An impairment benefit is a once-off lump sum payment made to a person as a result of their injury causing a physical and/or psychiatric permanent impairment. This is often referred to as pain and suffering. The TAC administer a ‘no fault’ scheme, meaning that this benefit can be paid regardless of who was at fault.
Assessment
If you believe that your injury has caused a permanent impairment, it must be assessed by a doctor who specialises in Impairment Assessment. You will have to wait until 12 months after the date that the injury occurred unless a doctor has confirmed that it has stabilised.
A TAC Lump Sum Coordinator will arrange the appointment/s, which you must attend. When determining the degree of impairment, the assessor is required to follow the American Medical Association Guide to the Evaluation of Permanent Impairment (the Guides).
As compensation figures constantly change, the amount you receive will depend on the date of your first Impairment Assessment. It may take up to 120 days to find out whether you are entitled a permanent impairment payment. Importantly, you may still be entitled to receive a payment even if you have returned to work.
Eligibility
The severity of your injury will be examined in accordance with a formula set out by law, meaning that all injuries are subject to the same assessment.
Unlike a Serious Injury claim, it is not necessary to prove that another person was at fault. You do however, need to meet the whole person impairment threshold. Your degree of impairment is expressed as a percentage with 100% referring to your whole person.
Physical Injuries
For physical injuries, your level of impairment must be greater than 11% of your ‘whole person’. This percentage is then applied to a schedule that indicates an approximate dollar value for each body part or function.
Combining Multiple Injuries
Where a person suffers multiple injuries, the suggested method in the Guides is to combine those injuries, which will determine a person’s final impairment rating.
Example
If a person suffers the loss of an arm, the degree of impairment will be 40%. This means that 60% of the whole person remains. However, if they suffer the loss of two arms, the second impairment value would need to be applied to the remaining 60%. This ensures that the final impairment rating does not exceed 100%. Therefore, the second rating would equal 24% (40% of 60%), with 36% now remaining.
With a 24% impairment rating, this person would be entitled to $16,667.78 (as at July 2016).
Psychiatric Injuries
A psychiatric injury must receive a rating of at least 30% to be regarded as a permanent impairment. The physical injury must also be the cause of the mental injury. That is, you are not entitled to compensation if the injury merely arose from the circumstances surrounding the accident.
When determining the severity of a psychiatric injury, a doctor will base their assessment on the following four areas:
- Activities of daily living;
Eating, sleeping or self care, for example. - Social functioning
Friends, group memberships and general ability to interact with people will be considered. - Concentration, persistence and pace;
This might include a person’s ability to complete tasks or organise finances. - Adaptation/Decomposition
How and why stress arises and whether it is manageable.
Similar to a physical injury, an assessor calculates the overall impairment by evaluating each area. A psychiatric impairment rating of 30% or more may arise if the person scores:
- Extreme in one area;
- Marked in two areas; or
- Moderate in four areas
Receiving a lump sum payment for permanent impairment will not affect your income support payments or right to medical and like expenses. It will also not prevent you from making a serious injury claim for pain and suffering, although, the permanent impairment amount may be deducted from the amount of damages awarded. Importantly, you must make a claim prior to bringing a claim for damages, otherwise your right to a permanent impairment payment will be lost.
As at July 2016, Impairments payments range from $1190.56 (11% impairment) to $101,150 (100% impairment). Benefits are indexed at the beginning of each financial year. Further information about impairment payments can be found on the TAC website.