Edition of AMA

Format

Substituted/removed

Authorisation of the guide

New South Wales

5th Edition

Modifier 1

NSW Workers compensation guidelines for the evaluation of permanent impairment - fourth edition (Guidelines), modify several Chapters in AMA5.

Removed: Chapter 18 Pain.

Substituted:

• Vision — AMA4
• Psychiatric and Psychological Disorders — Chapter 11, Guidelines, and
• Hearing - Chapter 9, Guidelines, with some reference to AMA5 (Chapter 11, pp 245–251), but uses National Acoustic Laboratory (NAL) Tables from the NAL Report No 118, Improved Procedure for Determining Percentage Loss of Hearing, January 1988.
• Evaluation of permanent impairment arising from chronic pain — Chapter 17, used for Complex Regional Pain Syndrome types 1 and 2.

s376, Workplace Injury Management and Workers Compensation Act 1998

Victoria

4th Edition

Designator 2

Statutory removal: Chapter 15 Pain.

• Statutory Guideline Substitutions: Chapter 9 s9.1a Hearing replaced with the Improved Procedures for Determination of Percentage Loss of Hearing (1988 Edition or later prescribed edition).
• Chapter 14 Mental and Behavioural Disorders replaced with The Guide to the Evaluation of Psychiatric Impairment for Clinicians.
• Omit from s3.3d of Chapter 3: ‘with the Injury Model, surgery to treat an impairment does not modify the original impairment estimate, which remains the same in spite of any changes in signs or symptoms that may follow the surgery and irrespective of whether the patient has a favourable or unfavourable response to treatment’.
• Replaced with: the degree of impairment resulting from an injury must be made after the injury has stabilised and based on the worker’s current impairment as at the date of the assessment, including any changes in the signs and symptoms following any medical or surgical treatment undergone by the worker in respect of the injury.
• Specified assessments of spinal impairment are to specify the whole person values derived in accordance with s3.3 of Chapter 3 of the AMA Guides.
• Statutory Guideline Extensions:
  • Impairment Assessment in Workers with Occupational Asthma, and
  • Clinical Guidelines to the Rating of Impairments arising from Infectious Occupational Diseases.

ss 54, 61, 64, 66 and s68, Workplace Injury Rehabilitation and Compensation Act 2013

Queensland

5th Edition

Modifier 1

The Guidelines for Evaluation of Permanent Impairment (the Queensland Guide) is Queensland’s guide for assessing permanent impairment. It is predominantly based on AMA5. Note that:

• Chapter 8, AMA4 applies to the assessment of permanent impairment of the visual system, subject to the modifications in the Queensland Guide.
• evaluation of permanent impairment due to hearing loss adopts the methodology in the Queensland Guide (Chapter 9) based on AMA5 (Chapter 11, pp 245–251) and National Acoustic Laboratory (NAL) Tables from the NAL Report No 118, Improved Procedure for Determining Percentage Loss of Hearing, January 1988.
• the AMA5 chapter on pain (Chapter 18) is excluded. Conditions associated with chronic pain are assessed on the basis of the underlying diagnosed condition. Where pain is commonly associated with a condition, an allowance is made in the degree of impairment under the Queensland Guide. Complex regional pain syndrome is assessed in accordance with Chapter 17 of the Queensland Guide.

Workers’ Compensation and Rehabilitation Regulation 2014

Western Australia

5th Edition

Modifier 1

The WorkCover WA Guidelines are based on the Safe Work Australia template National Guidelines.

Removed: Chapter 18 AMA5 regarding assessment of pain is excluded.

Substituted:

• Chapter 14 AMA5 — Mental and behavioural disorder replaced with chapter in WorkCover WA Guides on Psychiatric Impairment Rating Scale (PIRS)
• Chapter 18 AMA5 regarding assessment of pain is excluded
• Vision — based on AMA4, and
• Hearing loss — continues to be assessed based on s24A and s31E and Schedule 7 of the Workers’ Compensation and Injury Management Act 1981.

Workers’ Compensation and Injury Management Act 1981

s146R WorkCover Guides

WorkCover WA may issue directions with respect to the evaluation of degree of impairment:

1. The directions, and any amendment of them, are to be developed in consultation with an advisory committee appointed under s100A for the purposes of this section
2. The directions may adopt the provisions of other publications, whether with or without modification or addition and whether in force at a particular time or from time to time, and
3. ss41–44 of the Interpretation Act 1984 apply to the directions as if they were regulations.

South Australia

5th Edition

Modifier 1

Vision assessments based on AMA4.

Evaluation of permanent impairment due to hearing loss adopts the methodology indicated in these guides (Chapter 9) with some reference to AMA5, but uses National Acoustic Laboratory (NAL) tables from the NAL report No 118, ‘Improved procedure for determining percentage loss of hearing’, January 1988.

Pain (chapter 18, AMA5) and Mental and Behavioural Disorders (chapter 14, AMA5) are omitted as the Act excludes entitlement for psychiatric impairment (Refer to Impairment Assessment Guidelines).

The Impairment Assessment Guidelines are published in the South Australian Government Gazette under s22(4) of the Return to Work Act 2014,

Tasmania

4th Edition

Modifier 1

Guidelines for the Assessment of Permanent Impairment modify several chapters in AMA4.

Removed: Chapter 15 Pain.

Substituted:

• Chapter 7 of WorkCover Tasmania Guides (Mental and Behavioural Disorders) incorporating the Psychiatric Impairment Rating Scale (PIRS) is substituted for chapter 14 AMA4
• evaluation of hearing impairment adopts the methodology indicated in chapter 6 of WorkCover Tasmania Guides including the use of the National Acoustic Laboratory (NAL) Tables, Report No 118, Improved Procedure for Determining Percentage Loss of Hearing, January 1988, and
• guidelines (and legislation) require the level of binaural hearing impairment to be converted to WPI.

Workers Rehabilitation and Compensation Act 1988 — s72(1)(a)

Northern Territory

5th Edition

Modifier 1

The NT Guidelines for the Evaluation of Permanent Impairment (V1.1) is based on the Safe Work Australia template National Guidelines. The NT Guidelines modify several Chapters in AMA5.

Removed:

• Chapter 18 AMA5 regarding assessment of pain is excluded

Substituted:

• Vision — Chapter 8 of AMA4
• Chapter 14 AMA5 is excluded and replaced by Chapter 11 of the NT Guidelines - Psychiatric and psychological disorders — Psychiatric Impairment Rating Scale (PIRS) is used
• Hearing — Chapter 9, Guidelines, with some reference to AMA5 (Chapter 11, pp 245–251), but uses National Acoustic Laboratory (NAL) Tables from the NAL Report No 118, Improved Procedure for Determining Percentage Loss of Hearing, January 1988.

Variation:

• Maximum Medical Improvement includes where an assessment for a progressive disease is conducted, the claimant will be considered to have reached maximum medical improvement based on the assessment of the person as they present on the day of the assessment, provided the disease is in the course of its natural progression and is unlikely to substantially improve in the next 12 months.

Return to Work Act 1986 — s70,

Australian Capital Territory

5th Edition

Stand-alone (authorised by the Regs)

The ACT relies on the NSW Workers compensation guidelines for the evaluation of permanent impairment - fourth edition (Guidelines), modify several Chapters in AMA5.

Removed: Chapter 18 Pain.

Substituted:

• Vision — AMA4
• Psychiatric and Psychological Disorders — Chapter 11, Guidelines, and
• Hearing - Chapter 9, Guidelines, with some reference to AMA5 (Chapter 11, pp 245–251), but uses National Acoustic Laboratory (NAL) Tables from the NAL Report No 118, Improved Procedure for Determining Percentage Loss of Hearing, January 1988.

Evaluation of permanent impairment arising from chronic pain — Chapter 17, used for Complex Regional Pain Syndrome types 1 and 2.

Reg 5(1)(b) of the Workers’ Compensation Regulation 2002 allows the Minister to approve medical guidelines,

C’wealth Comcare

5th Edition

Stand-alone 3

The Guide to the Assessment of the Degree of Permanent Impairment is a stand-alone document that was prepared for the Comcare scheme predominantly based on AMA5 but with modifications and some substitution.

Substituted:

• Visual impairment is based on AMA4
• Psychiatric conditions assessed with reference to specific methodology
• Hearing impairment is assessed with reference to the National Acoustic Laboratory (NAL) Tables from the NAL Report No 118, Improved Procedure for Determining Percentage Loss of Hearing, January 1988

The Guide does provide for an assessment to be made with direct reference to AMA5 in the event that an employee’s impairment cannot be assessed in accordance with the provision of Part 1 of the Guide, with exceptions. An assessment is not to be made using the American Medical Association’s Guides to the Evaluation of Permanent Impairment for:

• mental and behavioural impairments
• impairments of the visual system
• hearing impairment, or chronic pain
• conditions except in the case of migraine or tension headaches.

Safety Rehabilitation and Compensation Act 1988

An ‘approved guide’ is defined by s4 of the SRC Act as meaning:

1. the document, prepared by Comcare in accordance with section 28 under the title ‘Guide to the Assessment of the Degree of Permanent Impairment’, that has been approved by the Minister and is for the time being in force; and
2. if an instrument varying the document has been approved by the Minister — that document as so varied.

Authority for the Guide rests in subsections 28(1), 28(2) and 28(3) of the SRC Act.

C’wealth Seacare

5th Edition

Stand-alone

The Guide to the Assessment of the Degree of Permanent Impairment is a stand-alone document that was prepared for the Comcare scheme predominantly based on AMA5 but with modifications and some substitution.

Substituted:

• Visual impairment is based on AMA4
• Psychiatric conditions assessed with reference to specific methodology
• Hearing impairment is assessed with reference to the National Acoustic Laboratory (NAL) Tables from the NAL Report No 118, Improved Procedure for Determining Percentage Loss of Hearing, January 1988

The Guide does provide for an assessment to be made with direct reference to AMA5 in the event that an employee’s impairment cannot be assessed in accordance with the provision of Part 1 of the Guide, with exceptions. An assessment is not to be made using the AMA Guides to the Evaluation of Permanent Impairment for:

• mental and behavioural impairments
• impairments of the visual system
• hearing impairment, or
• chronic pain conditions except in the case of migraine or tension.

Seafarers’ Rehabilitation and Compensation Act (1992)

An ‘approved guide’ is defined by s3 of the Seafarers Act as meaning:

1. the document, prepared by the Authority in accordance with section 42 under the title ‘Guide to the Assessment of the Degree of Permanent Impairment’, that has been approved by the Minister and is for the time being in force; and
2. if an instrument varying the document has been approved by the Minister — that document as so varied.

Authority for the Guide rests in subsections 42(1), 42(2) and 42(3) of the Seafarers Act

C’wealth DVA

4th Edition

Safety, Rehabilitation and Compensation (Defence-related Claims) Act 1988 (DRCA) — 5th Edition

Stand-alone 4

DRCA — Stand-alone 3

Substituted in whole

DRCA — The Guide to the Assessment of the Degree of Permanent Impairment is a stand-alone document that was prepared for the Comcare scheme predominantly based on AMA5 but with modifications and some substitution.

The AMA Guides are to be used on a very restricted basis for assessments of permanent impairment for Defence personnel, and then only in consultation with, or under the direction of, an approved medical provider. A common case of use of the AMA Guides is for fingers or toes in place of Table 9.4.

The Approved PI Guide Part 2 is used for Defence-related claims, and is based on the 5th edition of AMA, with the exception of the assessment psychiatric disorders whereby the relevant authority will assess under one table, based on AMA 2nd edition (which is not in keeping with the modern medical understanding of psychiatric injuries).

Military Rehabilitation and Compensation Act 2004 (MRCA) — Impairment points of a person means the points worked out for the person using the guide determined under s67 — (s5)

The Commission may determine, in writing, a guide setting out:

1. criteria to be used in deciding the degree of impairment of a person resulting from a service injury or disease, and
2. methods by which the degree of that impairment can be expressed in impairment points on a scale from 0 to 100, and
3. criteria to be used in assessing the effect of a service injury or disease on a person’s lifestyle, and
4. methods by which the effect of a service injury or disease on a person’s lifestyle can be expressed as a numerical rating, and
5. methods by which the impairment points of a person, and the effect on a person’s lifestyle, from a service injury or disease can be used to determine the compensation payable to the person under this Part by reference to the maximum compensation that can be payable to a person under this Part. — s67(1).

DRCA — An ‘approved guide’ is defined by s4 of the DRC Act as meaning:

1. the document prepared by MRCC in accordance with section 28 under the title ‘Guide to the Assessment of the Degree of Permanent Impairment’, that has been approved by the Minister and is for the time being in force; and
2. if an instrument varying the document has been approved by the Minister — that document as so varied.

Authority for the Guide rests in 28(1), 28(2) and 28(3) of the DRCA.

New Zealand

4th Edition

Designator 2

Modifier 1

AMA4

ACC User Handbook — this takes precedence over the AMA4

Injury Prevention, Rehabilitation, and Compensation (Lump Sum and Independence Allowance) Regulations 2002

Assessment tool for assessing eligibility for lump sum payments and independence allowance

Assessment of a person’s whole-person impairment, for the purposes of determining the person’s eligibility to receive lump sum compensation or an independence allowance, must be carried out by an assessor using the assessment tool prescribed by subclause (2).

1.    The assessment tool comprises:

a)    the AMA Guides to the Evaluation of Permanent Impairment (Fourth Edition), and b) the ACC User Handbook to AMA4.

2.    The ACC User Handbook to AMA4 prevails if there is a conflict between it and the AMA4 Guides to the Evaluation of Permanent Impairment.