TAC impairment assesment
Generally speaking, there are four entitlements open to a person to claim from the TAC if they’ve been involved in an accident.
These are: the payment of medical and like expenses, weekly payments, an impairment benefit lump sum claim and a common law lump sum claim.
Impairment assessments are primarily related to impairment benefit lump sum claims.
However, depending upon the outcome of an impairment assessment (or multiple assessments), there may be an impact on other entitlements.
What is an impairment assessment?
If you pursue an impairment lump sum claim, all of the injuries and conditions suffered in the accident that you wish to claim need to be assessed by specialist doctors.
These assessments are called impairment assessments.
A doctor that performs an impairment assessment will be specially trained to evaluate permanent impairment.
After you’ve been assessed, the doctor will complete a report that will then be sent to the TAC.
Specialist doctors
Each injury or condition type needs to be assessed by a specialist in those injuries or conditions.
So for example, if you suffered a broken leg in an accident you may need to be assessed by an orthopaedic surgeon.
If you suffered post traumatic stress disorder in an accident, then you may need to see a psychologist.
If you suffered an injury to your nose you may need to see an ear nose and throat doctor.
And if you suffered an injury to your head, you may need to see a neurologist or a neuropsychologist.
An impairment assessment involves attending an appropriate doctor who assesses any relevant injuries or conditions that they are able to.
They perform an impairment assessment which involves grading each of the relevant injuries or conditions.
They put percentage figures on your injuries and conditions and combine relevant injuries and conditions together to form one overall figure.
What then happens is if you have seen more than one doctor, these impairment figures then get combined into one overall impairment figure. This is called your whole person impairment rating.
If you have only seen one doctor, then the impairment assessment given to you by that doctor is your whole person impairment rating.
For the purposes of an impairment claim, the whole person impairment rating is what determines the compensation amount payable.
Who organises a TAC impairment assessment?
The answer to this is, it depends.
If you do not have legal representation, and you wish to pursue an impairment claim, then the TAC will organise any appropriate assessments on your behalf.
They will select the doctors that you see.
If you do have legal representation then what normally happens is that your lawyer will organise any impairment assessment on your behalf.
They will select the doctors that you see.
What happens during an impairment assessment?
Prior to am assessment the doctor may explain the purpose of the examination, explain their role, explain how you will be examined and obtain your consent to any physical examination before proceeding.
During an impairment assessment, depending upon the nature of the injury or condition being assessed, the doctor will perform a range of tests.
It is the doctor‘s job to assess you in accordance with the American Medical Association guides to the evaluation of permanent impairment (4th edition). This is referred to as the AMA guides.
This is a big red book that you may see in the doctors office.
The doctor will ask you a number of questions and perform any relevant tests as guided by this book.
It is important that you keep in mind that for the purposes of an impairment claim, the doctor is restricted in how they are to assess you.
You may be wondering why a doctor is not more interested in certain things that you are saying such as, for example, certain restrictions in regard to your activities of daily living.
The doctor that will be assessing you is not so much an interested in the way the injury impacts your life.
The doctor is interested in performing an assessment in accordance with the AMA guides and the criteria set out therein.
How long does an impairment assessment usually take?
This depends upon how many injuries need to be assessed and the nature of those injuries.
For example, if you had one physical injury, you may only be in with a doctor for 15 to 30 minutes.
If you have multiple physical injuries it may be longer than this.
If you’re seeing a psychiatrist your appointment could take an hour or two (or longer).
It also depends upon how much medical material the doctor has prior to the appointment.
Can any doctor perform an impairment assessment?
No, a doctor that performs an impairment assessment needs to have undergone specialised training to enable them to perform impairment assessments.
So this means that even a very experienced specialist doctor may not be able to perform an impairment assessment because they have not undergone the requisite training.
Who covers the cost of an impairment assessment?
In most cases, the TAC will cover the cost of an impairment assessment.
Do I need to attend an impairment assessment?
If you do not attend an impairment assessment, then you will not be able to finalise an impairment claim.
Also, if an impairment assessment has been organised and you do not attend, you may have to pay a non attendance fee to the doctor.
If you wish to cancel an impairment assessment, you need to contact whoever scheduled the appointment as soon as possible (either the TAC or your lawyer).
If you cancel an appointment too close to the appointment date, then you may have to pay a non attendance fee to the doctor.
How can an impairment assessment impact other parts of a TAC matter?
If you are assessed as having a 30% or greater whole person impairment rating following an impairment assessment or impairment assessment, then you are considered to have a serious injury which is an important part of a common law claim.
Also, if you are assessed as having a 50% or greater whole person impairment rating, then you will be entitled to the payment of income payments beyond the three mark.
Conclusion
An impairment assessment is a medical assessment that occurs in relation to a TAC impairment claim.
It involves seeing a doctor that has undergone specialised training who will grade an injury in accordance with the American Medical Association guides to the evaluation of permanent impairment.
The impairment assessment figure will be used to determine your whole person impairment rating which will then used to determine your impairment benefit compensation entitlement.
