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Appendix 1: Context and relevant provisions - Standard 20 - Permanent impairment assessment reports

StandardContext

Standard 20 - Permanent impairment assessment reports

Permanent impairment assessment reports must be objectively reviewed for accuracy and consistency with claim records.

This report is referred to in the legislation (section 73 of the 1987 Act) as a permanent impairment medical certificate.

A report of the assessment of permanent impairment may be obtained by the worker or insurer to certify that the worker has received a work-related injury resulting in permanent impairment, and the degree of permanent impairment resulting from the work-related injury.

The medical assessor must have successfully completed requisite training in using the NSW workers compensation guidelines for the evaluation of permanent impairment (that is in effect at the time of the assessment) for each body system they assess. These trained assessors are listed on the SIRA website.

A report of the assessment of permanent impairment may be used to:

  • claim non-economic loss compensation
  • provide evidence of reaching or surpassing a threshold to be entitled to certain ongoing or extended compensation
  • claim damages, or
  • seek to commute liability for a claim.

The permanent impairment assessment should contain factual information based on medical information and investigations, as well as the assessor’s history-taking and clinical examination. Other medical information, reports or investigations that are reviewed by the assessor must be referenced in the report. These facts should be thoroughly checked by the insurer.

Note: There are three permanent impairment methods of assessment:

  • assessment under the 1926 Act, using the Table of Maims
  • assessment under the 1987 Act, using the Table of Disabilities, which applies to injuries received from 4:00 pm on 30 June 1987 to 31 December 2001, and
  • assessment under the 1998 Act, using AMA 5 as modified by the NSW workers compensation guidelines for the evaluation of permanent impairment, which applies to injuries received on or after 1 January 2002.

The assessment under each method differs and there are different entitlements attached to each assessment. This Standard primarily addresses assessments of injuries received on or after 1 January 2002.