Guide to the Impairment Tables - DSS

1 1 A Guide TO THE Tables FOR THE ASSESSMENT OF WORK-RELATED Impairment FOR DISABILITY SUPPORT PENSION 2 TABLE OF CONTENTS TO THE Guide INTRODUCTORY NOTES ABOUT THE Guide .. 5 chapter 1: .. 6 Guide TO THE INTRODUCTION TO THE Impairment Tables .. 6 (A) PURPOSE OF THE Tables (PARAGRAPH 1).. 6 (B) DEFINITION OF WORK (PARAGRAPH 1).. 6 (C) CONCEPTUAL MODEL OF THE Tables (PARAGRAPHS 1, 2, 3) .. 6 (D) SIGNIFICANCE OF 20 POINTS Impairment LEVEL (PARAGRAPH 1) .. 7 (E) MEDICAL BASIS TO Impairment (PARAGRAPHS 1, 4).. 7 (F) DESIGN OF THE Tables (PARAGRAPHS 2, 3) .. 8 (G) APPROPRIATE SELECTION OF Tables (PARAGRAPHS 2, 7, 9, 12) .. 8 (H) DOUBLE COUNTING OF Impairment (PARAGRAPHS 7, 8, 12, 13).

2 9 (I) ASSESSING CHRONIC PAIN AND FATIGUE (PARAGRAPH 8) .. 11 (J) SCORING SYSTEM OF THE Tables (PARAGRAPHS 10, 11) .. 12 (K) DETERMINING PERMANENT Impairment (PARAGRAPHS 4, 5, 6) .. 13 (L) CONDITION VS Impairment (PARAGRAPHS 2, 3, 4, 5, 6, 7, 8, 9, 12, 13) .. 16 INTRODUCTION .. 17 chapter 2: .. 20 Guide TO TABLE 1. LOSS OF CARDIOVASCULAR AND/OR RESPIRATORY FUNCTION: EXERCISE 20 TABLE 1. LOSS OF CARDIOVASCULAR AND/OR RESPIRATORY FUNCTION: EXERCISE TOLERANCE 22 chapter 3: .. 25 Guide TO TABLE 2. LOSS OF RESPIRATORY FUNCTION: PHYSIOLOGICAL MEASUREMENTS .. 25 TABLE 2. LOSS OF RESPIRATORY FUNCTION: PHYSIOLOGICAL MEASUREMENTS .. 27 chapter 4.

3 30 Guide TO TABLE 3. UPPER LIMB FUNCTION .. 30 TABLE 3. UPPER LIMB FUNCTION .. 31 chapter 5: .. 32 Guide TO TABLE 4. FUNCTION OF THE LOWER 32 TABLE 4. FUNCTION OF THE LOWER 33 chapter 6: .. 34 Guide TO TABLE 5. SPINAL FUNCTION .. 34 TABLE 5. SPINAL FUNCTION .. 35 3 chapter 7: .. 37 Guide TO TABLE 6. PSYCHIATRIC 37 TABLE 6. PSYCHIATRIC 38 chapter 8: .. 40 Guide TO TABLE 7. ALCOHOL AND DRUG 40 TABLE 7. ALCOHOL AND DRUG DEPENDENCE ..41 chapter 9: .. 42 Guide TO TABLE 8. NEUROLOGICAL FUNCTION: MEMORY, PROBLEM SOLVING, DECISION MAKING ABILITIES AND COMPREHENSION .. 42 TABLE 8. NEUROLOGICAL FUNCTION: MEMORY, PROBLEM SOLVING, DECISION MAKING ABILITIES & COMPREHENSION.

4 43 chapter 10: .. 44 Guide TO TABLE 9. COMMUNICATION FUNCTION RECEPTIVE AND EXPRESSIVE LANGUAGE COMPETENCY .. 44 TABLE 9. COMMUNICATION FUNCTION - RECEPTIVE AND EXPRESSIVE LANGUAGE COMPETENCY .. 45 chapter 11: .. 46 Guide TO TABLE 10. INTELLECTUAL 46 TABLE 10. INTELLECTUAL DISABILITY .. 47 chapter 12: .. 49 Guide TO TABLE GASTROINTESTINAL: STOMACH, DUODENUM, LIVER AND BILIARY TRACT .. 49 TABLE GASTROINTESTINAL: STOMACH, DUODENUM, LIVER AND BILIARY TRACT .. 49 chapter 13: .. 51 Guide TO TABLE GASTROINTESTINAL: PANCREAS, SMALL AND LARGE BOWEL, RECTUM AND 51 TABLE GASTROINTESTINAL: PANCREAS, SMALL AND LARGE BOWEL, RECTUM AND ANUS 51 chapter 14.

5 53 Guide TO TABLE 12. HEARING 53 TABLE 12. HEARING FUNCTION .. 54 chapter 15: .. 61 Guide TO TABLE 13. VISUAL ACUITY IN THE BETTER EYE .. 61 TABLE 13. VISUAL ACUITY IN THE BETTER 62 chapter 16: .. 63 Guide TO TABLE 14. MISCELLANEOUS EYE CONDITIONS .. 63 TABLE 14. MISCELLANEOUS EYE CONDITIONS .. 63 4 chapter 17: .. 64 Guide TO TABLE 15. VISUAL 64 TABLE 15. VISUAL 64 chapter 18: .. 65 Guide TO TABLE 16. LOWER URINARY TRACT .. 65 TABLE 16. LOWER URINARY TRACT .. 65 chapter 19: .. 66 Guide TO TABLE 17. RENAL 66 TABLE 17. RENAL FUNCTION .. 66 chapter 20: .. 67 Guide TO TABLE 18. SKIN 67 TABLE 18. SKIN DISORDERS .. 67 chapter 21.

6 68 Guide TO TABLE 19. ENDOCRINE DISORDERS .. 68 TABLE 19. ENDOCRINE DISORDERS .. 68 chapter 22: .. 69 Guide TO TABLE 20. MISCELLANEOUS MALIGNANCY, HYPERTENSION, HIV INFECTION, MORBID OBESITY (ie BMI >40), HEART / LIVER/ KIDNEY TRANSPLANTS, MISCELLANEOUS EAR / NOSE / THROAT CONDITIONS & CHRONIC FATIGUE OR PAIN .. 69 TABLE 20. MISCELLANEOUS - MALIGNANCY, HYPERTENSION, HIV INFECTION, MORBID OBESITY (ie BMI >40), HEART/LIVER/KIDNEY TRANSPLANTS, MISCELLANEOUS EAR/NOSE/THROAT CONDITIONS & CHRONIC FATIGUE OR PAIN.. 70 chapter 23: .. 72 Guide TO TABLE 21. INTERMITTENT CONDITIONS .. 72 TABLE 21. INTERMITTENT CONDITIONS.

7 73 chapter 24: .. 76 Guide TO TABLE 22. GYNAECOLOGICAL CONDITIONS .. 76 TABLE 22. GYNAECOLOGICAL 76 INDEX TO THE Guide .. 77 5 INTRODUCTORY NOTES ABOUT THE Guide This Guide provides some enhancements to the presentation of the Tables for the Assessment of Work-Related Impairment for Disability Support Pension (1997) (referred to as the Tables ) in order to improve its user-friendliness. The Guide has not altered the contents of the Tables themselves as they form Schedule 1B of the Social Security Act 1991, and such amendments can only be enacted through Parliament. In order to improve ease of use in the application of the Tables , the Guide also provides clarification to assist in interpreting the Tables contents.

8 These explanations aim to clarify perceived ambiguities within the contents and to reflect the original intent of the Advisory Committee that developed the current version of the Tables . The Guide is not intended as a substitute for the explanatory notes within the Tables but should be read in conjunction with the Tables . Although examples of specific medical conditions have been used to help illustrate these explanations, it should be emphasised that they are not intended to be generally prescriptive for the purpose of assessing Impairment caused by such conditions. Each person s level of medical Impairment must be assessed on an individual basis to account for the varying spectrum of severity and stability that can occur with a particular medical condition.

9 Individualised assessments are also necessary to consider the effects of contributory non-medical factors on a person s work-related Impairment . 6 chapter 1: Guide TO THE INTRODUCTION TO THE Impairment Tables This chapter provides guidance and additional clarification relating to the thirteen paragraphs contained in the Introduction to the Tables for the Assessment of Work-Related Impairment for Disability Support Pension. This chapter is divided into subheadings emphasising significant concepts contained within the Introduction . The relevant paragraphs from the Introduction corresponding to each subheading are identified in parenthesis.

10 (A) PURPOSE OF THE Tables (PARAGRAPH 1) Establishing whether medical Impairment level reaches minimum qualifying threshold of 20 points for disability support pension purposes. The purpose of the Tables is to enable the assessment of medical Impairment to be made in respect of persons whose qualification for disability support pension is being determined. The relevance of such an assessment is that qualification for disability support pension as set under section 94(1)(b) of the Social Security Act 1991, requires first establishing that the person has an Impairment level of at least 20 points (previously, 20%). This minimum qualifying threshold is meant to be set at the level at or above which a person s Impairment has a significant adverse impact on their ability to work.