126.96.36.199 Stabilisation of injuries
The assessment of impairment can only be made when a worker’s injuries have stabilised.
The legislation refers to the impairment made in line with the AMA4 Guides, Records & Reports, Chapter 2, section 2.3 General Comments on Evaluations:
An impairment should not be considered “permanent” until the clinical findings, determined during a period of months, indicates that the medical condition is static and well stabilised.
Worker to be assessed by IIA
If the Agent is notified that the worker’s injuries has not stabilised by the time of the impairment assessment, the IB Impairment Benefits Specialist must:
- identify the injuries which are yet to stabilise
- request medical evidence from the worker’s treating practitioner to support the stabilisation of the injuries in question.
The Agent will only arrange for the worker to be examined by the IIA Independent impairment assessment when all accepted injuries are confirmed to be medically stable.
For claims lodged on or after 18/11/04 claims
If the condition is not stabilised the Agent must within 90 days of receipt of the IB claim advise the worker if the Impairment Benefit claim is to be suspended. For details on suspension of an IB claim – see: Suspend impairment process.
If the Agent is advised that the injury / condition has not stabilised post 90 days from the date of receipt of the IB claim the Agent cannot suspend the claim. However, the worker must be advised in writing why a determination of liability and entitlement cannot be issued within 120 days of receiving the IB claim.
IIA scheduled but worker has not been examined
If the Agent is notified that the worker’s injuries has not stabilised but they have already progressed the claim to have the worker examined by the IIA, the IB Specialist must:
- cancel the scheduled IIA examination
- request medical evidence from the worker’s treating practitioner to confirm when the condition/injury has stabilised.
The Agent will schedule a new IIA appointment for the worker when the accepted injuries has stabilised.
Worker attends IIA examination
To review the impairment report/s, the IB Specialist considers:
- impending surgical treatment, noted by the IIA in the report
- a treating practitioner request for further surgery
- IIA opinion that the worker’s injuries are not stable.
The Agent must communicate this information to the worker and request a medical report from the treating practitioner to confirm the stability of the injury in question and/or when stabilisation has been reached.