6.2.4 Impairment assessments
6.2.4.1 IIA combines the overall whole person impairment | 6.2.4.2 Assessment methods | 6.2.4.3 Find an IIA, HLA or dual purpose examiner | 6.2.4.4 Provide information to IIA | 6.2.4.5 Worker’s supporting medical evidence | 6.2.4.6 Multiple injuries - impairment assessment | 6.2.4.7 Deviation of impairment determinations | 6.2.4.8 Fee schedules
This section deals with how to assess a claim for impairment benefits.
6.2.4.1 IIA combines the overall whole person impairment
For calculating:
- IB Impairment Benefits claims
- common law entitlement
- voluntary settlement A lump sum payment that replaces an injured worker's right to ongoing weekly compensation.
the IIA is responsible for the following.
Combining physical impairments
Injuries between 12/11/97 to 02/12/03
For injuries which have occurred on or after 12/11/97 to 2/12/03, when all of a worker’s impairments have been assessed, one combining IIA should be requested to combine physical impairments related to injuries or diseases sustained on the same occasion (or through gradual onset due to the same duties or conditions) as follows:
- physical impairments related to the injuries or diseases sustained on the same occasion assessed under every chapter of the AMA4 Guides
- for claims lodged or claims with the first impairment assessment on or after 10 December 2009, spine injuries assessed under Chapter 3 of the AMA4 Guides sustained on the same occasion.
For claims lodged before 18/11/04 the IIA is required to combine the WPI Whole person impairment.
Agents can determine the liability and entitlement in relation to a claim for impairment benefits and therefore combine the impairments if they are unable to request an impairment assessor to complete the task.
Total impairment for each class of impairment
Injuries between 12/11/97 to 02/12/03
For injuries which have occurred between 12/11/97 and 2/12/03, the IIA should be requested to identify the overall impairment (physical and psychiatric) whole person assessment, caused by each event or circumstance (or through gradual onset due to the same duties or conditions) as follows:
- physical impairments related to the injuries or diseases sustained on the same occasion assessed under every chapter of the AMA4 Guides
- for claims lodged or claims with the first impairment assessment on or after 10 December 2009, spine injuries assessed under Chapter 3 of the AMA4 Guides sustained on the same occasion.
Agents can determine the liability and entitlement in relation to a claim for impairment benefits and therefore combine the impairments if they are unable to request an impairment assessor.
Injuries on or after 03/12/03
For injuries which have occurred on or after 3/12/03 the IIA should be requested to identify the overall:
- for claims lodged or claims with the first impairment assessment on or after 10 December 2009, whole person impairment for spine injuries assessed under Chapter 3 of the AMA4 Guides sustained on the same occasion
- whole person impairment for injuries assessed under Chapter 3 of the AMA4 Guides sustained on the same occasion
- whole person impairment (physical and psychiatric), caused by each event or circumstance.
IIA should also be requested to separate the total loss injuries from the overall impairment (physical and psychiatric) whole person assessment.
Agents can determine the liability and entitlement in relation to a claim for s98C and s98E and therefore combine the impairments if they are unable to identify:
- for claims lodged or claims with the fires impairment assessment on or after 10 December 2009, whole person impairment for spine injuries assessed under Chapter 3 of the AMA4 Guides sustained on the same occasion
- whole person impairment for injuries assessed under Chapter 3 of the AMA4 Guides sustained on the same occasion
- whole person impairment (physical and psychiatric) caused by each event or circumstance.
IIA should also separate the total loss injuries from the overall impairment (physical and psychiatric) whole person assessment.
Combining for common law threshold & voluntary settlement (ICRP)
For all injuries, the IIA should be requested to combine physical and non-secondary (primary) psychiatric impairments using the Combined Values Chart for two impairments or the formula in the Combined Values Calculator to combine three or more impairments in order for the Agent to advise the worker of their whole person impairment for common law election purposes and/or voluntary settlement.
Note: For a worker to be deemed as having a serious injury they must have a 30% or greater combined whole person impairment (both physical and primary psychiatric impairment). Physical and primary psychiatric impairment is not combined to calculate entitlement to compensation for impairment.