NSW Workers Compensation: How are psychiatric and psychological disorders assessed for permanent impairment?  

The NSW Workers Compensation Guidelines for the Evaluation of Permanent Impairment issued by SIRA dictates how the permanent impairment for psychiatric and psychological disorders are assessed. 

The first hurdle for injured workers is that the impairment rating must be based upon a primary recognisable psychiatric diagnosis. For example, the feeling of being sad is not a psychiatric diagnosis, but a description of the symptoms. However, “Anxiety” or “Depression” are proper recognisable psychiatric diagnosis which could cause a feeling of sadness. 

There are a number of facts that the assessor will need to take into consideration before determining whether the psychiatric disorder is permanent. The medical assessor must apply his/her clinical opinion and judgment, to be convinced that the condition is likely to continue indefinitely. Some of the factors that the medical assessor takes into consideration include the duration of the impairment, the likelihood of improvement in the condition, whether the injured worker has undertaken reasonable rehabilitative treatment (for e.g. consulting a psychiatrist and/or taking anti-depressant medication) and any other relevant matters.  

The medical assessor is also required to consider the effects of any medications, treatment and rehabilitation undertaken by the injured worker from the date of injury to date of assessment. The assessor will need to determine and provide a comment in the report of whether the effects of any treatment may or may not, alter the level of permanent impairment.  

If the injured worker suffers from any pre-existing condition (whether or not it’s work-related), the medical assessor is required to take history and consider all relevant information regarding the pre-existing condition, and then make the appropriate apportionment/deductions if applicable. 

For assessment of psychiatric disorders, the medical assessor is required to evaluate the behavioural consequences of the disorder based on six (6) categories, called the Psychiatric Impairment Rating Scale (PIRS). The 6 categories are: 

  1. Self-care and personal hygiene 
  2. Social and recreational activities
  3. Travel
  4. Social functioning (relationships)
  5. Concentration, persistence and pace 
  6. Employability

Within each category the behavior is classified ranging from Class 1 to Class 5, with Class 1 being minor impairment and Class 5 being totally impaired. The Guidelines provides some examples of activities of each class.  

Using category one of “Self-care and personal hygiene” as an example, examples of mild impairment (Class 2) behaviours are “Able to live independently; looks after self adequately, although may look unkempt occasionally; sometimes misses a meal or relies on take-away food” whilst examples of totally impaired (Class 5) behaviours are “Needs assistance with basic functions, such as feeding and toileting”.   

After the medical assessor has gone through each of the categories and assessed which class the injured worker’s behaviour falls under, the assessor will then rate the psychiatric impairment by first determining the median class score, and then calculate the aggregate score. After doing so, the assessor will then use the conversion table as dictated in the Guidelines to arrive a final permanent impairment

The above method is standard regardless the injured worker is attending the medical assessment arranged by his/her own lawyers, the insurer’s doctor and/or the medical assessment arranged by the Personal Injury Commission (PIC).  

This is a complex system and the above only provides a summary of how psychiatric disorder. If you believe you have sustained a primary psychiatric or psychological injury as a result of your employment or are unsure, we can provide you with some advice and help guide you through the entire process so that you are fairly compensated. 

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