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NSW workers compensation guidelines for the evaluation of permanent impairment

These guidelines explain permanent impairment assessment in the NSW workers compensation system. This is the fourth edition of these guidelines, published in April 2016.

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The State Insurance Regulatory Authority (SIRA) has issued the 4th edition of the NSW workers compensation guidelines for the evaluation of permanent impairment (Guidelines) for assessing the degree of permanent impairment arising from an injury or disease within the context of workers’ compensation. When a person sustains a permanent impairment, trained medical assessors must use the Guidelines to ensure an objective, fair and consistent method of evaluating the degree of permanent impairment.

The Guidelines are based on a template that was developed through a national process facilitated by Safe Work Australia. They were initially developed for use in the NSW system and incorporate numerous improvements identified by the then WorkCover NSW Whole Person Impairment Coordinating Committee over 13 years of continuous use. Members of this committee and of the South Australia Permanent Impairment Committee (see list in Appendix 2) dedicated many hours to thoughtfully reviewing and improving the Guidelines. This work is acknowledged and greatly appreciated.

The methodology in the Guidelines is largely based on the American Medical Association’s Guides to the Evaluation of Permanent Impairment, 5th Edition (AMA5). The AMA guides are the most authoritative and widely used in evaluating permanent impairment around the world. Australian medical specialists representing Australian medical associations and colleges have extensively reviewed AMA5 to ensure it aligns with clinical practice in Australia.

The Guidelines consist of an introductory chapter followed by chapters dedicated to each body system.

The Introduction is divided into three parts. The first outlines the background and development of the Guidelines, including reference to the relevant legislative instrument that gives effect to the Guidelines. The second covers general assessment principles for medical practitioners applying the Guidelines in assessing permanent impairment resulting from work-related injury or disease. The third addresses administrative issues relating to the use of the Guidelines.

As the template national guideline has been progressively adapted from the NSW Guideline and is to be adopted by other jurisdictions, some aspects have been necessarily modified and generalised. Some provisions may differ between different jurisdictions. For further information, please see the Comparison of Workers’ Compensation Arrangements in Australia and New Zealand report, which is available on Safe Work Australia’s website.

Publications such as this only remain useful to the extent that they meet the needs of users and those who sustain a permanent impairment. It is, therefore, important that the protocols set out in the Guidelines are applied consistently and methodically. Any difficulties or anomalies need to be addressed through modification of the publication and not by idiosyncratic reinterpretation of any part. All queries on the Guidelines or suggestions for improvement should be addressed to SIRA at contact@sira.nsw.gov.au.

18. Appendix 2. Working groups on permanent impairment

Permanent impairment coordinating committees

Permanent impairment coordinating committee 2013

NamePosition
Mr Gary JefferyChair
Mr Kim GarlingWorkCover Independent Review Officer
Ms Alisha Wilde/ Mr Shay DegauraUnions NSW
Dr Mark BurnsAustralian Faculty of Occupational and Environmental Medicine
Associate Professor Michael FearnsideAssociate Professor of Neurosurgery, Neurosurgical Society of Australasia
Dr John HarrisonOrthopaedic Surgeon, Australian Orthopaedic Association, Australian Society of Orthopaedic Surgeons
Dr Yvonne SkinnerPsychiatrist, Royal Australian and New Zealand College of Psychiatrists
Prof Ian CameronProfessor of Rehabilitation Medicine, Australasian Faculty of Rehabilitation Medicine
Dr Roger PillemerWorkers Compensation Commission, Senior Approved Medical Specialist
Dr Michael GliksmanAustralian Medical Association
Dr Neil BerryRoyal Australasian College of Surgeons
Mr Kevin GillinghamWorkCover WA
Mr David Caulfied/Mr Phil WaddasWorkCover SA
Ms Meg BrightonWorkSafe ACT

Permanent impairment coordinating committee 2008

NamePosition
Mr Rob ThomsonChair
Ms Mary YaagerUnions NSW
Dr Ian GardnerWorkers Compensation and Workplace Occupational Health and Safety Council of NSW
Associate Professor Michael FearnsideAssociate Professor of Neurosurgery, Neurosurgical Society of Australasia
Dr John HarrisonOrthopaedic Surgeon, Australian Orthopaedic Association, Australian Society of Orthopaedic Surgeons
Dr Yvonne SkinnerPsychiatrist, Royal Australian and New Zealand College of Psychiatrists
Prof Roger PillemerApproved Medical Specialist
Dr Michael GliksmanAustralian Medical Association
Dr Neil BerryRoyal Australasian College of Surgeons

Permanent impairment coordinating group 2001

NamePosition
Dr Jim StewartChair
Ms Kate McKenzieWorkCover
Mr John RobertsonLabor Council of NSW
Ms Mary YaagerLabor Council of NSW
Dr Ian GardnerMedical Representative to Workers Compensation and Workplace Occupational Health and Safety Council of NSW
Dr Stephen BuckleyRehabilitation Physician
Prof Michael FearnsideProfessor of Neurosurgery
Dr John HarrisonOrthopaedic Surgery
Dr Jonathan PhillipsPsychiatrist
Prof Bill MarsdenProfessor of Orthopaedic Surgery
Dr Dwight DowdaOccupational Physician
Associate Professor Ian CameronAssociate Professor of Rehabilitation Medicine
Dr Robin ChaseAustralian Medical Association
2005 revisions 
Dr Roger PillemerOrthpaedic Surgeon
Dr John DIxon HughesGeneral Surgeon
Dr Yvonne SkinnerPsychiatrist

Working groups