WorkCover Guides to the Evaluation of Permanent Impairment
The WorkCover scheme in Victoria relies on the Guides to the Evaluation of Permanent Impairment.
This is a book published by the American medical association. It’s purpose is to provide repeatable measurement frameworks for the assessment of permanent impairment in people that have suffered an injury, illness or condition that has resulted in the reduction of body function.
This page will explore the guides to the evaluation of permanent impairment further and explore specifically how they are used in Victorian WorkCover matters.
Table of Contents
What are the Guides to the Evaluation of Permanent Impairment?
The guides to the evaluation of permanent impairment are published by the American medical association.
Doctors and lawyers often refer to the book as the ‘AMA guides’ or ‘the guides’.
They are used in workers compensation systems and personal injury schemes around the world by doctors to rate impairment of different injuries, conditions and illnesses.
The AMA guides have been in use for more than half a century.
They provide a reliable, repeatable measurement framework for permanent impairment in patients have suffered an injury or illness, resulting in long-term loss of a body part or reduction of body function.
According to the AMA guides website, they incorporate science, evidence, based medicine, and assessment tools to provide a rigorous methodology to enable a fair and consistent evaluation.
How are the guides used in WorkCover in Victoria?
In Victoria, doctors and lawyers will use the fourth addition of the AMA guides (there are six editions of the guides).
The AMA guides have one use in the Victorian WorkCover system, and that is when it comes to impairment lump sum claims.
When you lodge an impairment lump sum claim, the WorkCover insurer will organise for you to be assessed by a doctor that is a specialist in the area relating to your injury, illness or condition.
This is called an impairment assessment.
So if you have a shoulder injury, you will likely be sent to see an orthopaedic surgeon or a general surgeon or a similar speciality. If you have a psychiatric condition, you’ll be sent off to see a psychiatrist.
When you see the relevant doctor (or doctors), they will be required to determine your whole person impairment rating.
When the doctor sees you and assesses you they will be doing so in accordance with the instructions the guides.
You might even notice a copy of the guides on the doctors desk or in their room.
Here’s a photo of our copy of the guides (obviously it’s not new):
When assessing you they will go to the section or sections in the guides that is relevant to your particular injury and assess you in accordance with that section.
So for example, if you have a shoulder injury, they will likely turn to page 41 and they will go through the assessments there and perform the relevant testing outlined from that page onwards.
Once they have performed all the testing, they will arrive at a single percentage figure which is your whole person impairment rating.
This whole person impairment rating figure will then match up to a compensation amount.
The guides do not outline compensation amounts, however. The compensation amounts are set out in a table provided by WorkSafe.
So if you have, for example 5% whole person impairment rating in accordance with the guides, then that will match up to a particular figure on the table.
And the higher, the impairment rating the higher, the compensation amount.
The guides do not rate disability
This is important for a person to understand when they are going through the impairment process.
The AMA guides are not used to rate disability
So if you are assessed as having a whole person impairment rating of 10% – this is not the same as having a 10% disability.
That is, the 10% rating is not saying that you have a 10% disability out of 100%.
In this instance, you should think of the whole person impairment rating of 10% as just a figure to be used to grade your injury for compensation purposes and nothing more.
The figure also has no other relevance (for the most part) to anything else other than your impairment claim.
It also has no relevance (again, for the most part) to anything outside of the Victorian WorkCover scheme.
The American medical association guys leave ocean Pettit impairment in the book, published by the American medical association that instructs doctors as to how to access injuries for the purposes of workers, compensation and personal injury matters.