Under subsection 77(1) of the MRCA [2], if PI compensation is payable under section 68 of the MRCA for a single accepted condition, that compensation is payable from the later of:
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:
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:
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:
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:
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:
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.
Under subsection 77(2) of the MRCA [2], if additional PI compensation is payable under subsection 71(1) of the MRCA for a single accepted condition, that compensation is payable from the later of:
5.7.2.1 Date additional compensation payable for more than one condition where person became entitled prior to 1 July 2013
If additional PI compensation is payable under section 71 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:
5.7.2.2 Date additional compensation payable for more than one condition where person became entitled on or after 1 July 2013
If additional PI compensation is payable under section 71 of the MRCA for more than one accepted condition and 5.7.2.1 does not apply because the date of effect is not earlier than 1 July 2013, the date that additional compensation is payable in respect of each of the conditions may vary.
In such cases the date of effect of the additional PI for each condition to which section 71(1) applies is the later of:
Note that the requirement for the increase in the overall impairment to constitute at least 5 impairment points can be met by the combination of several conditions. However, that criterion is not met by an individual condition that of itself is under the additional 5 point threshold, until the date it meets the threshold when combined with another condition (which is also likely to continue indefinitely and has stabilised).
Example 1 Client is in payment under section 68 for a number of accepted conditions. The client then claims liability and PI for a new condition on 12 June 2013. On the date of the claim all of the criteria for payment of additional PI are met. Subsequently, on 5 July 2013, the client claims another condition. As for the first condition, all criteria for payment of compensation under section 71 are met on the date of the claim for liability. The two claims are determined together in August 2013.
5.7.2.1 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:
Example 2 Client is in payment under section 68 for a number of accepted conditions. The client then claims liability and PI for a new condition on 13 August 2013. On the date of that claim all of the criteria for payment of additional PI under section 71 are met, except that the condition does not increase the whole person impairment by 5 impairment points. On 5 September 2013, the client claims liability and PI for another condition which is likely to continue indefinitely and is stable. All criteria are met on the date of the claim for liability and PI for the subsequent condition because the two conditions in combination increase the whole person impairment by more than 5 points. The two claims are determined together in October 2013.
The date of effect for the two conditions is 5 September 2013 because until combined with the subsequent condition, the condition claimed on 13 August 2013 did not meet the threshold required for payment of additional PI.
Example 3 Client is in payment under section 68 for a number of accepted conditions. Client claims liability and PI for an additional condition on 24 August 2013. On the date of the claim all of the criteria for payment of additional PI under section 71 are met. On 2 September 2013 the client claims a second additional 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:
Under subsection 77(3) of the MRCA [2], if additional PI compensation is payable under subsection 71(2) of the MRCA for deterioration of a single accepted condition, that compensation is payable from the later of:
5.7.3.1 Date additional compensation payable for deterioration of more than one condition where person became entitled prior to 1 July 2013
If additional PI compensation is payable under section 71 of the MRCA for the natural deterioration of more than one accepted condition from a date prior to 1 July 2013, that compensation is payable from the later of:
5.7.3.2 Date additional compensation payable for deterioration of more than one condition where person became entitled on or after 1 July 2013
If additional PI compensation is payable under section 71 of the MRCA for deterioration of more than one accepted condition and 5.7.3.1 does not apply because the date of effect is not earlier than 1 July 2013, the date that additional compensation is payable in respect of each of the conditions may vary.
In such cases the date of effect of the additional PI for each condition to which section 71(2) applies is the later of:
Links
[1] https://clik.dva.gov.au/user/login?destination=comment/reply/19384%23comment-form
[2] http://www.comlaw.gov.au/Series/C2004A01285
[3] https://clik.dva.gov.au/military-compensation-mrca-manuals-and-resources-library/policy-manual/ch-5-permanent-impairment/58-interim-permanent-impairment-compensation
[4] https://clik.dva.gov.au/user/login?destination=comment/reply/19339%23comment-form
[5] https://clik.dva.gov.au/user/login?destination=comment/reply/19351%23comment-form
[6] https://clik.dva.gov.au/service-eligibility-assistant-updates/all-determinations-order-date-signed-oldest-most-recent/determinations-under-mrca
[7] https://clik.dva.gov.au/user/login?destination=comment/reply/19381%23comment-form