Guidelines for the assessment of permanent impairment Version 3

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Table 5.1 Clinical Dementia RatingMemory (M)Orientation (O)Judgement and ProblemSolving (JPS)Community Affairs (CA)Home and Hobbies (HH)None0No memory loss or slightinconsistent forgetfulnessFully orientedSolves everyday problemsand handles business andfinancial affairs well;judgement good in relationto past performanceIndependent function atusual level in job, shopping,volunteer and social groupsLife at home, hobbies andintellectual interests wellmaintainedQuestionable0.5Consistent slightforgetfulness; partialrecollection of events;‘benign’ forgetfulnessFully oriented except forslight difficulty with timerelationshipsSlight impairment in solvingproblems, similarities anddifferencesSlight impairment in theseactivitiesLife at home, hobbies andintellectual interests slightlyimpairedImpairment Level and CDR ScoreMild1.0Moderate memory loss;more marked for recentevents; defect interfereswith everyday activitiesModerate difficulty withtime relationships; orientedin place at examination;may have geographicdisorientation else whereModerate difficulty inhandling problems,similarities, and differences;social judgement usuallymaintainedUnable to functionindependently at theseactivities although may stillbe engaged in some;appears normal to casualinspectionMild but definiteimpairment of function athome; more difficult choresabandoned; morecomplicated hobbies andinterests abandonedPersonal Care (PC) Fully capable of self care Fully capable of self care Needs promptingModerate2.0Severe memory loss, onlyhighly learned materialretained; new materialrapidly lostSevere difficulty with timerelationships; usuallydisoriented to time, often toplaceSeverely impaired inhandling problems,similarities, and differences;social judgement usuallyimpairedNo pretence ofindependent functionoutside home; appears wellenough to be taken tofunctions outside a familyhomeOnly simple chorespreserved; very restrictedinterests, poorly maintainedRequires assistance indressing, hygiene, keepingof personal effectsSevere3.0Severe memory loss; onlyfragments remainOriented to person onlyUnable to make judgementsor solve problemsNo pretence ofindependent functionoutside home; appears tooill to be taken to functionsoutside a family homeNo significant function athomeRequires much help withpersonal care; frequentincontinenceWCT Guidelines 1 October 2011 35
Table 5.2Criteria for rating impairment related to mental statusClass 1Class 2Class 3Class 41% - 14% Impairment ofthe Whole Person15% - 29% Impairmentof the Whole Person30% - 49% Impairmentof the Whole Person50% - 70% Impairmentof the Whole PersonImpairment exists, butability remains to performsatisfactory most activitiesof daily livingImpairment requiresdirection of some activitiesof daily livingImpairment requiresassistance and supervisionfor most activities of dailylivingUnable to care for selfand be safe in anysituation withoutsupervisionCDR = 0.5 CDR = 1.0 CDR = 2.0 CDR = 3.05.12 When using the CDR the worker’s cognitive function for each category should be scoredindependently. The maximum CDR score is 3. Memory is considered the primary category, theother categories are secondary. If at least three secondary categories are given the samenumeric score as memory then the CDR = M. If three or more secondary categories are given ascore greater or less than the memory score, CDR = the score of the majority of secondarycategories unless three secondary categories are scored less than M and two secondarycategories are scored greater than M. In this case CDR = M. Similarly if two secondarycategories are greater than M, two are less than M and one is the same as M, CDR=M.5.13 Corresponding impairment ratings for CDR scores are listed in Table 5.2 above.5.14 Assessment of Emotional or Behavioural Disturbances is done using Table 3 of the AMA 4Guides (p 142).5.15 Assessment of Arousal and Sleep Disorders, (pp143 - 144 and Table 6, p 143, AMA 4 Guides):The medical assessor should make assessments of Sleep and Arousal Disorders based on theclinical assessment that would normally have been done for clinically significant disorders ofthis type.5.16 Visual Impairment Assessment (p 144, AMA 4 Guides). An ophthalmologist 2 should assess allimpairment of visual acuity, visual fields or extra-ocular movements.5.17 Trigeminal Nerve Assessment (p 145, AMA 4 Guides). Sensory impairments of the trigeminalnerve should be assessed with reference to Table 9 (p145, AMA 4 Guides). The words “orsensory disturbance” should be added to the Table after the words “neuralgic pain” in eachinstance. Impairment percentages for the three divisions of the trigeminal nerve should beapportioned with extra weighting for the first division (e.g. division 1 40%, and division 2 & 32 A medical assessor accredited in line with section 77C of the Act and with a speciality in ophthalmology.WCT Guidelines 1 October 2011 36
Page 1 and 2: GUIDELINES FOR THE ASSESSMENT OFPER
Page 3 and 4: ForewordThe Workers Rehabilitation
Page 5 and 6: Table of ContentsPage No.Foreword .
Page 7 and 8: Causation of permanent impairment1.
Page 9 and 10: 1.18 Using these Guidelines and the
Page 11 and 12: Adjustments for Effects of Prosthes
Page 13 and 14: stable and the assessment of perman
Page 15 and 16: 2.8 Although range of motion appear
Page 17 and 18: (ii) Rate the upper extremity impai
Page 19 and 20: 3.7 Use of worksheets is essential.
Page 21 and 22: Table 3.2: Lower Extremity Workshee
Page 23 and 24: Table 3.3. Impairment for ankylosis
Page 25 and 26: Table 3.4Tibial Nerve Impairment Va
Page 27 and 28: Table 4.1 Assessing spinal impairme
Page 29 and 30: Specific interpretation of the AMA
Page 31 and 32: Definitions of clinical findings co
Page 33 and 34: 4.22 When allocating the worker to
Page 35 and 36: Sexual Functioning4.30 Sexual dysfu
Page 37 and 38: 4.45 One or more end plate fracture
Page 39: 5.7 Headache or other pain potentia
Page 43 and 44: Chapter 6Ear, Nose and Throat, and
Page 45 and 46: Scarring5% for loss of sense of tas
Page 47 and 48: 7.7 In order to measure the impairm
Page 49 and 50: impairment using precisely the meth
Page 51 and 52: Table 7.3TravelClass 1Class 2Class
Page 53 and 54: Table 7.7 Conversion TableClass1Cla
Page 55 and 56: Psychiatric Impairment Rating Scale
Page 57 and 58: 7.21 Examples1. A worker suffers a
Page 59 and 60: Chapter 8Impairment of Other Body S
Page 61 and 62: Pneumoconiosis (AMA 5 Guides, Secti
Page 63 and 64: 8.23 Hypertensive Cardiovascular Di
Page 65 and 66: The Digestive SystemIntroduction an
Page 67 and 68: Where there is a range of values in
Page 69 and 70: Appendix 1GlossaryCauda equina synd
Page 71 and 72: WorkCover Tasmania - Template for R

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