The following Protocol will be followed when a dispute about the degree of permanent impairment arising from a brain injury is referred to the Medical Assessment Service (MAS). This Protocol has been developed following consultation with the expert Assessors appointed by MAS to assess injuries of this type.
This Protocol is designed to ensure that proper consideration is given to all the symptoms arising from a brain injury, and that the degree of permanent impairment is fully assessed.
How it will work
Appointments will be arranged for the injured person to be assessed by different Assessors, including a brain injury specialist and psychiatrist. The psychiatric appointment may not be required in all cases, and the psychiatrist Assessor will be advised if this appointment is to be cancelled.
The injured person will be referred to a MAS Medical Assessor who has particular expertise in the assessment of brain injuries. This will be a rehabilitation physician, neurologist or neurosurgeon with experience in this area.
In accordance with the required method for assessing permanent impairment, the Assessor must first consider whether a brain injury has occurred. Generally there would need to be evidence of a significant impact to the head, cerebral insult, or high velocity impact.
The Assessor will also consider the initial injury records (including Glasgow Coma Score and duration of post-traumatic amnesia), any radiological investigations (such as CT scans and MRI scans of the brain), the results of any psychometric or neuropsychological testing, and the results of the Assessor’s clinical examination.
If the Assessor is unable to determine the degree of permanent impairment without neuropsychological testing, the Assessor will advise MAS who will arrange for testing by an experienced neuropsychologist who is also a MAS medical Assessor.
The results of this testing will be provided to the Assessor who will then complete their assessment and issue their certificate. The certificate and the neuropsychological test results will be forwarded to the parties.
There are two possible outcomes.
1. The Assessor determines that the symptoms reported by the injured person cannot be fully explained by a brain injury. A psychiatrist will then assess the injured person.
2. The Assessor determines that there is a permanent whole person impairment arising from the brain injury which is greater than 10% OR
there are no symptoms which relate to a possible psychiatric impairment.
In these cases there will be no need for the psychiatric assessment. MAS will cancel the psychiatric appointment and advise the parties accordingly.
If a separate brain injury and a separate psychiatric injury are listed in the MAS form(s), the injured person will be assessed by both a brain injury Assessor and a psychiatrist Assessor, regardless of the findings of the brain injury Assessor.
Unless the brain injury Assessor advises otherwise, (except in cases where a psychiatric injury is separately listed in the MAS forms), the injured person will also be referred to an experienced psychiatrist for assessment.
MAS will provide the psychiatrist Assessor with a copy of the certificate issued by the brain injury Assessor, together with neuropsychological test results if these were obtained.
In accordance with the required method for assessing permanent impairment arising from a psychiatric injury, the psychiatrist must first consider whether the injured person has a recognised psychiatric condition. If the psychiatrist finds that there is a recognised psychiatric condition that is related to the motor vehicle accident, he or she will determine the extent of permanent impairment arising from this condition.
A separate certificate will be issued by the psychiatrist Assessor which will be forwarded to the parties.
For all brain injury assessments
The same procedures apply as for all MAS assessments. You should also be aware of the following additional points:
- You will be advised if the injured person has communication difficulties.
- A support person or carer may accompany the injured person to the assessments.
- A family member or support person who is familiar with the injured person may be asked to provide information during the course of the assessment.
- The injured person may consult a diary or other notes during the course of the assessments.
If you have any queries when referred this type of matter, please contact the Case Manager listed on your letter of referral.