Part 1 – Preliminary
1 Name of Determination
This Determination is the Social Security (Tables for the Assessment of Work-related Impairment for Disability Support Pension) Determination 2011.
2 Commencement
This Determination commences immediately after the commencement of Schedule 3 of the Social Security and Other Legislation Amendment Act 2011.
3 Interpretation
In this Determination:
Act means the Social Security Act 1991.
allied health practitioner includes, but is not limited to, a person who practises chiropractic, exercise physiology, physiotherapy, psychology, occupational therapy, osteopathy, pharmacy, podiatry or rehabilitation counseling.
appropriately qualified medical practitioner means a medical practitioner whose qualifications and practice are relevant to diagnosing a particular condition.
condition means a medical condition.
descriptor means the information set out under the column headed “Descriptors” in each Table, describing the level of functional impact resulting from a permanent condition.
health professional includes an appropriately qualified medical practitioner and an allied health practitioner.
impairment means a loss of functional capacity affecting a person’s ability to work that results from the person’s condition.
impairment rating is the number in the column in a Table headed “Points” corresponding to a descriptor.
Tables means the tables relating to the assessment of work-related impairment for disability support pension which are set out in Part 3 of this Determination.
treating doctor means the medical practitioner who has or has had the responsibility for the treatment of a person’s condition.
4 Impairment Tables and the rules for applying the Tables
(1) Part 2 of this Determination specifies rules for applying the Tables for the purposes of subsection 26(3) of the Act.
(2) Part 3 of this Determination:
(a) sets out tables for the assessment of work-related impairment for disability support pension for the purposes of subsection 26(1) of the Act; and
(b) specifies rules, in the introduction to each Table, for applying that Table for the purposes of subsection 26(3) of the Act.
Part 2 – Rules for applying the Impairment Tables
5 Purpose and design of the Tables
(1) In applying the Tables, regard must be had to the principles set out in subsections (2) and (3).
Purpose and general design principles
(2) The Tables:
(a) unless otherwise authorised by law, are only to be applied to assess whether a person satisfies the qualification requirement in paragraph 94(1)(b) of the Act; and
(b) are function based rather than diagnosis based; and
(c) describe functional activities, abilities, symptoms and limitations; and
(d) are designed to assign ratings to determine the level of functional impact of impairment and not to assess conditions.
Note: impairment is defined in section 3 to mean a loss of functional capacity affecting a person’s ability to work that results from the person’s condition.
Scaling system and descriptors
(3) In the Tables:
(a) subject to section 11, where a descriptor applies in relation to an impairment, an impairment rating can be assigned to that impairment; and
Note: For impairment rating and descriptor see section 3.
(b) the first line of each descriptor, which is formatted in italics, describes the level of impact of the impairment to be identified by reference to the particular examples of functional activities, abilities, symptoms and limitations contained in the numbered paragraphs below it, if any; and
(c) the introduction to each Table sets out further rules with which to apply the Tables and rate an impairment.
6 Applying the Tables
Assessing functional capacity
(1) The impairment of a person must be assessed on the basis of what the person can, or could do, not on the basis of what the person chooses to do or what others do for the person.
Applying the Tables
(2) The Tables may only be applied to a person’s impairment after the person’s medical history, in relation to the condition causing the impairment, has been considered.
Note: For additional information that must be taken into account in applying the Tables see section 7.
Impairment ratings
(3) An impairment rating can only be assigned to an impairment if:
(a) the person’s condition causing that impairment is permanent; and
Note: For permanent see subsection 6(4).
(b) the impairment that results from that condition is more likely than not, in light of available evidence, to persist for more than 2 years.
Example: A condition may last for more than 2 years, but the impairment resulting from that condition may be assessed as likely to improve or cease within 2 years – if this is the case, an impairment rating under the Tables cannot be assigned to the impairment.
Permanency of conditions
(4) For the purposes of paragraph 6(3)(a) a condition is permanent if:
(a) the condition has been fully diagnosed by an appropriately qualified medical practitioner; and
(b) the condition has been fully treated; and
Note: For fully diagnosed and fully treated see subsection 6(5).
(c) the condition has been fully stabilised; and
Note: For fully stabilised see subsection 6(6).
(d) the condition is more likely than not, in light of available evidence, to persist for more than 2 years.
Fully diagnosed and fully treated
(5) In determining whether a condition has been fully diagnosed by an appropriately qualified medical practitioner and whether it has been fully treated for the purposes of paragraphs 6(4)(a) and (b), the following is to be considered:
(a) whether there is corroborating evidence of the condition; and
(b) what treatment or rehabilitation has occurred in relation to the condition; and
(c) whether treatment is continuing or is planned in the next 2 years.
Fully stabilised
(6) For the purposes of paragraph 6(4)(c) and subsection 11(4) a condition is fully stabilised if:
(a) either the person has undertaken reasonable treatment for the condition and any further reasonable treatment is unlikely to result in significant functional improvement to a level enabling the person to undertake work in the next 2 years; or
(b) the person has not undertaken reasonable treatment for the condition and:
(i) significant functional improvement to a level enabling the person to undertake work in the next 2 years is not expected to result, even if the person undertakes reasonable treatment; or
(ii) there is a medical or other compelling reason for the person not to undertake reasonable treatment.
Note: For reasonable treatment see subsection 6(7).
Reasonable treatment
(7) For the purposes of subsection 6(6), reasonable treatment is treatment that:
(a) is available at a location reasonably accessible to the person; and
(b) is at a reasonable cost; and
(c) can reliably be expected to result in a substantial improvement in functional capacity; and
(d) is regularly undertaken or performed; and
(e) has a high success rate; and
(f) carries a low risk to the person.
Impairment has no functional impact
(8) The presence of a diagnosed condition does not necessarily mean that there will be an impairment to which an impairment rating may be assigned.
Example: A person may be diagnosed with hypertension but with appropriate treatment the impairment resulting from this condition may not result in any functional impact.
Assessing functional impact of pain
(9) There is no Table dealing specifically with pain and when assessing pain the following must be considered:
(a) acute pain is a symptom which may result in short term loss of functional capacity in more than one area of the body; and
(b) chronic pain is a condition and, where it has been diagnosed, any resulting impairment should be assessed using the Table relevant to the area of function affected; and
(c) whether the condition causing pain has been fully diagnosed, fully treated and fully stabilised for the purposes of subsections 6(5) and (6).
7 Information that must be taken into account in applying the Tables
(1) Subject to subsection (2), in applying the Tables the following information must be taken into account:
(a) the information provided by the health professionals specified in the relevant Table; and
(b) any additional medical or work capacity information that may be available; and
(c) any information that is required to be taken into account under the Tables, including as specified in the introduction to each Table.
(2) A person may be asked to demonstrate abilities described in the Tables.
8 Information that must not be taken into account in applying the Tables
(1) Symptoms reported by a person in relation to their condition can only be taken into account where there is corroborating evidence.
Note: Examples of the corroborating evidence that may be taken into account are set out in the Introduction of each Table in Part 3 of this Determination.
(2) Unless required under the Tables, the impact of non-medical factors when assessing a person’s impairment must not be taken into account.
Example: Unless specifically referred to by a descriptor in a Table, the following must not be taken into account in assessing an impairment: the availability of suitable work in the person’s local community; English language competence; age; gender; level of education; numeracy and literacy skills; level of work skills and experience; social or domestic situation; level of personal motivation; or religious or cultural factors.
9 Use of aids, equipment and assistive technology
A person’s impairment is to be assessed when the person is using or wearing any aids, equipment or assistive technology that the person has and usually uses.
10 Selecting the applicable Table and assessing impairments
Selection steps
(1) Table selection is to be made by applying the following steps:
(a) identify the loss of function; then
(b) refer to the Table related to the function affected; then
(c) identify the correct impairment rating.
(2) The Table specific to the impairment being rated must always be applied to that impairment unless the instructions in a Table specify otherwise.
Single condition causing multiple impairments
(3) Where a single condition causes multiple impairments, each impairment should be assessed under the relevant Table.
Example: A stroke may affect different functions, thus resulting in multiple impairments which could be assessed under a number of different Tables including: upper and lower limb function (Tables 2 and 3); brain function (Table 7); communication function (Table 8); and visual function (Table 12).
(4) When using more than one Table to assess multiple impairments resulting from a single condition, impairment ratings for the same impairment must not be assigned under more than one Table.
Multiple conditions causing a common impairment
(5) Where two or more conditions cause a common or combined impairment, a single rating should be assigned in relation to that common or combined impairment under a single Table.
(6) Where a common or combined impairment resulting from two or more conditions is assessed in accordance with subsection 10(5), it is inappropriate to assign a separate impairment rating for each condition as this would result in the same impairment being assessed more than once.
Example: The presence of both heart disease and chronic lung disease may each result in breathing difficulties. The overall impact on function requiring physical exertion and stamina would be a combined or common effect. In this case a single impairment rating should be assigned using Table 1.
11 Assigning an impairment rating
(1) In assigning an impairment rating:
(a) an impairment rating can only be assigned in accordance with the rating points in each Table; and
(b) a rating cannot be assigned between consecutive impairment ratings; and
Example: A rating of 15 cannot be assigned between 10 and 20.
(c) if an impairment is considered as falling between 2 impairment ratings, the lower of the 2 ratings is to be assigned and the higher rating must not be assigned unless all the descriptors for that level of impairment are satisfied; and
(d) a rating cannot be assigned in excess of the maximum rating specified in each Table.
(2) In deciding whether an impairment has no, mild, moderate, severe or extreme functional impact upon a person, the relative descriptors for each impairment rating in a Table should be compared to determine which impairment rating is to be applied.
Descriptors involving performing activities
(3) When determining whether a descriptor applies that involves a person performing an activity, the descriptor applies if that person can do the activity normally and on a repetitive or habitual basis and not only once or rarely.
Example: If, under Table 2, a person is being assessed as to whether they can unscrew a lid of a soft drink bottle, the relevant impairment rating can only be assigned where the person is generally able to do that activity whenever they attempt it.
Episodic and fluctuating conditions
(4) When assessing impairments caused by conditions that have stabilised as episodic or fluctuating a rating must be assigned, which reflects the overall functional impact of those impairments, taking into account the severity, duration and frequency of the episodes or fluctuations as appropriate.
No impairment resulting from a condition
(5) To avoid doubt, where a person’s diagnosed condition results in no impairment, the impairment should be assessed as having no functional impact and a zero rating must be assigned.
Part 3 – The Tables
Table 1 - Functions requiring Physical Exertion and Stamina
Introduction to Table 1 |
· Table 1 is to be used where the person has a permanent condition resulting in functional impairment when performing activities requiring physical exertion or stamina. · The diagnosis of the condition must be made by an appropriately qualified medical practitioner. · Self-report of symptoms alone is insufficient. · There must be corroborating evidence of the person’s impairment. · Examples of corroborating evidence for the purposes of this Table include, but are not limited to, the following: - a report from the person’s treating doctor;
- a report from a medical specialist confirming diagnosis of conditions commonly associated with cardiac or respiratory impairment (e.g. cardiac failure, cardiomyopathy, ischaemic heart disease, chronic obstructive airways/pulmonary disease, asbestosis, mesothelioma, lung cancer, chronic pain);
- a report from a medical specialist confirming diagnosis of conditions commonly associated with extreme fatigue or exhaustion or other conditions affecting physical exertion or stamina (e.g. end stage organ failure, widespread/metastatic cancer, chronic pain, or other long-term conditions where treatment cannot sufficiently control symptoms);
- results of exercise, cardiac stress or treadmill testing.
|
Points | Descriptors |
0 | There is no functional impact on activities requiring physical exertion or stamina. (1) The person: (a) is able to undertake exercise appropriate to their age for at least 30 minutes at a time; and (b) has no difficulty completing physically active tasks around their home and community. |
5 | There is a mild functional impact on activities requiring physical exertion or stamina. (1) The person: (a) experiences occasional symptoms (e.g. mild shortness of breath, fatigue, cardiac pain) when performing physically demanding activities and, due to these symptoms, the person has occasional difficulty: (i) walking (or mobilising in a wheelchair) to local facilities (e.g. a corner shop or around a shopping mall, larger workplace or education or training campus), without stopping to rest; or (ii) performing physically active tasks (e.g. climbing a flight of stairs or mobilising up a long, sloping pathway or ramp if in a wheelchair) or heavier household activities (e.g. vacuuming floors or mowing the lawn); and (b) is able to perform most work-related tasks, other than tasks involving heavy manual labour (e.g. digging, carrying or moving heavy objects, concreting, bricklaying, laying pavers). |
10 | There is a moderate functional impact on activities requiring physical exertion or stamina. (1) The person: (a) experiences frequent symptoms (e.g. shortness of breath, fatigue, cardiac pain) when performing day to day activities around the home and community and, due to these symptoms, the person: (i) is unable to walk (or mobilise in a wheelchair) far outside the home and needs to drive or get other transport to local shops or community facilities; or (ii) has difficulty performing day to day household activities (e.g. changing the sheets on a bed or sweeping paths); and (b) is able to: (i) use public transport and walk (or mobilise in a wheelchair) around a shopping centre or supermarket; and (ii) perform work-related tasks of a clerical, sedentary or stationary nature (that is, tasks not requiring a high level of physical exertion). |
20 | There is a severe functional impact on activities requiring physical exertion or stamina. (1) The person: (a) usually experiences symptoms (e.g. shortness of breath, fatigue, cardiac pain) when performing light physical activities and, due to these symptoms, the person is unable to: (i) walk (or mobilise in a wheelchair) around a shopping centre or supermarket without assistance; or (ii) walk (or mobilise in a wheelchair) from the carpark into a shopping centre or supermarket without assistance; or (iii) use public transport without assistance; or (iv) perform light day to day household activities (e.g. folding and putting away laundry or light gardening); and (b) has or is likely to have difficulty sustaining work-related tasks of a clerical, sedentary or stationary nature for a continuous shift of at least 3 hours. |
30 | There is an extreme functional impact on activities requiring physical exertion or stamina. (1) The person: (a) is completely unable to perform activities requiring physical exertion or stamina; or (b) experiences symptoms (e.g. shortness of breath, fatigue, cardiac pain) when performing any activities requiring physical exertion or stamina and, due to these symptoms, the person is unable to move around inside the home without assistance. (2) This impairment rating level includes people who require Oxygen treatment (e.g. the use of an Oxygen concentrator during the day or to move around). |
Table 2 – Upper Limb Function
Introduction to Table 2 |
· Table 2 is to be used where the person has a permanent condition resulting in functional impairment when performing activities requiring the use of hands or arms. · The diagnosis of the condition must be made by an appropriately qualified medical practitioner. · Self-report of symptoms alone is insufficient. · There must be corroborating evidence of the person’s impairment. · Examples of corroborating evidence for the purposes of this Table include, but are not limited to, the following: - a report from the person’s treating doctor;
- a report from a medical specialist confirming diagnosis of conditions associated with upper limb impairment (e.g. arthritis or other condition affecting upper limb joints, paralysis or loss of strength or sensation resulting from stroke or other brain or nerve injury, cerebral palsy or other condition affecting upper limb coordination, inflammation or injury of the muscles or tendons of the upper limbs, amputation or absence of whole or part of upper limb);
- a report from an allied health practitioner (e.g. physiotherapist, occupational therapist or exercise physiologist) confirming the functional impact;
- results of diagnostic tests (e.g. X-Rays or other imagery);
- results of physical tests or assessments.
· For the purposes of this Table upper limbs extend from the shoulder to the fingers. |
Points | Descriptors |
0 | There is no functional impact on activities using hands or arms. (1) The person can pick up, handle, manipulate and use most objects encountered on a daily basis without difficulty. |
5 | There is a mild functional impact on activities using hands or arms. (1) The person can manage most daily activities requiring the use of the hands and arms, but has some difficulty with most of the following: (a) picking up heavier objects (e.g. a 2 litre carton of liquid or carrying a full shopping bag); (b) handling very small objects (e.g. coins); (c) doing up buttons; (d) reaching up or out to pick up objects. |
10 | There is a moderate functional impact on activities using hands or arms. (1) The person has difficulty with most of the following: (a) picking up a 1 litre carton full of liquid; (b) picking up a light but bulky object requiring the use of 2 hands together (e.g. a cardboard box); (c) holding and using a pen or pencil; (d) doing up buttons or tying shoelaces; (e) using a standard computer keyboard; (f) unscrewing a lid on a soft-drink bottle. |
20 | There is a severe functional impact on activities using hands or arms. (1) Most of the following apply to the person: (a) the person has limited movement or coordination in both arms or both hands, or has an amputation rendering a hand or arm non-functional; (b) the person has severe difficulty handling, moving or carrying most objects even when using or wearing any prosthesis or assistive device that they have and usually use; (c) the person has difficulty using a computer keyboard despite appropriate adaptations; (d) the person has severe difficulty using a pen or pencil; (e) the person has severe difficulty turning the pages of a book without assistance. |
30 | There is an extreme functional impact on activities using hands or arms. (1) The person is unable to perform any activities requiring the use of both hands or both arms. |
Table 3 – Lower Limb Function
Introduction to Table 3 |
· Table 3 is to be used where the person has a permanent condition resulting in functional impairment when performing activities requiring the use of legs or feet. · The diagnosis of the condition must be made by an appropriately qualified medical practitioner. · Self-report of symptoms alone is insufficient. · There must be corroborating evidence of the person’s impairment. · Examples of corroborating evidence for the purposes of this Table include, but are not limited to, the following: - a report from the person’s treating doctor;
- a report from a medical specialist confirming diagnosis of conditions associated with lower limb impairment (e.g. arthritis or other condition affecting lower limb joints, paralysis or loss of strength or sensation resulting from stroke or other brain or nerve injury, cerebral palsy or other condition affecting lower limb coordination, inflammation or injury of the muscles or tendons of the lower limbs, amputation or absence of whole or part of lower limb);
- a report from an allied health practitioner (e.g. physiotherapist, occupational therapist or exercise physiologist) confirming the functional impact;
- results of diagnostic tests (e.g. X-Rays or other imagery);
- results of physical tests or assessments.
· For the purposes of this Table lower limbs extend from the hips to the toes. |
Points | Descriptors |
0 | There is no functional impact on activities requiring use of the lower limbs. (1) The person can: (a) walk without difficulty on a variety of different terrains and at varying speeds; and (b) walk without difficulty around the home and community; and (c) kneel or squat and rise back to a standing position without difficulty; and (d) stand unaided for at least 10 minutes; and (e) use stairs without difficulty. |
5 | There is a mild functional impact on activities using lower limbs. (1) At least one of the following applies: (a) the person has some difficulty walking to local facilities (e.g. shops or bus-stop); or (b) the person has some difficulty walking around a shopping mall or supermarket without a rest; or (c) the person has some difficulty climbing stairs; and (2) At least one of the following applies: (a) the person is unable to stand for more than 10 minutes; (b) the person can mobilise effectively but needs to use a lower limb prosthesis or a walking stick. |
10 | There is a moderate functional impact on activities using lower limbs. (1) At least one of the following applies: (a) the person is unable to walk far outside their home and needs to drive or get other transport to local shops or community facilities; or (b) the person is unable to use stairs or steps without assistance; or (c) the person is unable to stand for more than 5 minutes; and (2) The person is able to use public transport or a motor vehicle and walk around in a shopping centre or supermarket. (3) This impairment rating level includes a person who can: (a) move around independently using a wheelchair and can independently transfer to and from a wheelchair (e.g. can use a wheelchair accessible toilet independently); or (b) move around independently using walking aids (e.g. quad stick, crutches or walking frame). Note: The person may require additional time and effort to move around a workplace, may need to use disabled access entries, lifts and toilets, and may not be able to access some areas of a workplace or training facility. |
20 | There is a severe functional impact on activities using lower limbs. (1) The person: (a) is unable to do any of the following: (i) walk around a shopping centre or supermarket without assistance; (ii) walk from the carpark into a shopping centre or supermarket without assistance; (iii) stand up from a sitting position without assistance; and (b) requires assistance to use public transport. (2) This impairment rating level includes a person who requires assistance to: (a) move around in, or transfer to and from a wheelchair (e.g. the person needs personal care assistance to use a toilet); or (b) move around using walking aids (e.g. a quad stick, crutches or walking frame), that is, the person needs assistance from another person to walk on some surfaces and could not move independently around a workplace or training facility, even when using a walking aid. |
30 | There is an extreme functional impact on activities using lower limbs. (1) The person is unable to mobilise independently. |
Table 4 – Spinal Function
Introduction to Table 4 |
· Table 4 is to be used where the person has a permanent condition resulting in functional impairment when performing activities involving spinal function, that is, bending or turning the back, trunk or neck. · The diagnosis of the condition must be made by an appropriately qualified medical practitioner. · Self-report of symptoms alone is insufficient. · There must be corroborating evidence of the person’s impairment. · Examples of corroborating evidence for the purpose of this Table include, but are not limited to, the following: - a report from the person’s treating doctor;
- a report from a medical specialist confirming diagnosis of conditions commonly associated with spinal function impairment (e.g. spinal cord injury, spinal stenosis, cervical spondylosis, lumbar radiculopathy, herniated or ruptured disc, spinal cord tumours, arthritis or osteoporosis involving the spine);
- a report from a physiotherapist or other rehabilitation practitioner confirming loss of range of movement in the spine or other effects of spinal disease or injury.
· In using Table 4, descriptors are to be met only from spinal conditions. Restrictions on overhead tasks resulting from shoulder conditions should be rated under Table 2. |
Points | Descriptors |
0 | There is no functional impact on activities involving spinal function. (1) The person can: (a) bend down to pick a light object off the floor (e.g. a piece of paper); and (b) turn their trunk from side to side; and (c) turn their head to look to the sides or upwards. |
5 | There is a mild functional impact on activities involving spinal function. (1) The person has some difficulty in: (a) activities over head height (e.g. activities requiring the person to look upwards); or (b) bending to knee level and straightening up again without difficulty; or (c) turning their trunk or moving their head (e.g. to look to the sides or upwards). |
10 | There is a moderate functional impact on activities involving spinal function. (1) The person is able to sit in or drive a car for at least 30 minutes, and at least one of the following applies: (a) the person is unable to sustain overhead activities (e.g. accessing items over head height); or (b) the person has difficulty moving their head to look in all directions (e.g. turning their head to look over their shoulder); or (c) the person is unable to bend forward to pick up a light object placed at knee height; or (d) the person needs assistance to get up out of a chair (if not independently mobile in a wheelchair). |
20 | There is a severe functional impact on activities involving spinal function. (1) The person is unable to: (a) perform any overhead activities; or (b) turn their head, or bend their neck, without moving their trunk; or (c) bend forward to pick up a light object from a desk or table; or (d) remain seated for at least 10 minutes. |
30 | There is an extreme functional impact on activities involving spinal function. (1) The person is: (a) completely unable to perform activities involving spinal function; or (b) unable to bend or turn their trunk or their neck to complete the most basic of daily activities (e.g. dressing, bathing, showering or light housework). |
Table 5 – Mental Health Function
Introduction to Table 5 |
· Table 5 is to be used where the person has a permanent condition resulting in functional impairment due to a mental health condition (including recurring episodes of mental health impairment). · The diagnosis of the condition must be made by an appropriately qualified medical practitioner (this includes a psychiatrist) with evidence from a clinical psychologist (if the diagnosis has not been made by a psychiatrist). · Self-report of symptoms alone is insufficient. · There must be corroborating evidence of the person’s impairment. · Examples of corroborating evidence for the purposes of this Table include, but are not limited to, the following: - a report from the person’s treating doctor;
- supporting letters, reports or assessments relating to the person’s mental health or psychiatric illness;
- interviews with the person and those providing care or support to the person.
· In using Table 5 evidence from a range of sources should be considered in determining which rating applies to the person being assessed. · The person may not have good self-awareness of their mental health impairment or may not be able to accurately describe its effects. This is to be kept in mind when discussing issues with the person and reading supporting evidence. · The signs and symptoms of mental health impairment may vary over time. The person’s presentation on the day of the assessment should not solely be relied upon. · For mental health conditions that are episodic or fluctuate, the rating that best reflects the person’s overall functional ability must be applied, taking into account the severity, duration and frequency of the episodes or fluctuations as appropriate. |
Points | Descriptors |
0 | There is no functional impact on activities involving mental health function. (1) The person has no difficulties with most of the following: (a) self care and independent living; Example: The person lives independently and attends to all self care needs without support. (b) social/recreational activities and travel; Example 1: The person goes out regularly to social and recreational events without support. Example 2: The person is able to travel to and from unfamiliar environments independently. (c) interpersonal relationships; Example: The person has no difficulty forming and sustaining relationships. (d) concentration and task completion; Example 1: The person has no difficulties concentrating on most tasks. Example 2: The person is able to complete a training or educational course or qualification in the normal timeframe. (e) behaviour, planning and decision-making; Example: There is no evidence of significant difficulties in behaviour, planning or decision-making. (f) work/training capacity. Example: The person is able to cope with the normal demands of a job which is consistent with their education and training. |
5 | There is a mild functional impact on activities involving mental health function. (1) The person has mild difficulties with most of the following: (a) self care and independent living; Example: The person lives independently but may sometimes neglect self-care, grooming or meals. (b) social/recreational activities and travel; Example 1: The person is not actively involved when attending social or recreational activities. Example 2: The person sometimes is reluctant to travel alone to unfamiliar environments. (c) interpersonal relationships; Example: The person has interpersonal relationships that are strained with occasional tension or arguments. (d) concentration and task completion; Example 1: The person has difficulty focusing on complex tasks for more than 1 hour. Example 2: The person has some difficulties completing education or training. (e) behaviour, planning and decision-making; Example 1: The person has unusual behaviours that may disturb other people or attract negative attention and may sometimes be more effusive, demanding or obsessive than is appropriate to the situation. Example 2: The person has slight difficulties in planning and organising more complex activities. (f) work/training capacity. Example: The person has occasional interpersonal conflicts at work, education or training that require intervention by a supervisor, manager or teacher or changes in placement or groupings. |
10 | There is a moderate functional impact on activities involving mental health function. (1) The person has moderate difficulties with most of the following: (a) self care and independent living; Example: The person needs some support (that is, an occasional visit by or assistance from a family member or support worker) to live independently and maintain adequate hygiene and nutrition. (b) social/recreational activities and travel; Example 1: The person goes out alone infrequently and is not actively involved in social events. Example 2: The person will often refuse to travel alone to unfamiliar environments. (c) interpersonal relationships; Example: The person has difficulty making and keeping friends or sustaining relationships. (d) concentration and task completion; Example 1: The person finds it very difficult to concentrate on longer tasks for more than 30 minutes (such as reading a chapter from a book). Example 2: The person finds it difficult to follow complex instructions (such as from an operating manual, recipe or assembly instructions). (e) behaviour, planning and decision-making; Example 1: The person has difficulty coping with situations involving stress, pressure or performance demands. Example 2: The person has occasional behavioural or mood difficulties (such as temper outbursts, depression, withdrawal or poor judgement). Example 3: The person’s activity levels are noticeably increased or reduced. (f) work/training capacity. Example: The person often has interpersonal conflicts at work, education or training that require intervention by supervisors, managers or teachers or changes in placement or groupings. |
20 | There is a severe functional impact on activities involving mental health function. (1) The person has severe difficulties with most of the following: (a) self care and independent living; Example: The person needs regular support to live independently, that is, needs visits or assistance at least twice a week from a family member, friend, health worker or support worker. (b) social/recreational activities and travel; Example: The person travels alone only in familiar areas (such as the local shops or other familiar venues). (c) interpersonal relationships; Example 1: The person has very limited social contacts and involvement unless these are organised for the person. Example 2: The person often has difficulty interacting with other people and may need assistance or support from a companion to engage in social interactions. (d) concentration and task completion; Example 1: The person has difficulty concentrating on any task or conversation for more than 10 minutes. Example 2: The person has slowed movements or reaction time due to psychiatric illness or treatment effects. (e) behaviour, planning and decision-making; Example: The person’s behaviour, thoughts and conversation are significantly and frequently disturbed. (f) work/training capacity. Example: The person is unable to attend work, education or training on a regular basis over a lengthy period due to ongoing mental illness. |
30 | There is an extreme functional impact on activities involving mental health function. (1) The person has extreme difficulties with most of the following: (a) self care and independent living; Example 1: The person needs continual support with daily activities and self care. Example 2: The person is unable to live on their own and lives with family or in a supported residential facility or similar, or in a secure facility. (b) social/recreational activities and travel; Example: The person is unable to travel away from own residence without a support person. (c) interpersonal relationships; Example: The person has extreme difficulty interacting with other people and is socially isolated. (d) concentration and task completion; Example 1: The person has extreme difficulty in concentrating on any productive task for more than a few minutes. Example 2: The person has extreme difficulty in completing tasks or following instructions. (e) behaviour, planning and decision-making; Example 1: The person has severely disturbed behaviour which may include self harm, suicide attempts, unprovoked aggression towards others or manic excitement. Example 2: The person’s judgement, decision-making, planning and organisation functions are severely disturbed. (f) work/training capacity. Example: The person is unable to attend work, education or training sessions other than for short periods of time. |
Table 6 – Functioning related to Alcohol, Drug and Other Substance Use
Introduction to Table 6 |
· Table 6 is to be used where the person has a permanent condition resulting in functional impairment due to excessive use of alcohol, drugs or other harmful substances (e.g. glue or petrol) or the misuse of prescription drugs. · This Table applies to people who have current, continuing alcohol, drug or other harmful substance use disorders and those in active treatment. · Former users with resulting long-term impairments should be assessed under the relevant Table(s). Example: Table 7 (Brain Function) should be used where the person has permanent neurological impairment resulting from previous alcohol, drug or other harmful substance use. · The diagnosis of this condition must be made by an appropriately qualified medical practitioner. · Self-report of symptoms alone is insufficient. · There must be corroborating evidence of the person’s impairment. · Examples of corroborating evidence for the purposes of this Table include, but are not limited to, the following: - a report from the person’s treating doctor;
- a report from a medical specialist (e.g. addiction medicine specialist or psychiatrist with experience in diagnosis or treatment of substance use disorders) confirming diagnosis of substance use disorder and resulting impairment of other body systems or functions;
- results of investigations (e.g. liver function tests, alcohol and substance use assessment scales);
- reports or other records of participation in treatment or rehabilitation programs;
- work or training attendance records.
· The use of drugs or alcohol does not in itself constitute or necessarily indicate permanent impairment. |
Points | Descriptors |
0 | There is no functional impact from alcohol, drugs or other harmful substance use. (1) The person: (a) is able to reliably attend and effectively participate in work, education or training activities; and (b) attends to all aspects of personal care and daily living tasks. |
5 | There is mild functional impact from alcohol, drugs or other harmful substance use. (1) At least one of the following applies: (a) the person engages in alcohol or illicit drug use and experiences some physical or cognitive effects that carry over into working hours (e.g. poor concentration, lethargy, irritability); or (b) the person has occasional difficulties in reliably attending work, education or training sessions or appointments or completing duties or assigned tasks; or (c) the person is sometimes absent from work, education or training activities due to the effects of alcohol, drugs or other harmful substance use. |
10 | There is moderate functional impact from alcohol, drugs or other harmful substance use. (1) Most of the following apply: (a) the person regularly uses alcohol, drugs or other harmful substances and as a result experiences difficulties performing physical or cognitive tasks; (b) the person often has difficulty completing daily tasks and responsibilities due to the short term or long term effects of alcohol, drugs or other harmful substances; (c) the person’s use of alcohol, drugs or other harmful substances is having a detrimental effect on family or social relationships and activities; (d) the person has more frequent difficulties in reliably attending appointments or completing duties or assigned tasks; (e) the person is often absent from work, education or training activities due to the effects of alcohol, drugs or other harmful substance use. (2) This impairment rating level includes a person in receipt of treatment and in sustained remission (e.g. a person who is receiving Methadone treatment or other opiate replacement therapy) and who is able to complete most activities of daily living. |
20 | There is severe functional impact from alcohol, drug or other harmful substance use. (1) Most of the following apply: (a) the person neglects personal care, hygiene, nutrition and general health; (b) the person spends most of the time using, procuring or recovering from the effects of, alcohol, drugs or other harmful substance use; (c) there is medical or psychological evidence that the person has physical or cognitive impairment resulting from excessive use of alcohol, drugs or other harmful substances (e.g. diagnosed end organ damage, psychological or psychiatric assessment showing sustained and significant impairment or behavioural dysfunction linked to brain damage resulting from substance use); (d) remission is only very brief if it occurs; (e) the person is frequently absent from work, education or training activities due to the effects of alcohol, drugs or other harmful substance use. |
30 | There is an extreme functional impact from alcohol, drug or other harmful substance use. (1) Most of the following apply: (a) the person has a long-term, entrenched and diagnosed alcohol, drug or other harmful substance use disorder and has engaged in multiple attempts at various treatment programs without any significant periods of sustained remission or sustained improvement; (b) the person neglects most aspects of self care, family relationships, social interaction and community involvement; (c) there is well-documented medical evidence of significant and permanent damage to physical health (e.g. failure of the liver or other organs) or diagnosed brain injury with severely impaired cognitive function resulting from alcohol, drugs or other harmful substance use; (d) the person is rarely able to attend work, education, or training activities due to the effects of alcohol, drugs or other harmful substance use. |