or prevents the fulfilment of a role that is normal for a veteran of the same age without the accepted condition. GARP [8] rates four components of a veteran's life that may be affected by war-caused incapacity:
Personal relationships refer to the veteran's ability to take part in and maintain customary social, sexual and interpersonal relationships. GARP attempts to establish how the physical and psychological effects of accepted conditions affect these relationships.
Mobility refers to the veteran's ability to move about effectively in carrying out the ordinary activities of life. GARP measures the effects of the accepted conditions on the veteran's mobility. It allows for the veteran's ability to use available forms of transport. Both physical and psychological impediments to mobility are taken into account when determining a mobility rating.
Recreational and community activities refer to the veteran's ability to take part in any activities of the veteran's choosing. When determining a rating the limitation placed by the accepted condition on the veteran's normal recreational and community activities is measured. The need to modify recreational activities or seek alternatives is taken into account.
Employment activities refers to the veteran's ability to work and domestic activities refers to the veteran's ability to sustain effective routines in a domestic environment The effects of the accepted conditions on the veteran's ability to work and/or perform domestic activity is taken into account.
Lifestyle effects are used to calculate an overall lifestyle rating. The rating is expressed as a number on a scale from zero to seven. A zero rating indicates that the veteran's lifestyle is only negligibly affected by the accepted condition. A rating of seven indicate that the effect of the accepted conditions on a veteran's lifestyle is of the utmost severity.
More → [48]
Veterans can use three optional methods to have their lifestyle effects rated:
A person’s lifestyle rating is expected to be broadly consistent with the degree of medical impairment from the accepted conditions. In most cases, a lifestyle rating that falls within the shaded area of Table 23.1 of GARP V is broadly consistent with the degree of medical impairment. Accordingly GARP V states:
“The self-assessed rating should not usually be queried although further information may be requested if necessary. It is expected that the self-assessed lifestyle rating would be broadly consistent with the level of impairment. A delegate may reject a self-assessment of lifestyle rating because it overestimates, or underestimates, the level of rating that is broadly consistent with the level of impairment from accepted conditions”
However, 'broad consistency' is not equivalent to the shaded area only. As lifestyle ratings are inherently subjective, it is possible for a client's self-assessed lifestyle rating to be above the shaded area, should the effect on the client's lifestyle warrant it. The lifestyle effects of a knee injury on a professional triathlete are likely to be greater than the lifestyle effects of a knee injury on a person who enjoys only sedentary activities.
In addition to this, the DVA form D2670 – Lifestyle Rating (the form sent to clients to enable them to choose the optional methods of lifestyle assessment in accordance with Chapter 22) states, “The Department relies on your honesty when filling in the self assessment. However, we will check a small number of forms and may ask for more information. It is important that you fill in the self assessment carefully.”
Delegates should accept a client self-assessed rating unless there is evidence to indicate that it is a vast over or underestimation. That a self-assessed lifestyle rating falls outside the shaded area does not automatically invalidate the self-assessed rating, except in situations where it is clear that the self-assessed rating is not supported by the evidence.
After a rounded combined impairment rating and lifestyle rating has been obtained they are combined to determine the degree of incapacity. The degree of incapacity is expressed by a number, which is a percentage.
More ? [54]
Degree of incapacity and other eligibility criteria determines whether the veteran [8] will receive:
For the purposes of Part VI of the VEA [21], a reference to a veteran is taken to be a reference to:
For the purposes of Part VII of the VEA [21], according to subsection 5C(1), veteran means a person (including a deceased person):
The Extreme Disablement Adjustment (EDA) is the equivalent of 150% of the General Rate. It is payable to very severely incapacitated veterans of 65 years & over who do not qualify for the Special or Intermediate Rates.
Cardiorespiratory impairment generally results from conditions or diseasses that affect the function of a person's heart or lungs.
GARP explains what conditions should be assessed under Chapter 1 of the Guide and how the assessment of a client’s condition should be performed to calculate the impairment rating. In assessing the impairment clinical features of injuries or diseases are to be taken into account and in all cases should be determined by following each of the steps described in the Chapter. Assessors should be aware of the ‘Introduction’ and ‘How To Use This Guide’ sections of GARP and follow these in conjunction with the relevant medical sections of the chapter when assessing and determining the relevant impairment rating.
Generally, cardiorespiratory impairment is measured by reference to exercise tolerance.
Spirometry should always be obtained if any condition affecting the function of the lungs is present. The spirometry tests will obtain the usual physiological measurements of lung function which are FEVl, FVC, and MEF 25-75. Chapter 1 sets out the steps for obtaining the readings from spirometry tests and how to find the corresponding impairment rating.
For the purpose of determining a rating under Table 1.1, GARP instructs that first all relevant data/measurements (including MEF25-75) are collected and expressed as a percentage of the predicted measurement.
The Guide states that the person assessing the data should determine the 'appropriateness' of the MEF data in the particular circumstances, and whether it is included in following steps to calculate the impairment rating. The person undertaking the GARP assessment and determining the level of impairment therefore has scope for the consideration of the inclusion or exclusion of the MEF 25-75 data as a marker of impairment, and this discretion should be exercised on a case-by-case basis, rather than a one-size-fits-all approach
There is no explicit ruling made on the use of the measurement, however the Guide states for the measurements of lung function that readings of spirometry should be consistent with the conditions affecting the veterans and there should be no unexplained inconsistencies between various reports/readings. The collection and inclusion of the recorded MEF data, if obtained by an assessing doctor should generally be used as part of the GARP assessment where it is consistent with the client's condition and impairment. When the "nature of the Spirometry cannot be reconciled with other relevant information" repeat Spirometry tests should be conducted or Specialist review to reconcile any differences.
There are cases where a discrepancy will exist between the clinical-scientific understanding of a condition or other evidence of the functional impairment and the impairment rating obtained (when including MEF data). Examples below have been provided as a guide that illustrate such cases and where MEF data may or may not be relevant to assessing an impairment rating under GARP.
There is a strong relationship to other markers of disease severity and FEV1 and FVC are often normal, MEF25-75 can accurately represent the impact of the disease.
MEF25-75 may well have been used as the diagnostic test and should be used for the impairment assessment. If there is a marked discrepancy between the MEF25-75 rating and a MET rating in the presence of cardiac disease, it would be reasonable to obtain further information in order to reconcile the differences.
In this case, the MEF25-75 may not be a reliable investigation findings (as it is not reproducible), not an accurate marker of the severity of the disease, and not likely to reflect the functional impact.
Note: these are examples only, and should not limit an assessor’s consideration of other or different conditions for which MEF data may or may not be an accurate marker of the disease and included in the assessment.
If there is medical opinion provided that use of MEF data is not appropriate at Step 4, reasons for this are to be provided by a CMA for excluding the measurement from the GARP assessment rather than disregarding MEF data in all cases. A CMA opinion ultimately is not an independent decision from the GARP assessment, therefore it is up to the Delegate to determine the final impairment and if the CMA’s opinion is accepted and incorporated into the final assessment. Part of the Delegate’s decision making is to weigh up all of the available medical evidence including input from a CMA when determining impairment. Delegates should ensure they understand the medical opinion being provided by a CMA and be reasonably satisfied with any justification provided in support of including or excluding MEF 25-75 data.
9.8.6 Chapter 3 – Impairment of Spine and Limbs
This chapter is used to assess the motor function of the spine and limbs.
In the assessment of spinal conditions using this chapter, GARP states;
‘If a spinal condition causes an effect on limb function, then that effect on limb function is also to be assessed under Parts 3.1 or 3.2 ……. For example, if a spinal condition which causes a reduced range of spinal movement also interferes with the proper function of the limbs, then a rating from Table 3.3.1 may be combined with a rating from Table 3.1.2 or 3.2.2”
GARP provides that spinal conditions that ‘cause an effect’ on limb function are assessed not only under the tables relating to spinal conditions (3.3), but that the effect of the spinal condition on limb function is also to be assessed under a table from Parts 3.1 (upper limb) or 3.2 (lower limb), whichever is relevant.
The lumbar spine and associated musculature are fundamental structures for mobility, stabilising the walking apparatus and allowing for upright posture; both requirements for efficient lower limb function. Medical evidence supports the understanding that lumbar spine disease, including degenerative joint diseases such as Lumbar Spondylosis, impacts lower limb function.
It is important to recognise some conditions will affect more than one body part/systems and may require consideration/assessment under more than one table and/or chapter. Functional outcomes such as difficulty with stair climbing, slowed walking speed, and the need for walking aids, can all be direct outcomes of lumbar spine disease, and are only adequately addressed by Table 3.2.2 in the GARP. For example, where there is loss of the ability to climb stairs due to a diagnosis of Lumbar Spondylosis, it is appropriate to assess this under table 3.2.2.
Delegates should be particularly mindful of applying this when the effect of a spinal condition on limb function is supported with appropriate medical evidence from the clients treating or assessing medical practitioner.
Medical opinion on the functional loss may be based on an examination of the client, medical history, and/or diagnostic imaging. The delegate would need to be satisfied that the medical report provided supports the rating allocated under any of the GARP tables. Further evidence can be sought from the assessing medical practitioner if this is unclear.
Therefore, if there is medical evidence to support that there is a loss covered by one of the limb tables as a result of a spine condition, then an impairment rating should be assigned and the veteran compensated accordingly.
The below outlines a general policy for assessing permanent impairment (PI) compensation and Disability Compensation Payment (DCP) for tinnitus. The purpose of the policy is to align permanent impairment assessment with clinical best practise and ensure claims are evaluated consistently and accurately.
This policy applies to all cases regardless of whether the person is a serving member or a former member. Unlike the incapacity provisions of the MRCA, the PI provisions do not make a distinction between serving and former members. The VEA DCP provisions also apply equally to former and serving members.
Where tinnitus is very severe it is a debilitating condition causing extreme discomfort with significant effect to an individual’s lifestyle.
Where milder, the condition may be tolerable for much of the time, with a minor effect to lifestyle.
Determination of a PI or DCP claim for tinnitus should NOT rely on self-assessment alone with regard to severe to very severe tinnitus (tinnitus warranting a GARP rating of 10 to 15). However, provided the delegate is comfortable with the assessment (i.e. there is no contrary evidence), milder tinnitus (tinnitus warranting a GARP rating of 0 to 5) can be determined without further investigation.
Where the evidence indicates a severe or very severe impairment, a client must be referred to an audiologist before the delegate determines the appropriate GARP impairment rating.
An audiologist is qualified to assess and determine tinnitus severity using a set of scientifically validated questions known as the Tinnitus Functional Index (TFI). There are available alternative assessment methodologies but, among other advantages, the TFI was developed and validated with a veteran population and exhibits sensitivity to mental health issues.
Delegates should explicitly request the TFI be used (See Hearing Condition - Medical Assessment.pdf [63]). The audiologist will provide a TFI score out of 100 in their clinical report. This score is sufficient to determine the impairment rating under GARP in the vast majority of cases.
The delegate should make use of Table A to translate the TFI score into an impairment rating.
impairment rating | criteria | tfi score |
---|---|---|
NIL | No tinnitus or occasional tinnitus. | 0 - 17 |
TWO | Very mild tinnitus: not present every day. | 18 - 31 |
FIVE | Tinnitus every day, but tolerable for much of the time. | 32 - 53 |
TEN | Severe tinnitus, e.g. of similar severity to that requiring a masking device, present every day. | 54 - 72 |
FIFTEEN | Very severe tinnitus, present every day, causing distraction, loss of concentration and extreme discomfort, and regularly interfering with sleep. | 73 - 100 |
Table A
If the audiologist is unable to accurately assess a person, or if the audiologist suspects there may be other medical issues that require attention, the audiologist can refer the person for an assessment by a specialist (e.g. an ENT or neurologist). The delegate should make the referral processes clear to the audiologist. The delegate should not refer the person to an ENT unless this is recommended by the audiologist, GP or another specialist.
Person already has an audiology report
In the event that the person already has an audiologist report, this should be used – provided that it is no more than three years old. Ideally the report would have some score or evaluation relating to tinnitus. If there is not sufficient evidence in the report on hand, the assessing audiologist should be contacted by the delegate in order to clarify their view of the tinnitus severity.
Audiologist does not make use of the TFI
Although the TFI is most suitable for the veteran population, this does not discount other questionnaires as invalid for the assessment of tinnitus. Some audiologists may decline to use the TFI and make use of an alternative assessment methodology. In the event this occurs, the delegate should utilise this alternative assessment method (such as the Tinnitus Handicap Questionnaire or the Tinnitus Reaction Questionnaire) in determining impairment. The audiologist should not be asked to reassess on the basis that they have substituted the TFI for an alternative method, nor should the client be sent for another assessment. However, it would be permissible for the client to be reassessed if the audiologist report makes no reference to an assessment methodology and provides no helpful description of the symptoms at all - for example, there is a single statement along the lines of “experiences severe tinnitus” – or makes no reference to tinnitus at all (i.e. is just a hearing assessment).
Tables for the conversion from these alternative assessment scores into impairment ratings under GARP can be found in HP content manager at record number 20167512E
Some points as to why the TFI is the preferred assessment tool:
TFI score is on the boundary of an impairment rating
The advancement of research in tinnitus has resulted in a mismatch between the broad categories of the GARP impairment ratings and the detailed information provided by the TFI. As such, there are going to be cases in which a client will receive a TFI score which is on the boundary of the impairment rating under GARP. For example, a client may have a TFI score of 72, which is on the upper boundary for a GARP impairment rating of ten. Only a single TFI point would have placed such a person in the higher GARP impairment rating of 15. Or a person may have a TFI score of 54, which is the lower boundary of the impairment rating of ten.
In such a situation, the delegate should determine the person in the higher or lower rating only if there is sufficient reason to do so. Simply being on the boundary is not a sufficient reason to place them in the alternative rating.
What would constitute sufficient reason for placing the client in a lower or higher impairment rating? Delegates should consider other information that helps determine the functional impact of tinnitus, such as the presence or absence of mental health conditions, reported information about its impact on work performance, sleep or close relationships.
If the delegate has information that shows a discrepancy between the impairment rating and a boundary TFI score, the delegate may make a decision to determine a higher or lower impairment rating. Table B may help in this regard.
impairment rating | criteria | tfi score | impact guide | presentation guide |
---|---|---|---|---|
NIL | No tinnitus or occasional tinnitus | 0 - 17 | Not a problem | Non. |
TWO | Very mild tinnitus: not present ever day. | 18 - 31 | Small problem | May be noticed occasionally, no impact on daily life. |
FIVE | Tinnitus ever day, but tolderable for much of the time. | 32 - 53 | Moderate problem | Frequently noticed, may interfere with sleep, occasional impact on performing everyday tasks. |
TEN | Severe tinnitus, e.g. of similar severity to that requiring a masking device, present every day. | 54 - 72 | Big problem | Always noticed, frequently distracts and impairs everyday tasks, frequently interferes with sleep, evidence of anxiety, depression, anger, irritability. |
FIFTEEN | Very severe tinnitus, present every day, causing distraction, loss of concentration and extreme discomfort, and regularly interfering with sleep. | 73 - 100 | Very big problem | Advanced trouble performing everyday activities, insomnia, psychological consultation, failure of human relations, suicial ideation. |
Table B
The fourth and fifth columns provide descriptions based on validation of the TFI in the latest research. These may be used by the delegate to override the boundary TFI score and place the person in a higher or lower impairment rating (note that these two columns are for internal use only). For example, if a person has a TFI score of 72, and yet information on hand shows they match the description in the 6th row of the fifth column (the Presentation Guide), then it would be appropriate to determine an impairment rating of fifteen. Likewise, if a person’s TFI score was 53, and they did not report impact on performing daily tasks or significant sleep interference, then a rating of five would be appropriate. Benefits and Payments Policy section can be contacted if the delegate requires guidance in this regard.
The delegate is entitled to assume that an impairment rating is permanent and stable. Given the nature of the condition, a person with tinnitus is highly likely to satisfy the legislative requirements for permanency and stability [64]. With regard to tinnitus:
Although there are available therapeutic treatments, such as Tinnitus Retraining Therapy, for managing tinnitus, these are not designed to resolve the underlying condition. Rather, they are designed to help manage a person’s response to tinnitus. A person’s response to tinnitus is highly subjective and variable, and depends on many factors that may be unique to a given person. As such, there is no guarantee that such treatment regimens would improve a person’s ability to manage their tinnitus.
Also to be considered is that a refusal by the person to participate in such treatment programs would be compatible with the policy on reasonable refusal of treatment [65].
For claims made under section 68 or section 71(1), the date of effect for tinnitus would normally be the date of the liability claim, even in cases where evidence of impairment thresholds is obtained later. The intention of this policy is to enable the delegate to determine the date of effect no later than the original date of liability claim for tinnitus.
However, for re-assessments under s71(2), delegates will be required to consider the date of the new PI claim, rather than the liability claim, and new evidence indicating that the impairment has deteriorated to the requisite degree. The following table provides an overview of the relevant considerations for the delegate:
Claim type | Permanent & stable | Date of effect |
New claims (s68 or s71(1)) | An assumption can be made that tinnitus is permanent and stable from the date it was diagnosed (usually before the liability claim)
| The date of effect (the later date) will usually be the liability claim date |
Reassessments (s71(2)) | An assumption can be made that tinnitus is permanent and stable from the date it was diagnosed (usually before liability claim) | The date of effect will be the later of either: (a) the date of written or oral request for additional compensation, or (b) the date the delegate is satisfied the impairment increased by at least 5 points, in most cases, by way of a new TFI report |
Where a person, before the introduction of the policy requiring the use of objective testing (i.e. the TFI or similar), already attained a rating of 15 points for tinnitus (being the maximum points available under GARP), the Department’s approach is that no further testing or investigation is necessary.
Where a person’s tinnitus is yet to be rated at 15 points, and the veteran is requesting an increase to their DCP, or reassessment for MRCA PI purposes, then the condition is subject to a reassessment, and the Department should use the current testing guidelines to examine whether a change to the tinnitus rating is appropriate.
The below outlines a general policy for assessing PI compensation and DCP for the assessment of hearing loss where the veteran has undergone surgery to fit a cochlear implant device. A known side-effect of implanting the device is that the veteran’s remaining natural hearing loss is destroyed, however, with the device switched on, the veteran’s level of hearing is significantly improved.
The GARP provides clear instructions regarding the assessment of hearing loss in situations where the veteran has a hearing aid. In that situation, a veteran’s hearing loss must be measured without the benefit of any hearing aid. For consistency and to align this principle with all hearing loss claims, the assessment of hearing loss should be performed with the cochlear device switched off.
When considering PI under the MRCA, the delegate should also consider whether the impairment has reached a stable and static level following the medical procedure to implant the device, as the stabilisation of hearing following this process can take some months.
The VEA DCP provisions however do not require the delegate makes any consideration regarding permanence or stability.
Part 10.1 of GARP relates to the assessment of impairment associated with an accepted loss of sexual function.
Key Points
Therapies for Sexual Dysfunction for the purposes of GARP
GARP (V/M) was written prior to the introduction of medical therapies for the treatment of sexual dysfunction. Where medical treatment has been used successfully, this should be considered equivalent to “impotence ameliorated by surgical treatment”. Where medical treatment has been used unsuccessfully, is associated with limiting side effects, or is contraindicated, this should be considered equivalent to “impotence not ameliorated by surgical treatment”. That is, for the purpose of obtaining a rating of the impairment due to sexual dysfunction, medical and surgical therapies are equivalent.
Assessment under GARP for sexual dysfunction conditions and the impairment
Based on the above policy, it follows that in the case of successful treatment with medical therapy, a rating should still be selected from the relevant Table (Table 10.1.1) for erectile dysfunction in males. For consistency, in the case of successfully treated female sexual dysfunction, a rating should still be applied from Table 10.1.2, or scope given to allow an appropriate over-ride impairment rating.
Table 10.1.1 of the GARP describes the impairment rating associated with various degrees of loss of sexual function in a male. The table provides for a different rating for impotence which is ameliorated by surgical treatment to that which is not so ameliorated. It is important to note that successful treatment does not result in a rating of zero (with one exception). This position recognises that, by the nature of the condition, the impairment associated with erectile dysfunction is not limited to the physical aspect alone.
Implicit in Table 10.1.1 is that the rating for “impotence not ameliorated by surgical treatment” should be applied only when therapy has been tried and has been unsuccessful, is associated with limiting side effects, or is contraindicated. In addition, given the availability and ease-of-use of current therapies, lack of treatment may reflect a lower subjective level of impairment. Therefore, in most cases, the lower impairment rating should be awarded in the absence of a trial of reasonable treatment.
If there is complete resolution of the condition, for example following treatment of an underlying medical condition, a rating of negligible may be appropriate.
Links
[1] https://clik.dva.gov.au/user/login?destination=node/16030%23comment-form
[2] https://clik.dva.gov.au/book/export/html/16030#tgt-cspol_part9_ftn620
[3] clik://RESEARCH/G5-instrument
[4] https://clik.dva.gov.au/compensation-and-support-policy-library/part-4-disability-compensation-eligibility/41-disability-compensation-payment-eligibility
[5] clik://LEGIS/VEA/section 29
[6] https://clik.dva.gov.au/book/export/html/16030#ref-cspol_part9_ftn620
[7] https://clik.dva.gov.au/user/login?destination=node/16029%23comment-form
[8] https://clik.dva.gov.au/%23
[9] https://clik.dva.gov.au/book/export/html/16030#tgt-cspol_part9_ftn621
[10] https://clik.dva.gov.au/book/export/html/16030#tgt-cspol_part9_ftn622
[11] https://clik.dva.gov.au/book/export/html/16030#tgt-cspol_part9_ftn623
[12] https://clik.dva.gov.au/book/export/html/16030#tgt-cspol_part9_ftn624
[13] https://clik.dva.gov.au/compensation-and-support-policy-library/part-9-principles-determining-pension-rate/98-guide-assessment-rates-veterans-pensions-garp/982-what-garp
[14] https://clik.dva.gov.au/book/export/html/16030#ref-cspol_part9_ftn621
[15] https://clik.dva.gov.au/compensation-and-support-policy-library/part-9-principles-determining-pension-rate/98-guide-assessment-rates-veterans-pensions-garp/983-elements-degree-incapacity/medical-impairment
[16] https://clik.dva.gov.au/book/export/html/16030#ref-cspol_part9_ftn622
[17] https://clik.dva.gov.au/compensation-and-support-policy-library/part-9-principles-determining-pension-rate/98-guide-assessment-rates-veterans-pensions-garp/983-elements-degree-incapacity/lifestyle-effects
[18] https://clik.dva.gov.au/book/export/html/16030#ref-cspol_part9_ftn623
[19] https://clik.dva.gov.au/compensation-and-support-policy-library/part-9-principles-determining-pension-rate/98-guide-assessment-rates-veterans-pensions-garp/984-degree-incapacity-and-assessment-pension
[20] https://clik.dva.gov.au/book/export/html/16030#ref-cspol_part9_ftn624
[21] http://clik.dva.gov.au/legislation-library
[22] https://clik.dva.gov.au/user/login?destination=node/16119%23comment-form
[23] https://clik.dva.gov.au/book/export/html/16030#tgt-cspol_part9_ftn625
[24] https://clik.dva.gov.au/book/export/html/16030#tgt-cspol_part9_ftn626
[25] https://clik.dva.gov.au/book/export/html/16030#tgt-cspol_part9_ftn627
[26] https://clik.dva.gov.au/book/export/html/16030#tgt-cspol_part9_ftn628
[27] https://clik.dva.gov.au/book/export/html/16030#ref-cspol_part9_ftn625
[28] clik://LEGIS/VEA/section 29(1)
[29] https://clik.dva.gov.au/book/export/html/16030#ref-cspol_part9_ftn626
[30] https://clik.dva.gov.au/compensation-and-support-policy-library/part-9-principles-determining-pension-rate/98-guide-assessment-rates-veterans-pensions-garp/983-elements-degree-incapacity
[31] https://clik.dva.gov.au/book/export/html/16030#ref-cspol_part9_ftn627
[32] https://clik.dva.gov.au/book/export/html/16030#ref-cspol_part9_ftn628
[33] https://clik.dva.gov.au/user/login?destination=node/16135%23comment-form
[34] https://clik.dva.gov.au/user/login?destination=node/16078%23comment-form
[35] https://clik.dva.gov.au/book/export/html/16030#tgt-cspol_part9_ftn629
[36] https://clik.dva.gov.au/book/export/html/16030#tgt-cspol_part9_ftn630
[37] https://clik.dva.gov.au/book/export/html/16030#tgt-cspol_part9_ftn631
[38] https://clik.dva.gov.au/book/export/html/16030#tgt-cspol_part9_ftn632
[39] https://clik.dva.gov.au/book/export/html/16030#tgt-cspol_part9_ftn633
[40] https://clik.dva.gov.au/reports-studies-research-papers-library
[41] https://clik.dva.gov.au/book/export/html/16030#ref-cspol_part9_ftn629
[42] https://clik.dva.gov.au/book/export/html/16030#ref-cspol_part9_ftn630
[43] https://clik.dva.gov.au/book/export/html/16030#ref-cspol_part9_ftn631
[44] https://clik.dva.gov.au/book/export/html/16030#ref-cspol_part9_ftn632
[45] https://clik.dva.gov.au/book/export/html/16030#ref-cspol_part9_ftn633
[46] https://clik.dva.gov.au/user/login?destination=node/16131%23comment-form
[47] https://clik.dva.gov.au/book/export/html/16030#tgt-cspol_part9_ftn634
[48] https://clik.dva.gov.au/book/export/html/16030#tgt-cspol_part9_ftn635
[49] https://clik.dva.gov.au/book/export/html/16030#tgt-cspol_part9_ftn636
[50] https://clik.dva.gov.au/book/export/html/16030#ref-cspol_part9_ftn634
[51] https://clik.dva.gov.au/book/export/html/16030#ref-cspol_part9_ftn635
[52] https://clik.dva.gov.au/book/export/html/16030#ref-cspol_part9_ftn636
[53] https://clik.dva.gov.au/user/login?destination=node/16082%23comment-form
[54] https://clik.dva.gov.au/book/export/html/16030#tgt-cspol_part9_ftn637
[55] clikpopup://DEF/Special Rate (T&PI)
[56] https://clik.dva.gov.au/book/export/html/16030#tgt-cspol_part9_ftn638
[57] https://clik.dva.gov.au/book/export/html/16030#ref-cspol_part9_ftn637
[58] https://clik.dva.gov.au/book/export/html/16030#ref-cspol_part9_ftn638
[59] https://clik.dva.gov.au/tags/garp
[60] https://clik.dva.gov.au/tags/impairment
[61] https://clik.dva.gov.au/tags/spine
[62] https://clik.dva.gov.au/tags/limbs
[63] http://auth-clik.dvastaff.dva.gov.au/system/files/images/Hearing_Tinnitus%20Condition%20%282019%20final%29_0.pdf
[64] https://clik.dva.gov.au/military-compensation-mrca-manuals-and-resources-library/policy-manual/ch-5-permanent-impairment/53-when-impairment-likely-continue-indefinitely
[65] https://clik.dva.gov.au/military-compensation-mrca-manuals-and-resources-library/policy-manual/ch-5-permanent-impairment/55-unreasonable-refusal-medical-treatment-examination-or-rehabilitation-program