Guide to Determining Impairment and Compensation (MRCA Instrument No. 1 of 2004) (Cth)
MRCA Instrument No. 1 of 2004
GUIDE TO DETERMINING IMPAIRMENT AND COMPENSATION
Definitions
In this instrument:
C&T Act means the Military Rehabilitation and Compensation (Consequential and Transitional Provisions) Act 2004.
GARP V means the Guide to the Assessment of Rates of Veterans’ Pensions, instrument No.9 of 1997 determined on 30 September 1997 by the Repatriation Commission under section 29 of the VEA and approved by the Minister for Veterans’ Affairs on 1 October 1997.
MRCA means the Military Rehabilitation and Compensation Act 2004.
MRCC means the Military Rehabilitation and Compensation Commission.
SRCA means the Safety, Rehabilitation and Compensation Act 1988.
VEA means the Veterans’ Entitlements Act 1986.
Guide determination
For the purposes of section 67 of the MRCA, it is determined by the Military Rehabilitation and Compensation Commission that GARP V, as modified by this instrument, applies as the guide for the determination of the degree of impairment and lifestyle ratings when determining the compensation payable to a person under the MRCA.
Modifications to GARP V
The modifications to GARP V are as follows:
(a) Omit the title to GARP V and substitute the following title:
Guide to the Assessment of Rates of Veterans' Pensions V, Modified (GARP V (M))
(b) Omit the Introduction to GARP V and substitute the Introduction in Schedule 1 to this instrument.
(c) Omit the “How to use this Guide” in GARP V and substitute the “How to use this Guide” in Schedule 2 to this instrument.
(d) Chapters 1 to 16 of GARP V contains tables related to “Other Impairment” (physical) and “Functional Loss”. These tables are to be applied as if:
Each benchmark is a threshold value, that is, the rating applies only if the threshold is achieved or exceeded.
Ratings are not to be rounded up to the next benchmark.
Ratings between benchmark values contained in the tables are not to be interpolated. If a rating is not reached on the evidence of the condition it must be rated only at the achieved rating in the Guide.
(e) Omit the words “Table 23.1 in Chapter 23 (Conversion to Degree of Incapacity)” in Chapter 22 and substitute “Tables 23.1 and 23.2 in Chapter 23 (Calculating Permanent Impairment Compensation)”.
(f) Omit Chapters 23 and 24 of GARP V and substitute Chapters 23, 24 and 25 in Schedule 3 to this instrument.
Short title
The short title for the Guide is “GARP V (M)”.
Commencement
This instrument commences on 1 July 2004.
Power under C&T Act
Subsection 13(4) of the C&T Act provides that the MRCC may include in the guide under section 67 of the MRCA one or more methods of determining working out the amount of compensation a person is entitled to under Part 2 of Chapter 4 of the MRCA for a service injury or disease where a person also has:
(a) a separate war-caused or defence-caused injury or disease (within the meaning of the VEA); or
(b) a separate injury or disease (within the meaning of the SRCA).
A method may (but does not have to) include a method of offsetting payments made to the person under the VEA or SRCA in respect of the old injury or disease.
Power under Acts Interpretation Act
(c) Subsection 4(1) of the Acts Interpretation Act 1901 provides that if an Act that is not to come into operation immediately upon its enactment and is expressed to confer power to make an instrument of a legislative or administrative character (including rules, regulations or by-laws), then, unless the contrary intention appears, the power may be exercised, and anything may be done for the purpose of the power or of bringing the instrument into effect, before the Act concerned comes into operation as if it had come into operation.
Dated this …21…… day of June 2004
NEIL JOHNSTON CHAIR …………………………………………..
IAN CAMPBELL MEMBER …………………………………………..
SIMON HARRINGTON MEMBER …………………………………………..
BRIAN ADAMS MEMBER …………………………………………..
BARBARA BENNETT MEMBER …………………………………………..
Military Rehabilitation and Compensation Commission
MRCA Instrument No. 1 of 2004
Schedule 1
INTRODUCTION
Purpose
This Guide is to be applied to assess the degree of impairment from service injury or disease. Its provisions are binding on the Military Rehabilitation and Compensation Commission, the Veterans’ Review Board, and the Administrative Appeals Tribunal.
Legal background
The Military Rehabilitation and Compensation Act 2004 provides for periodic payments to be made to members for impairment resulting from service injuries or diseases as defined in section 5 of the Act.
Part 2 of Chapter 4 of the Act provides that periodic payments are payable only if certain thresholds are reached as determined by reference to the extent of the veteran’s incapacity as assessed in accordance with this Guide. Subsection 67(1) of the Act provides that the Guide prepared by the Military Rehabilitation and Compensation Commission sets out:
(a) criteria to be used in deciding the degree of impairment of a person resulting from a service injury or disease; and
(b) methods by which the degree of that impairment can be expressed in impairment points on a scale from 0 to 100; and
(c) criteria to be used in assessing the effect of a service injury or disease on a person’s lifestyle; and
(d) methods by which the effect of a service injury or disease on a person’s lifestyle can be expressed as a numerical rating; and
(e) methods by which the impairment points of a person, and the effect on a person’s lifestyle, from a service injury or disease can be used to determine the compensation payable to the person under this Part by reference to the maximum compensation that can be payable to a person under this Part.
In addition the Guide, in accordance with subsection 67(2) of the Act
(a) specifies different methods under paragraph (1)(e) for:
(i) service injuries or diseases that relate to warlike service or non-warlike service; and
(ii) other service injuries or diseases; and
(b) specifies a method for determining the compensation payable to a person who has both:
(i) a service injury or disease that relates to warlike service or non-warlike service; and
(ii) another service injury or disease.
Definitions
In this Guide, unless a contrary intention appears:
accepted condition means an injury or disease that has been determined to be caused by service.
Act means the Military Rehabilitation and Compensation Act 2004 as amended from time to time.
add means find the arithmetic sum of two or more numbers.
clinical features includes signs and symptoms.
combine means produce a result by combining two or more numbers by applying Chart 18.1 (Combined Values Chart) in Chapter 18 in accordance with that Chapter.
Commission means the Military Rehabilitation and Compensation Commission.
condition means an injury or a disease.
defence-caused injury and defence-caused disease have the meaning given in section 70 of the VEA.
disease means:
(a) any physical or mental ailment, disorder, defect or morbid condition (whether of sudden onset or gradual development); or
(b) the recurrence of such an ailment, disorder, defect or morbid condition;
but does not include:
(c) the aggravation of such an ailment, disorder, defect or morbid condition; or
(d) a temporary departure from:
the normal physiological state; or
the accepted ranges of physiological or biochemical measures;
that results from normal physiological stress (for example, the effect of exercise on blood pressure) or the temporary effect of extraneous agents (for example, the effect of alcohol on blood cholesterol levels).
GARP V means the Guide to the Assessment of Rates of Veterans’ Pensions, Fifth Edition (GARP V), instrument No.9 of 1997 determined on 30 September 1997 by the Repatriation Commission under section 29 of the VEA and approved by the Minister for Veterans’ Affairs on 1 October 1997.
Guide means GARP V as applied and modified by MRCA Instrument No 1 of 2004.
impairment, in relation to a person, means the loss, the loss of the use, or the damage or malfunction, of any part of the person’s body, of any bodily system or function, or of any part of such a system or function.
impairment rating means a measure of the degree of medical impairment on a scale of 0 to 100.
injury means any physical or mental injury (including the recurrence of a physical or mental injury) but does not include:
(a) a disease; or
(b) the aggravation of a physical or mental injury.
lifestyle points means the number of points determined using the tables in Chapter 22 of this Guide.
lifestyle averaged points means the total of lifestyle points added together and averaged for each of the tables used.
lump sum means the amount payable after determining the periodic payment for a service injury or disease and converted to a single dollar amount in accordance with the tables provided by the Australian Government Actuary for that purpose.
member or former member means a member or former member of the Defence Force who serves or served on or after 1 July 2004.
non-accepted condition means any injury or disease that has not been determined under the Act to be service related or has been determined under the Act not to be service related.
non-service condition means an injury or disease that has not been determined under the Act to be service related or has been determined under the Act not to be service related.
periodic payment means the amount determined by reference to the tables in this guide for warlike and non-warlike service or for peacetime service and the maximum amount payable under the relevant provision of the Act.
service means service in the Defence Force which is warlike service, non-warlike service or peacetime service as determined by the Minister for Defence from time to time.
service disease has the meaning given by section 27, subsections 29(1) and (2), and section 30 of the Act.
Note: A reference to a service disease being contracted includes a reference to a disease being aggravated by defence service (see section 7 of the Act).
service injury has the meaning given by section 27, subsections 29(1) and (2), and section 30 of the Act.
Note: A reference to a service injury being sustained includes a reference to an injury being aggravated by defence service (see section 7 of the Act).
service condition means an injury or disease that has been determined under the Act to be related to service.
SRCA means the Safety, Rehabilitation and Compensation Act 1988.
Statement of Principles means:
(a) a Statement of Principles determined by the Repatriation Medical Authority under section 196B of the VEA and to which section 19 of the Consequential and Transitional Provisions Act 2004 applies; or
(b) a determination made by the Commission under subsection 340(2) or (3) of the Act.
VEA means the Veterans’ Entitlements Act 1986.
veteran means a member or former member of the Defence Force (including a deceased person) under section 5 of the MRCA in respect of whom an injury or disease has been determined to be caused by that service.
war-caused injury and war-caused disease have the meaning given in section 9 of the VEA.
worksheet means a page or pages of this Guide, identified as such, that gives a structure by which certain calculations may be set out to assist in determining an impairment rating.
Definitions of words and phrases that are used in only one chapter are to be found in that chapter.
______________________________________________________________
Acknowledgment of sources
The Guide to the Assessment of Rates of Veterans’ Pensions Fifth Edition, Part A Chapters 1–12 and Part B Chapters 13-17 and Part C Chapters 18-21 are the basic tables for this Guide.
That publication acknowledges that the following published works were found to be useful in the preparation of the VEA Guide (GARP) and therefore were basic to this Guide as well:
Guides to the Evaluation of Permanent Impairment, 4th edition, American Medical Association, 1993;
International Classification of Impairments, Conditions, and Handicaps, World Health Organisation, Geneva, 1980; and
Publication No 118 of the National Acoustic Laboratories, Improved Procedure for Determining Percentage Loss of Hearing, by J. Macrae, Australian Government Publishing Service, Canberra, 1988.
Military Rehabilitation and Compensation Commission
MRCA Instrument No. 1 of 2004
Schedule 2
HOW TO USE THIS GUIDE
The subject of assessment
This Guide is to be applied to assess the impairment points due to injuries or diseases, or both, that are determined to be service related.
In making any determination on the impairment the clinical features of service injuries or diseases are to be taken into account. Sequelae of service conditions can only be assessed after the sequelae have been determined to be service related.
The elements of whole person impairment and compensation
The two elements required to determine a periodic payment are medical impairment and lifestyle. Impairment is dealt with in Chapters 1 – 21 of this Guide. Lifestyle effects are dealt with separately and are described in Chapter 22 of this Guide.
Chapters 1 to 16 of this Guide contain two principal types of tables. Physical loss is to be rated against criteria in “Other Impairment” tables. Functional loss is to be rated against criteria in “Functional Loss” tables.
Greater emphasis has been given throughout this Guide to functional loss as a basis for assessment. It is measured by reference to an individual’s performance efficiency compared with an average, healthy person of the same age and sex, in a set of defined vital functions. This is a means of compensating for the loss of ability to perform everyday functions.
Each table contains benchmark values, generally at intervals of five points. In some cases the range between nil and five includes a rating of two points. In some other cases intervals are greater than five points because lesser increments of impairment cannot be distinguished.
Each benchmark is a threshold value, that is, the rating applies only if the threshold is achieved or exceeded. Ratings are not to be rounded up to the next benchmark. Similarly, ratings between benchmark values contained in the tables are not to be interpolated.
In some tables more than one criterion is stated opposite a benchmark value. The different criteria are marked by dot points. Where more than one criterion is stated for a particular value, the condition being assessed has to satisfy one of the criteria in order to attract the impairment rating of that value.
Each chapter contains step-by-step instructions to be followed in the use and application of the tables.
Determining compensation payable
This Guide specifies the only way of determining the amount of compensation payable is by reference to the maximum compensation that can be paid. The maximum is specified in the Act as a weekly amount. It becomes payable only when a person’s impairment rating reaches 80 points.
The Guide includes tables that will give a compensation factor for different impairment and lifestyle ratings. Different tables are used for warlike and non-warlike service and for peacetime service. The maximum compensation is multiplied by the compensation factor to give the weekly amount of compensation payable.
Medical impairment
Under this Guide medical impairment has two components:
(a) physical loss of, or disturbance to, any body part or system; and
(b) the resultant functional loss.
Whole person impairment
Medical impairment is expressed in impairment points, out of a maximum rating of 100. On this scale, zero corresponds to no impairment or negligible impairment from accepted conditions, and 100 points corresponds to death. Effectively, impairment points are percentages of the impairment of the whole person.
Loss of hearing, loss of taste, loss of smell, loss of a finger or of a toe as impairment for a single condition can be compensated for under this Guide only if a threshold value of 5 impairment points is reached. Any combination of loss from conditions that delivers a combined impairment of 10 or more will attract compensation.
Example
Loss of taste rated at 5 impairment points and mild reflux rated at 2 impairment points.
¨ A payment for loss of taste is permitted but, since 5 plus 2 is 7 and does not reach the threshold of 10 impairment points, no other payment is made.
Loss of taste rated at 5 impairment points and reflux rated at 5 impairment points.
¨ The reflux 5 points when combined with the loss of taste reaches the threshold of 10 impairment points and so payment is made on the basis of 10 impairment points.
Functional loss
Medical impairment is measured chiefly by loss of vital functions and is addressed in the twelve system specific chapters of this Guide, as follows:
Cardio-Respiratory Impairment
Hypertension and Non-Cardio Vascular Conditions
Impairment of Spine and Limbs
Emotional and Behavioural
Neurological Impairment
Gastro-intestinal Impairment
Ear, Nose, and Throat Impairment
Visual Impairment
Renal and Urinary Tract Function
Sexual Function, Reproduction, and Breasts
Skin Impairment
Endocrine and Haemopoietic Impairment
Other Impairment
Other Impairment is the physical loss of, or disturbance to, any body part or system. This concept is extended in some chapters in this Guide to include discomfort, pain, poor prognosis and other, less tangible, effects of accepted conditions.
Lifestyle effects
Lifestyle effects are to be assessed by applying Chapter 22 of this Guide in accordance with that Chapter.
The Tables
Types of Tables
There are several different sorts of tables used in GARP V that remain common to both GARP V and this Guide. Basically these are various impairment tables, the lifestyle tables and the tables to deal with more complex matters.
However the MRCA requires the Commission to specify two particular tables that are not used in GARP V or the VEA. These are tables that arise from the method specified by the Commission to determine compensation payable for warlike and non-warlike as distinct from peacetime service (see Tables 1 and 2 of Chapter 23). In addition the Commission must specify a method for determining compensation payable when a mixture of warlike (or non-warlike) and peacetime service causes the whole person impairment
Gender Use
Some tables are for men only, some for women only, and others (the majority) are not gender specific. Each table is clearly marked in the top right hand corner:
¨ the symbol
means that the table is only to be used for the assessment of female veterans;
¨ the symbol
means that the table is only to be used for the assessment of male veterans;
¨ the symbol
means that the table is used for either male or female veterans.
Age Adjustment
Some tables incorporate age dependent criteria. Some other tables have no such criteria and require subsequent age adjustment by applying tables provided for that purpose.
Each table is clearly marked in the bottom left hand corner with instructions on age adjustment for ratings derived from that table.
Conversion Factor Tables
The Commission is required by paragraph 67(1)(e) to provide methods that enable Lifestyle to be combined with Impairment to give compensation for each type of service by reference to the maximum compensation payable. These are set out as compensation factors in tables in Chapter 23 and include a different set of factors to be used for warlike and non-warlike service and for other service as provided for in the Act (see subsection 67(2)).
Non-system specific assessments
This Guide has chapters describing alternate methods of assessing certain conditions:
Chapter 13 — Negligible Impairment
Chapter 14 — Malignant Conditions
Chapter 15 — Intermittent Impairment
Chapter 16 — Activities of Daily Living
Chapter 17 — Disfigurement
Conditions and their sequelae
Only the clinical features of an accepted condition may be taken into account in making an assessment. If the accepted condition causes some other distinct and diagnosable condition (sequela), the symptoms of the sequela cannot be taken into account when assessing the original accepted condition.
Sequelae can only be assessed when they have been separately determined to be service related.
Applying the instructions
To the extent of any inconsistency between an instruction in this “How to use the Guide” and a specific instruction concerning a particular matter in this Guide, the specific instruction in this “How to use the Guide” is to apply to that particular matter.
Duration of assessment period or date of determination and commencement of periodic payment and permanent impairment and interim payments
Assessment can only be made by reference to the available medical and other material that, of necessity, relates to a particular point or period in time.
The assessment of the impairment and lifestyle ratings must be based on the Commission’s reasonable satisfaction on the available material. If there is a significant change in impairment during the course of an investigation a payment may still be made as an interim payment. Interim payments are made until the Commission is satisfied that the condition has stabilised at an impairment level.
If the condition worsens after the last payment is made the person may claim additional compensation for the worsening and further periodic payments or lump sums can be made.
Apportionment of impairment ratings
It is sometimes necessary, for an accepted condition, to compare an impairment rating derived from one table with an impairment rating derived from another table. When two or more conditions contribute to the impairment ratings from either or both tables, and comparison is necessary, the method called “apportionment” is to be applied before making the comparison.
Details of the application of apportionment are given in Chapter 20.
Apportionment between tables
If a condition can be rated using both a functional loss table and an “Other Impairment” table, only the higher of the two ratings is to be given to the veteran.
Paired organ policy
The paired organ policy applies to eyes, kidneys etc and is described in detail in Chapter 21 of this Guide.
Impairment for specific disabilities
The Act provides only for impairment and does not convert that rating into a degree of incapacity like the VEA requires. Instead the impairment and lifestyle ratings determine a factor, not a degree of incapacity. Incapacity applies to ability to perform military service or a civilian occupation. Therefore, Chapter 24, “Degree of incapacity for specific disabilities” of GARP V, has been omitted. Instead impairment ratings are based only on the Tables from Chapter 1 to 21 of this Guide.
Military Rehabilitation and Compensation Commission
MRCA Instrument No. 1 of 2004
Schedule 3
Chapter 23
CALCULATING PERMANENT IMPAIRMENT COMPENSATION
Section 67 of the Military Rehabilitation and Compensation Act 2004 provides that this Guide can specify how the Military Rehabilitation and Compensation Commission is to determine the compensation payable to a person under Part 2 of that Act.
Different factors apply for any combination of impairment (no rounding up or down) and lifestyle effect (where rounding to nearest integer is allowed). Once a rating of 80 impairment points is achieved no lifestyle needs to be calculated as this rating pays the maximum weekly payment under the Act. The maximum payment is payable at 80 impairment points for all types of service.
Warlike, non-warlike and peacetime service
Table 1 is for warlike and non-warlike service. Table 2 is for peacetime service. The factors for warlike and non-warlike service reflect a premium where impairment has resulted from that service rather than peacetime service.
The differential lessens as impairment rates over 50 points are reached. Impairment of 80 or more points attracts the same level of compensation regardless of the nature of the service that gave rise to the injury or disease.
How to calculate a weekly compensation payment
Petty Officer Andrews is 28 when she applies for compensation. It is determined that she has incapacity caused by an injury suffered on non-warlike service. She is assessed as having an impairment rating of 15 and 1 lifestyle point.
From the table for non-warlike service the factor for her injury is .155.
The maximum payment is $240.06 per week. When this amount is factored she is entitled to $37.21 per week (note that the maximum payment amount is indexed annually).
Combining impairment ratings
If all accepted conditions have been given impairment ratings, the ratings are to be combined by applying Table 18.1 (Combined Values Chart) in this Guide.
Details on how to apply Table 18.1 are given in Chapter 18.
However, the combined impairment rating obtained by applying Table 18.1 (Combined Values Chart) is not to be rounded. Rounding is unnecessary since impairment periodic payments are based on whatever impairment rating is determined and are not in multiples of 5 or 10 as in the VEA.
Determining the factor for compensation payment
The combined impairment rating which is obtained by applying Chapter 18 (Combined Values Chart) is to be combined with the lifestyle rating on either the Warlike and Non-warlike Factors Table (Table 23.1) or the Peacetime Factors Table (Table 23.2). This is to determine the factor to be multiplied by the maximum lump sum payment available under the Act.
A veteran’s lifestyle rating is expected to be broadly consistent with the degree of medical impairment from accepted conditions as measured by the Combined Impairment Rating. In most cases a lifestyle rating that falls within the shaded area of Tables 23.1 and 23.2 will satisfy the requirement of broad consistency. There may be exceptional cases and, in accordance with Chapter 22 of this Guide, a lifestyle rating outside the shaded area may be allocated.
Where a member or former member has two or more types of service and different conditions under each then the instructions on “Combined Ratings” apply.
Table 23.1: COMPENSATION FACTORS FOR CALCULATING PERMANENT IMPAIRMENT COMPENSATION - WARLIKE AND NON-WARLIKE SERVICE
Lifestyle Impairment 0 1 2 3 4 5 6 7 0 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 5 0.044 0.067 0.089 0.111 0.133 0.156 0.178 0.200 6 0.053 0.075 0.098 0.120 0.142 0.165 0.187 0.209 7 0.062 0.084 0.107 0.129 0.151 0.173 0.196 0.218 8 0.071 0.093 0.115 0.138 0.160 0.182 0.205 0.227 9 0.080 0.102 0.124 0.147 0.169 0.191 0.213 0.236 10 0.088 0.111 0.133 0.155 0.178 0.200 0.222 0.245 11 0.097 0.120 0.142 0.164 0.187 0.209 0.231 0.253 12 0.106 0.128 0.151 0.173 0.195 0.218 0.240 0.262 13 0.115 0.137 0.160 0.182 0.204 0.227 0.249 0.271 14 0.124 0.146 0.168 0.191 0.213 0.235 0.258 0.280 15 0.133 0.155 0.177 0.200 0.222 0.244 0.267 0.289 16 0.142 0.164 0.186 0.208 0.231 0.253 0.275 0.298 17 0.150 0.173 0.195 0.217 0.240 0.262 0.284 0.307 18 0.159 0.182 0.204 0.226 0.248 0.271 0.293 0.315 19 0.168 0.190 0.213 0.235 0.257 0.280 0.302 0.324 20 0.177 0.199 0.222 0.244 0.266 0.288 0.311 0.333 21 0.186 0.208 0.230 0.253 0.275 0.297 0.320 0.342 22 0.195 0.217 0.239 0.262 0.284 0.306 0.328 0.351 23 0.203 0.226 0.248 0.270 0.293 0.315 0.337 0.360 24 0.212 0.235 0.257 0.279 0.302 0.324 0.346 0.368 25 0.221 0.243 0.266 0.288 0.310 0.333 0.355 0.377 26 0.230 0.252 0.275 0.297 0.319 0.342 0.364 0.386 27 0.239 0.261 0.283 0.306 0.328 0.350 0.373 0.395 28 0.248 0.270 0.292 0.315 0.337 0.359 0.382 0.404 29 0.257 0.279 0.301 0.323 0.346 0.368 0.390 0.413 30 0.265 0.288 0.310 0.332 0.355 0.377 0.399 0.422 31 0.274 0.297 0.319 0.341 0.363 0.386 0.408 0.430 32 0.283 0.305 0.328 0.350 0.372 0.395 0.417 0.439 33 0.292 0.314 0.337 0.359 0.381 0.403 0.426 0.448 34 0.301 0.323 0.345 0.368 0.390 0.412 0.435 0.457 35 0.310 0.332 0.354 0.377 0.399 0.421 0.443 0.466 36 0.318 0.341 0.363 0.385 0.408 0.430 0.452 0.475 37 0.327 0.350 0.372 0.394 0.417 0.439 0.461 0.483 38 0.336 0.358 0.381 0.403 0.425 0.448 0.470 0.492 39 0.345 0.367 0.390 0.412 0.434 0.457 0.479 0.501 40 0.354 0.376 0.398 0.421 0.443 0.465 0.488 0.510 41 0.363 0.385 0.407 0.430 0.452 0.474 0.497 0.519 42 0.372 0.394 0.416 0.438 0.461 0.483 0.505 0.528 43 0.380 0.403 0.425 0.447 0.470 0.492 0.514 0.537 44 0.389 0.412 0.434 0.456 0.478 0.501 0.523 0.545 45 0.398 0.420 0.443 0.465 0.487 0.510 0.532 0.554 46 0.407 0.429 0.452 0.474 0.496 0.518 0.541 0.563 47 0.416 0.438 0.460 0.483 0.505 0.527 0.550 0.572 48 0.425 0.447 0.469 0.492 0.514 0.536 0.558 0.581 49 0.434 0.456 0.478 0.500 0.523 0.545 0.567 0.590 50 0.442 0.465 0.487 0.509 0.532 0.554 0.576 0.598 51 0.461 0.483 0.504 0.526 0.547 0.569 0.590 0.612 52 0.480 0.500 0.521 0.542 0.563 0.584 0.604 0.625 53 0.498 0.518 0.538 0.558 0.578 0.598 0.619 0.639 54 0.517 0.536 0.555 0.575 0.594 0.613 0.633 0.652 55 0.535 0.554 0.572 0.591 0.610 0.628 0.647 0.665 56 0.554 0.572 0.590 0.607 0.625 0.643 0.661 0.679 57 0.572 0.590 0.607 0.624 0.641 0.658 0.675 0.692 58 0.591 0.607 0.624 0.640 0.656 0.673 0.689 0.706 59 0.610 0.625 0.641 0.656 0.672 0.688 0.703 0.719 60 0.628 0.643 0.658 0.673 0.688 0.703 0.717 0.732 61 0.647 0.661 0.675 0.689 0.703 0.717 0.732 0.746 62 0.665 0.679 0.692 0.706 0.719 0.732 0.746 0.759 63 0.684 0.697 0.709 0.722 0.735 0.747 0.760 0.772 64 0.703 0.714 0.726 0.738 0.750 0.762 0.774 0.786 65 0.721 0.732 0.743 0.755 0.766 0.777 0.788 0.799 66 0.740 0.750 0.761 0.771 0.781 0.792 0.802 0.813 67 0.758 0.768 0.778 0.787 0.797 0.807 0.816 0.826 68 0.777 0.786 0.795 0.804 0.813 0.822 0.830 0.839 69 0.796 0.804 0.812 0.820 0.828 0.836 0.845 0.853 70 0.814 0.822 0.829 0.836 0.844 0.851 0.859 0.866 71 0.833 0.839 0.846 0.853 0.859 0.866 0.873 0.880 72 0.851 0.857 0.863 0.869 0.875 0.881 0.887 0.893 73 0.870 0.875 0.880 0.885 0.891 0.896 0.901 0.906 74 0.888 0.893 0.897 0.902 0.906 0.911 0.915 0.920 75 0.907 0.911 0.914 0.918 0.922 0.926 0.929 0.933 76 0.926 0.929 0.932 0.935 0.938 0.941 0.943 0.946 77 0.944 0.946 0.949 0.951 0.953 0.955 0.958 0.960 78 0.963 0.964 0.966 0.967 0.969 0.970 0.972 0.973 79 0.981 0.982 0.983 0.984 0.984 0.985 0.986 0.987 80 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 For impairment greater than 80 points, the value is always 1.00.
Table 23.2: COMPENSATION FACTORS FOR CALCULATING PERMANENT IMPAIRMENT COMPENSATION - PEACETIME SERVICE
Lifestyle Impairment 0 1 2 3 4 5 6 7 0 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 5 0.025 0.037 0.050 0.062 0.075 0.087 0.100 0.112 6 0.030 0.042 0.055 0.067 0.080 0.092 0.105 0.117 7 0.035 0.047 0.060 0.072 0.085 0.097 0.110 0.122 8 0.040 0.052 0.065 0.077 0.090 0.102 0.114 0.127 9 0.045 0.057 0.070 0.082 0.094 0.107 0.119 0.132 10 0.050 0.062 0.074 0.087 0.099 0.112 0.124 0.137 11 0.054 0.067 0.079 0.092 0.104 0.117 0.129 0.142 12 0.059 0.072 0.084 0.097 0.109 0.122 0.134 0.147 13 0.064 0.077 0.089 0.102 0.114 0.127 0.139 0.152 14 0.069 0.082 0.094 0.107 0.119 0.132 0.144 0.157 15 0.074 0.087 0.099 0.112 0.124 0.137 0.149 0.162 16 0.079 0.092 0.104 0.117 0.129 0.142 0.154 0.167 17 0.084 0.097 0.109 0.122 0.134 0.147 0.159 0.172 18 0.089 0.102 0.114 0.127 0.139 0.152 0.164 0.176 19 0.094 0.107 0.119 0.131 0.144 0.156 0.169 0.181 20 0.099 0.111 0.124 0.136 0.149 0.161 0.174 0.186 21 0.104 0.116 0.129 0.141 0.154 0.166 0.179 0.191 22 0.109 0.121 0.134 0.146 0.159 0.171 0.184 0.196 23 0.114 0.126 0.139 0.151 0.164 0.176 0.189 0.201 24 0.119 0.131 0.144 0.156 0.169 0.181 0.194 0.206 25 0.124 0.136 0.149 0.161 0.174 0.186 0.199 0.211 26 0.129 0.141 0.154 0.166 0.179 0.191 0.204 0.216 27 0.134 0.146 0.159 0.171 0.184 0.196 0.209 0.221 28 0.139 0.151 0.164 0.176 0.189 0.201 0.213 0.226 29 0.144 0.156 0.169 0.181 0.193 0.206 0.218 0.231 30 0.149 0.161 0.173 0.186 0.198 0.211 0.223 0.236 31 0.153 0.166 0.178 0.191 0.203 0.216 0.228 0.241 32 0.158 0.171 0.183 0.196 0.208 0.221 0.233 0.246 33 0.163 0.176 0.188 0.201 0.213 0.226 0.238 0.251 34 0.168 0.181 0.193 0.206 0.218 0.231 0.243 0.256 35 0.173 0.186 0.198 0.211 0.223 0.236 0.248 0.261 36 0.178 0.191 0.203 0.216 0.228 0.241 0.253 0.266 37 0.183 0.196 0.208 0.221 0.233 0.246 0.258 0.271 38 0.188 0.201 0.213 0.226 0.238 0.251 0.263 0.275 39 0.193 0.206 0.218 0.230 0.243 0.255 0.268 0.280 40 0.198 0.210 0.223 0.235 0.248 0.260 0.273 0.285 41 0.203 0.215 0.228 0.240 0.253 0.265 0.278 0.290 42 0.208 0.220 0.233 0.245 0.258 0.270 0.283 0.295 43 0.213 0.225 0.238 0.250 0.263 0.275 0.288 0.300 44 0.218 0.230 0.243 0.255 0.268 0.280 0.293 0.305 45 0.223 0.235 0.248 0.260 0.273 0.285 0.298 0.310 46 0.228 0.240 0.253 0.265 0.278 0.290 0.303 0.315 47 0.233 0.245 0.258 0.270 0.283 0.295 0.308 0.320 48 0.238 0.250 0.263 0.275 0.288 0.300 0.312 0.325 49 0.243 0.255 0.268 0.280 0.292 0.305 0.317 0.330 50 0.248 0.260 0.272 0.285 0.297 0.310 0.322 0.335 51 0.273 0.285 0.297 0.309 0.321 0.333 0.345 0.357 52 0.298 0.309 0.321 0.333 0.344 0.356 0.368 0.379 53 0.323 0.334 0.345 0.356 0.368 0.379 0.390 0.401 54 0.348 0.359 0.369 0.380 0.391 0.402 0.413 0.424 55 0.373 0.383 0.394 0.404 0.415 0.425 0.435 0.446 56 0.398 0.408 0.418 0.428 0.438 0.448 0.458 0.468 57 0.423 0.433 0.442 0.452 0.461 0.471 0.480 0.490 58 0.448 0.457 0.466 0.476 0.485 0.494 0.503 0.512 59 0.473 0.482 0.491 0.499 0.508 0.517 0.526 0.534 60 0.498 0.507 0.515 0.523 0.532 0.540 0.548 0.557 61 0.523 0.531 0.539 0.547 0.555 0.563 0.571 0.579 62 0.549 0.556 0.563 0.571 0.578 0.586 0.593 0.601 63 0.574 0.581 0.588 0.595 0.602 0.609 0.616 0.623 64 0.599 0.605 0.612 0.619 0.625 0.632 0.639 0.645 65 0.624 0.630 0.636 0.642 0.649 0.655 0.661 0.667 66 0.649 0.655 0.660 0.666 0.672 0.678 0.684 0.690 67 0.674 0.679 0.685 0.690 0.696 0.701 0.706 0.712 68 0.699 0.704 0.709 0.714 0.719 0.724 0.729 0.734 69 0.724 0.729 0.733 0.738 0.742 0.747 0.752 0.756 70 0.749 0.753 0.757 0.762 0.766 0.770 0.774 0.778 71 0.774 0.778 0.782 0.785 0.789 0.793 0.797 0.800 72 0.799 0.803 0.806 0.809 0.813 0.816 0.819 0.823 73 0.824 0.827 0.830 0.833 0.836 0.839 0.842 0.845 74 0.850 0.852 0.854 0.857 0.859 0.862 0.864 0.867 75 0.875 0.877 0.879 0.881 0.883 0.885 0.887 0.889 76 0.900 0.901 0.903 0.905 0.906 0.908 0.910 0.911 77 0.925 0.926 0.927 0.928 0.930 0.931 0.932 0.933 78 0.950 0.951 0.951 0.952 0.953 0.954 0.955 0.956 79 0.975 0.975 0.976 0.976 0.977 0.977 0.977 0.978 80 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 For impairment greater than 80 points, the value is always 1.00.
Combined ratings
If the two service-caused conditions lead to impairment ratings of A for warlike (or non-warlike) service and B for peacetime service, then the compensation payable will be a weighted average. This is determined on the amount that would be paid if they both were caused by warlike (or non-warlike) and both by peacetime service. The weights used are the impairment ratings A and B. If the combined impairment is C (see Chapter 18) and the lifestyle effect is L, this can be expressed as:
CFfinal(C,L) = A * CFwl(C,L) + B * CFpt(C,L)
(A + B)
where the CF values for warlike (or non-warlike) and peacetime service are taken from the relevant tables the final value of CF is applied to determine the final level of compensation.
Captain Brown has two conditions, a gastro-intestinal condition (A) resulting from warlike service assessed as 20 impairment points and a spinal injury (B) resulting from peacetime service assessed as 30 impairment points.
The lifestyle rating (L) from these conditions is 4.
The combined impairment rating (C) is 44.
The compensation factor that would be applied if both conditions resulted from warlike service would be 0.478.
If both conditions resulted from peacetime service it would be 0.268.
The weighted average, using the above formula, is (20 * 0.478 + 30 * 0.268)/(20 + 30) or 0.352.
The maximum compensation payable of $240.06 is multiplied by this factor to give a periodic payment of $84.50 per week.
Note: If the gastro-intestinal condition had arisen from peacetime service and the spinal condition from warlike service, with the same impairment and lifestyle ratings, the final compensation factor would be (30 * 0.478 + 20 * 0.268)/(30 + 20) or 0.394, with a periodic payment of $94.58 per week.
Chapter 24
CONVERTING WEEKLY SUMS INTO LUMP SUMS
Once the MRCC determines that compensation is payable under any of sections 68, 71 or 75(2) of the Act it must notify the claimant of the weekly amount of compensation and advise if it may be converted wholly or partly into a lump sum.
A member may accept the weekly payment for life or convert all or part of it to a lump sum using factors approved by the Australian Government Actuary.
The convertible amount
The convertible amount (see section 78) is the weekly amount of compensation that is payable.
If the convertible amount is less than 10% of the maximum weekly amount payable under the Military Rehabilitation and Compensation Act 2004, the person may convert the entire amount to a lump sum.
If the convertible amount is at least 10% but not more than 20% of the maximum weekly amount payable under the Act then the person may convert 50% or 100% to a lump sum.
If the convertible amount is more than 20% of the maximum weekly amount payable under the Act then the person may convert 25%, 50%, 75% or 100% to a lump sum.
Chapter 25
Method of working out the amount of compensation payable under the MRCA for a person with a VEA or SRCA injury or disease
This Chapter deals with situations where an injury or disease (the condition) has been accepted under the VEA or the SRCA before a claim is made under the MRCA. The claim under the MRCA may be for a new condition unrelated to the first or for an aggravation of the pre-existing condition. The method to deal with amounts of compensation already paid for the condition and the amount due under the MRCA now or later is described below.
Bringing across impairment points from an unrelated VEA injury or disease
A claim made under section 319 of the MRCA may result in liability for an injury or disease being accepted and compensation payable. Where a person entitled to a payment under MRCA in respect of permanent impairment is also entitled to a payment of disability pension under the VEA, or has an accepted condition under the VEA, the combined impairment must be determined under the MRCA using this Guide. An accepted condition under the VEA is referred to as the old injury or disease.
The MRCA claim may not result in a greater impairment rating, or result in a compensation periodic payment because it is too small to meet the threshold value. It may also be that it is only a temporary change. In the latter case liability is established for the purpose of paying incapacity payments.
In order to decide whether or not compensation is payable under the MRCA the impairment resulting from any old injury or disease must be determined using this Guide, as at the date of the MRCA determination. The points so derived for the old injury or disease must then be combined with those attributable to the injury or disease claimed under the MRCA using the combined impairment table to determine the overall impairment assessment for the purpose of the MRCA.
IR—Impairment Rating
V—Old VEA injury or disease
M—MRCA injury or disease
Total IR(V + M) = combined [IR(V) + IR(M)]
Determine the lifestyle effect of both V and M taken together.
Calculate the MRCA periodic payment for the resulting total impairment ratings and lifestyle effects in $/week.
Subtract VEA disability pension payment in $/week.
The remainder is the net MRCA periodic payment.
The net MRCA periodic payment is the periodic payment due to the claimant because of the effects of the MRCA injury or disease. The VEA disability pension continues in payment for life. The net periodic payment under the MRCA continues for life.
The net MRCA periodic payment, but not the VEA disability pension, can be converted to a lump sum in accordance with section 78 of the MRCA.
Bringing across impairment points from a VEA injury or disease that is aggravated
A claim can be made under section 319 is in respect of the cause, aggravation or material contribution to the old injury or disease. The combined impairment must be determined under the MRCA using this Guide.
A claim can be made for the aggravation or material contribution to the signs or symptoms of such an injury or disease because of section 30 of the MRCA.
The MRCA claim may not result in a greater impairment rating, or result in a compensation periodic payment because it is too small to meet the threshold value. It may also be that it is only a temporary change. In the latter case liability is established for the purpose of paying incapacity payments.
IR—Impairment Rating
V—Old VEA injury or disease
V*—MRCA injury or disease (aggravation of V)
IR(V+V*) = impairment rating for the aggravated condition
Determine the lifestyle effect of both V and V* taken together.
Calculate the MRCA periodic payment for the resulting total impairment ratings and lifestyle effects in $/week.
Subtract VEA disability pension payment in $/week.
The remainder is the net MRCA periodic payment.
The net MRCA periodic payment is the periodic payment due to the claimant because of the effects of the MRCA injury or disease. The VEA disability pension continues in payment for life. The net periodic payment under the MRCA continues for life.
The net MRCA periodic payment, but not the VEA disability pension, can be converted to a lump sum in accordance with section 78 of the MRCA.
Bringing across impairment points from an unrelated SRCA injury or disease
A claim made under section 319 of the MRCA may result in liability for an injury or disease being accepted and compensation payable. Where a person entitled to a payment under MRCA in respect of permanent impairment was or is paid a lump sum for permanent impairment under the SRCA or liability for a condition accepted under the SRCA the combined impairment must be determined under the MRCA using this Guide. An accepted liability under the SRCA is referred to as the old injury or disease.
This may not result in a greater impairment rating, or result in a compensation periodic payment because it is too small to meet the threshold value. It may also be that it is only a temporary change. In the latter case liability is established for the purpose of paying incapacity payments.
The impairment resulting from any old injury or disease must be determined using this Guide as at the date of the MRCA determination. The points so derived for the old injury or disease must then be combined using the combined impairment table to determine the overall impairment assessment for the purpose of the MRCA.
IR—Impairment Rating
S—Old SRCA injury or disease
M—MRCA injury or disease
Total IR(S + M) = combined [IR(S) + IR(M)]
Determine the lifestyle effect of both M and S taken together.
The SRCA lump sum, converted to a periodic payment, is subtracted from the MRCA periodic payment to get the net MRCA periodic payment.
In order to calculate the net MRCA periodic payment the SRCA lump sum must be converted to a periodic payment. The SRCA amount is converted to a current lump sum value (by multiplying by the ratio of the current value for maximum SRCA section 24 payment to the value when the lump sum payment was made) and the amount converted to a periodic payment by dividing by an age-based number provided by the Australian Government Actuary for this purpose. The age to be used in applying this age-based number is the age the person was at the time the SRCA lump sum was paid. The amount is indexed annually (on 1 July) using the indexation factor calculated under section 404 of the MRCA.
The net MRCA periodic payments continue for life or can be converted to a lump sum in accordance with section 78 of the MRCA.
Bringing across impairment points from a SRCA injury or disease that is aggravated
A claim can be made under section 319 is in respect of the aggravation or material contribution to the old injury or disease, or the aggravation or material contribution to the signs or symptoms of such an injury or disease. The total impairment must be determined under the MRCA using this Guide.
This may not result in a greater impairment rating, or result in a compensation periodic payment because it is too small to meet the threshold value. It may also be that it is only a temporary change. In the latter case liability is established for the purpose of paying incapacity payments.
The impairment resulting from any old injury or disease must be determined using this Guide as at the date of the MRCA determination. The points so derived for the old injury or disease must then be combined using the combined impairment table to determine the overall impairment assessment for the purpose of the MRCA.
IR—Impairment Rating
S—Old SRCA injury or disease
S*—MRCA injury or disease (aggravation of S)
IR(S + S*) = impairment rating for the aggravated condition
Determine the lifestyle effect of both S and S* taken together.
The SRCA lump sum, converted to a periodic payment, is subtracted from the MRCA periodic payment to get the net MRCA periodic payment.
In order to calculate the net MRCA periodic payment the SRCA lump sum must be converted to a periodic payment. The SRCA amount is converted to a current lump sum value (by multiplying by the ratio of the current value for maximum SRCA section 24 payment to the value when the lump sum payment was made) and the amount converted to a periodic payment by dividing by an age-based number provided by the Australian Government Actuary for this purpose. The age to be used in applying this age-based number is the age the person was at the time the SRCA lump sum was paid. The amount is indexed annually (on 1 July) using the indexation factor calculated under section 404 of the MRCA.
The net MRCA periodic payments continue for life or can be converted to a lump sum in accordance with section 78 of the MRCA.
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