NSW CTP – Permanent Impairment – Causation of Injuries

Clause 2(a) of Schedule 2 of the Act establishes that the assessment of the degree of permanent impairment is a medical assessment matter. This evaluation must determine the degree of permanent impairment suffered by the injured person as a result of the motor accident. Therefore, all assessments of permanent impairment assume a determination of whether the injury is related to the accident in question. Medical assessors must be knowledgeable of the relevant provisions of the AMA4 Guides, as well as the common law principles that would be applied by a court or the Personal Injury Commission when evaluating such matters. 

The definition of causation provided in the AMA4 Guides, and in summary explains that causation refers to a physical, chemical, or biologic factor that contributed to the occurrence of a medical condition. It is necessary to confirm two things to determine whether a factor alleged to have caused or contributed to the occurrence or worsening of a medical condition has indeed done so: 

1.  the alleged factor could have caused or contributed to the worsening of the impairment, which is a medical decision, and  
2. the alleged factor did cause or contribute to the worsening of the impairment, which is a non-medical determination. This entails a medical decision and an informed non-medical judgement.