Military Rehabilitation and Compensation Commission

Military Rehabilitation and Compensation (Catastrophic Injury or Disease) Determination 2018

Instrument 2018 No. MRCC66

The Military Rehabilitation and Compensation Commission, under subsection 213(2) of the Military Rehabilitation and Compensation Act 2004, makes the following instrument.

Dated this         4th              day of        September                2018

The Seal of the                                                                    )
Military Rehabilitation and Compensation Commission    )  SEAL
was affixed hereto in the                                                     )
presence of:                                                                         )

Elizabeth Cosson
ELIZABETH COSSON	
C Orme
CRAIG ORME	
M A Kelly
Major General Mark Kelly	

AM CSC	
DSC AM CSC	
AO DSC	

CHAIR	
MEMBER	
MEMBER	

B S Wolski
REAR ADMIRAL BRETT WOLSKI	
T Smart
AIR VICE-MARSHAL TRACY SMART	

AM	
AM	

MEMBER	
MEMBER

	

1 Name 
This instrument is the Military Rehabilitation and Compensation (Catastrophic Injury or Disease) Determination 2018.
2 Commencement
This instrument commences on the day after it is registered on the Federal Register of Legislation. 
3 Authority
This instrument is made under subsection 213(2) of the Military Rehabilitation and Compensation Act 2004.
4 Purpose
The purpose of this instrument is to prescribe conditions that must be satisfied for the purpose of the definition of catastrophic injury or disease in subsection 213(1) of the Act. 

5 Definitions
In this instrument:

Act means the Military Rehabilitation and Compensation Act 2004.

catastrophic amputation injury or disease, see section 9.

catastrophic blindness injury or disease, see section 11.

catastrophic brain injury or disease, see section 8.

catastrophic burn injury or disease, see section 10.

catastrophic injury or disease, see subsection 213(1) of the Act.

catastrophic nerve injury or disease, see section 7.

disease means a disease in respect of which compensation is payable under the Act. 
FIMTM score sheet is the Functional Independence Measure score sheet which is a basic indicator of severity of functional limitation, being the version of the document as it exists on the day of commencement of this instrument and published by the Australasian Rehabilitation Outcomes Centre.

Note: The FIMTM score sheet is available at: https://ahsri.uow.edu.au/aroc/whatisfim/index.html by opening the page and clicking on the excel diagram under the heading “AN-SNAP Calculator With Benchmarks”.

injury means an injury in respect of which compensation is payable under the Act. 
Standardised Mini-Mental State Examination (SMMSE) tool is a common cognitive screening or assessment tool used in clinical practices, being the version of the document as it exists on the day of commencement of this instrument and published by the Independent Hospital Pricing Authority.

Note : The Standardised Mini-Mental State Examination (SMMSE) tool is available at: https://www.ihpa.gov.au/what-we-do/standardised-mini-mental-state-examination-smmse by opening the page and clicking on the heading “Standard Mini-Mental Examination (SMMSE) tool”.
6 Conditions of a catastrophic injury or disease 
For the purposes of the definition of catastrophic injury or disease in subsection 213(1) of the Act, an injury or disease is a catastrophic injury or disease if both of the following conditions are satisfied:

(a)	the injury or disease results in an impairment assessed by a FIMTM credentialed medical or health care professional at a score of 5 or less on any of the items on the FIMTM score sheet;

(b)	the Commission is satisfied that the injury or disease is:

(i)	a catastrophic nerve injury or disease; or

(ii)	a catastrophic brain injury or disease; or

(iii)	a catastrophic amputation injury or disease; or

(iv)	a catastrophic burn injury or disease; or

(v)	a catastrophic blindness injury or disease.
7 Catastrophic nerve injury or disease 
An injury or disease is a catastrophic nerve injury or disease if the injury or disease is a lesion of the spinal cord, cauda equina, brachial plexus, lumbosacral plexus, cervical plexus or coccygeal plexus which results in one or more of the following:

(a)	sensory deficit;

(b)	motor deficit;

(c)	bladder dysfunction;

(d)	bowel dysfunction.
8 Catastrophic brain injury or disease
An injury or disease is a catastrophic brain injury or disease if the injury or disease results in an impairment of cognitive, physical or psychosocial functions and it results in:

(a)	one or more of the following:

(i)	a period of post traumatic amnesia of at least 7 days;

(ii)	a significant brain imaging abnormality;

(iii)	a score for the Standardised Mini-Mental State Examination (SMMSE) tool of less than 25; or

(b)	damage to the brain similar in effect and severity to that referred to in subparagraph (a)(i), (ii) or (iii).
9 Catastrophic amputation injury or disease
An injury or disease is a catastrophic amputation injury or disease if the injury or disease results in:

(a)	one or more of the following:

(i)	a forequarter amputation;

(ii)	a shoulder disarticulation;

(iii)	a hindquarter amputation;

(iv)	a hip disarticulation;

(v)	an amputation involving the loss of 65% or more of the length of the femur; or

(b)	the loss of at least two of the following:

(i)	50% or more of the length of the tibia of the left leg;

(ii)	50% or more of the length of the tibia of the right leg;

(iii)	the thumb of the left hand at or above the first metacarpophalangeal joint;

(iv)	the thumb of the right hand at or above the first metacarpophalangeal joint.
10 Catastrophic burn injury or disease
An injury or disease is a catastrophic burn injury or disease if the injury or disease is:

(a)	full thickness burns:

(i)	for a person aged 16 years or above at the time of the injury or disease–greater than 40 per cent of the total body surface area; or

(ii)	for a person aged under 16 years at the time of the injury or disease–greater than 30 per cent of the total body surface area; or

(iii)	to the hands, face or genital area; or

(b)	inhalation burns resulting in vital capacity or forced expiratory volume in one second which is less than 50% of that predicted for the person’s age, height and ethnicity.
11 Catastrophic blindness injury or disease
An injury or disease is a catastrophic blindness injury or disease if the injury or disease results in one or more of the following:

(a)	visual acuity after correction by suitable lenses of less than 6/60 in both eyes;

(b)	constriction to within 10 degrees of fixation in the better eye irrespective of corrected visual acuity;

(c)	a combination of visual defects resulting in the same degree of visual impairment as that specified in paragraph (a) or (b).

Note: A person would have visual acuity of 6/60 if he or she is only able to see at a distance of 6 metres a symbol which a person with normal vision could see at a distance of 60 metres.