| The AMA Guides |
Under the WorkCover legislation physical injuries must be assessed in accordance with the fourth edition of The American Medical Association Guides For The Evaluation Of Permanent Impairment. Although these Guides are now in their six edition, the WorkCover legislation requires the fourth edition to be used. The Guides have been modified by the legislation which removes the pain chapter. The Guides have been the subject of significant criticism because they provide relatively depressed impairment assessments for musculoskeletal injuries particularly spinal injuries. Indeed, there are good grounds for believing that the scores of the most common industrial injuries were deliberately lowered when the Guides were being developed in America. Nonetheless, significant impairment scores can be obtained under these Guides from the aggregation of all the effects of injury. The Guides are highly complex and can provide markedly fluctuating impairment assessments when the same claimant is assessed by medical practitioners. These fluctuations, in large measure, are due to the discretion that is provided to medical examiners in respect of choosing the appropriate methodology for some assessments, particularly involving limb function.
The psychological guides
Under the WorkCover legislation a psychological impairment must be assessed in accordance with the Medical Panel Guides for the Evaluation of Psychiatric Impairment which was developed by psychiatric members of the Medical Panel Victoria. The impairment assessment methods consider a number of levels of psychiatric or psychological functioning including the following:
- Intelligence - (capacity for understanding).
- Thinking - (the ability to form or conceive in the mind).
- Perception - (the brain's interpretation of internal and external stimuli).
- Judgement - (ability to assess a given situation and act accordingly).
- Mood - (emotional tone underlying all behaviours).
- Behaviour - (behaviour which is disruptive, distressing or aggressive).
In order to be eligible for an impairment payment it is necessary to obtain an impairment score of 30% 'primary' psychiatric impairment. A primary psychiatric impairment can be combined with a physical impairment for the purposes of reaching the 30% threshold for common law damages claims.
The physical guides
Physical injuries must be assessed in accordance with The American Medical Association Guides For The Evaluation Of Permanent Impairment. Although these Guides are now in their 6th edition, the WorkCover legislation requires the 4th edition to be used. The Guides have been modified by the legislation which removes the pain chapter. The Guides have been heavily criticised because they provide relatively low impairment assessments for musculoskeletal injuries particularly spinal injuries. It appears that the most common industrial injuries were deliberately lowered when the Guides were being developed in America. Nonetheless, significant impairment scores can be obtained under these Guides from combining all the effects of injury. The Guides are highly complex and can provide markedly fluctuating impairment assessments when the same claimant is assessed by medical practitioners. These fluctuations, in large measure, are due to the discretion that is provided to medical examiners in respect of choosing the appropriate methodology for some assessments, particularly involving limb function.
The infectious diseases guides under WorkCover
The American Medical Association Guides For the Evaluation of Permanent Impairment (fourth edition) provides very poor assessment levels for the full effects of some industrial diseases. The diseases most affected were conditions such as Q fever, leptosporosis and some other infectious conditions. The American Guides were unsatisfactory as they focused on the clinical evidence of injury rather than the more subtle effects of an infective condition. A working party comprised specialists, lawyers, unions and employers groups developed a much clearer alternative guide. Commonly, a person who has contracted Q fever can suffer severe lethargy, sleep disturbance and disrupted cerebral functioning as a result of post Q fever syndrome. This improved guide enables a claimant to choose between the impairment score under the American Guides or their score under this alternative guide. This alternative guide enables measurements of any restriction of a claimant's ability to undertake activities of daily living. It will usually, though not all ways, result in a higher impairment score than the American Guide.
The Industrial Asthma Guidelines under WorkCover
Initially, the American Guides were used for the assessment of industrial asthma. These guides were highly unsatisfactory because they focused mainly on lung function tests and failed to take account of whether or not a claimant was taking medication to improve lung function and the effect of the condition on the activities of daily living. There was concern that in order to demonstrate the proper level of impairment, a claimant would have to stop taking medication that time of assessment which could be highly dangerous. A special guide for the assessment of industrial asthma was developed by a working party set up by the WorkCover Authority containing employers, union representatives, lawyers and medical specialists, which resulted in a much fairer assessment method. For example, if a claimant had good lung function, solely because of their adherence to a medication regime, the medical assessors can now give a reasonable impairment score on the basis of their medication history.
Source: http://workforcelegal.com.au/pages/about-us.html
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