GARP M provides detailed instructions and tables for the assessment of the degree of medical impairment suffered by the claimant as a result of the accepted condition(s).  Medical impairment has two components:

• physical loss of, or disturbance to, any body part or system; and
• the resultant functional loss.

Chapter 1 to 17 of GARP M contain two principal types of tables for each of these components.  Physical loss is given an IP rating against criteria in “Other Impairment” tables and functional loss is given an IP rating against criteria in “Functional Loss” tables.

Medical impairment, as measured chiefly by loss of vital functions, is addressed in twelve system specific chapters, as follows:

• Chapter 1  Cardiorespiratory Impairment
• Chapter 2  Hypertension and Non-Cardiac Vascular Conditions
• Chapter 3  Impairment of Spine and Limbs
• Chapter 4  Emotional and Behavioural
• Chapter 5  Neurological Impairment
• Chapter 6  Gastrointestinal Impairment
• Chapter 7  Ear, Nose, and Throat Impairment
• Chapter 8  Visual Impairment
• Chapter 9  Renal and Urinary Tract Function
• Chapter 10  Sexual Function, Reproduction, and Breasts
• Chapter 11  Skin Impairment
• Chapter 12  Endocrine and Haemopoietic Impairment

There are five chapters describing methods of assessing certain non-system specific conditions.  They are:

• Chapter 13  Negligible Impairment
• Chapter 14  Malignant Conditions
• Chapter 15  Intermittent Impairment
• Chapter 16  Activities of Daily Living
• Chapter 17  Disfigurement and Social Impairment

R&C ISH is a system designed to assist in determining all Rehabilitation and Compensation Claims.  The Delegate Step by Step [4]guide will assist in recording Lifestyle ratings. 

5.16.3.1 Method of assessment of lifestyle effect for calculating interim impairment payments

When calculating an interim impairment payment amount under subsection 75(2) of the MRCA [6], the Commission must allocate a lifestyle rating using the following methodology:

Step 1:

Obtain the lifestyle rating for all conditions previously determined.

Step 2:

Work out the lifestyle rating for all conditions (including the current condition in respect of which a determination has not been made) using:

(a) the top of the shaded area for impairment points between 0 and 15; or

(b) in any other case — the bottom of the shaded area.

Step 3:

Use the highest of the lifestyle ratings from steps 1 and 2 to calculate the interim PI payment

This method of assessment for interim permanent impairment is not to be used when subsection 75(4) of the Act applies. The methods as outlined in Section 5.16.3.2 should then be used.

5.16.3.2 Optional methods of assessment when all conditions stabilised

Once all conditions have stabilised, lifestyle effects are to be assessed by applying Tables 22.1 to 22.5 in Chapter 22 in accordance with that chapter. There are three optional methods of assessing lifestyle effects:

· Option 1 allows the claimant to self-assess the effects of the accepted conditions on his or her lifestyle;

· Option 2 is to be used if the claimant chooses not to self-assess or to complete a Lifestyle Questionnaire;

· Option 3 is to be used if the claimant completes a Lifestyle Questionnaire.

The claimant may choose which of these methods is to be used for his or her assessment. Where no option has been or can be chosen, the delegate is to determine a lifestyle rating by following Option 2. See Chapter 22: Lifestyle Effects of GARP M for more information.

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 or Table 23.2 of GARP M is broadly consistent with the degree of medical impairment.  Accordingly GARP M 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”

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.