Searchshow menu

On 11 April 2019 the Australian Government assumed a caretaker role, with an election to be held 18 May 2019.
Information on websites maintained by Comcare will be published in accordance with the Guidance on Caretaker Conventions until after the election and conclusion of the caretaker period.

Permanent impairment assessments

In order to determine a claim for permanent impairment, an assessment should be obtained from a medical specialist in an area relevant to the claimed injury. There is no requirement under the Safety, Rehabilitation and Compensation Act 1988 (SRC Act) for those conducting a permanent impairment (PI) assessment to be accredited. They need only to be legally qualified medical practitioners.

A medical assessment informs the claims manager, but the responsibility for weighing up all the evidence and making a determination under the SRC Act on a PI claim rests with the claims manager.

A PI must be assessed against the Comcare Guide, or if no methodology is provided there, the American Medical Association’s Guides to the Evaluation of Permanent Impairment (5th Edition) (AMA5).

As there is no accreditation or approval system for PI assessors in the Comcare scheme, PI assessors can be identified and engaged through medico-legal service providers, via state/territory assessor lists (see each state/territory WorkCover/WorkSafe website) or directly using professional networks or general searches.

You should ensure, however, that whoever you choose is actually registered as a medical practitioner with the Australian Health Practitioner Regulation Agency (AHPRA – www.ahpra.gov.au), and they are registered with a specialty appropriate to the claim.

Related links

What happens after I submit my claim for a permanent impairment benefit?

After we receive your claim, your claims manager will register and acknowledge your application within 48 hours of receipt and notify your employer. If you do not receive an acknowledgement within a week of lodgement, please contact your claims manager on 1300 366 979 or email us at general.enquiries@comcare.gov.au.

The claims manager will contact you or your representative at regular intervals to inform you of their progress.

What are the steps in the permanent impairment claims management process?

When we receive a PI claim form, it goes through a five-step process:

  1. Registration and acknowledgement
  2. Initial investigation and medical examination if necessary
  3. Assessment of evidence
  4. Determination
  5. Quality assurance and payment of PI benefit, if applicable.

Do I really need another medical?

Where there is sufficient medical evidence on your file to make a decision, your claims manager may make a determination without the need for an independent medical examination. However, the claims manager may need you to have one to help assess the degree of your PI.

If you do need to have a medical examination, the claims manager will provide the specialist with all the relevant information about your claim, including a case summary and copies of any relevant reports held in our files. If you have any other information that may help the medical examiner—such as radiological and other investigations—please take them to the assessment.

Assessments by independent medical examiners are made in accordance with the provisions of the Safety, Rehabilitation and Compensation Act 1988 and the applicable Guide to the Assessment of the Degree of Permanent Impairment (the Guide).

We keep a list of independent medical examiners that are trained in using the Guide and your claims manager will arrange your appointment with one of these based on their specialty and availability. Your claims manager will contact you to notify you of the appointment details.

It is very important that you attend the scheduled appointment. However, if you need to reschedule the specialist examination, please contact the claims manager at the earliest possible date before the appointment to avoid cancellation fees.

Can I provide more evidence after lodging my permanent impairment application?

We recommend you submit any supporting evidence with your application. However, you or your representative can provide more evidence at any time before we make a determination.

How long will it take to complete the permanent impairment assessment?

As mentioned above, your PI claim will progress through a five-step process. We aim to complete this process within 90 days. However, each claim is considered on its own merits and unforeseen circumstances can occur (for example, the complexity of the claim, unavailability of specialists, or rescheduling of appointments).

More information

Read more about permanent impairment determinations.

Page last updated: 17 May 2017